Kruskal-Wallis ANOVA Research Articles

P0286 Assessment of clinical predictive factors for the development of short bowel syndrome in a cohort of patients with Crohn’s disease

Abstract Background Short bowel syndrome(SBS)is a severe clinical condition occuring when,following multiple intestinal resections,the remaining small bowel in continuity is ≤200cm.SBS is associated with intestinal failure(IF)when the intestinal absorptive function is compromised,requiring intravenous nutritional or electrolyte supplementation.Crohn’s disease(CD)is one of adults’ most frequent causes of SBS.The aim of this study was to identify clinical predictive factors of SBS in CD pts Methods We performed a prospective study, enrolling consecutive CD outpatients (pts).Statistical univariate comparison for primary outcome was assessed for continuous variables by the Mann-Whitney U test and the Kruskal-Wallis ANOVA test.Categorical variables were compared using the chi-square test.We also assessed a multivariate logistic regression model to identify independent predictors of SBS Results We enrolled 169 CD pts(47.3% male,mean age 43.5 years[±14.1]).45.5% of them were smokers;extraintestinal manifestations(EIMs)were present in 45.5% of pts, and 67.5% of pts had bowel resections(26.6% of them with more than one surgical intervention).Median disease duration and median time between diagnosis and the first resection were 9y(IQR 4-17)and 6.5y(IQR 1-13),respectively.At baseline,101 pts were on anti-TNF therapy,and considering the course of the disease,overall,20.1% of the pts were exposed to ≥3 biologics.10% of pts had SBS and 5.3% IF.In univariate analysis,comparing patients with and without SBS,the following variables were statistically different:disease duration(p=0.000),upper gastrointestinal disease location(p=0.001),ileocolonic location(p=0.008),stenosing behavior(p=0.040),perianal disease(p=0.000)and time elapsing from CD diagnosis to start biological therapy(0.002).At multivariate analysis,disease duration(p=0.000),perianal disease(p=0.05)and time elapsing from CD diagnosis to start biological therapy(p=0.016)resulted independently associated with the development of SBS Conclusion Our data identify the clinical features that would allow the gastroenterologists to predict the risk of developing SBS in a cohort of CD pts.Further studies would be needed to confirm our findings.Funded by:2.1 “Rafforzamento e potenziamento della ricerca biomedica del SSN”,finanziato dall’Unione europea–NextGenerationEU, CUP C53C22001140007. 2022 PNRR Project “Changing the future of intestinal failure in intestinal chronic inflammation:towards innovative predictive factors and therapeutic targets”code:PNRR-MAD-2022-12376791

P0214 Notch Pathway-Mediated epithelial-mesenchymal transition and Fibrosis in Complicated Crohn’s Disease

Abstract Background The dysregulation of epithelial-mesenchymal transition (EMT) is linked to numerous pathologies, including fibrotic diseases. The Notch pathway may selectively mediate fibrogenic processes, such as EMT. Previous studies by our group have demonstrated elevated expression of NOTCH3, NOTCH4 receptors, and the DLL4 ligand in the intestines of patients with complicated Crohn’s disease (CD)1. This study aims to explore the potential of the Notch pathway as a therapeutic target in intestinal fibrosis associated with CD. Methods We analyzed ileal samples from Crohn’s disease patients with complicated lesions to assess the localization of NOTCH3/4 receptors using immunohistochemistry (IHQ) and performed RT-qPCR and Western blot (WB) analysis. In vitro studies were conducted using DLL4-coated plates (1 µg/ml), with or without the γ-Secretase Inhibitor DAPT (10 μL/ml), to evaluate protein and mRNA expression of HES1 and EMT markers (VIMENTIN, SNAIL, and E-CADHERIN) in two primary epithelial cell lines: small intestine (HIEC6) and colon (CoEpi) cells over 48 hours. Data, presented as fold induction (mean ± SEM) relative to water-treated cells or control tissues, were analyzed using parametric or non-parametric ANOVA (Kruskal-Wallis) based on normality testing (*P < 0.05). Results RT-qPCR analysis revealed significantly increased mRNA levels of the Notch receptors NOTCH3 and NOTCH4. WB analysis showed elevated levels of NOTCH3 (235±87*), but not NOTCH4 (87±13), protein in affected versus control tissues (100±8 and 100±7, respectively). In terms of cellular localization, NOTCH3 was detected in endothelial and smooth muscle cells, lamina propria cells, and with lower intensity in the epithelium. NOTCH4 was primarily found in cells of the lamina propria. In vitro assays indicated that DLL4 significantly altered mRNA and protein expression of HES1 and certain EMT markers (VIMENTIN and SNAIL) in both epithelial cell lines. Co-treatment with DAPT significantly reversed some EMT markers induced by DLL4 (VIMENTIN and SNAIL) (Figure 1). Conclusion NOTCH3 may play a role in the fibrogenic processes of CD, with elevated expression observed. The activation of EMT markers by DLL4 suggests that Notch signaling has a critical function in driving fibrosis and tissue remodeling in CD. References M Rodriguez-Antequera, J Cosin-Roger, D Macias-Ceja, P Salvador, L Gisbert-Ferrándiz, S Coll, J Manyé, R Alós, F Navarro-Vicente, S Calatayud, M D Barrachina, D Ortiz-Masia, P041 Differences in NOTCH signalling between stricturing and penetrating behaviour in Crohn’s disease, Journal of Crohn’s and Colitis, Volume 13, Issue Supplement_1, March 2019, Page S107, https://doi.org/10.1093/ecco-jcc/jjy222.165

P0164 Lauric Acid in Inflammatory Bowel Disease: Balancing Fibrosis Modulation and epithelial-mesenchymal transition Activation

Abstract Background Metabolomics has recently emerged as a valuable tool for understanding inflammatory bowel disease (IBD), revealing distinct metabolic profiles for ulcerative colitis (UC) and Crohn’s disease (CD). Lauric acid (LA), a medium-chain fatty acid with anti-inflammatory properties, has an unclear role in IBD, particularly within a fibrotic context. LA interacts with G protein-coupled receptor 84 (GPR84), which is notably elevated in UC1. Methods We evaluated the effects of LA (0, 50, 100, and 250 µM) on human intestinal fibroblasts (HSIF) and colonic epithelial cells (CoEpi) under basal and pro-fibrotic (TGFβ1 10 ng/ml) conditions. Fibrotic markers were analyzed using PCR (HSIF: COLA1A, COL3A1, COL4A1, ACTA2, FN1, TGFβ, GPR84; CoEpi: SNAI1/2, CDH1, COLA1A, FNCD4, VIM, GPR84) and Western blot (HSIF: GPR84). Data, expressed as fold induction (mean ± SEM) relative to 0 µM LA, were analyzed using either parametric or non-parametric ANOVA (Kruskal-Wallis) based on normality testing (*P < 0.05 vs. 0 nM LA, **P < 0.01 vs. 0 µM LA, #P < 0.05 vs. 0 µM LA + TGFβ1, ##P < 0.05 vs. 0 µM LA + TGFβ1). Results Under basal conditions, LA significantly reduced mRNA expression of collagen molecules [COL1A1 (250 µM: 0.2 ± 0.07**) and COL3A1 (50 µM: 0.4 ± 0.1**)] and αSMA [ACTA2 (100 µM: 0.1 ± 0.1**)] in HSIF cells. In pro-fibrotic conditions, LA maintained or enhanced its protective effect, often at lower doses [COL1A1 (50 µM: 1.1 ± 0.15##), COL3A1 (50 µM: 0.24 ± 0.1#), COL4A1 (250 µM: 0.6 ± 0.1#), ACTA2 (100 µM: 0.7 ± 0.4#)]. LA also increased GPR84 mRNA and protein expression under basal (250 µM: 1167 ± 646*) and pro-fibrotic (250 µM: 1048 ± 505##) conditions, with no changes in fibronectin or TGF expression in HSIF cells. In CoEpi cells, LA promoted epithelial-mesenchymal transition (EMT) under both conditions, shown by changes in mRNA for VIMENTIN (250 µM: 3.9 ± 0.6*; 250 µM + TGFβ1: 6.4 ± 1.5#), SNAI2 (250 µM: 3.4 ± 0.5*; 250 µM + TGFβ1: 3.9 ± 0.5##), E-CADHERIN (250 µM: 0.5 ± 0.08*; 250 µM + TGFβ1: 0.3 ± 0.07#), and FIBRONECTIN (250 µM: 2.6 ± 0.5*; 250 µM + TGFβ1: 4.4 ± 0.8##). GPR84 mRNA was significantly elevated by LA in basal (250 µM: 6.9 ± 1.5**) and pro-fibrotic (250 µM: 5.1 ± 1.0##) conditions. No changes were observed for COLA1A or SNAI1 expression in CoEpi cells. Conclusion LA exhibits a dual role in colonic epithelial and fibroblast cells, showing context-dependent effects that can offer therapeutic benefits or pose challenges. Its interaction with GPR84 underscores a complex regulatory function that requires further study. References Bauset C, Carda-Diéguez M, Cejudo-Garcés A, Buetas E, Seco-Cervera M, Macias-Ceja DC, Navarro-Vicente F, Esplugues JV, Calatayud S, Mira Á, Ortiz-Masiá D, Barrachina MD, Cosín-Roger J. A disturbed metabolite-GPCR axis is associated with microbial dysbiosis in IBD patients: Potential role of GPR109A in macrophages. Biochim Biophys Acta Mol Basis Dis. 2024 Dec;1870(8):167489. doi: 10.1016/j.bbadis.2024.167489. Epub 2024 Sep 2. PMID: 39233260.

Efficacy of Rapid Salivary C-Reactive Protein Test to Assess Early Changes in Malignancy in the Oral Cavity and Its Utility in Screening for Oral Cancer.

Background/Objectives: The present study aimed to test the efficacy of the chair-side rapid salivary C-reactive protein assay kit in differentiating oral potentially malignant disorders (OPMDs) and oral cancer from normal mucosa using whole salivary samples. Methods: In this study, unstimulated saliva samples of cases (OPMDs and oral cancer) and controls (systemically healthy subjects) were used to detect CRP levels using a novel colorimetric, quantitative rapid assay kit. Kruskal-Wallis ANOVA with a post hoc Dunn's test were applied to determine the difference in the mean and SD values between the case and control groups. ROC analysis was performed to identify the positive and negative likelihood ratios. Results: The mean calculated salivary CRP level in the oral cancer group was 4.21 ng/mL, in the OPMD group it was 2.51 ng/mL and in the healthy controls it was 0.7 ng/mL. Post hoc tests showed that the salivary CRP levels were significantly higher in the oral cancer and OPMD groups than in the controls. Conclusions: The present study showed that the novel rapid salivary test kit could significantly differentiate between the salivary CRP values of cases and controls but there was no significant difference between the OPMD and malignancy groups. It also showed higher sensitivity values, confirming the efficacy of this kit as a screening tool.

Psychosocial dimensions of the work environment of medical workers during the COVID-19 pandemic

The work environment of medical workers changed significantly during the COVID-19 pandemic. It concerned not only physical, chemical, biological, but also psychosocial factors shaping working conditions. The study focuses on presenting the results of research carried out during the pandemic on a group of medical workers regarding the psychosocial aspects of a safe work environment. STATISTICA software was used in the process of developing research results. To assess the significance of differences in variables analyzed, non-parametric tests were used: Mann-Whitney U test (UMW), Kruskal-Wallis ANOVA test (AKW). Kendall’s tau correlation coefficient was used to assess the strength of correlations between variables. The research results revealed a significant deterioration of the psychosocial dimension of the work environment in relation to medical workers employed in public health care units, in particular in hospitals, including single- name hospitals. The results also indicate a very strong relationship between the family/home situation of the respondents and their feelings about security, satisfaction, and meaning of work.

Consumer Awareness and Beliefs Regarding Sustainable Products

Objective: To identify consumer awareness and beliefs regarding sustainable products according to a consumer profile. Research Design & Methods: A quantitative approach was used. A questionnaire containing 24 variables was conducted using an online survey. 570 correctly completed records were obtained. The analysis used the difference test between structure indicators (chi-square), Kruskal-Wallis ANOVA and Mann-Whitney U test. Findings: The best predictors of differences in consumer awareness and attitudes were respondents’ education, gender and place of residence. Age and financial situation proved to be weak predictors. Implications / Recommendations: The results make it possible to suggest thematic areas and groups (profiles) of respondents to which educational activities should be directed at various levels of education on the circular economy and sustainable development. Manufacturers seeking to promote product sustainability could also benefit from the study’s results. Contribution: The article identifies the product sustainability degree model as well as variables that create a consumer profile and differentiate consumers’ awareness and attitudes towards sustainable products. The differences between individuals uare also classified.

Unlocking Micro Small and Medium Enterprises Potential: Addressing Financial Barriers Through Government Initiatives

MSMEs are pivotal contributors to India's economic landscape, fostering entrepreneurship, mitigating regional economic disparities. Despite their significance, these entities grapple with numerous challenges, including inadequate access to finance, shortage of skilled workforce, and limited support in marketing and technology adoption. This study aims to identify the financial hurdles faced by MSMEs and evaluate governmental initiatives designed to address these challenges. The research collected data from 605 MSMEs across Maharashtra and Gujarat states in India through a comprehensive questionnaire, subjecting the gathered information to various statistical analyses. Expanding on our previous research that sampled five major cities of Gujarat State, this study broadens its scope by including both Maharashtra and Gujarat. The new approach incorporates rural and backward regions from these states, providing a more comprehensive perspective beyond urban centers. Key findings reveal that MSME growth is primarily impeded by complexities in loan application processes, exacerbated by a lack of financial literacy among MSME owners, and excessive collateral requirements imposed by financial institutions. Furthermore, the study highlights the ineffective implementation of government schemes due to insufficient awareness among potential beneficiaries, protracted compliance procedures, and a significant digital divide, particularly pronounced in rural areas. The research employed a range of statistical techniques to ensure robust and reliable results, including Cronbach's alpha for reliability testing, Kruskal-Wallis ANOVA and Mann-Whitney U tests to evaluate differences between micro, small, and medium enterprises, Friedman rank tests to prioritize identified issues, and Spearman's rank correlation to examine the relationship between financial challenges and government initiatives.

The effect of self-administered acupressure on pain severity and sleep quality of patients with knee osteoarthritis: a randomized controlled trial

BackgroundPain in the knee joint area and reduced sleep quality are prevalent symptoms of knee osteoarthritis. This study examines the impact of self-administered acupressure on pain severity and sleep quality in patients with knee osteoarthritis.MethodsIn this trial conducted in 2023, 126 patients were enrolled. They completed a demographic characteristics form, the Visual Analogue Scale (VAS), and the Pittsburgh Sleep Quality Index (PSQI). Afterward, they were randomly allocated to three groups: acupressure, sham, and control. While the control group received routine care, patients in the acupressure and sham groups were instructed to apply pressure on selected acupoints daily for one minute for a duration of one month. All participants completed the PSQI and the VAS one month after the intervention began and one month after it ended. Data analysis involved Fisher’s exact tests, chi-square, Kruskal-Wallis, and one-way ANOVA tests. Also, per-protocol analyses were conducted with linear mixed-effects models.ResultsNo significant effects associated with group allocation were observed on pain VAS scores in acupressure and sham groups compared to the control group. However, participants in the acupressure group showed a significant decrease in pain VAS scores as time progressed. PSQI scores significantly decreased over time. Interaction effects showed that PSQI scores decreased more in the acupressure than in the control group over time. Finally, PSQI scores in the acupressure group demonstrated a significant decrease from pretest to follow-up, while no significant change was observed over time in the sham group.ConclusionsSelf-administered acupressure may be useful in improving sleep quality in patients with knee osteoarthritis. This work may be informative in developing acupressure interventions with more effective outcomes in future research.Trial registrationThis trial is registered on the Iranian Registry of Clinical Trials website with the identifier IRCT20211221053475N1 (Date: 10/01/2022).

Preliminary investigations of plasma lipidome and selenium levels in adults with treated hypothyroidism and in healthy individuals without selenium deficiency

The present preliminary study aimed to provide a targeted lipidomic analysis of Hashimoto (HT) and non-HT patients with well-controlled hypothyroidism as well as in healthy adults, and is the first to demonstrate the association of several components of the human lipidome with hypothyroidism in relation to the total plasma selenium content. All the patients and age-, sex-, and BMI-matched healthy controls met the very strict qualification criteria. Se levels were analyzed by ICP-MS, and lipidome studies were conducted using TQ-LC/MS. The 40 acylcarnitines, 90 glycerophospholipids, and 15 sphingomyelins were identified and quantified. PCaaC26:0 and PCaaC40:1 were negatively correlated with Se concentrations. Other lipids that were negatively correlated with Se concentrations but did not present significant differences between the three groups in the Kruskal–Wallis ANOVA test were PCaaC32:0, PCaeC30:0, PCaeC36:5, SMC18:0, and SM C18:1. In the multiple linear regression analyses, Se levels showed negative relationship, whereas different phosphatidylcholines: PCaaC24:0, PCaaC26:0, PCaeC30:1, PCaeC34:0, PCaeC36:4, PCaeC42:0 were positively associated with the presence of (H). Different lipidome components were identified in healthy and hypothyroid patients regardless of the cause of that condition. Studies on larger populations are needed to determine cause-and-effect relations and the potential mechanisms underlying these associations.

Assessment of Quality of Life in Head and Neck Cancer Patients before and after Radiation Therapy- A Prospective, Analytical Questionnaire-Based Study from a Tertiary Cancer Centre

Head-and-neck cancer (HNC) is a major global health issue, with significantly higher incidence rates in India compared to other countries. The diagnosis and treatment of HNC can severely affect a patient’s quality of life (QoL). This study aims to evaluate and compare the QoL of head and neck cancer patients before and after radiation therapy with or without chemotherapy. We conducted a prospective study on 45 newly diagnosed HNC patients who underwent radiation therapy, either alone or in combination with chemotherapy at our department. We assessed QoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) for general assessment and the EORTC QLQ H&N-35 for head and neck-specific evaluation before starting of the treatment and 4 weeks after the completion of the treatment. We used paired t-tests, Mann-Whitney U test and Kruskal-Wallis ANOVA for statistical analysis, with a significance level set at p ≤ 0.05. The most commonly affected site was the oral cavity. All participants initially had a good performance status (PS) of either 1 or 2, with Stage IV being the most prevalent. Analysis of the EORTC QLQ-C30 revealed a decline in global health status, and the EORTC QLQ H&N-35 showed deterioration across all domains from pretreatment. On the functional scale, emotional well-being was notably more impaired, while physical, cognitive, and social functions were less affected. Pain, swallowing difficulties, mucositis, and speech issues were identified as the most severely impacted aspects of QoL. In Conclusion, our study shows a significant decline in QoL following treatment due to the acute and subacute side effects of radiation therapy and chemotherapy. These findings highlight the need for comprehensive supportive care to address the broad impact of HNC treatment on patients quality of life.

Mapping and assessing the future provision of lake ecosystem services in Lithuania

Lakes supply multiple ecosystem services (ES), key to supporting socio-ecologic systems and human well-being. In the context of future land use and climate changes, it is imperative to anticipate potential impacts on lake ES supply. Hence, studies that deal with future lake ES, such as mapping, are lacking. In this work, we mapped and assessed the future supply of three ES: (1) maintenance of nursery conditions (nursery ES), (2) maintenance of chemical conditions of freshwaters (nutrient regulation ES), and (3) direct and indirect cultural outputs (recreation ES) in Lithuania. Four future scenarios were utilised, integrating land use and climate changes: A0 - business as usual; A1-urbanisation; A2: land abandonment and afforestation; and A3 - agricultural intensification. The projected year was 2050, following the intermediate Representative Concentration Pathway (RCP 4.5). The future scenarios were simulated using the open-source software Dinamica EGO based on a 6-step modelling framework. Statistical differences among the scenarios and ES were analysed by applying a Kruskal-Wallis ANOVA test. Spatial analysis was done by performing a Moran's I and Getis-Ord (Gi∗) hotspot analysis. The results showed significant differences in nursery and nutrient regulation ES. The highest supply in nursery ES was observed for the A0 scenario. For nutrient regulation ES, the lowest ES supply was identified for the A1 scenario and for recreation ES, the highest was found in the A2 scenario. The eastern and northeastern regions of Lithuania showed a high ES supply. Hot spots were only identified in the eastern region. These regions are associated with a high area covered by forests and protected areas. The central region shows a low ES supply, identified as a cold spot where the agricultural landscape dominates. The results of the PCA analysis revealed an association between nursery and recreation ES. Nutrient regulation was not associated with the other two ES. Mapping and assessing the impact of future scenarios is vital to anticipating the potential dynamics of lake ES, especially in the context of climate change. This information is essential in the context of environmental management, helping decision-makers to ensure a sustainable ES supply and contributing to human wellbeing.

Impact of Agricultural Activities on Soil Particle Size, pH, and Organic Matter in the Dimonika Biosphere Reserve, Mayombe (Republic of Congo)

Land-use change disrupts several soil physico-chemical parameters. This study aimed to analyze the influence of agricultural activities, topography, and localities on soil texture, pH, and organic matter in the Dimonika Biosphere Reserve. To achieve this, 90 soil samples were collected using an auger based on land use types, topography, and localities. Analyses of soil texture, pH, total organic carbon (TOC), and total nitrogen (TN) were conducted at the IRSEN laboratory in Pointe-Noire. The results showed that clay texture predominates in the studied area, which is related to the nature of the soils. The Kruskal-Wallis ANOVA test highlighted a significant effect of agricultural activities on soil acidity, with an acidic pH ranging from 4.2 to 5 in cultivated areas, compared to a very acidic pH (3.5 to 4.2) in mature forests. However, neither topography nor localities affected pH. Total organic carbon significantly decreased in old plantations (1.3±0.3%) and fallows (1.5±0.5%) compared to mature forests (1.9±0.5%) and savannahs (2.3±0.6%), while total nitrogen showed no notable variations. Topography also had no influence on organic status (TOC, TN). However, at the local level, the Makaba area stood out with significantly higher TOC (2±0.5%) and TN (0.2±0.03%) compared to Les Saras (0.14±0.03%) and Kayes (0.16±0.2%). The C/N ratio, influenced only by agricultural activities, was below 15, indicating rapid organic matter mineralization and a low TOC content. Several potential solutions were proposed for sustainable soil management.

Frailty prevalence and associated factors in community dwelling older adults: An examination of the frailty care model

BackgroundAge-related changes put older adults at risk for frailty. The Frailty Care Model was created to inform the care of older adults with or at risk for frailty. The purpose was to test the Frailty Care Model. MethodsThis was a cross-sectional study to identify associations between factors in the Frailty Care Model, and frailty components in older adults’ strength, fatigue, ability to ambulate, and weight loss over the last year. Comparisons across frailty groups used Pearson's chi-square tests or Fisher's exact tests. ANOVA tests and Kruskal-Wallis tests were used. Multivariable ordinal regression models were fit. ResultsOdds of frailty increased by 137% for those who lived alone, 20% for those who were depressed, and 433% for those who were classified as “at risk for malnutrition”. ConclusionsThis study was the first to test the Frailty Care Model with a focus on modifiable factors that predict frailty.

Systematic Review and Spatiotemporal Assessment of Mercury Concentration in Fish from the Tapajós River Basin: Implications for Environmental and Human Health.

This study reviews the literature on mercury (Hg) pollution in the Tapajós River basin from 1992 to 2022, focusing on the bioaccumulation in fish and the associated health risks to humans via ingesting contaminated species. Variability in Hg bioaccumulation was analyzed from both spatial (sub-basins) and ecological (trophic levels) perspectives. Mercury concentrations in fish muscle tissue and spatial differences in Hg levels were analyzed using nonparametric Kruskal-Wallis ANOVA and mapped with Inverse Distance Weighting. Additionally, a risk assessment of mercury contamination was conducted using the Target Hazard Quotient (THQ) and Maximum Safe Consuming Quantity (MSCQ) indices. Results indicate that Hg contamination is pervasive across the basin, with piscivorous fish showing the highest Hg levels, particularly in the middle Tapajós, upper Tapajs óand Teles Pires sub-basins, identified as contamination hotspots. Piscivorous species exhibited high Target Hazard Quotients (THQ), suggesting health risks for local consumers. The MSCQ values indicated that 75% of the fish species analyzed should be consumed in quantities lower than the current consumption daily average to avoid health risks.

The Relationship of Body Mass Index with Length of Stay in Acute Appendicitis Patients Who Have Undergoing Open Appendectomy at RSUS Lippo Village Karawaci Hospital

Background : Appendicitis is an inflammation that occurs in the veriform appendix. The Indonesian Ministry of Health announced that the number of inpatients with appendicitis is the fourth most common disease in Indonesia. Open appendectomy is a procedure for treating appendicitis. Patients who have an open appendectomy procedure require hospitalization for the wound to heal. Various studies have been conducted to find a relationship between body mass index and length of stay in patients with appendicitis but have different results, besides that research on this topic is still minimal in Indonesia. Therefore, this study was conducted to analyze the relationship between body mass index and length of stay in acute appendicitis patients who had undergone open appendectomy. Methods : This study used a cross-sectional study design with a sample population of acute appendicitis patients at Lippo Village Hospital Karawaci. 182 samples were selected using a purposive sampling technique. The research sample data was taken from the patient's medical records and will be tested for analysis using SPSS 25 with the Kruskal Wallis ANOVA method. Result : From 182 research samples, it was found that the median length of stay of patients with different body mass indexes was 3 days. Based on the Kruskal Wallis ANOVA test, there was no significant elationship between gender and length of stay (p > 0.05). Conclusions : This study shows that there is no relationship between body mass index and length of stay in acute appendicitis patients who have undergone open appendectomy.

Impact of SGLT2 inhibitor dapagliflozin on myocardial protein profile in rats with long-standing Type 1 diabetes mellitus

Abstract Background Sodium-glucose cotransporter 2 (SGLT2) inhibitors have beneficial effects on the cardiovascular system in diabetes mellitus (DM) patients. However, as most trials have focused on Type 2 DM, the impact of SGLT2 inhibitors on Type 1 DM remains unclear. Objective To investigate the effects of long-term treatment with SGLT2 inhibitor dapagliflozin on the left ventricular (LV) proteome in Type 1 DM rats. Methods Male Wistar rats were divided into three groups: Control (C, n=7); Diabetes (DM, n=6); and Diabetes treated with Dapagliflozin (DM+DAPA, n=8) for 30 weeks. Diabetes was induced by streptozotocin (40 mg/kg). Dapagliflozin was added to chow at 5 mg/kg/day. Label-free mass spectrometry was used to assess LV proteome using a nanoAcquity UPLC-Xevo QTof MS system and ProteinLynx Global Server (PLGS) software. Cytoscape software, Cluster Marker, and Cluego plugins were used for bioinformatic analysis. Statistical analysis: ANOVA and Tukey or Kruskal-Wallis and Dunn. Results Dapagliflozin increased body weight (C 574±43; DM 339±31*; DM+DAPA 413±30*# g; p<0.05: * vs C; # vs DM) and reduced glycemia [C 108 (101–111); DM 554 (529–562)*; DM+DAPA 343 (237–416)*# mg/dL; p<0.05: * vs C; # vs DM]. One rat died in C and two in DM+DAPA. A total of 252 differentially expressed proteins were identified. Most proteins identified in the networks were downregulated in DM vs C and upregulated in DM+DAPA vs DM. Six proteins related to energy metabolism (Atp5j, P21571; CKm, P00564; Ak1, P39069; Atp5h, P31399; Mdh1, O88989; and Idh2, P56574), four involved in myocyte excitation-contraction (Act1, P68065; Casq2, P51868; SERCA1, Q64578; and SERCA2a, P11507), and two associated with oxidative stress (Sod1, P07632; and Sod2, P07895) were upregulated in DM+DAPA x DM. Comparing DM with C, the KEEG Pathway with the highest percentage of gene associations for upregulated proteins was related to gap junction (25.6%), necroptosis (25.6%), and fatty acid degradation (25.6%), and for downregulated proteins was related to Alzheimer disease (27.3%), cardiac muscle contraction (25%) and glycolysis/gluconeogenesis (13.6%). Comparing DM+DAPA with DM, the KEEG Pathway with the highest percentage of gene associations for upregulated proteins was related to Parkinson disease (18.3%), cardiac muscle contraction (14.2%), citrate acid cycle (9.47%), necroptosis (8.88%), and cGMP-PKG signaling (7.10 %), and for downregulated proteins was related to ketone bodies synthesis and degradation (100%). Conclusion Dapagliflozin is safe and prevents changes in the expression of proteins related to energy metabolism, cardiac muscle contraction, and oxidative stress in Type 1 diabetes mellitus rats. These results offer new insights into the cardioprotective mechanisms of dapagliflozin in Type 1 diabetes mellitus.

Effect of curcumin on physico-mechanical properties of heat polymerized denture base resin

PurposeCurrent denture base resins lack adequate strength and antimicrobial properties, necessitating the exploration of alternative solutions. The purpose of this study was to evaluate the effects of curcumin incorporation on the physico-mechanical properties of heat-cured denture base resin, filling a gap in the literature regarding this correlation.MethodsHeat-cured denture base resin was supplemented with increasing concentrations of curcumin (CR). Groups were designated as CR-0 (0%), CR-0.05 (0.05%), CR-0.10 (0.10%), CR-0.50 (0.50%), and CR-1 (1%), based on the increasing concentrations of curcumin incorporated into the material. Physico-mechanical properties, including flexural strength, surface roughness, fracture toughness, impact strength, and color difference, were evaluated following the testing standards. Statistical analysis involved Kruskal-Wallis ANOVA followed by Dunn’s test for multiple comparisons, with significance set at P ≤ 0.05 and Bonferroni’s correction applied to p-values.ResultsFlexural strength peaked at 153.80 MPa in the CR-0.10 group, while surface roughness was lowest at 0.14 micrometers in the CR-0.50 group. Fracture toughness reached its highest value at 1.80 kJ/m^2 in the CR-0.05 group, and impact strength was greatest at 6.52 Joules in the CR-0.05 group. Additionally, color difference was least pronounced in the CR-0.50 group. Flexural strength, surface roughness, fracture toughness, impact strength, and color difference varied significantly among the control group and different curcumin concentrations (P < 0.05).ConclusionsIncorporating curcumin into denture base resin alters both optical and mechanical properties. Further research is required to validate the findings and determine the optimal curcumin concentration without compromising the material efficacy.

Human biomonitoring of essential and toxic trace elements (heavy metals and metalloids) in urine of children, teenagers, and young adults from a Central European Cohort in the Czech Republic.

Exposure to toxic trace elements, which include metals and metalloids, can induce adverse health effects, including life-threatening diseases. Conversely, essential trace elements are vital for bodily functions, yet their excessive (or inadequate) intake may pose health risks. Therefore, identifying levels and determinants of exposure to trace elements is crucial for safeguarding human health. The present study analyzed urinary concentrations of 14 trace elements (arsenic, cadmium, cobalt, chromium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, selenium, thallium, and zinc) and their exposure determinants in 711 individuals, spanningfrom children to young adults from a Central European population from the Czech Republic. Multivariate linear regression and non-parametric Kruskal-Wallis ANOVA were used to investigate exposure determinants. Estimates of 95th percentile concentrations and confidence intervals were carried out to establish reference values(RV95). The study also assessed the percentage of population exceeding health-based guidance values (GVs) to gauge health risks. Young adults showed elevated toxic element concentrations, whereas children exhibited higher concentrations of essential elements. Mercury concentrations were associated with both dental amalgam filling count and seafood intake; arsenic concentrations were associated with seafood, rice, and mushroom consumption. Mushroom consumption also influenced lead concentrations. Sex differences were found for cadmium, zinc, nickel, and cobalt. Between 17.9% and 25% of the participants exceeded recommended GV for arsenic, while 2.4% to 2.8% exceeded GV for cadmium. Only one participant exceeded the GV for mercury, and none exceeded GVs for chromium and thallium. Essential trace elements' GVs were surpassed by 38% to 68.5% participants for zinc, 1.3% to 1.8% for molybdenum, and 0.2% to 0.3% for selenium. The present study examines trace element exposure in a Central European population from the Czech Republic, unveiling elevated exposure levels of toxic elements in young adults and essential elements in children. It elucidates key determinants of trace element exposure, including dietary and lifestyle indicators as well as dental amalgam fillings. Additionally, the study establishes novel reference values and acomparison with established health-based human biomonitoring guidance values, which are crucial for public health decision-making. This comprehensive biomonitoring study provides essential data to inform public health policies and interventions.

GC-MS and PCA Analysis of Fatty Acid Profile in Various Ilex Species.

Natural compounds are important source of desired biological activity which helps to improve nutritional status and brings many health benefits. Ilex paraguariensis St. Hill. which belongs to the family Aquifoliaceae is a plant rich in bioactive substances (polyphenols, saponins, alkaloids) with therapeutic potential including hepatic and digestive disorders, arthritis, rheumatism, and other inflammatory diseases, obesity, hypertension, hypercholesterolemia. In terms of phytochemical research I. paraguariensis has been the subject of most intensive investigations among Ilex species. Therefore, we concentrated on other available Ilex varieties and focused on the content of fatty acids of these shrubs. The fatty acid compounds present in Ilex sp. samples were analyzed by GC-MS. 27 different fatty acids were identified in the extracts. The results showed that many constituents with significant commercial or medicinal importance were present in high concentrations. The primary component in all samples was α linolenic acid(18:3 Δ9,12,15). Differences of this component concentration were observed between cultivars and extensively analyzed by PCA, one- way ANOVA and Kruskal-Wallis ANOVA. Significant correlations between compound concentrations were reported.

Does the Composition of Breast Milk in the First Week Postpartum Differ Due to Maternal Factors or Neonatal Birth Weight and Percent Fat Body Mass?

Background: The composition of breast milk is dependent on numerous factors. However, the precise impact of maternal health conditions on breast milk composition remains to be fully elucidated. Similarly, there is a paucity of evidence regarding the correlation between neonatal body composition and human milk. The objective of the study was to evaluate the macronutrient composition of breast milk collected during the first week postpartum from mothers with gestational diabetes and healthy mothers in terms of selected maternal and neonatal factors. Methods: n = 70 breast milk samples were analyzed for fat, protein, carbohydrate, dry matter, true protein, and energy. The results were evaluated in terms of selected maternal factors, as well as neonatal birth weight (BW) and percent fat body mass (%FBM), which was assessed with a bioimpedance method. Results: Energy of breast milk in the study group was as follows: median 55.5 kcal/dL in GDM G1, median 55.5 kcal/dL in GDM G2, and median 65.0 kcal/dL in non-GDM, which differed significantly in Kruskal–Wallis ANOVA. Neonatal %FBM, but not BW, was found to be significantly related to concentrations of protein, true protein and dry matter. Maternal gestational weight gain, history of hypothyroidism, and classification by study group were identified as factors affecting both breast milk and neonatal body composition. Conclusions: The composition of breast milk in the initial week following childbirth is predominantly determined by maternal factors. The relationship between selected macronutrients and neonatal percent fat body mass was found to be weak, yet the significance of this finding is unclear. Further research is required to ascertain the influence of maternal milk composition on early infantile nutritional programming.