Baseline T0 Research Articles

Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care): study protocol for an exploratory cluster-randomised trial

IntroductionOlder age is associated with multimorbidity, chronic diseases and acute deteriorations and leads to complex care needs. Nursing home residents are more often unnecessarily transferred to emergency departments or hospitals...

An Online Mindfulness Intervention for International Students: A Randomized Controlled Feasibility Trial.

Student mobility across borders poses challenges to health systems at the university and country levels. International students suffer from stress more than their local peers, however, do not seek help or underutilize existing help offers. Some barriers to help-seeking among international students are insufficient information regarding the health offers, stigma, and language, which might be overcome via culturally adapted internet and mobile-based interventions (IMI). A randomized controlled feasibility trial with a parallel design assessed the feasibility and potential efficacy of an online mindfulness intervention adapted for international university students. Participants were randomized into either an adapted online mindfulness intervention (StudiCareM-E) (IG, n = 20) or a waitlist control group (WL, n = 20). Participants were assessed at baseline (t0) and eight-week post-randomization (t1). The feasibility of StudiCareM-E was evaluated regarding intervention adherence, client satisfaction, and potential negative effects. The potential efficacy of StudiCareM-E was measured by means of the level of mindfulness, perceived stress, depression, anxiety, presenteeism, and wellbeing. Efficacy outcomes were evaluated with regression models on the intention-to-treat (ITT) sample (n = 40), adjusting for the baseline values. Participants' formative feedback suggested improvements in the content of the IMI. There were no crucial negative effects compared to WL. Assessment dropout was 35% (IG: 50%: WL: 20%), and intervention dropout was 60%. StudiCareM-E yielded significant improvements in mindfulness (β = .34), well-being (β = .37), and anxiety (β = -.42) compared to WL. StudiCareM-E might be used among culturally diverse international student populations to improve their well-being. Future studies might carefully inspect the extent of the adaptation needs of their target group and design their interventions accordingly.

Effects of a Web-Based Lifestyle Intervention on Weight Loss and Cardiometabolic Risk Factors in Adults With Overweight and Obesity: Randomized Controlled Clinical Trial.

The high proportion of people with overweight and obesity has become a worldwide problem in recent decades, mainly due to health consequences, such as cardiovascular diseases, neoplasia, and type 2 diabetes mellitus. Regarding effective countermeasures, the digitization of health services offers numerous potentials, which, however, have not yet been sufficiently evaluated. Web-based health programs are becoming increasingly interactive and can provide individuals with effective long-term weight management support. The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of an interactive web-based weight loss program on anthropometric, cardiometabolic, and behavioral variables and to compare it with a noninteractive web-based weight loss program. The randomized controlled trial included people who were aged between 18 and 65 years (mean 48.92, SD 11.17 years) and had a BMI of 27.5 to 34.9 kg/m2 (mean 30.71, SD 2.13 kg/m2). Participants (n=153) were assigned to either (1) an interactive and fully automated web-based health program (intervention) or (2) a noninteractive web-based health program (control). The intervention program focused on dietary energy density and allowed for dietary documentation with appropriate feedback on energy density and nutrients. The control group only received information on weight loss and energy density, but the website did not contain interactive content. Examinations were performed at baseline (t0), at the end of the 12-week intervention (t1), and at 6 months (t2) and 12 months (t3) thereafter. The primary outcome was body weight. The secondary outcomes were cardiometabolic variables as well as dietary and physical activity behaviors. Robust linear mixed models were used to evaluate the primary and secondary outcomes. The intervention group showed significant improvements in anthropometric variables, such as body weight (P=.004), waist circumference (P=.002), and fat mass (P=.02), compared with the control group over the course of the study. The mean weight loss after the 12-month follow-up was 4.18 kg (4.7%) in the intervention group versus 1.29 kg (1.5%) in the control group compared with the initial weight. The results of the nutritional analysis showed that the energy density concept was significantly better implemented in the intervention group. Significant differences in cardiometabolic variables were not detected between the 2 groups. The interactive web-based health program was effective in reducing body weight and improving body composition in adults with overweight and obesity. However, these improvements were not associated with relevant changes in cardiometabolic variables, although it should be noted that the study population was predominantly metabolically healthy. German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249. RR2-10.3390/ijerph19031393.

ASSESSING THE EFFECTIVENESS OF PROANECY HEPA MILK FOR PREVENTING AN INCREASE OF BLOOD ETHANOL CONCENTRATION

Aims: This study aimed to investigate whether consuming 6ml/kg of Proanecy Hepa milk prior to alcohol consumption could limit the increase in blood alcohol concentration (BAC). Methods: A self-controlled clinical trial with 6 ethanol pharmacokinetic crossover trials was performed. Ten fasting students were divided into six groups, each receiving different substances before consuming 0.5g of ethanol/kg. The substances administered included Pure water, Alcohol antidote, Proanecy Hepa milk, Proanecy Hepa milk without Silymarin, Silymarin, and Liver support milk. BAC was measured at five-time points using gas chromatography: baseline (t0), 60 minutes (t1), 120 minutes (t2), 180 minutes (t3), and 240 minutes (t4) after alcohol intake. iAUC of blood ethanol were presented as median (interquartile range). Results: The group that consumed Proanecy Hepa demonstrated a significantly lower increase in BAC, as indicated by the incremental area under the curve (iAUC) (170.9, 50.5-470.8), compared to the other groups (p< 0.001). The median iAUC for the remaining groups were as follows: pure water 2885.1 (2405.7-3005.3), alcohol antidote 2973.9 (2744.2-3369.5), Proanecy Hepa without Silymarin 2295.9 (1222.5-2569.4), Silymarin 3411.8 (3006.2-3922), and Liver support milk 2739.4 (2431.8-3149.4). Furthermore, individuals who consumed 6ml/kg of Proanecy Hepa before alcohol intake maintained BAC below the positive threshold of 10 mg/dl at all measured time points (60, 120, 180, and 240 minutes). In contrast, individuals in the control groups exceeded the positive threshold at those time points except for minute 240. Conclusions: The study suggests that consuming 6 ml/kg of Proanecy Hepa milk 30 minutes before consuming 0.5g of ethanol/kg can help prevent blood alcohol levels from exceeding the positive threshold of 10 mg/dl.

Comparative efficacy of topical povidone-iodine and chlorhexidine gel on dental plaque regrowth in toddlers: A randomized controlled trial.

This study aimed to compare and evaluate the efficacy of topical use of povidone-iodine (PVP-I) solution and chlorhexidine (CHX) gel on dental plaque regrowth after 3 and 7 days in toddlers aged 24-36 months. A randomized controlled trial that included 45 healthy toddlers aged 24-36 months, who were randomly assigned to three groups. The first group received a placebo (distilled water (DW)) (negative control). The second group received topical CHX gel (0.2% w/v) (positive control). The third group received topical PVP-I solution (10% w/v). Plaque accumulation was measured at the baseline (t0 ), after 3 days (t1 ) and after 7 days (t2 ) using the Turesky-modified Quigley-Hein plaque index (TMQHPI). Oral hygiene practices were prohibited during the trial period. The trial ID is ACTRN12623000567628. In the DW group, the mean of the TMQHPI score was 1.89 ± 0.67 at t0 and decreased to 1.45 ± 0.66 at t1 (p = .028). Similarly, in the CHX group, the mean of the TMQHPI score was 1.83 ± 1.06 at t0 and decreased to 1.02 ± 0.99 at t1 (p = .033). Regarding the PVP-I group, the mean of the TMQHPI score went from 1.84 ± 0.85 to 1.01 ± 0.61 at t1 and then increased to 1.57 ± 0.74 at t2 . Those changes were statistically significant (p = .001) and (p = .002), respectively. No statistically significant difference was noted between TMQHPI scores at t0 (p = .789). Regarding t1 and t2 , no statistically significant difference was found between the three groups (p > .05). CHX and PVP-I efficacy lasted only for 3 days, and PVP-I was not superior to CHX in terms of plaque control in toddlers. However, further studies are needed to determine the long-term efficacy of these antiplaque agents in toddlers.

Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial

BackgroundAdherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order). MethodsWe randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses. ResultsAnalyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (ηp2 = 0.067–0.077). Time of utilization and number of modules completed did not differ between groups. LimitationsNo placebo control group, short follow-up period, self-report assessment. ConclusionsiCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.

980-P: Quantitatively Integrating Carbohydrate Counting, Insulin (I), and Continuous Glucose Monitoring (CGM)

Introduction: Diabetes Care Education Specialists teach patients with insulin requiring Type 1 and 2 diabetes to develop CHO/I ratios to manage mixed diet glucose (G) excursions and improve A1c. and qualitatively examine summary CGM data when available. Conversely, medical scientists have used complex mathematical models, with/without radiolabeled glucose to describe meal-related glucose excursions. Method: This study bypasses the above complexities as CGM regularly measures interstitial fluid glucose (ISFG) over time. CGM can define an individual’s meal specific G/I ratio as well as define Glucose Clearance (GCL) and Insulin Sensitivity Index (Si}. The approach uses referenced meal carbohydrate information (mg CHO). CGM frames the timing (T = t1 - t0) and amount (I) administered before the timed glucose excursion and return to baseline (t2 - t1). This and an Interstitial fluid (ISF) Volume of Distribution (Vd in dL) = 0.15*kg body weight*10 corrected for blood glucose values defines Timed Insulin Glucose Clearance ((T,I)GCL) = (T,I)Vd/(t2 - t1) and (T,I)Si = (T,I)GCL/I). (ISF) glucose for that meal.: Gisf = dietary glucose (Gd)/1.1. Rate Glucose disappearance from ISF space Gisf/(t2 - t1). Discussion: The above parameters are patient specific and refer to the insulin related glucose disposal for that meal. They assess the glucose excursion using the timing and amount of insulin as well the inferring effect of the other dietary components, e.g., protein and fat that contribute to T, and t2 - t1. It avoids complicated descriptions of the glucose curve as it begins with glucose input. It includes hepatic glucose uptake and glucose production, as well as insulin resistance as these are reflected in prolonging of t1-t0 and t2 - t1. Conclusion: CGM has provided the time values for the onset and duration of the meal-related glucose concentration curve. As with Vg, this will assist a patient to develop individualized (I) responses to complex meals using parameters unavailable before CGM. Disclosure J.S.Melish: None.

Change of iron content in brain regions after intravenous iron therapy in restless legs syndrome: quantitative susceptibility mapping study.

The pathomechanism of restless legs syndrome (RLS) is related to brain iron deficiency and iron therapy is effective for RLS; however, the effect of iron therapy on human brain iron state has never been studied with magnetic resonance imaging. This study aimed to investigate the change of brain iron concentrations in patients with RLS after intravenous iron therapy using quantitative susceptibility mapping (QSM). We enrolled 31 RLS patients and 20 healthy controls. All participants underwent initial baseline (t0) assessment using brain magnetic resonance imaging, serum iron status, and sleep questionnaires including international RLS Study Group rating scale (IRLS). RLS patients underwent follow-up tests at 6 and 24 weeks (t1 and t2) after receiving 1000 mg ferric carboxymaltose. Iron content of region-of-interest on QSM images was measured for 13 neural substrates using the fixed-shaped method. RLS symptoms evaluated using IRLS were significantly improved after iron treatment (t0: 29.7 ± 6.5, t1: 19.5 ± 8.5, t2: 21.3 ± 10.1; p < .001). There was no significant difference in susceptibility values between the controls and RLS patients at t0. In the caudate nucleus, putamen, and pulvinar thalamus of RLS patients, the QSM values differed significantly for three timepoints (p = .035, .048, and .032, respectively). The post-hoc analysis revealed that the QSM values increased at t1 in the caudate nucleus (66.8 ± 18.0 vs 76.4 ± 16.6, p = .037) and decreased from t1 to t2 in the putamen (69.4 ± 16.3 vs 62.5 ± 13.6, p = .025). Changes in the QSM values for the pulvinar and caudate nuclei at t1 were positively and negatively correlated with symptomatic improvement, respectively (r = 0.361 and -0.466, respectively). Intravenous iron treatment results in changes in brain iron content which correlate to reductions in RLS severity. This suggests a connection between symptom improvement and the associated specific brain regions constituting the sensorimotor network.

Effect of orthodontic bonding with different surface treatments on color stability and translucency of full cubic stabilized zirconia after coffee thermocycling.

To assess the color stability and translucency of full cubic stabilized zirconia (FSZ) following orthodontic bonding with different surface treatments and coffee thermocycling (CTC). This in vitro study was conducted on 120 disc-shaped specimens of FSZ. Thirty specimens were selected as the control group and remained intact. The remaining specimens were randomly divided into three groups based on the type of surface treatment (n = 30): airborne particle abrasion (APA), silica-coating (CoJet), and carbon dioxide (CO2) laser. After metal bracket bonding in the test groups, debonding and polishing were performed. Subsequently, all specimens underwent CTC (10,000 cycles). Color parameters, color difference (ΔE00), and translucency parameter (TP) were measured three times at baseline (t0), after debonding and polishing (t1), and after CTC (t2). Data were statistically analyzed (α = 0.05). Significant difference existed among the groups regarding ΔE00t0t2 (p < 0.001). The APA group showed minimum (ΔE00 = 1.15 ± 0.53) and the control group showed maximum (ΔE00 = 0.19 ± 0.02) color stability, with no significant difference between the laser and CoJet groups (p = 0.511). The four groups were significantly different regarding ΔTPt0t2 (p < 0.001). Maximal increases in TP were noted in the CoJet (1.00 ± 0.18) and APA (1.04 ± 0.38) groups while minimal increase was recorded in the control group (0.1 ± 0.02). Orthodontic treatment makes zirconia restorations susceptible to discoloration and increased translucency. Nonetheless, the recorded ΔE00 and ΔTP did not exceed the acceptability threshold.

“Goals in Focus”—a targeted CBT approach for motivational negative symptoms of psychosis: study protocol for a randomized-controlled feasibility trial

BackgroundThe reduction of goal-directed behavior is the main characteristic in motivational negative symptoms of psychosis as it accounts for the long-term decline in psychological well-being and psychosocial functioning. However, the available treatment options are largely unspecific and show only small effects on motivational negative symptoms. Interventions that directly target the relevant psychological mechanisms are likely to be more effective. For “Goals in Focus”, we translated findings from basic clinical research on mechanisms underlying motivational negative symptoms into a tailored and comprehensive novel psychological outpatient treatment program. With this study, we will test the feasibility of the therapy manual and the trial procedures. We also aim to examine first estimates of the effect size that can be expected from “Goals in Focus” to inform the sample size calculation of a subsequent fully powered trial.MethodsThirty participants diagnosed with a schizophrenia spectrum disorder and at least moderate motivational negative symptoms will be randomly assigned to either 24 sessions of “Goals in Focus” over the course of 6 months (n = 15) or to a 6-month wait-list control group (n = 15). Single-blind assessments will be conducted at baseline (t0) and 6 months after baseline completion (t1). Feasibility outcomes include patient recruitment, retention, and attendance rates. Acceptability will be rated by trial therapists and by participants at end of treatment. Primary outcome for effect size estimation is the motivational negative symptom subscale sum score of the Brief Negative Symptom Scale at t1 corrected for baseline values. Secondary outcomes include psychosocial functioning, psychological well-being, depressive symptoms, expressive negative symptoms, negative symptom factor scores, and goal pursuit in everyday life.DiscussionThe feasibility and acceptability data will be used to improve trial procedures and the “Goals in Focus” intervention where necessary. The treatment effect on the primary outcome will provide the basis for the sample size calculation for a fully powered RCT.Trial registration1) ClinicalTrials.gov, NCT05252039. Registered on 23 February 2022.2) Deutsches Register Klinischer Studien, DRKS00018083. Registered on 28 August 2019.

Association of the AAV-PRO questionnaire with established outcome measures in AAV.

The ANCA-associated vasculitis (AAV) patient-reported outcome (AAV-PRO) questionnaire was developed to capture the impact of AAV and its treatment. We investigated the association of specific AAV-PRO domains with disease activity and extent, damage, depression, health-related quality of life, and treatment. In a prospective longitudinal study, AAV-PRO, Beck's depression inventory (BDI), Short Form 36 (SF-36), BVAS and Vasculitis Damage Index (VDI) were completed at baseline (t1) and after 3-6 months (t2). In addition, patient data (including diagnosis, therapies, relapses, and organ manifestations) were recorded. Data were analysed by t-tests and correlation-based regression analyses. A total of 156 patients with AAV participated. The mean BVAS at the time of enrolment was 1.4 ± 3.74. The median AAV-PRO domain scores were higher in patients reporting 'active disease' compared with those reporting 'in remission' (P < 0.001). In the correlation analyses, all AAV-PRO domain scores correlated strongly with the BDI (all r ≥ 0.319, all P ≤ 0.001) as well as with all eight SF-36 subdomains (all |r|≥0.267, all P ≤ 0.001). The regression analyses showed that AAV-PRO domains were strongly predicted by the BDI and SF-36 domains (|β| ≥ 0.240 for the strongest predictor of each domain). In the longitudinal comparison (t1/t2), there were no significant changes in the overall results. Our data show convergent validity for all AAV-PRO subdomains, using the established questionnaires BDI and SF-36. The AAV-PRO domains scores were not correlated with clinician-derived instruments (including the BVAS and the VDI). Thus, we regard the AAV-PRO questionnaire as a valuable measure of outcomes that might complement traditional end-points in clinical trials.

Procrastination Predicts Future Internet Use Disorders in Adolescents but Not Vice Versa: Results from a 12-Month Longitudinal Study.

Use of Internet applications is often associated with postponing real-life obligations. Previous cross-sectional studies have reported a positive association between procrastination and Internet use disorders (IUDs). Further, procrastination is included in theoretical models explaining the development of IUDs. However, little is known about the temporal relationship; thus, longitudinal studies identifying the specific predictive direction are required. Using a cross-lagged panel design, a total of 240 students who were at high risk for IUDs, aged between 12 and 18 years (M = 15.17, SD = 1.66) were assessed at baseline (t1) and reassessed one year later (t2) with standardized measures for IUDs and procrastination. Our results showed that IUD symptom severity at t2 was significantly predicted both by IUD symptom severity at t1 and procrastination at t1. However, procrastination at t2 was predicted only by procrastination at t1 but not by IUD symptom severity at t1. We could not find a reciprocal relationship between procrastination and IUD symptom severity. Procrastination appears to be a causal risk factor for IUDs, but not a consequence. As a modifiable risk factor, procrastination is a promising starting point for preventive and therapeutic interventions for IUDs.

Psycho-Oncological Care Provision in Highly Distressed Breast Cancer Patients.

Objective To evaluate the proportion of breast cancer (BC) patients with distress or psychological comorbidity as well as offer and use of psychological support in subgroups of BC patients with different extents of distress. Methods 456 patients with BC were evaluated at baseline (t1) and until 5 years after diagnosis (t4) at the BRENDA certified BC centers. Logistic regression was used to analyze if patients with distress at t1 received offers and actual psychological support more often than patients without distress at t1. Regression analyses were used to examine if acute, emerging or chronic disease was associated with higher rates of offer and use of psychotherapy as well as intake of psychotropic drugs. Results In 45% of BC patients psychological affection was detected at t4. The majority of patients with moderate or severe distress at t1 (77%) received the offer for psychological service, while 71% of those received the offer for support at t4. Patients, who were psychologically affected at t1, have not been offered psychological services more often than those without, but they significantly more often used services if offered. Especially patients with acute comorbidity received significantly more often an offer for psychotherapy compared to unimpaired patients, while those patients with emerging or chronic disease did not. 14% of BC patients took psychopharmaceuticals. This mainly concerns patients with chronic comorbidity. Conclusion Psychological services were offered to and used by a fair amount of BC patients. All subgroups of BC patients should be addressed, in order to improve the comprehensive supply with psychological services.

Encouragement of patients’ self-management in primary care for the prevention of cardiovascular diseases (DECADE): protocol for a cluster randomised controlled trial

IntroductionCardiovascular diseases are the most common cause of death in Germany and among the most frequent reasons for encounters in primary care. Most patients with cardiovascular risks (CVRs) have difficulties...

The cost of anticipating stigma: a longitudinal examination of HIV stigma and health

ABSTRACT Levels of HIV stigma remain high, however there is a limited understanding around how different types of stigma interact to impact health. This study uses data from two time points to examine how enacted and internalized stigma lead to worse health through anticipated stigma as a mediator. We recruited 341 participants in Ontario, Canada to complete the HIV Stigma Index survey at baseline (t1) from September 2018 to August 2019 and follow up (t2) approximately two years later. Mediation models were created with enacted and internalized stigma at t1 as the antecedents, anticipated stigma at t2 as the mediator, and physical health, mental health, and overall health at t2 as the outcomes. Only the model with internalized stigma (t1) as the antecedent had anticipated stigma (t2) as a significant mediator contributing to both decreased mental and overall health. This highlights the need to address internalized stigma and the potential for anticipated stigma interventions to be effective at improving the health and wellbeing of people living with HIV.

Fascial layers encountered in the lateral skull base region: A cadaveric and radiological analysis.

In our experience, the anterior carotid sheath forms an important plane of dissection when excising temporal bone region cancers. However, its anatomical composition, relationships, and radiological appearance remains unclear. Eight sides of cadaveric heads were dissected. Anatomical findings were correlated with a high-resolution baseline T1 MRI. The anterior carotid sheath was formed by the tensor-vascular-styloid fascia, stylopharyngeal fascia, buccopharyngeal fascia (BPF), and longus capitis fascia (LCF), and appeared as a hypointense line on MRI. Not previously described, the glossopharyngeal nerve pierced the sheath 9.0 mm (SD 2.1 mm) below the skull base and traveled through its LCF and BPF layers to exit near the pharynx. Multiple fascial layers formed the anterior carotid sheath at the skull base, and this was radiologically identifiable. Further studies are required to validate findings and investigate the role this fascial plane has in forming an effective barrier to spread of malignancy.

Multi-arm U-Net with dense input and skip connectivity for T2 lesion segmentation in clinical trials of multiple sclerosis

T2 lesion quantification plays a crucial role in monitoring disease progression and evaluating treatment response in multiple sclerosis (MS). We developed a 3D, multi-arm U-Net for T2 lesion segmentation, which was trained on a large, multicenter clinical trial dataset of relapsing MS. We investigated its generalization to other relapsing and primary progressive MS clinical trial datasets, and to an external dataset from the MICCAI 2016 MS lesion segmentation challenge. Additionally, we assessed the model’s ability to reproduce the separation of T2 lesion volumes between treatment and control arms; and the association of baseline T2 lesion volumes with clinical disability scores compared with manual lesion annotations. The trained model achieved a mean dice coefficient of ≥ 0.66 and a lesion detection sensitivity of ≥ 0.72 across the internal test datasets. On the external test dataset, the model achieved a mean dice coefficient of 0.62, which is comparable to 0.59 from the best model in the challenge, and a lesion detection sensitivity of 0.68. Lesion detection performance was reduced for smaller lesions (≤ 30 μL, 3–10 voxels). The model successfully maintained the separation of the longitudinal changes in T2 lesion volumes between the treatment and control arms. Such tools could facilitate semi-automated MS lesion quantification; and reduce rater burden in clinical trials.

Evaluation of fetoplacental oxygenation in a rat model of gestational diabetes mellitus using BOLD-MRI at 7.0-T

Objective: To compare the differences in blood oxygen level-dependent (BOLD) parameters following maternal hyperoxia between normal pregnancy and pregnancy in the rat model of gestational diabetes mellitus (GDM). Methods: GDM was induced by high-fat and sucrose diet (HFS) combined with an intraperitoneal injection of streptozotocin (STZ). On embryonic day 19 (E19), the two groups of pregnant rats were imaged using a 7.0-T animal MRI scanner. TurboRARE was initially used to localize the fetoplacental units (FPUs). Next, multiple gradient echo BOLD was performed during the air and oxygen inhalation periods. T2* map was then generated, and the baseline T2* and absolute changes in T2* value (ΔT2*, difference between T2*oxy and T2*air) were calculated. Following the MRI scan, the placentas and fetuses were aseptically stripped, weighed, and immunostained. Results: Nine rats were used in this study. After maternal oxygen inhalation, T2* increased significantly in all subjects in both groups. The ΔT2* for the placenta (5.97 vs. 7.81 msec; P = 0.007) and fetal brain (2.23 vs. 3.97 msec; P = 0.005) differed significantly between the GDM and control groups. Histochemical detection of placental glycogen content and inflammatory cytokines (IL-6 and TNF-α) showed significantly higher levels in the GDM than in the normal placenta. Conclusions: BOLD-MRI revealed abnormalities in the fetoplacental response to maternal hyperoxygenation in rats with GDM. We believe that this approach can potentially be used to evaluate placental dysfunction and assess the state of the fetus during pregnancy with GDM.

Effect of obesity on tooth movement using an orthodontic device and changes in inflammatory cytokines, periodontal tissues, and orofacial pain.

This study aimed to investigate the effect of obesity prospectively on tooth movement via an orthodontic device and changes in inflammatory cytokines, periodontal tissues, and orofacial pain. Prospective design in which data was gathered at baseline T0, 1 hour, 24 hours, and 1 week after the application of fixed orthodontic appliances. The total sample size was 60 participants aged between 12 to 18 years and divided into 2 groups based on the inclusion and exclusion criteria. Anthropometrical estimation was made using a bioimpedance meter. A clinical assessment was performed before the application of fixed appliance bonding (T0) one hour after bonding (T1), after 24 hours (T2), and finally after one week (T3). At T0 little irregularity index was assessed, gingival crevicular fluid (GCF) was collected and periodontal examination including probing depth (PD), gingival bleeding (GB), and the presence or absence of calculus were measured. Orofacial pain was assessed at three levels: 1 hours, 24 hours, and 1 week after application of fixed orthodontics using a visual analog scale. For inter-group comparison, Mann-Whitney and t-tests were used and for interphase, comparison cluster analysis was performed. The level of significance was p<0.05. The participants in obese groups were significantly higher in terms of weight, BMI, WHR, FM, and BF than in the non-obese group (p<0.05). Obese participants had significantly more PD 4-5 mm (0.64±0.23 mm) and significantly higher BoP than non-obese participants (0.13±0.10 mm). Little's irregularity index at T0 and T3 showed no significant difference among obese and non-obese participants. The inflammatory cytokines level of IL-β was higher in the obese group compared to non-obese groups. The intensity of orofacial pain was higher in obese participants after 24 hours along with high levels of IL-β pro-inflammatory cytokines before and during orthodontic treatment. No difference was noted in tooth movement in both obese and non-obese during orthodontic treatment in the first week.

Clinicopathologic and gastrointestinal effects of administration of prednisone, prednisone with omeprazole, or prednisone with probiotics to dogs: A double-blind randomized trial.

The efffect of administering of probiotics or twice-daily omeprazole on glucocorticoid-induced gastric bleeding in dogs is unknown. Compare gastrointestinal bleeding among dogs administered placebo, prednisone (2mg/kg q24h), prednisone with omeprazole (1mg/kg q12h), or prednisone with probiotics (Visbiome, 11.2-22.5 billion CFU/kg q24h) for 28 days. Twenty-four healthy research dogs. Double-blinded, placebo-controlled randomized trial. Clinical signs and endoscopic gastrointestinal mucosal lesion scores at baseline (t1 ), day 14 (t2 ), and day 28 (t3 ) were compared using split-plot repeated-measures mixed-model ANOVAs. Fecal score differed by treatment-by-time (F[6,40] = 2.65, P < .03), with higher scores in groups receiving prednisone at t3 than t1 . Nineteen of thirty-three episodes of diarrhea occurred in the prednisone with omeprazole group. Gastric mucosal lesion scores differed by treatment-by-time (F[6,60] = 2.86, P=.05), among treatment groups (F[3,60] = 4.9, P=.004), and over time (F[2,60] = 16.5, P < .001). Post hoc analysis revealed lesion scores increased over time for all groups receiving prednisone. At t3 , scores for the prednisone (8.7 ± 4.9) and prednisone with probiotics (8.7 ± 4.9) groups differed significantly from placebo (1.8 ± 1.8; P ≤ .04), whereas scores for the prednisone with omeprazole (6.5 ± 5.5) group did not differ from placebo (P=.7). Ulcers occurred only in dogs receiving prednisone. Prednisone-induced gastric bleeding. Co-administration of omeprazole partially mitigated bleeding, but a similar protective benefit was not demonstrated by co-administration of the evaluated probiotic.