Activity Index Research Articles

Lacticaseibacillus casei IB1 Alleviates DSS-Induced Inflammatory Bowel Disease by Regulating the Microbiota and Restoring the Intestinal Epithelial Barrier

Inflammatory bowel disease (IBD) is becoming an increasingly serious health problem in humans and animals. Probiotics can inhibit the development of IBD. Due to the specificity of the strains, the function and mechanism of action of different strains are still unclear. Here, a DSS-induced colitis mouse model was utilized to investigate the ability and mechanism by which Lacticaseibacillus casei IB1 alleviates colitis. Treatment with L. casei IB1 improved DSS-induced colitis in mice, as indicated by increased body weight, colon length, and goblet cell numbers and decreased disease activity index (DAI), proinflammatory factor (TNF-α, IL-1β, and IL-6) levels, and histopathological scores after intake of IB1. IB1 supplementation also improved the expression of tight junction proteins and inhibited the activation of the MAPK and NF-κB signaling pathways to alleviate intestinal inflammation. In addition, IB1 rebalanced the intestinal microbial composition of colitis mice by increasing the abundance of Faecalibaculum and Alistipes and decreasing the abundance of Bacteroides and Escherichia_Shigella. In summary, L. casei IB1 showed great potential for relieving colitis by regulating the microbiota and restoring the epithelial barrier. It can be used as a potential probiotic for the prevention and treatment of UC in the future.

Anticorrosion Performance of Waterborne Coatings with Modified Nanoscale Titania under Subtropical Maritime Climate.

Steel structures located in subtropical marine climates face harsh conditions such as strong sunlight and heavy rain, and they are extremely corroded. In this study, a waterborne coating with excellent corrosion resistance, hydrophobic ability, high-temperature resistance and high density was successfully prepared by using modified nanoscale titania powders and grafted polymers. The effects of three modifiers on titania nanoparticles and waterborne coatings' properties were studied independently. The experimental results showed that the activation index of the modification employing methacryloxy silane reached 97.5%, which achieved the best modification effect at 64.4 °C for 43.3 min. The waterborne coating with nanoscale titania modified by methacryloxy silane exhibited the best hydrophobic effect, with a drop contact angle of 115.4° and excellent heat resistance of up to 317.2 °C. The application of the waterborne modified coating in steel structures under subtropical maritime climates showed that the waterborne titania coatings demonstrated excellent resistance to corrosion, high temperatures and harsh sunlight, with a maximum service life of up to five years. Economic analysis indicated that, considering a conservative three-year effective lifespan, this coating could save more than 50% in cost compared with conventional industrial coatings. Finally, the strengthening mechanism of the polymer coatings with modified nanoscale titania was analyzed.

Pig-Derived Probiotic Bacillus tequilensis YB-2 Alleviates Intestinal Inflammation and Intestinal Barrier Damage in Colitis Mice by Suppressing the TLR4/NF-κB Signaling Pathway.

The search for new probiotics has been regarded as an important approach to improving intestinal health in animals. Bacillus has many advantages, such as strong resistance to harmful external factors, wide distribution, and easy colonization of the intestine. Hence, this study aims to screen for a probiotic Bacillus strain that improves animal intestinal health and to elucidate its probiotic mechanism so as to provide probiotic resources for the development of feed-using probiotic formulations. In this research, a strain of Bacillus was isolated from adult pig feces and named B. tequilensis YB-2. In vitro probiotic experiments showed that B. tequilensis YB-2 had strong acid and bile salt resistance, indicating that this strain can customize in the intestine. To further explore the effect of B. tequilensis YB-2 upon animal intestinal health, DSS-induced murine colitis models were established, and the body weight, colonic morphology, inflammatory cytokines level, and intestinal-barrier- and TLR4/NF-κB-pathway-related protein were determined. The results showed that mice receiving drinking water with 3% DSS were found to develop colitis symptoms, including body weight loss and increased disease activity index (DAI); colon length and microvilli shedding were shortened; tight junctions were disrupted; goblet cells decreased; anti-inflammatory cytokines were inhibited; and pro-inflammatory cytokines and the TLR4/NF-κB signaling pathway were activated. Notably, orally received B. tequilensis YB-2 alleviated symptoms of DSS-induced colitis in mice. The above results indicated that B. tequilensis YB-2 was capable of improving colitis in mice by weakening inflammation and intestinal barrier damage, and its mechanism may involve the TLR4/NF-κB pathway. Overall, this research suggests that B. tequilensis YB-2 has the potential to serve as an animal feed additive to prevent intestinal inflammation.

Impact of anti-human IgG hinge peptide antibodies on identification of patients with early seronegative rheumatoid arthritis.

The early diagnosis of seronegative rheumatoid arthritis (SNRA), characterised by the absence of rheumatoid factor and anti-citrullinated antibody, involves a greater challenge compared to seropositive RA (SPRA). This study aimed to assess the discriminatory potential of anti-human IgG hinge antibodies (AHAs) for patients with early SNRA. DMARDs-naive patients with SPRA (n=43), SNRA (n=21), and non-RA (n=49), with disease duration < 2 years, were included. Antigens comprised IgG1 or IgG4 F(ab')2 cleaved by pepsin or MMP-3 and their hinge peptide analogues. Eight IgG anti-hinge antibodies (AHAs) against these antigens were measured in sera from the patients and 58 healthy controls (HCs) using ELISA. Serum CRP and MMP-3 levels, and clinical disease activity index (CDAI), were obtained from medical records. The area under the curve (AUC) obtained from logistic regression and receiver operating characteristic curve analyses were used as a discriminant indicator. The levels of the IgG AHAs were as follows: SPRA≥SNRA≈non-RA>HC. None of the AHAs were effective in discriminating SNRA from non-RA. However, the combination of MMP-3 and AHAs against IgG4 hinge peptide analogues demonstrated the utility (AUC=0.94). Furthermore, combination of MMP-3, AHAs against IgG1 hinge peptide analogues and CDAI maximally exerted discriminatory power (AUC=0.997). Specific AHAs in combination with MMP-3 and CDAI are potentially useful to discriminate SNRA from non-RA.

Risk factors for vertebral fracture in rheumatoid arthritis patients using biological disease-modifying anti-rheumatic drugs (cases over 5 years): An observational study.

While biological disease-modifying anti-rheumatic drugs (bDMARDs) are considered beneficial for preventing osteoporosis and bone fracture, it is unclear whether bone loss is involved in the development of vertebral fracture, and few reports have examined the factors related to vertebral fracture in rheumatoid arthritis (RA) patients using bDMARDs. This study aims to identify factors influencing vertebral fracture in RA patients treated with bDMARDs. We retrospectively examined the records of 129 RA patients treated with bDMARDs for over 5 years. The lumbar spine and femoral bone mineral density, Disease Activity Score-28-C-Reactive Protein (DAS28-CRP) value, Simplified Disease Activity Index (SDAI), and modified Health Assessment Questionnaire (mHAQ) score were evaluated. The frequency of new vertebral fracture during the study and their risk factors were investigated. A comparison between the fracture group and the nonfracture group was performed. Multivariate analysis was performed using logistic regression analysis to detect risk factors for new vertebral fracture. The number of patients with new vertebral fracture during follow-up was 15 (11.6%) of the 129 patients in the study. Age and mHAQ score were significantly higher and lumbar spine and femoral neck bone mineral density were significantly lower in the fracture group than the nonfracture group. The risk factors for new vertebral fracture during the disease course were older age and higher mHAQ score indicating no remission over the 5 years of follow-up. In this study, there was no significant difference in disease indices such as the DAS28-CRP value and the SDAI between the fracture and nonfracture groups, suggesting an effective control of RA with bDMARDs. However, age and the mHAQ score, an index of RA dysfunction, were significantly higher in the fracture group. These results suggest that improving functional impairment may be important to prevent vertebral fracture in patients using bDMARDs.

A real-life pediatric experience of Crohn's disease exclusion diet at disease onset and in refractory patients.

We aimed to appraise the real-life efficacy of Crohn's disease exclusion diet (CDED) coupled with partial enteral nutrition (PEN) in inducing clinical and biochemical remission at disease onset and in patients with loss of response to biologics and immunomodulators. We retrospectively gathered data of patients aged less than 18 years of age with a diagnosis of Crohn's disease (CD), who received CDED coupled with PEN at a tertiary level pediatric inflammatory bowel disease center. Sixty-six patients were identified. Forty (60.6%) started CDED plus PEN at disease onset and 26 (39.4%) received CDED with PEN as add-on therapy. Forty-six (69.7%) patients achieved clinical remission (weighted Pediatric Crohn's Disease Activity Index < 12.5) at the end of Phase 1, 44 (66.7%) normalized c-reactive protein levels (<0.5 mg/dL) and 18 (27.2%) patients normalized calprotectin levels (<150 microg/g). Nine of 19 (47.3%) of patients with clinically severe disease (defined by Physician Global Assessment) achieved clinical remission at the end of Phase I. Patients with extraintestinal manifestations had statistically lower clinical response rates to the dietary regimen (p = 0.018). Among patients who received CDED + PEN as add-on treatment, a previous successful course of Exclusive Enteral Nutrition was associated with statistically higher clinical remission rates at Week 8 (p = 0.026). Clinical response at Week 4 was an independent predictor of clinical remission and fecal calprotectin normalization at Week 8 (p = 0.002). CDED with PEN confirmed its efficacy in a real-life setting, proving to be effective also in refractory patients and those with severe disease. Early clinical response predicts clinical remission at the end of Phase 1.

Interleukin-17 as a biomarker for lupus nephritis: correlation with disease activity indices and histopathological classification

BackgroundLupus nephritis (LN) is one of the devastating manifestations of systemic lupus erythematosus (SLE). It is a leading cause of death in SLE patients. Interleukin 17(IL-17) is involved in the development of several autoimmune diseases. It causes inflammation and organ damage by exaggerating the immune response and augmenting antibody production by B cells. We assessed the role of IL-17A in LN and its relation to other markers of disease activity and different histopathological classes.ResultsWe evaluated serum IL-17A in forty LN patients and thirty SLE patients without LN (non-LN). We found that LN patients had a significantly higher IL-17A level in comparison to non-LN. In the LN group, IL-17A was positively correlated with the systemic lupus erythematosus disease activity index (SLEDAI), protein/creatinine (P/C) ratio, 24-hour urinary proteins, anti-nucleosome, and anti-dsDNA antibodies and negatively correlated with C3 and C4. IL-17A was higher in class III and IV compared to class II and V LN. ROC curve analysis of IL-17A revealed 75% sensitivity and 76.7% specificity for LN, and the AUC was 0.791.ConclusionLupus nephritis patients have a higher serum level of IL-17A than those without LN, which is more pronounced in patients with class-III and IV LN. Moreover, IL-17A has good sensitivity and specificity for LN and correlates with the disease activity indices; hence, it may be a prognostic marker for LN in SLE patients.

Serum Levels of CXCL10 in Patients with Lupus Nephritis and its Relation with Disease Activity

Abstract Objective To evaluate the levels of CXCL10 in lupus nephritis (LN) patients and its relation with the activity of lupus nephritis. Patients and Methods Thirty four lupus patients were enrolled in our study, 17patients had lupus nephritis (LN) and 17 patients were without evidence of had lupus nephritis (LWN). Seventeen healthy subjects were also participated as a control group. Complete biochemical and serological parameters were measured and their correlation with serum levels of CXCL10 were assessed in the studied groups. Results The mean age of the LN patients was 31.94 ± 6.37,the mean age of LWN patient was 31.11± 6.42 and the mean age of the controls was 30.471± 4.705, Serum levels of CXCL10 were significantly elevated in LN patients group than LWN and control group with p-value &amp;lt;0.001,While serum CXCL10 in LWN was statistically increased than control group with p-value&amp;lt;0.001. Based on the receiver operator characteristic (ROC) curve analysis the efficacy of Serum CXCL10 levels in LN in a sample of Egyptian SLE patient This biomarker may be useful due to its high accuracy, with a sensitivity 94.12% and specificity of 76.47% as a biomarker of nephritis in SLE. There were statistically significant positive correlations between CXCL10 and 24 urinary protein (p-value = 0.031) (r = 0.524), creatinine (p-value = 0.003) (r = 0.682), renal activity (RSLEDAI) (p-value = 0.013) (r = 0.590) and Activity index (p-value = 0.003) (r = 0.669), whereas there was negative correlations between them and C3 (p-value = 0.021) (r=-0.554). Conclusion Being higher in patients with LN, CXCL10 might play a role in the pathogenesis of the disease. In addition to its excellent diagnostic performance for discriminating patients with lupus nephritis from other SLE patients, it might be helpful to predict the onset and progression of lupus nephritis in SLE patients and to detect renal flares.

The Value of Magnetic Resonance Enterography Activity Indices in Evaluation of Crohn’s Disease Clinical Activity

Abstract Background Crohn’s disease is a chronic inflammatory segmental bowel disorder characterized by attacks of remission and exacerbation that can significantly affect the patients’ quality of life. Hence monitoring the disease activity is crucial to achieve longer symptom free intervals which may result either from active inflammation and its complications as deep ulceration, fistulae formation and abscesses or sequelae from longstanding inflammatory process as fibrotic scarring and strictures. Aim of the Work to compare the performance of the currently available scoring systems Maria, Clermont, CDMI and MEGS to the clinical disease activity index and endoscopic indices Patients and Methods the study was conducted at the Diagnostic Radiology Unit; Radiology Department, Ain Shams University Hospitals. Over a period of 9 months. Convenience sample of proven cases of Crohn’s disease based on clinical suspicion, biomarkers, endoscopy and histopathological specimens who were referred for MRE enterography at our institution. Results We studied the relevance of 18 different single MR parameters and 5 indices in conjunction with clinical and endoscopic based scores. Our aim was to identify if any of the MR parameters can be used solely or in combination with others (indices) as predictors of disease activity. In our study, we identified that the presence of ulcers reflected the clinical rather than the endoscopic severity. Other individual MR parameters couldn’t predict either the clinical or endoscopic severity. The MaRIA score showed significant correlation with the clinical but not endoscopic score. The simplified MaRIA score reflected both the endoscopic and clinical severity scores regarding their absolute values and severity grade. Neither Diffusion- MaRIA/Clermont nor the CDMI scores could predict the degree of clinical and endoscopic disease severity. MEGS score was the most reliable score in determining the endoscopic activity despite being a consuming score with relative subjectivity in comparison to the forementioned scores. Conclusion MR indices provide an adjunct tool for evaluation of disease activity and identifying the severe disease evidenced by MaRIA, simplified MaRIA and MEGS scores. However, the use of a single MR parameter doesn’t provide a true reflection of the ongoing disease process, even the presence of ulcers and haustral loss may be associated with chronic disease.

B-cell lymphoma of the skin. Clinical observation

Currently, there is an increase and an increase in the incidence of primary skin lymphomas worldwide. B-cell cutaneous lymphomas (BCLCS) account for 25-30% of primary skin lymphomas. Among all skin lymphomas, primary cutaneous lymphoma from follicular center cells occurs in 10-11% of cases and is characterized by great diagnostic difficulties due to the great similarity of clinical manifestations with other dermatoses, such as benign lymphoplasia, Beck's sarcoidosis, Jesner-Kanof lymphocytic infiltration, skin metastases. This paper presents a clinical case of B-cell lymphoma in a 29-year-old woman with a lesion of the facial skin in the form of a node, initially incorrectly interpreted as benign lymphoplasia. For five years, the patient received therapy with topical glucocorticosteroids with no effect from. Subsequently, histological examination and immunohistochemistry were performed for the purpose of differential diagnosis of sarcoidosis with B-cell lymphoma. Histologically, there is nodular proliferation of atypical lymphoid cells in the dermis, most of which have cytological characteristics of a centrocyte with an admixture of a small number of central blasts. Nodular proliferates contain an admixture of compactly arranged small lymphocytes. There are no signs of epidermotropism. During immunohistochemical examination, cells forming nodular proliferates express CD20, bc16 with an index of proliferative activity for the expression of nuclear protein K167 – 20-30%, a dissociated network of follicular dentritic cells expressing CD21 is determined at the base of nodular proliferates. They are not expressed by bc12, CD3, CD2, CD5 proliferate cells. CD117 is expressed by an admixture of discretely distributed mast cells. Conclusion: The morphological picture corresponds to primary cutaneous centrofollicular lymphoma. The node was excised. Radiation therapy was not prescribed due to the patient's pregnancy. This clinical observation highlights the importance of considering the diagnosis of lymphoma in the differential diagnosis of treatment-resistant dermatological diseases.

Role of Ultrasound in Evaluation of Median and Ulnar Nerves in Rheumatoid Arthritis Patients in Correlation with Nerve Conduction Studies

Abstract Background Rheumatoid arthritis (RA) is a systemic inflammatory disease of unknown etiology characterized by the involvement of the joints. RA is also associated with vasculopathy, peripheral, autonomic, and entrapment neuropathy. The presence of peripheral neuropathy contributes significantly to the functional limitation in rheumatoid arthritis patients. Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and consists of the compression of the median nerve as it courses through the carpal tunnel followed by the cubital tunnel syndrome which is the most common site for entrapment for the ulnar nerve. Aim of the Work to evaluate the role of ultrasound in evaluation of median and ulnar nerves in rheumatoid arthritis patients in correlation with nerve conduction studies. Patients and Methods to elucidate this aim, 25patients diagnosed with RA, diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for diagnosis of RA. And 25 healthy control subjects (matched for age and body mass index) were enrolled. Results this study was carried on 25 patients, 9 (34.7%) of whom were females, and 17 (68%) were males. The mean age of the studied group was (38.96±6.24 years old). The mean disease duration was 7 ±1.13 years; the mean disease activity index was 4.28 ±0.15. All the studied cases suffer from needle sensation, 24 (96) had numbness and 17(68) had burning sensation. All the studied cases in patient group had distal weakness and negative sensory testing (light touch, pinprick, temperature and vibration). As regarding to extra-articular manifestations, the most common was dry mouth and dry eye in all the studied cases followed by itchy skin in 13(52) patient, then joints aches and subcutaneous nodules in 2(8) patient and purpura was seen in only a case. Conclusion US has the advantage of early detection of median and ulnar nerves neuropathy and can assess the morphology of median and ulnar nerves and its surroundings. US measurements of median and ulnar nerves have a comparable diagnostic value as a non- invasive and an alternative modality for the evaluation of carpal tunnel syndrome and cubital tunnel syndrome.

Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt

Abstract Background Comparing cases of adult onset and late onset systemic lupus erythematous (SLE) reveals significant differences in clinical, serological, disease activity, and damage score. Objective This study aimed to analyze clinical manifestations, laboratory data, serological markers, and prognosis of late-onset SLE (L-SLE) and for comparing with adult- onset SLE. Patients and Methods One hundred fifty individuals with SLE were included in a cross-sectional study conducted at Ain Shams University Hospital divide into Group 1: 100 cases with adult-onset (age of onset ≥ 19 years and below 50 years). Group 2: 50 Patients with L-SLE (age of onset ≥ 50 years). All patients were subjected to medical history, physical examination, disease activity measured by the SLE disease activity index (SLEDAI-2K) and a damage score. Laboratory investigations as complete blood count (CBC), serum creatinine, anticardiolipin antibodies, lupus anticoagulant, protein creatinine ratio, serum complement (C3, C4), anti-dsDNA antibody, and antinuclear antibodies (ANA). Results Mucocutaneous manifestations, frequency of hematuria, proteinuria, urinary cast, consumed C3, positive anti-dsDNA antibodies, anti-cardiolipin antibody and lupus anticoagulant titers had considerably greater rates in-group 1 compared to group 2 (P-value &amp;lt;0.05) while group 2 had significantly more musculoskeletal symptoms (P-value &amp;lt;0.05). The SLEDAI scores of the two groups were equivalent, however the damage index was greater in group 2 (P-value 0.00). Neuropsychiatric, cutaneous, renal, and skin damage were more frequent in group 1, while musculoskeletal, endocrinal, pulmonary, cardiovascular and ocular damage were more frequent in- group 2. Conclusion L-SLE is different from adult onset SLE with more frequent damage.

Impact of Race on the Efficacy and Safety of Tofacitinib in Rheumatoid Arthritis: Post Hoc Analysis of Pooled Clinical Trials.

Racial disparities in disease activity, clinical outcomes, and treatment survival persist despite advancements in rheumatoid arthritis (RA) therapies and clinical management. In this post hoc analysis of pooled data from the tofacitinib global clinical program, we evaluated the impact of race on the efficacy and safety of tofacitinib in patients with RA. Data were pooled from 15 phase 2-3b/4 studies of patients with RA treated with tofacitinib 5 or 10mg twice daily, adalimumab, or placebo. Outcomes were stratified by self-reported patient race (White/Black/Asian/Other). Efficacy outcomes to month 12 included: American College of Rheumatology (ACR)20/50/70 responses, Clinical Disease Activity Index (CDAI)/Disease Activity Score in 28 joints, erythrocyte sedimentation rate [DAS28-4(ESR)] low disease activity (LDA) rates, least squares (LS) mean change from baseline (∆) in CDAI, DAS28-4 (ESR), Health Assessment Questionnaire-Disability Index (HAQ-DI), and Pain [Visual Analog Scale (VAS)]. Odds ratios (ORs; 95% CI) versus placebo, and placebo-adjusted ∆LS means were calculated for active treatments using logistic regression model and mixed-effect model of repeated measurements, respectively. Safety outcomes were assessed throughout. A total of 6355 patients were included (White, 4145; Black, 213; Asian, 1348; Other, 649). For tofacitinib-treated patients, ORs for ACR20/50/70 responses and CDAI/DAS28-4(ESR) LDA rates through month 3 were generally numerically higher for White/Asian/Other versus Black patients. Across active treatments, trends toward higher placebo-adjusted improvements from baseline in CDAI, DAS28-4 (ESR), HAQ-DI, and Pain (VAS) were observed in Asian/Other versus White/Black patients. Numerically higher placebo responses in Black versus White/Asian/Other patients were generally observed across outcomes through month 12. Safety outcomes were mostly similar across treatment/racial groups. In patients with RA, tofacitinib was efficacious across racial groups with similar safety outcomes; observed racial differences potentially reflect patient demographics or regional practice disparities. ClinicalTrials.gov identifiers: NCT00147498; NCT00413660; NCT00550446; NCT00603512; NCT00687193; NCT01164579; NCT00976599; NCT01359150; NCT00960440; NCT00847613; NCT00814307; NCT00856544; NCT00853385; NCT01039688; NCT02187055.

CHANGES IN THE FACTORS OF NON-SPECIFIC RESISTANCE IN PATIENTS WITH ISCHEMIC HEART DISEASE

Ischemic heart disease is the most common form of heart disease.CHD occurs as a result of atheromatous changes in the vessels that supply the heart.It is the atheromatous changes in the vessels that result from decreased myocardial perfusion, which causes angina due to ischemia and can lead to myocardial infarction (MI) and/or heart failure.It is one of the leading causes of death in the world. Given that coronary heart disease is a medical and social problem today, it is important to study the diagnosis and prognosis of the course of this pathology. The refore, there is a need to find new sensitive markers for early diagnosis of this pathology. In patients with cardiovascular diseases, the functional state of the cells of the nonspecific immunity of neutrophils often depends on the form of the disease and the severity of the course, and early detection of changes in chemotaxis of neutrophils can help to more accurately assess the risk of infectious complications. Study of factors of the non-specific link of immunity in patients with coronary heart disease. Study of factors of non-specific resistance, namely determination of indicators of phagocytic number, phagocytic index, number of active phagocytes, absolute index of phagocytic activity, percentage of HST-positive neutrophils, detection of cationic lysosomal proteins with calculation of cytochemical coefficients, bactericidal activity of neutrophils (BAN) was performed in 30 patients with coronary artery disease. The control group consisted of 30 healthy age- and gender-matched volunteer donors. Thus, it was established that in patients of the group of patients with coronary artery disease, in comparison with the indicators of the control group, in addition to the decrease in phagocytic activity and activation of the redox function, there is a decrease in the number of cationic lysosomal proteins and the bactericidal activity of NG.

Filling the "GAP" in Real-World Assessment of Psoriatic Arthritis Disease Activity: Performance Characteristics of a Global/Pain Composite Endpoint.

Some retrospective data sources, such as electronic health records in the USA, report composite outcome measures not fully validated in psoriatic arthritis (PsA). However, they often contain global assessments, such as a Physician Global Assessment (PhGA) and Patient Global Assessment (PatGA), along with patient-reported pain scores, which individually are considered validated in PsA. This research described the performance characteristics of a 3-item global assessment and pain (GAP) composite endpoint using data from the ixekizumab phase3 PsA clinical trial program. Discrimination of GAP was assessed by comparing placebo to active treatment arms. The magnitude of treatment effect and responsiveness were compared to Disease Activity Index for PsA (DAPSA), clinical DAPSA, DAPSA28, and Psoriatic Arthritis Disease Activity Score (PASDAS) using effect size (ES) and standardized response mean (SRM), respectively. Construct validity was evaluated through correlation among the composite endpoints, and with other physician- and patient-reported outcomes. Change in GAP was compared in patients who reached low disease activity (LDA) levels based on DAPSA, cDAPSA, and PASDAS vs those who did not. GAP discriminated between active treatment and placebo with statistically significant separation as early as week1. The largest ES/SRM was seen with GAP (2.29/1.74) and PASDAS (2.47/1.68). GAP had the strongest correlation with PASDAS (0.81-0.92) and showed moderate correlations with patient-assessed physical function, low correlations with physician-assessed skin and nail psoriasis, and low to moderate correlation with physician-assessed enthesitis. A significantly greater improvement in GAP was seen in the groups achieving LDA states compared to those not (p < 0.001). The GAP composite, an abbreviated endpoint comprising measures common in electronic health records, has promising performance characteristics and could be used to address important clinical questions regarding outcomes and impact of PsA in existing datasets. CLINTRIALS. NCT01695239; NCT02349295.

A Whole Blood Method for Assessing the Innate Immune Response in Chickens

Innate immunity is considered the first line of immune defense and is typically an unmeasured response. Here we report a method for evaluating the innate immune response in chickens by using whole blood which has been activated by lipopolysaccharide (LPS) to induce IL-6 release by innate immune cells. It was found that a 24-h LPS activation time interval was the optimum time interval for inducing the IL-6 response. An activation index, defined as the PBS activated control response subtracted from the LPS activated response and then divided by the PBS activated control response and expressed as a percentage, was useful for demonstrating and comparing the magnitude of the innate immune response. Results indicated that there was wide variation between the IL-6 response between individual birds although statistically significant results were obtained for all individual birds at the 24-h activation time interval. The activation indices from all birds were greatest at the 24-h activation time interval. Statistically significant results were achieved when all the data from all birds at the 24-h activation time interval were combined. The cells responsible for the IL-6 response were identified as the peripheral blood monocytes.

Relationship Between Physical Activity and Body Mass Index with Uric Acid Levels in The Community

Physical activity is related to uric acid levels in the blood, and an increase in body mass index (BMI) is associated with an increase in uric acid levels due to increased triglyceride synthesis in the liver associated with increased purine synthesis by new routes, thereby accelerating uric acid production. The results of Riskesdas in 2018 showed the number of joint diseases from the weighted average results in Ogan Komering Ulu Regency was 1,040. This study aims to determine whether there is a relationship between BMI, physical activity, and uric acid levels in the community in Sukaraya Village, East Baturaja District, Ogan Komering Ulu Regency in 2023. This study used an accidental sampling method with a cross-sectional approach and involved 67 respondents with criteria aged between 26 and 45 years, living in Sukaraya Village, being able to read and communicate well, and being willing to be respondents, while the exclusion criteria in this study were not willing to be respondents and could not communicate, and willing to be a respondent, while the exclusion criteria in this study are not willing to be a respondent and cannot be communicated with. The instruments used were the International Physical Activity Quitioner (IPAQ) questionnaire to measure physical activity, scales to measure body weight and height, and uric acid sticks and digital devices (easytouch) to measure uric acid levels. Data were processed using SPSS and chi-square analysis to determine the relationship between the independent variable and the dependent variable. The results of chi-square data analysis showed a relationship between physical activity and uric acid levels (p-value 0.005) and a relationship between BMI and uric acid levels (p-value 0.000). Physical activity and BMI index correlate with uric acid levels in residents in Sukaraya Village, East Baturaja District, Ogan Komering Ulu Regency. It is necessary to increase knowledge about joint health for the community by providing counseling on joint health and also holding activities such as gymnastics so that physical activity and body mass index can be controlled so as to reduce the risk of high uric acid levels.

Results of a 12-Week Open-Label, Non-Interventional Study of the Efficacy and Safety of Olokizumab Therapy in Patients with Rheumatoid Arthritis after Switching from Anti-B-Cell Therapy during the SARS-CoV-2 Pandemic.

The purpose of the study was to evaluate the efficacy and safety of the drug Artlegia® (olokizumab), solution for subcutaneous injection, 160 mg/ml-0.4 ml, manufactured by R-Pharm JSC, Russia) for the treatment of patients with rheumatoid arthritis in real clinical practice after switching with rituximab during the COVID-19 pandemic. The study included 14 patients with a confirmed diagnosis of rheumatoid arthritis (RA), who were previously on rituximab therapy at a dose of 1000-500 mg twice with an interval of 2 weeks, who received at least one course of therapy with this drug. As RA worsened, patients were switched to olokizumab against the background of standard DMARDs. On weeks 0, 4, 8, and 12 after the switch, the severity of pain was assessed on the VAS scale, the number of tender and swollen joints (TJC28 and SJC28), the level of acute-phase inflammation markers, the DAS28 (disease activity score), ESR, CRP, CDAI (clinical activity index), and the functional state index HAQ (Health Assessment Questionnaire) were determined, as well as the safety profile of therapy was assessed. Data analysis was performed using median values (Me) were used for data analysis. A significant decrease in TJC28 was detected after 8 and 12 weeks of treatment with olokizumab (Artlegia®) (Me baseline = 10, Me 8 weeks = 4, Me 12 weeks = 4, p < 0.05) and a decrease in TSC28 was detected after 4, 8, and 12 weeks of treatment (Me baseline = 9, Me 4 weeks = 3.5, Me 8 weeks = 2.5, Me 12 weeks = 2.0, p < 0.05). Laboratory markers of inflammation showed a decrease in CRP and ESR levels after 4 weeks of treatment (CRP: Me4 weeks = 21, Me4 weeks = 1, p < 0.05, ESR: Mesno = 31, Me4 weeks = 7, p < 0.05). Positive dynamics persisted on 8 and 12 weeks (CRP: Me 8 weeks = 1, Me 12 weeks = 0; ESR: Me 8 weeks = 4, Me 12 weeks = 5). The level of CRP by week 4 became within the normal range, regardless of the initial values. All activity indices improved from week 4 in each evaluation period compared to baseline: DAS28-ESR: Me baseline = 5.52, Me 4 weeks = 3.59, Me 8 weeks = 3.33, Me 12 weeks = 3.22, p < 0.05; DAS28CRP: Me baseline = 5.39, Me 4 weeks = 3.71, Me 8 weeks = 3.35, Me 12 weeks = 3.45, p < 0.05; CDAI: Me baseline = 28.5, Me 4 weeks = 18.0, Me 8 weeks = 16.5, Me 12 weeks = 16.0, p < 0.05. All patients showed a reduction in pain (VAS scale) by week 8. The functional status of patients, according to the HAQ index, showed a significant decrease only by week 12 of the study: Me baseline = 1.62, Me 12 weeks = 1.31, p < 0.05. The study found that switching from rituximab to olokizumab was effective and safe during the COVID-19 pandemic.

Functional improvement and characterization of protein hydrolysates prepared by the fermentation of irradiated tilapia skin

Gamma irradiation (γ-irradiation) sterilizes and modifies proteins. This study aimed to enhance the performance of protein hydrolysates of fermented tilapia fish skin using irradiation. The results showed that γ-irradiation could effectively kill harmful microorganisms in fish skin at 6 kGy. Irradiation at 1–6 kGy dose disintegrated the internal structure of fish skin proteins, thus increasing the degree of hydrolysis after fermentation by Bacillus subtilis L4; however, irradiation at 9–12 kGy caused cross-linking and aggregation of fish skin proteins. The solubility, and water and oil holding capacity of the protein hydrolysates were significantly improved compared to those of the non-irradiated sample. The maximum emulsifying activity (164.61±16.28 m2/g), foaming activity (91.13±2.30mL), and surface hydrophobicity index (5766.43±770.56) were observed in the protein hydrolysates fermented from fish skin irradiated at 12 kGy. The antioxidant activity of the protein hydrolysates increased with increasing irradiation doses. This suggested that the functional properties and antioxidant activity of protein hydrolysates from fish skin fermentation can be improved by appropriate irradiation pretreatment, providing a feasible method for improving the utilization and quality of proteins in fishery waste.

COMPREHENSIVE EDUCATIONAL-REHABILITATION APPROACH IN A PERSON POST-STROKE: A CASE STUDY

A stroke occurs due to a disruption in brain circulation, leading to partial or complete loss of motor, sensory, perceptual, or cognitive abilities. This can result in disability and reduced rehabilitation potential. Therefore, the approach to working with individuals who have experienced a stroke is crucial, adapting to their individual needs in a holistic manner. In this context, the aim of this study was to present a comprehensive rehabilitation approach for an 88-year-old patient following a stroke through the implementation of educational-rehabilitation treatment, achieving gradual improvements in the recovery process. Tests such as the Mini-Mental State Examination, Motor Evaluation Scalefor Upper Extremity in Stroke patients, The Barthel Index for Activities of Daily Living, Aphasic Depression Rating Scale, and The Modified Rankin Scale were applied to assess the set goal. The educational-rehabilitation treatment was conducted daily for 45 minutes, for two months within clinical rehabilitation and nine months in home conditions. The treatment was based on the principles of brain neuroplasticity and motor learning, involving cognitive training, motor training, adaptive skills training, relaxation, education and counseling, motivational training, and the promotion of metacognitive abilities. The research data underwent analysis through descriptive statistics, and the findings were visually illustrated in graphical representations. Based on the obtained results, it can be concluded that there is noticeable functional progress in the patient across all evaluated areas.Keywords:stroke, rehabilitation, educational-rehabilitation treatment