AO Groups Research Articles

A comparison of ondansetron in preventing postoperative nausea and vomiting for patients with or without preoperative anxiety with painless egg retrieval: a prospective, randomized, controlled trial.

Patients undergoing painless egg retrieval are prone to preoperative anxiety, and whether preoperative anxiety induces postoperative nausea and vomiting (PONV) is debated. The primary objective of this prospective, randomized, controlled study was to compare the clinical effect of ondansetron in preventing PONV for patients with and without preoperative anxiety. The secondary objective was to investigate whether preoperative anxiety was associated with PONV. The self-rating anxiety scale (SAS) was used to assess the anxiety patients undergoing painless egg retrieval. Patients with a SAS standard score of 50-60 were selected to the anxiety group (n=105); and patients with a SAS standard score of 25-35 were assigned to the non-anxiety group (n=104). Venous blood samples of both groups of patients were obtained during admission and 1 hour after surgery, and all serotonin (5-HT) levels were tested using an enzyme-linked immunosorbent assay. The anxiety group was then randomly assigned into two subgroups: ondansetron (AO group, n=53) and placebo saline (AS group, n=52). Similarly, patients in the non-anxiety group were also randomly assigned to one of two subgroups: ondansetron (NO group, n=51) and placebo saline (NS group, n=53). The AO and NO groups received 8 mg (4 mL) of intravenous ondansetron 15 minutes before surgery, while the AS and NS groups received an equivalent volume (4 mL) of normal saline. We then analyzed the vital signs, risk factors for nausea and vomiting, intraoperative anesthetic doses, incidences of nausea and vomiting in 24 hours after surgery, serum 5-HT level before and after surgery, other adverse responses, pain scores, and satisfaction. A total of 200 patients eventually completed this study. The serum 5-HT values in the anxiety group were higher before and after surgery than in the non-anxiety group (P<0.05), but there was no significant difference in serum 5-HT before and after surgery in the same group (P>0.05). The incidence of PONV was more significant in the AS group than in the NS group (P<0.05). The incidence of PONV was also higher in the AS group than in the AO group (P<0.05). Still, there was no statistically significant difference between the NO and NS groups (P>0.05). There were no significant differences between the four groups in vital signs, risk factors for nausea and vomiting, intraoperative anesthetic doses, other adverse responses and pain scores (P>0.05). Patients in the AS group had lower satisfaction scores than those in the other three groups (P<0.05). Patients experiencing preoperative anxiety have a greater risk of PONV following painless egg retrieval compared to those without preoperative anxiety. Ondansetron can reduce the occurrence of PONV in patients with preoperative anxiety, but it has no discernible preventative effect in non-anxious patients. Chinese Clinical Trial Registry ChiCTR2400079504.

Evaluation of Salvia officinalis in the Treatment of Acetic Acid-induced Ulcerative Colitis in a Rat Model

Abstract Introduction Ulcerative colitis (UC) is an inflammatory bowel disease that causes long-lasting inflammation and ulcers within the digestive tract. This study aims to determine the histochemical alteration of Salvia officinalis (sage), an anti-inflammatory and antioxidant herbal agent on UC. Materials and Methods The disease was induced in 37 Sprague-Dawley rats with 2 mL of 3% acetic-acid (AA) enema. The rats were divided into five groups: a control group (AA), two 5-aminosalicylic (5-ASA) groups treated either orally (AO) or rectally (AR) with a dose of 100 mg/kg, and two salvia groups treated with 300mg/kg salvia orally (SO) or rectally (SR). Histopathological analyses of the colon were done on day 7, and markers such as C-reactive protein (CRP), superoxide dismutase (SOD), and complete blood count were measured. Result In macroscopic evaluation, the AO group demonstrated the lowest involvement, followed by the SO, SR, AR, and AA groups, respectively (p = 0.01). There was no significant difference between the SO and AO groups (p = 0.10), and the SR and AR groups (p = 0.58). Regarding microscopic histopathological findings, the AO and SO group demonstrated the most satisfactory results, with no significant difference between the AO versus SO, and AR versus SR groups. Inflammation was resolved in all of the AO and SO subjects. Conclusion Salvia can be beneficial in the treatment course of UC by inhibiting inflammatory responses, increasing the growth and viability of intestinal mucosa, and its antioxidant effects. Therefore, we propose the prescription of salvia as an adds-on or alternative therapy in the management of UC.

Bone mineral density in adults growth hormone deficiency with different ages of onset: a real-world retrospective study.

Bone mineral density (BMD) impairment is one of the critical factors for long-term quality of life in adults growth hormone deficiency (AGHD). This study aims to investigate the annual changes in BMD in AGHD patients with different ages of onset and to identify predicting factors that influence BMD. AGHD patients (n = 160) with available data for 4 years follow-up from a major tertiary medical center in China were retrospectively included (110 [68.8%] childhood-onset, 119 [74.4%] male). BMD of the axial bone (including total hip, neck of femur, and L1-4) derived from dual X-ray absorptiometry and final height were investigated at the first visit, 12 months, 24 months, 36 months, and 48 months thereafter. Low BMD was defined as Z-score ≤ -2. The prevalence of low BMD was 30.0% at baseline and 12.5% at 4 years of follow-up. The CO AGHD group presented a significantly lower BMD than the AO AGHD group at the baseline (P = 0.009). In contrast, the CO AGHD group had significantly greater median annual BMD change than the AO AGHD group (0.044 vs. -0.0003 g/cm2/year in L1-4, P < 0.001), indicating a significant difference in the overall BMD trend between CO and AO groups. Childhood-onset (odds ratio [OR] 0.326, P = 0.012), low serum testosterone (OR 0.847; P = 0.004) and FT4 (OR 0.595; P = 0.039) level were independent risk factors for BMD loss. The annual changes of BMD show a different pattern in AGHD patients with varying ages of onset. Patients with CO AGHD have a lower bone mass, and in general, appropriate replacement therapy is necessary for long-term bone health in AGHD patients.

Probiotic supplementation as an alternative to antibiotics in broiler chickens.

The broiler chicken digestive tract microbiome maintains the bird's immunity. Its composition has been shown to be important not only for the immune system but also for the gastrointestinal function and productivity of broiler chickens. If the microbiome is populated by supplementation with Lactobacillus, Pediococcus and Saccharomyces spp. - microorganisms with probiotic properties and alternatives to antibiotics - the immune system is stimulated. The use of probiotic supplements in the broiler production cycle can boost bird immunity and prevent adenovirus infection. The resilience of broiler chickens in different feeding schemes including supplementation with these microorganisms was assessed. Four groups of Ross 308 chickens vaccinated on the standard scheme were investigated over 42 days. Group P received probiotics, prebiotics and vitamins; group AO received antibiotics; group P&AO received probiotics, prebiotics, vitamins and antibiotics; and the control group C received none of these. The birds' immunocompetence against common viral poultry pathogens and their immune response to an experimental challenge with a field strain of infectious bronchitis was evaluated by ELISA and production parameters were recorded. Mortality was only observed in the control group and was 10%. All birds from the P, P&AO and AO groups responded to the challenge as would be expected of appropriately immunised chickens. The obtained results indicated that supplementation with synbiotic products and vitamins can enhance broiler chicken immunity and result in better production parameters.

The Efficiency of Antiosteoporosis Medicine after Intertrochanteric Fracture Surgery: A Retrospective Study of Refracture Rate, Function Recovery, Complications, and Mortality in the Chinese Elderly Population

Abstract Objective This research aimed to discern the effects of antiosteoporosis medication on postoperative functional recovery, refracture incidence, complications, and mortality in geriatric patients with intertrochanteric fractures. Methods A retrospective study was conducted on 250 patients aged 65 years and above who underwent surgery for intertrochanteric fractures between January 2013 and December 2014. Intertrochanteric fracture is diagnosed with International Classification of Diseases 10th Revision code (S72.101) and classified by the Evans–Jensen system. Collected data encompassed demographic details, pre- and postoperative histories of antiosteoporotic medication, functional outcomes (measured using Harris hip score, Parker Mobility Score, and EuroQol-5 Dimension [EQ-5D] scores), refracture incidences, complications, and survival rates. The antiosteoporotic regimen was categorized into essential (calcium, vitamin D) and advanced medications (bisphosphonate, calcitonin, etc.). Outcomes between patients on antiosteoporosis treatment (AO group) and those without (control group) were compared. Results The cohort comprised 250 patients, with a gender distribution of 85 males (34%) and 165 females (66%), and a mean age of 79.8 ± 7.0 years. The median follow-up period was 15.82 months (maximum 31.13 months). Postoperatively, 126 (50.4%) patients were administered antiosteoporotic treatment. The refracture incidence in the AO group (2.4%, n = 3) was notably lower than the control group (8.9%, n = 11), manifesting a substantial risk reduction (odds ratio 0.251, 95% confidence interval 0.068–0.920, p = 0.024). While no marked differences in functional outcomes between the AO and control groups were observed (Harris score [96.17 ± 7.77 vs. 97.29 ± 6.74, p = 0.074), Parker score [8.54 ± 1.26 vs. 8.62 ± 1.18, p = 0.411], EQ-5D [0.83 ± 0.05 vs. 0.82 ± 0.06, p = 0.186]), patients administered a combination of essential and advanced drugs showcased significantly improved Harris and EQ-5D scores compared to those on essential drugs alone (Harris score [77.93 ± 2.04 vs. 84.94 ± 2.73, p = 0.015], EQ-5D [0.65 ± 0.03 vs. 0.75 ± 0.04, p = 0.015]). Conclusion Postoperative antiosteoporosis treatment acts as a deterrent against refracture following intertrochanteric fracture surgeries, evidenced by a decline in refracture rates. However, the treatment's impact on functional recovery, quality of life, complications, and mortality remains indistinct. Interestingly, the combined administration of essential and advanced antiosteoporotic drugs seems to foster enhanced functional outcomes, warranting further exploration in future studies.

Changes in Aβ42, Neprilysin, and γ-Secretase in the Hippocampus of Male Rats Alzheimer’s model: The Effects of Aerobic Training and Omega-3 Intake

Background: Alzheimer›s disease (AD) is characterized by excessive deposition of the amyloid-β peptide (Aβ) in the central nervous system and reducing its level is the goal of many medications. This study aimed to investigate the effect of aerobic training and omega-3 intake on Aβ42, neprilysin, and γ-secretase levels in the hippocampus of male rats Alzheimer›s model. Methods: Fifty male Wistar rats (age: 12 weeks-old and weight: 222.31±11.91 g), were divided into the five groups including control Alzheimer’s (AC), Alzheimer’s with omega-3 intake (AO), Alzheimer’s training (AT), Alzheimer’s with omega-3 intake and training (AOT) and Healthy Control (HC). AD was induced by the injection of homocysteine (60mM) into the rat brain ventricle. Training on the treadmill with a speed of 20 m/min (60 minutes and 5 days/week) was applied. The supplement group received omega-3 supplement 800 mg/kg of body weight, daily for eight weeks. Levels of Aβ42, γ-secretase, and neprilysin protein were measured using ELISA method. In data analysis, one-way ANOVA and Tukey test as post hoc were used (P&lt;0.05). Results: The obtained results showed that the level of Aβ42 in the hippocampus of AC group was significantly higher than that of the HC group (P=0.001). Also, the level of Aβ42 in the hippocampus of AC group was significantly higher as compared to AO, AT, and AOT groups (P values 0.001, 0.007, and 0.003 respectively). The γ-Secretase level in the hippocampus of AC group was significantly higher than that in the HC group (P=0.001). Moreover, the γ-secretase levels in the hippocampus of the AC group were significantly higher compared to AO, AT, and AOT groups (P values: 0.002, 0.001, and 0.001 respectively). There was no significant difference in neprilysin levels of the hippocampus among the research groups (P=0.534). Conclusion: It appears that exercise training and omega-3 consumption, can affect amyloidogenic pathways through reducing the level of γ-secretase, and lead to reduced level of hippocampus Aβ in AD subjects. Therefore, aerobic exercise training and omega-3 intake can be studied as a complementary therapy in Alzheimer’s patients.

REBOA for the Treatment of Blast Polytrauma: Zone 3 Provides Cerebral Perfusion, Attenuates Organ Dysfunction and Reperfusion Coagulopathy Compared to Zone 1 in a Swine Model.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a lifesaving therapy for hemorrhagic shock following pelvic/lower extremity injuries in military settings. However, Zone 1 aortic occlusion (AO; above the celiac artery), while providing brain/cardiac perfusion, may induce/worsen visceral ischemia and organ dysfunction. In contrast, AO Zone 3 (below the renal arteries) provides abdominal perfusion potentially minimizing ischemia/reperfusion injury. We hypothesized that, compared with AO Zone 1, AO Zone 3 provides neuro/cardioprotection while minimizing visceral ischemia and reperfusion coagulopathy after severe traumatic hemorrhage due to pelvic/lower extremity injuries. Fifty-kilogram male Yorkshire swine underwent a blast polytrauma injury followed by a resuscitation protocol with randomization to no AO (No AO, n = 6) or AO with REBOA at Zone 1 (AO Zone 1; n = 6) or Zone 3 (AO Zone 3; n = 4). Vital signs and intracranial pressure (ICP) were monitored for 240 minutes. Citrate native and tissue plasminogen activator challenge thrombelastography, prothrombin time, creatinine, lipase, total bilirubin, troponin, and enzyme-linked immunosorbent assays protein levels were measured at set intervals. Both AO groups had significant increases in mean arterial pressure during aortic occlusion. All three groups had significant increases in ICP, but final ICP in the No AO group (26 ± 5.8 mm Hg) was significantly elevated compared with AO Zone 1 (17 ± 5.2 mm Hg) and AO Zone 3 (16 ± 4.2 mm Hg) ( p < 0.01). The final mean troponin in the No AO group (4.10 ± 5.67 ng/mL) was significantly higher than baseline (0.03 ± 0.02 ng/mL, p < 0.05), while the two AO groups had no significant changes ( p > 0.05). AO Zone 1 was the only group associated with hyperfibrinolysis ( p < 0.05) and significantly increased prothrombin time ( p < 0.05). Only AO Zone 1 group had significantly higher markers of organ damage. Compared with AO Zone 1, AO Zone 3 provided similar neuro/cardioprotection but with less organ dysfunction and coagulopathy. This study suggests that Zone 3 REBOA may be preferable over Zone 1 for treating military relevant blast polytrauma with minimal intra-abdominal and chest trauma, but further clinical investigation is warranted.

Selective D3 receptor antagonism modulates neural response during negative emotional processing in substance dependence.

Negative affective states contribute to the chronic-relapsing nature of addiction. Mesolimbic dopamine D3 receptors are well placed to modulate emotion and are dysregulated in substance dependence. Selective antagonists might restore dopaminergic hypofunction, thus representing a potential treatment target. We investigated the effects of selective D3 antagonist, GSK598809, on the neural response to negative emotional processing in substance dependent individuals and healthy controls. Functional MRI BOLD response was assessed during an evocative image task, 2 h following acute administration of GSK598809 (60 mg) or placebo in a multi-site, double-blind, pseudo-randomised, cross-over design. Abstinent drug dependent individuals (DD, n = 36) comprising alcohol-only (AO, n = 19) and cocaine-alcohol polydrug (PD, n = 17) groups, and matched controls (n = 32) were presented with aversive and neutral images in a block design (contrast of interest: aversive > neutral). Whole-brain mixed-effects and a priori ROI analyses tested for group and drug effects, with identical models exploring subgroup effects. No group differences in task-related BOLD signal were identified between DD and controls. However, subgroup analysis revealed greater amygdala/insular BOLD signal in PD compared with AO groups. Following drug administration, GSK598809 increased BOLD response across HC and DD groups in thalamus, caudate, putamen, and pallidum, and reduced BOLD response in insular and opercular cortices relative to placebo. Multivariate analyses in a priori ROIs revealed differential effects of D3 antagonism according to subgroup in substantia nigra; GSK598809 increased BOLD response in AO and decreased response in PD groups. Acute GSK598809 modulates the BOLD response to aversive image processing, providing evidence that D3 antagonism may impact emotional regulation. Enhanced BOLD response within D3-rich mesolimbic regions is consistent with its pharmacology and with attenuation of substance-related hypodopaminergic function. However, the lack of group differences in task-related BOLD response and the non-specific effect of GSK598809 between groups makes it difficult to ascertain whether D3 antagonism is likely to be normalising or restorative in our abstinent populations. The suggestion of differential D3 modulation between AO and PD subgroups is intriguing, raising the possibility of divergent treatment responses. Further study is needed to determine whether D3 antagonism should be recommended as a treatment target in substance dependence.

Onion and Apple Functional Ingredients Intake Improves Antioxidant and Inflammatory Status and Vascular Injury in Obese Zucker Rats.

The objective of this study was to investigate the effects of onion and apple functional ingredients in homozygous (fa/fa) obese Zucker rats. Rodents were fed three diets: standard diet [obese control (OC) group], standard diet containing 10% onion [obese onion 10% (OO) group] and standard diet containing 10% apple [obese apple 10% (OA) group] for 8 weeks. Food intake and body weight gain were higher in obese than in lean rats. Food efficiency was lower in OO and AO groups compared with OC group. Within the obese groups, total cholesterol, LDL-cholesterol, triacylglycerols, glucose, insulin and triglyceride-glucose index were lower in OO group than in OC group, and HDL-cholesterol was higher in OO group than in OC group. In general, antioxidant activity (ABTS•+ and FRAP), antioxidant enzyme activities (CAT, SOD, GPx), GSH/GSSG ratio, nitrate/nitrite and GLP-1 increased in OO and OA groups compared with OC. Oxidative stress biomarkers, namely protein carbonyls, 8-hydroxy-2′-deoxyguanosine, 8-epi-prostaglandin F2α, inflammatory and vascular injury biomarkers (PAI-1, TIMP-1, VEGF, sICAM-1, sE-Selectin, MCP-1) and leptin, were lower in OO and OA groups than in OC group. Endothelial impairment was partially reversed, and superoxide content and gene expression of NLRP3, NFKβ1 and COX2 decreased, in OO and OA groups with respect to OC group. The study demonstrates that high pressure-processed onion and apple functional ingredients administration to obese Zucker rats causes beneficial effects on metabolic health, in particular through improving food efficiency ratio; exerting pronounced lipid-lowering effects; reducing glycemia, insulinemia, and biomarkers of hepatic injury (ALT, AST); improving antioxidant, oxidative stress, inflammatory and vascular injury biomarkers, metabolic hormones, and endothelial function; and decreasing proinflammatory gene expression of NLRP3, NFKβ1 and COX2.

Variability and Patterning in Permanent Tooth Dimensions among Four Ethnic Groups from the North-eastern States of India.

Methods The study was a comparative cross-sectional study among four different ethnic groups of North-east India among the age group of 20-30 years. Dimensions of the maxillary and mandibular teeth were measured with a digital Vernier calliper using the dental casts of 50 male and 50 female subjects from each of the four ethnic groups under study. The data were statistically analyzed using a Student's t-test and one-way analysis of variance. Statistical significance was set at p < 0.05. Results The tooth dimensions of all four ethnic groups were significantly lower than the standard values except for the MD dimension of the maxillary second molars of the Singpho group (9.13 mm vs. 9.0 mm); mandibular central incisors of the Meitei group (5.01 mm vs. 5.0 mm); and mandibular lateral incisors of the Meitei, Ao, and Singpho groups (>standard value of 5.5 mm) and BL dimension of the mandibular first premolars of the Meitei and Ao groups (>standard value of 7.5 mm); mandibular second premolars of the Meitei and Singpho groups (>standard value of 8.0 mm); and mandibular second molars of the Ao group (10.04 mm vs. 10.0 mm). In some instances, the comparative analysis revealed group variations in different tooth dimensions among the four ethnic groups (p < 0.05). Conclusion Variations were observed in the tooth dimensions among the four ethnic groups and within the same population. Unlike other parts of India, the North-eastern population belongs to a distinct ethnic race of indigenous people of East Asia, Southeast Asia, and the Arctic region of North America. Hence, population-specific data for India's North-eastern region are necessary for forensic odontology, dental anthropology, routine dental practice, and effective treatment planning.

A single-institution, retrospective examination of new contrast enhancement, progression, and pseudoprogression in IDH mutant glioma.

2043 Background: IDH mutant glioma patients are followed by MRI, where new contrast enhancement (CEnew) is a hallmark of tumor progression. Interpretation of CEnew is confounded by pseudoprogression (PsP), the appearance of CEnew that spontaneously resolves on subsequent scans. PsP has been characterized in IDH wildtype patients, but is poorly understood in the IDH mutant category. This study represents an examination of the characteristics and impacts on patient survival of CEnew in IDH mutant gliomas. Methods: Of the 724 confirmed IDH mutant glioma patients treated at UCLA between 1998 and 2022, 587 were included (median follow-up = 5.23 years). Patients were excluded based on these criteria: &lt;4 MRI scans, unknown IDH status, and unknown WHO 2016 diagnosis. CEnew was first identified by direct review of images and confirmed by the radiology report. Any new enhancement appearing on the first post surgical MRI was not considered CEnew. CEnew was interpreted as progression after surgical resection indicating tumor or the re-initiation of chemotherapy or radiation and was considered PsP after the resolution of enhancement without new treatment initiation. Some PsP patients could have received bevacizumab. Kaplan-Meier survival analyses were used to examine overall survival differences between groups. Results: 327 of 587 patients developed CEnew. The incidence of CEnew was higher in Grade 4 Astrocytoma (G4 Astro) versus all other pathologies and lowest in LO (p &lt; 0.05). The Enhancement Free Survival (EFS) was shortest for G4 Astro patients (p =.002); LO patients had the longest median EFS of 2602 days (p = 0.002). The development of CEnew and presence of preoperative enhancement were both found to be negative survival prognosticators in all pathologies (p &lt; 0.05). From our analysis, 92 patients developed PsP and 177 developed progression. The median duration of a PsP spot was 244 days. PsP spots appeared earlier than progression spots (median 538 vs 1113 days, p =.001). The incidence of PsP was highest in the G4 Astro group and lowest in LO patients. Survival analysis of patients with progression versus those with PsP and progression shows PsP is associated with longer OS in the entire cohort and the LO, AO, AA, and G4 Astro groups (p &lt; 0.05). 100% of PsP patients received radiation therapy (RT). The median time from the end of RT to PsP was 209 days. Conclusions: While CEnew in IDH mutant gliomas is associated with reduced OS, poorer outcome is driven by progressors. PsP represents 28% of CEnew instances, typically occurs within 1 year of RT and have superior outcome to progressors and equivalent to of patients that do not display CEnew. [Table: see text]

Comparison of alternative arterial anastomosis site during liver transplantation when the recipient's hepatic artery is unusable.

Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable. We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA. Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.4%) with unusable recipient HA were analyzed. Four groups were defined according to the site of anastomosis: the splenic artery (SA group, n=26), coeliac trunk (CT group, n=12), aorta using or not the donor's vessel (Ao group, n=91) and aorta using a vascular prosthesis (Ao-P group, n=12) as conduit. The median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups (5, 5, 8.5 and 16 for SA, CT, Ao and Ao-P group respectively, P=0.002), as well as fresh frozen plasma (4.5, 2.5, 10, 17 for the SA, CT, Ao and Ao-P groups respectively, P=0.001). Hospitalization duration was also significantly increased in the Ao and Ao-P groups (15, 16, 24, 26.5 days for the SA, CT, Ao and Ao-P groups respectively, P<0.001). The occurrence of early allograft dysfunction (EAD) (P=0.07) or arterial complications (P=0.26) was not statistically different. Level of factor V, INR, bilirubin and creatinine during the 7th postoperative days (POD) was significantly improved in the SA group. No difference was observed regarding graft (P=0.18) and patient (P=0.16) survival. In case of unusable HA, intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.

Abatacept is Efficacious in the Treatment of Older Patients with csDMARD-Refractory Rheumatoid Arthritis: A Prospective, Multicenter, Observational Study.

IntroductionAbatacept efficacy in older patients with rheumatoid arthritis (RA) has been primarily demonstrated via retrospective comparisons with younger patients. The objective of this study was to compare efficacy of abatacept in older vs. younger patients with RA, and efficacy of abatacept with that of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in both age groups.MethodsThis prospective, multicenter, observational study (UMIN000014913) enrolled csDMARD-refractory patients without previous biological DMARD treatment. Abatacept (A) or csDMARDs (C) were administered at the treating physician’s discretion to older (O, ≥ 65 years) and younger (Y, 20–64 years) patients, producing AO, AY, CO, and CY groups. Clinical efficacy after 24 weeks was evaluated using European League Against Rheumatism (EULAR) erythrocyte sedimentation rate response criteria.ResultsOverall, 202 patients were evaluated. Compared with the CO group, more patients in the AO group achieved a EULAR good or moderate response (p < 0.0001). Compared with the CY group, more patients in the AY group achieved a EULAR good or moderate response (p < 0.01). Similar proportions of patients in the AO and AY groups achieved a EULAR good response or a good or moderate response. Few adverse events were reported.ConclusionsThis prospective study demonstrated that abatacept is efficacious and safe in older patients with RA and a history of being refractory to csDMARDs. Abatacept was shown to be more efficacious than adding or switching to a new csDMARD in both younger and older csDMARD-refractory patients with RA.Trial RegistrationUMIN000014913.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40744-021-00356-2.

Stability of Various Types of Aspheric Intraocular Lenses After Implantation: A One-Year Retrospective Study.

ObjectiveThe aim of the present study was to evaluate the stability of four different types of aspheric intraocular lenses (IOLs) after implantation.MethodsThis retrospective study included 124 eyes implanted with four different types of aspheric IOLs including a one-piece four-loop fixed hydrophilic acrylic IOL, a one-piece flat fixed acrylic IOL, a one-piece two-loop fixed acrylic IOL, and a three-piece two-loop fixed silicone IOL. IOL decentration, tilt, and ocular coma‐like aberration (coma) at one-week, one-month, three-month, and one-year time points were evaluated postoperatively.ResultsIOL decentration, tilt, and coma in the AO, 36A, IQ, and KS-AiN implantation groups were statistically significantly different one week and one year postoperatively (p < 0.01). There were significant differences between each of the pairs of groups (p < 0.01), except for coma between the AO and 36A implantation groups one week postoperatively (p > 0.05). When comparing the different time points (ie, one week, one month, three months, and one year postoperatively), IOL decentration, tilt, and coma were significantly different in each group (p < 0.05). IOL decentration, tilt, and coma in each group increased over the period from one week to one year postoperatively. A positive linear correlation was observed between IOL decentration or tilt and coma one year postoperatively (p < 0.01).ConclusionOne-piece multi-point fixed acrylic IOLs demonstrate better stability when compared with three-piece two-point fixed silicone IOLs. IOL decentration, tilt, and coma increase gradually over time. Ocular coma‐like aberrations are influenced by the stability of IOLs.

P640 Characteristics of elderly onset Inflammatory Bowel Disease in a cohort of Hispanics

Abstract Background The incidence and prevalence of elderly-onset Inflammatory Bowel Disease (EO-IBD), defined as diagnosed &amp;gt;60 y/o, is increasing. The natural history of this cohort is unclear. Disease behavior in elderly patients may differ between adult onset IBD (AO-IBD) and EO-IBD. Comorbidities, age-related frailty and side effects of medications are challenges. We compare a cohort of Hispanic EO-IBD and elderly AO-IBD patients in the IBD Registry, a database collecting demographic and medical data of patients since 1995. Methods Of 1345 subjects,122 were ≥60 y/o at recruitment, including AO and EO subjects. Variables included age at diagnosis, gender, IBD type, family history of ulcerative colitis (UC) and Crohn’s disease (CD), disease extent, extraintestinal manifestations (EIM), surgery, and medications. Descriptive statistics were calculated for interval and ratio variables. Frequencies and percentages were calculated for nominal variables cross-tabulated by age of diagnosis. The study is approved by the IRB. Results Of the 122 subjects, 59 (48.4%) had AO-IBD and 63 (51.6%) EO-IBD. Mean age of diagnosis was 49.6 y/o for the AO group and 66.4 y/o for the EO group, disease duration was 15.37 yr for AO and 3.73 yr for EO (P&amp;lt;.001). Female gender was more frequent (52.5%: AO, 55.6%: EO-IBD). Most were non-smokers (AO: 57.6%, EO:54%). UC was more common (AO: 62.7%, EO: 60.3%). Family history of CD was low (AO: 6.8%, EO: 6.4%), while family history of UC was more frequent in AO-IBD (18.6% vs 12.7 % in EO-IBD). Small bowel CD was the most frequent (48%) in both groups. UC extension was most commonly pancolitis (AO:58%, EO: 41%. Corticosteroid and biologic use were higher in AO-IBD (see table). EIMs were reported by 41% of AO and 27% of EO, the most frequent was joint involvement (17% AO and 16% EO). Cancer was reported in 3.4% of AO-IBD and 1.6% of EO-IBD. Osteoporosis was reported on 14% of AO-IBD and only 2% in EO-IBD. Surgery was more frequent in the AO group, 41% (n = 24) vs 24% (n = 15) in EO. Conclusion Baseline characteristics, disease location and behavior were similar in AO and EO IBD groups. Use of corticosteroids, biologics and surgery were less frequent in the EO-IBD group (not significant). Whether these findings are related to a shorter disease duration, less severe disease or a more conservative management dictated by age and co-morbidities needs to be explored. Selecting the appropriate treatment option for elderly individuals is an important clinical issue.

Acmella oleracea extract increases collagen content and organization in partially transected tendons.

Acmella oleracea contains spilanthol as the main active compound, which possesses analgesic and anti-inflammatory effects that can favor tendon reorganization. To analyze the effect of A. oleracea on the content and organization of collagen in injured tendons, the calcaneal tendon of male Lewis rats was partially transected and treated at the site of injury with a topical application of 20% A. oleracea ointment (AO group) or with the ointment base without the plant extract (B group). The animals were euthanized 21 days after partial transection. Higher collagen concentration was observed in the AO group than in the B group, and morphological analysis using polarization microscopy showed higher birefringence in the AO group than in the B group, indicating higher collagen organization. No difference was observed in the number of fibroblasts, blood vessels, proteoglycan distribution, and maximum load between the B and AO groups. In conclusion, topical application of 20% A. oleracea ointment increased the molecular organization and content of collagen, thus indicating a potential application in tendon repair. Studies on the later phases of the tendon healing process are necessary to demonstrate the possible biomechanical changes after the application of A. oleracea ointment.

Assessing reinforcing versus aversive consequences in a real-time secondhand smoke intervention.

Few studies have examined the relative effectiveness of reinforcing versus aversive consequences at changing behavior in real-world environments. Real-time sensing devices makes it easier to investigate such questions, offering the potential to improve both intervention outcomes and theory. This research aims to describe the development of a real-time, operant theory-based secondhand smoke (SHS) intervention and compare the efficacy of aversive versus aversive plus reinforcement contingency systems. Indoor air particle monitors were placed in the households of 253 smokers for approximately three months. Participants were assigned to a measurement-only control group (N = 129) or one of the following groups: 1.) aversive only (AO, N = 71), with aversive audio/visual consequences triggered by the detection of elevated air particle measurements, or 2.) aversive plus reinforcement (AP, N = 53), with reinforcing consequences contingent on the absence of SHS added to the AO intervention. Residualized change ANCOVA analysis compared particle concentrations over time and across groups. Post-hoc pairwise comparisons were also performed. After controlling for Baseline, Post-Baseline daily particle counts (F = 6.42, p = 0.002), % of time >15,000 counts (F = 7.72, p < 0.001), and daily particle events (F = 4.04, p = 0.02) significantly differed by study group. Nearly all control versus AO/AP pair-wise comparisons were statistically significant. No significant differences were found for AO versus AP groups. The aversive feedback system reduced SHS, but adding reinforcing consequences did not further improve outcomes. The complexity of real-world environments requires the nuances of these two contingency systems continue to be explored, with this study demonstrating that real-time sensing technology can serve as a platform for such research.

Effect of raw and fermented grape seed on growth performance, antioxidant capacity, and cecal microflora in broiler chickens

Grape seed (GS) is a by-product of the fruit juice and wine industry with the potential to be an alternative to synthetic antioxidants due to its antioxidant activity. Agro-industrial residues can be converted to more effective products by solid-state fermentation. The objective of the study was to investigate the effects of GS and fermented grape seed (FGS) on the growth performance, antioxidant capacity, and cecal microflora in broiler chickens. A total of 128 female broilers were randomly allocated into four treatment groups, each consisting of four replicates of eight birds. Throughout the 42-day feeding period, the birds were fed with soybean-corn based diet (CON), 0.15 g/kg synthetic antioxidant (butylated hydroxyanisole) supplemented diet (AO), 5 g/kg GS supplemented diet (GS), and 5 g/kg FGS supplemented diet (FGS). Dietary GS, FGS, and AO supplementation increased the BW (P < 0.05) and average daily weight gain (ADG, P < 0.05) compared with the CON group in the overall period of 42 days. Dietary FGS also increased the ADG (P < 0.05) in the period of 22–42 days compared with the control group. The pH of the breast meat of the chickens fed GS was higher (P < 0.01) than CON and FGS groups. Dietary FGS and AO decreased the b* value (P < 0.01) of breast meat compared with the CON group. Grape seed had the highest serum glutathione peroxidase (P < 0.05) and catalase (CAT, P < 0.01) levels among the treatment groups. The FGS also increased serum CAT level (P < 0.01) compared with the AO group. Moreover, dietary FGS supplementation increased Lactobacillus spp. (P < 0.05) in the cecum compared with the other treatment groups and decreased Staphylococcus aureus (P < 0.05) compared with the CON and AO groups. The present findings indicate that GS and FGS can be used in broiler diets as alternatives to synthetic antioxidants.

Highly efficient U(VI) capture by amidoxime/carbon nitride composites: Evidence of EXAFS and modeling

The recovery of uranium from wastewater and safe treatment of U(VI)-containing wastewater are of great important to ensure the sustainable development of nuclear-related energy. Although abundant studies of U(VI) sorption on various adsorbents have been widely achieved, U(VI) sorption at extreme pH and trace concentration is challenging issues due to limited sorption activity of natural adsorbents. The development of novel materials with highly efficient and excellent selectivity for capturing U(VI) from nuclear-related wastewater and seawater is highly desirable. In this study, amidoxime/carbon nitride (AO/g-C3N4) was fabricated and captured U(VI) under a variety of water chemistry. We demonstrated that AO/g-C3N4 exhibited the high adsorption capacities (312 mg/g at pH 6.8), fast removal equilibrium (>98% at 10 min) and superior selectivity for U(VI) compared with the other radionuclides (e.g., 19.76 mg/g of Cs(I)). In addition, AO/g-C3N4 exhibited the high uranium extraction capacity from natural seawater (9.55 mg/g at saturation time of 5.5 days) compared to vanadium (1.85 mg/g). U(VI) adsorption behavior at different pH can be excellently fitted by the surface complexation modeling with three inner sphere surface complexes (i.e., SOUO2(CO3)23−, SO(UO2)3(OH)50 and SOUO2+ species). According to XPS (X-ray Photoelectron Spectroscopy) analysis, the strong complexation of U(VI) with AO groups retained in C3N4 nanosheet. The split of U-Oeq2 subshell and the occurrence of U–C shell further demonstrated inner-sphere surface complexation by EXAFS (X-Ray Absorption Fine Structure) spectra analyses. These results revealed that the high potential of AO/g-C3N4 materials for selective U(VI) capture from wastewater and seawater.

Comparison of the effect of rapeseed oil or amaranth seed oil supplementation on weight loss, body composition, and changes in the metabolic profile of obese patients following 3-week body mass reduction program: a randomized clinical trial

BackgroundAmaranth seed oil (ASO) and rapeseed oil (RSO) are functional foods that display antioxidant and hepatoprotective properties. These oils are also known to lower glucose and cholesterol levels. The current study compared the effects exerted by RSO and ASO on weight loss and metabolic parameters during a 3-week body mass reduction program.MethodsEighty-one obese subjects (BMI > 30 kg/m2), aged 25–70 years, were enrolled in a 3-week body mass reduction program based on a calorie-restricted diet and physical activity. Participants were randomly categorized into an AO group (administered 20 mL/d of ASO), a RO group (administered 20 mL/d of RSO), and a C group (control; untreated). Anthropometric and metabolic parameters were measured at baseline and endpoint.ResultsSignificant decreases in weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), fat mass (FM), lean body mass (LBM), visceral fat mass (VFM), and total body water (TBW%) were observed in all groups (P < 0.05). No significant improvements were observed in the clinical parameters of group C. Fasting insulin (Δ − 5.9, and Δ − 5.7) and homeostatic model assessment of insulin resistance (HOMA-IR) (Δ − 1.1 and Δ − 0.5) were decreased in both RO and AO groups, respectively. Fasting glucose (Δ -8.5; P = 0.034), total cholesterol (Δ -14.6; P = 0.032), non-HDL cholesterol (Δ 15.9; P = 0.010), TG/HDL ratio (Δ -0.6; P = 0.032), LDL cholesterol (Δ -12.3; P = 0.042), and triglycerides (Δ -6.5; P = 0.000) were significantly improved in the AO group, compared to the RO group.ConclusionsThe 3-week body mass reduction intervention caused a significant reduction in the weight, BMI, WC, HC, FM, and VFM of all groups. Except for HOMA-IR, there were no statistical differences between the clinical parameters of all groups. However, a trend toward improved insulin levels and HDL% was noticeable in AO and RO. Therapies involving edible oils with high nutritional value, such as RSO and ASO, show potential for improving metabolic measurements during body mass reduction programs. Thus, obese patients undertaking weight reduction programs may benefit from RSO and ASO supplementation.Trial registrationretrospectively registered, DRKS00017708.