Common Treatment Research Articles

Regulating the lncRNA DSCR9/RPLP2/PI3K/AKT axis: an important mechanism of Xinfeng capsules in improving rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic and symmetrical polyarthritis. RA patients often experience inflammatory reaction and hypercoagulable state, which together affect the self-perception of patient (SPP). Currently, inhibiting inflammation and hypercoagulable state are common treatment methods for alleviating RA symptoms. Xinfeng Capsules (XFC) has a long history of treating RA, and can effectively improve the inflammatory response and hypercoagulable state of RA. However, the potential mechanisms have not yet been determined. This study elucidated the action mechanism of XFC in RA inflammation and hypercoagulability through the lncDSCR9/RPLP2/PI3K/AKT axis. Clinical observations indicated that there was a strong link between XFC therapy and improvements in inflammatory and coagulation biomarkers, as well as SPP among RA patients. The subsequent network pharmacology analysis results identified the PI3K/AKT signaling pathway as a potential mediator for XFC treatment of RA. Furthermore, clinical validation and sequencing results revealed that lncRNA DSCR9 expression (a gene implicated in inflammation and coagulation) was negatively correlated with clinical markers of inflammation and coagulation, while positively correlated with SF-36 indicators. Notably, XFC treatment remarkably upregulated lncRNA DSCR9 expression and downregulated PI3K and AKT expressions, showing opposite expression trends to the untreated cases.The regulatory effect of XFC on the lncRNA DSCR9/RPLP2/PI3K/AKT axis in RA was investigated using techniques such as RNA pull-down assay, Western blot analysis, RT-PCR, and EdU assay. Moreover, the administration of the PI3K/AKT agonist RMH can counteract the effects of XFC on p-PI3K, p-AKT, inflammation, and hypercoagulability, reinforcing the role of pathway. Finally, animal studies utilizing HE staining and transmission electron microscopy (TEM) demonstrated that XFC notably decreased PI3K and AKT expressions in adjuvant-induced arthritis (AA) rats, mitigated inflammation and hypercoagulability, and enhanced the ultrastructure of synovial cells. These findings underscored the potential mechanisms of XFC in the treatment of RA. Regulating the lncRNA DSCR9/RPLP2/PI3K/AKT axis may be an important mechanism by which XFC improved RA inflammatory response and hypercoagulable state.

Surgical and Endoscopic Approaches to Management of Submucosal Tumors of the Gastroesophageal Junction: Technical Considerations and Systematic Review of the Literature

Background: Gastroesophageal junction (GEJ) submucosal tumors are comprised predominantly of leiomyomas, followed by gastrointestinal stromal tumors. Methods: Herein we provide a comprehensive review of GEJ submucosal tumors including a systematic review of the literature. Results: Computed tomography, esophagogastroduodenoscopy, and endoscopic ultrasound are the most commonly used diagnostic imaging modalities. Surgical resection via laparoscopy is the most common treatment approach, with simultaneous upper endoscopy utilized in approximately half of the cases. Concomitant fundoplication is performed by certain groups to minimize risk for postoperative leak, gastroesophageal reflux, and esophagitis. Conclusions: Prospective studies evaluating long-term outcomes are needed to help guide treatment.

Sequential super-assembled nanomotor adsorbents for NIR light-Powered blood lead removal

Hemoperfusion is a common treatment for lead poisoning, where hemoperfusion adsorbents are used to remove lead ions from blood. However, traditional hemoperfusion adsorbents often suffer from limited efficiency and poor biocompatibility, reducing their effectiveness for human use. To address these limitations, we developed a novel photothermal nanomotor adsorbent through a controllable sequential super-assembly strategy. Gold nanoparticles (Au NPs) were incorporated into the nanochannels of halloysite nanotubes (HNTs), followed by modification of the outer HNT surface with polydopamine (PDA) and 2,3-dimercaptosuccinic acid (DMSA), forming Au@HNTs@PDA-DMSA. This nanomotor adsorbent leverages the photothermal properties of Au NPs to achieve self-propulsion via thermophoresis under near-infrared (NIR) light irradiation. The performance of this nanomotor was evaluated for Pb(II) removal in both aqueous solutions and human blood samples, reaching adsorption equilibrium within 20 min and a maximum capacity of 45.980 mg/g. The adsorption kinetics followed a pseudo-second-order model with a high fitting coefficient (R2 = 0.999), and the Langmuir model fit better than the Freundlich model, indicating monolayer adsorption. Notably, when driven by 808 nm NIR light at 1.0 W cm−2, the Au@HNTs@PDA-DMSA nanomotors showed a significantly enhanced adsorption capacity of 151.769 mg/g, improving blood lead removal efficiency by 1.80 times compared to non-irradiated conditions. Furthermore, the addition of sulfhydryl and carboxyl groups from DMSA provided more active sites, leading to a 9.76-fold increase in lead removal compared to passive adsorbents using HNTs. In vitro tests confirmed the excellent biocompatibility and biosafety of the nanomotor adsorbent, achieving a blood lead removal rate of 91.25 %. This advancement overcomes the limitations of traditional lead adsorbents, offering a promising solution for more effective lead detoxification in clinical and environmental settings.

Delivering therapy over telephone in a humanitarian setting: a pilot randomized controlled trial of common elements treatment approach (CETA) with Syrian refugee children in Lebanon

BackgroundIn recent years, the number of forcibly displaced persons has risen worldwide, with approximately 40% being children and adolescents. Most of them are hosted in low- and middle-income countries (LMICs). Many individuals meet the criteria for mental health issues, which can also be exacerbated by a number of risk factors, including low socioeconomic status, displacement, and stressors linked to conflicts in their country or region of origin. However, the vast majority never receive treatment for their psychological problems due to multiple reasons, including a shortage of mental health professionals in LIMCs, transportation challenges in accessing clinics, and clinic hours conflicting with family commitments. In the current study we investigated whether individual psychotherapy delivered by trained lay counsellors over telephone to Syrian refugee children living in Lebanon is effective and overcomes barriers to treatment access.MethodsAfter adaptation of Common Elements Treatment Approach (CETA) to remote delivery over telephone (t-CETA), preliminary effectiveness of the treatment modality was assessed with a pilot single blind randomised controlled trial including a total sample of 20 refugee children with diagnosed mental health problems. Data was analysed applying a Bayesian approach.ResultsThere was a significant session-by-session decrease in self-reported mental health symptoms over the course of treatment. Independent assessments showed that t-CETA resulted in a greater reduction of symptoms than standard in-person treatment as usual. There was no difference between groups for impairment. Importantly, the majority of children allocated to t-CETA completed treatment whilst no children in the treatment as usual condition were able to do so.ConclusionThe study provides preliminary evidence that telephone-delivered psychotherapy in a humanitarian setting, delivered by lay counsellors under supervision, works and significantly increases access to treatment compared to traditional in-person treatment. However, findings remain to be replicated in larger trials.Trial RegistrationClinical Trials. gov ID: NCT03887312; registered 22nd March 2019.

An in-Depth Exploration of Consumer and Consumer Representative Views on Chronic Pain Management in Australia: A Key Informant Interview Study

Chronic pain affects millions of Australians. Despite guidelines recommending non-pharmacological approaches as the first line treatment, opioid medications remain among the most common treatments. This study interviewed consumers and consumer representatives (i.e., representatives of peak pain advocacy organizations in Australia) to gain first-hand perspectives on chronic pain treatment in Australia. Individual semi-structured Key Informant Interviews (KIIs) with three consumers and three representatives were undertaken. Interviews were transcribed, and thematic analysis applied. Results showed that consumers and consumer representatives identified critical treatment access barriers. Another shared theme related to overarching principles of care, with sub-themes pertaining to the need for an interdisciplinary approach and pain education. A further shared theme focused on typical medical interventions, with one shared subtheme regarding the benefits and drawbacks of pain medications. Both groups highlighted the importance of a biopsychosocial approach with consideration of mental health, particularly related to perceived stigma and comorbidities. These findings highlight that chronic pain remains both undertreated and inadequately treated in Australia. There is a critical need to use novel approaches to overcome access barriers and stigma, and to advance precision medicine to match patients to the treatment most likely to be of benefit as early as possible in their journey.

Clinical and patient reported treatment outcomes of livedoid vasculopathy: A systematic review

Abstract Livedoid vasculopathy (LV) is a rare condition affecting the lower extremities, often linked to hypercoagulable states or vascular disorders, and despite increasing treatment options, patients frequently experience suboptimal outcomes. Our systematic review of 44 studies, involving 216 patients, found that Rivaroxaban was the most common treatment, with complete (n=18, 31%) or partial (n=40, 68%) ulcer healing and complete pain resolution in the 19% reported, while IVIG also showed promise, though results were mixed. The review highlights the need for further research to identify optimal treatments for LV and establish a standard of care for future clinical trials.

Factors associated with the initiation of high-efficacy disease-modifying agents over moderate-efficacy disease-modifying agents in multiple sclerosis

BackgroundWith multiple treatment options, choosing the initial disease-modifying agent (DMA) could be crucial to managing multiple sclerosis (MS). Common treatment strategies recommend starting patients with moderate-efficacy disease-modifying agents (meDMAs), while others advocate initiating high-efficacy disease-modifying agents (heDMAs). However, limited real-world evidence exists regarding the factors associated with utilizing differing treatment strategies in the MS. ObjectiveThis study evaluated the factors associated with the initiation of heDMAs in comparison to meDMAs among patients with MS. MethodsA retrospective cohort study was conducted using the Merative MarketScan Commercial Claims Database. Adult (18–64 years) MS patients with ≥1 DMA prescription were identified from 2016 to 2019. Patients were classified as incident heDMA or meDMA users based on their earliest DMA prescription, with a 12-month washout period. All covariates were measured during the 12-month baseline before the index DMA date. A multivariable logistic regression model, guided by the Andersen Behavioral Model, was applied to examine the predisposing, enabling, and need factors associated with using heDMAs over meDMAs. ResultsThere were 10,003 eligible MS patients, with the majority of users being female (74.92 %), middle-aged adults (35–54 years, 58.97 %), and enrolled in the Preferred Provider Organization (PPO, 53.10 %) healthcare plan. Overall, 2293 (22.92 %) MS patients initiated heDMAs. The multivariable logistic regression model revealed that male patients (adjusted odds ratio [aOR]: 1.46, 95 % Confidence Interval [CI]: 1.30–1.64) had higher odds of initiating heDMAs. Meanwhile, patients with bladder dysfunction medications (aOR: 1.39, 95% CI: 1.21-1.61), fatigue medications (aOR: 1.77, 95 %CI: 1.44–2.17), and impaired walking (aOR: 1.62, 95 %CI: 1.42–1.86) were more likely to initiate treatment with heDMAs. In contrast, patients with higher Elixhauser comorbidities scores, sensory symptoms (aOR: 0.47, 95 %CI: 0.42–0.53), visual symptoms (aOR: 0.63, 95 %CI: 0.54–0.73), and brainstem symptoms (aOR: 0.81, 95 %CI: 0.67–0.97) were less likely to be prescribed with heDMAs. ConclusionThe study found that approximately one in four MS patients initiated heDMAs. Both demographic and clinical factors influenced the selection of heDMA. More work is needed to understand the differential value of selecting heDMAs over meDMAs for personalizing DMA treatment.

Effect of refrigeration and reheating on the lipid oxidation and volatile compounds in silver carp surimi gels.

As unsaturated and saturated aldehydes, ketones are known to be responsible for off-odors in surimi products, and they are mainly derived from lipid oxidation. Because surimi-based products are rich in unsaturated fatty acids, they are prone to producing off-odors during the refrigeration and reheating processes, which are common treatments for leftovers. The present study investigated the color, lipid oxidation productions, fatty acid profiles and volatile components in surimi gels during refrigeration at 4 °C for 3 days with multiple reheating. The results revealed that the accumulation rate of hydroperoxides was higher in the refrigeration stage, whereas the decomposition rate was higher during reheating in surimi gels. Both refrigeration and reheating treatments promoted conjugated diene values, acid values and carbonyl values. Nevertheless, reheating treatment decreased tohiobarbituric acid reactive substances and whiteness. The contents of unsaturated fatty acids, especially α-linolenic acid, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid, were reduced, whereas the contents of saturated fatty acids increased during refrigeration and multiple reheating. The unsaturated fatty acids were lost as a result of their oxidative deterioration. The volatile components profile showed that the accumulation of volatile components mainly occurred in the refrigeration stage. Multivariate data analysis was utilized to further clarify whether the off-odors in surimi gels were mainly generated in refrigeration. Refrigeration and reheating both contributed to lipid oxidation and the generation of volatile compounds in surimi gels, but the off-odors were mainly generated during refrigeration. This research provides a novel understanding of the formation of food odors in processing. © 2024 Society of Chemical Industry.

Synergic process of molybdenum recovery and ceramic preparation for clean and efficient utilization of industrial leaching residues

Ammonia-leaching residues of roasted molybdenite concentrates are intractable wastes and are mostly stockpiled in factories. Common treatments suffer from low Mo recovery and secondary pollution. This study has developed a synergistic process involving a single-step roasting with the addition of Al2O3 and MoO3 to recover Mo and simultaneously prepare porous refractories from the residues containing 5.6% Mo. The Mo separation efficiency, ceramic properties, and thermal behaviors—including chemical reactions, melting transformations, ceramic structure evolutions, and Mo species migrations—were comprehensively investigated. It was found that the addition of Al2O3 facilitated CaMoO4 decomposition to release volatile MoO3, thus promoting Mo recovery. The mullite started to form at about 900 °C, grew into whiskers, and further into interconnected clusters, under the catalytic effect of liquid MoO3 and the sintering effect of glassy melt. Liquid MoO3 was scattered on the outer surface of whisker clusters, achieving a high separation efficiency of over 98% after roasting at 1300 °C for 150 min. Meanwhile, a ceramic with a high porosity of 64.2% and a high compressive strength of 21.2 MPa was obtained, exhibiting promise for serving as a high-temperature insulation refractory. Overall, this study presents a novel approach for both the profound recovery of Mo and the value-added utilization of gangue minerals derived from CaMoO4-bearing wastes.

Protein nutritional support: The prevention and regulation of colorectal cancer and its mechanism research

AbstractColorectal cancer (CRC) is a common malignant tumor of the digestive tract in China; its incidence rates and mortality rates have been on the rise in recent years, ranking third in terms of incidence and second in mortality. Rational dietary intervention plays an important role in human health, and prevention and adjuvant treatment of CRC through dietary supplementation is the most ideal and safest way to treat the disease at present. More importantly, dietary protein is the basis of our diet and the key nutrient to maintain the normal function of the human body. Therefore, this narrative review delivered an overview of the common causes and therapeutic treatments for CRC. It emphasized the importance of dietary interventions, with a particular focus on elucidating the distinct regulatory impacts of plant proteins, animal proteins, and their mixed proteins.

Wound Healing and Scar Patterning After Addition of Autologous Skin Cell Suspension to Meshed Grafts

IntroductionA common treatment for large deep-to-full-thickness burns is excision and grafting with a widely meshed split-thickness skin graft (mSTSG). Due to the differential healing of the interstices and adhered split-thickness skin graft, wound patterning and delayed wound healing are common outcomes of this treatment. Delayed healing may increase infection rates and wound care requirements, while wound patterning may be psychologically and aesthetically consequential for patients. Autologous skin cell suspension (ASCS) can be used to “over spray” a meshed autograft. It was hypothesized that the use of ASCS combined with mSTSG would increase the rate of wound healing and decrease patterning in healed burn wounds. MethodsFull-thickness burns or excisional wounds (n = 8 each) were created in red Duroc pigs and received 4:1 mSTSGs after wound bed preparation. Half of the wounds received ASCS and half did not at the time of grafting. Percent re-epithelialization, patterning, rete ridge ratio, cellularity, dermal and epidermal thickness, immunofluorescent S100β staining, and melanin index were assessed for each scar. ResultsWounds that received ASCS exhibited increased rates of re-epithelialization (burn +ACSC versus burn-ASCS; day 3 (53.9 ± 3.1 versus 34.3 ± 3.3, P = 0.009): day 5 (68.1 ± 1.6 versus 40.8 ± 3.2, P < 0.001)). Excision +ASCS versus excision-ASCS; day 7 (98.1 ± 1.2 versus 86.4 ± 2.0, day 7 P = 0.022) compared to wounds not treated with ASCS. There was no difference in rete ridge ratio, cellularity, dermal thickness, epidermal thickness, S100β staining, melanin index, or patterning was measured between wounds that received ASCS and those that did not. ConclusionsThe addition of ASCS to 4:1 mSTSGs leads to increased rate of wound healing but does not impact the degree of patterning in this model, suggesting that ASCS application likely robustly transfers keratinocytes but not functioning melanocytes at acute timepoints.

Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID-19.

Nasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS-CoV-2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP-I), and intranasal corticosteroids (INCS) at reducing SARS-CoV-2 NVL and transmissibility. Databases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov. A systematic review was completed with pre-defined search criteria using keywords related to nasal irrigation and COVID-19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in-vivo studies testing nasal irrigation with either saline, PVP-I, or INCS for reducing NVL were included. Nine out of ten studies on saline-based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP-I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP-I. No studies were found on INCS. Saline nasal irrigation showed the best efficacy in reducing SARS-CoV-2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP-I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. Laryngoscope, 2024.

Awareness of Antimicrobial Resistance and Antimicrobial Drugs Prescription Pattern in Small Animal Clinical Practice in Ogun State, Nigeria

Antimicrobial resistance (AMR) is a global health challenge in veterinary and human health, leading to monitoring of resistance and promotion of responsible antimicrobial use. This survey assessed the use of antimicrobials among government veterinarians in Ogun state, Nigeria. Clinicians were requested to fill questionnaires designed to extract information on the frequency of antibiotics use, antibiotic prescription patterns and evaluation of perception on AMR and use of antibiotics with compromised efficacy in veterinary practice in the last three years. Fifty-two (52) questionnaires were administered and duly completed upon return. Data analysis showed 100% awareness of AMR with 80.8% (42/52) agreeing to have encountered AMR in the course of managing small animal cases. The tetracycline class of antibiotics 49(94.2%) was the most prescribed, followed by aminoglycosides 40(76.9%) and fluoroquinolones 35(67.3%). Empirical therapy (34/52) 65.4% is the most common treatment option among clinicians while 18 (34.6%) out of 52 clinicians performed antibiotic susceptibility testing along with laboratory diagnosis as treatment guide. Furthermore, 75.0% of the respondents affirmed administering antibiotics formulated for human use in small animal treatment. Thirty-three (63.5%) respondents administered human antimicrobials in animals according to the recommended dosage in humans. This survey identified that AMR was common in small animals in the state studied and this may be due to the irrational use of antibiotics. Promoting antimicrobial stewardship in small animal medicine therefore is paramount to mitigating antimicrobial resistance and data obtained from this study will contribute to developing evidence-based policy on the rational use of antibiotics in small animal practice in Nigeria.

A New Class of Gold(I) NHC Complexes with Proapoptotic and Resensitizing Properties towards Multidrug Resistant Leukemia Cells Overexpressing BCL-2.

From previous studies, it is evident that metal-organic gold(I) complexes have antiproliferative activities. The aim of this study is not only to find new anticancer agents but also to overcome existing cytostatic resistance in cancer cells. The synthesis and medicinal evaluation of two cationic 1,3-disubstituted gold(I) bis-tetrazolylidene complexes 1 and 2 are reported. To determine apoptosis-inducing properties of the complexes, DNA fragmentation was measured using propidium iodide staining followed by flow cytometry. Gold(I) complex 1 targets explicitly malignant cells, effectively inhibiting their growth and selectively inducing apoptosis without signs of necrosis. Even in cells resistant to common treatments such as doxorubicin, it overcomes multidrug resistance and sensitizes existing drug-resistant cells to common cytostatic drugs. It is assumed that gold(I) complex 1 involves the mitochondrial pathway in apoptosis and targets members of the BCL-2 family, enhancing its potential as a therapeutic agent in cancer treatment.

10. Complex regional pain syndrome.

Complex regional pain syndrome (CRPS) is a clinical disorder that can develop following surgery or trauma. Based on the most prominent underlying pathophysiological mechanisms, CRPS can be classified into different subtypes, namely inflammatory, nociplastic/neuropathic, vasomotor, and motor. Depending on the subtype, personalized treatment can be applied. If conservative treatments are insufficient or ineffective, more invasive treatments may be recommended. This article provides an overview of the most recent insights into CRPS and discusses the most common invasive treatments. The literature regarding interventional treatments for CRPS has been systematically reviewed and summarized. Bisphosphonates are effective in treating the inflammatory subtype, while ketamine can provide pain relief for the nociplastic/neuropathic subtype. Sympathetic blocks are effective in addressing vasomotor disturbances. For patients with refractory symptoms, neurostimulation is a viable option due to its multimechanistic properties for all subtypes. End-of-line motor disturbances may benefit from intrathecal baclofen. CRPS is a debilitating condition with an unpredictable course. The effectiveness of treatment varies from patient to patient. When conservative approaches prove insufficient, gradual progression to invasive treatments based on the underlying subtype is recommended.

Harnessing hazardous wastes: the production, characterization, and performance of controlled low strength materials using common effluent treatment plant sludge

India's rapid industrialization has led to an increase in waste generation, necessitating efficient disposal methods. This research addresses this challenge by exploring the use of Common Effluent Treatment Plant (CETP) sludge, a hazardous waste, in the production of Controlled Low-Strength Materials (CLSM). The study aims to mitigate the environmental impacts associated with CETP sludge disposal while providing a sustainable solution. To assess the feasibility of this approach, an experimental program was conducted with variations in the mix ratio of CETP sludge and slag sand, a byproduct of steel production. The properties of the produced CLSM, such as flowability and unconfined compressive strength (UCS), were thoroughly examined using Scanning Electron Microscopy, X-ray Diffraction, and X-ray Fluorescence analyses. The results reveal that the CLSM produced with CETP sludge and slag sand exhibits promising performance, with excellent flowability and UCS values ranging from 1.8 to 5.5 MPa. This research underscores the potential of waste materials in creating sustainable and environmentally friendly construction materials, contributing to effective waste management practices and sustainable industrial growth.

Assessing antidepressant exposure and response using UK electronic health record data

Objective and ApproachMany people do not respond to antidepressants and our poor mechanistic understanding of antidepressant response has hampered efforts to personalise treatment. Understanding how and when antidepressants work at an individual level requires real-world antidepressant exposure and response data, at scale. To date, studies have rarely had access to sufficiently detailed clinical data at the scales needed to derive such phenotypes and track them longitudinally. Indeed, many studies use research-based measures and phenotypes that are not commonly used in clinical settings, making translation to clinically-applicable tools difficult. This study aims to develop novel measures of antidepressant treatment exposure and response by capitalising on the variety and volume of UK clinical records. We identify cases of depression from national primary and secondary care records, and derive longitudinal antidepressant treatment episodes from national community dispensing data. ResultsFocusing on the Generation Scotland cohort (N = 21,000), we describe common antidepressant treatment trajectories and identify changes in medication, dose and strength. We examine the frequency of drug switching, augmentation, and drug stability, contrasting these to other UK linked cohorts. We also describe the demographic characteristics of those defined as treatment resistant and those identified as in drug maintenance. ConclusionsLinked electronic records provide the opportunity to track antidepressant exposure and response longitudinally. Changes in treatment can provide new measures that help to better understand treatment resistance and maintenance. ImplicationsBy better tracking antidepressant response, the present study helps inform mechanistic research to understand treatment effectiveness and ultimately to develop personalised treatments.

Effect of D,L methionine and ammonium chloride on urine acidification, urinary fractional excretion of calcium, and blood bicarbonate in clinically healthy goats.

Urinary acidification with ammonium chloride (AC) for urolith dissolution is a common treatment for goats with urolithiasis. Studies have reported increased fractional excretion of calcium (FECa) following AC administration, which could increase calcium-based urolithiasis. D,L methionine (MET) may result in similar acidification with less calcium excretion. To compare the effects of orally administered MET and AC on urine and blood pH, FECa, and blood HCO3- concentrations in male goats. Prospective, randomized, crossover study. 12 healthy, 5-to-6-month-old Boer-cross wethers were administered 200 mg/kg of AC or MET orally for 14 days with a 7-day washout period between trials. Venous blood and urine samples were collected every 2 days. The effects of treatment and treatment day on urine and blood pH, HCO3-, and FECa were assessed using linear mixed models. Ammonium chloride and MET lowered least squares means (LSM) urine pH on day 6 (LSM, 7.49; 95% CI, 6.44 to 8.54), 8 (LSM, 7.78; 95% CI, 6.73 to 8.83), and 10 (LSM, 7.53; 95% CI, 6.49 to 8.58) when compared to day 0 (LSM, 8.23; 95% CI, 7.18 to 9.28). Some goats' urine indicated acidification (pH < 7.0) in the first phase of the trial; however, for the entire trial, a significant treatment effect was not detected on urine pH, blood pH, blood HCO3- or log10 FECa. Ammonium chloride and MET acidified urine of some goats. Dietary cation-anion difference should be considered when treating healthy goats to acidify their urine.

Patient-specific finite element analysis of four different fixation methods for transversely unstable radial head fractures

Plate fixation is a common treatment option for radial head fractures (RHFs). Due to the benefits of less invasiveness and fewer complications of internal fixation, the application of small-diameter headless compression screws (HCSs) to treat RHFs has become a new trend. This study aimed to compare the mechanical stability of four distinct internal fixation protocols for transversely unstable RHFs via finite element analysis. Using computed tomography data from 10 patients, we developed 40 patient-specific FE models of transversely unstable RHFs fixed by parallel, crossed, and tripod HCSs and mini-T plate (MTP). Under simulated physiological loading of the elbow joint, the construct stiffness, displacement, and von Mises stresses were evaluated and verified by a biomechanical experiment. Under shear loading, the MTP group exhibited lower construct stiffness, larger displacement, and higher Von Mises stress than the HCSs group. The stiffness of tripod HCSs was greater than parallel and crossed screw fixation techniques. There was a strong relationship between apparent bone density and construct stiffness (R = 0.98 to 0.99). In the treatment of transversely unstable RHFs, HCSs have superior biomechanical stability than MTP. The tripod technique was also more stable than parallel and crossed fixation.

Common odds ratio test and interval estimation for stratified bilateral and unilateral data.

In clinical research, data are commonly collected bilaterally from paired organs or bodily parts within individual subjects. However, unilateral data arise when constraints or limiting factors impede the collection of complete bilateral data. In this article, we propose three large-sample tests and five confidence interval methods for making inferences on the common treatment effect, measured by the odds ratio, in a stratified design under integrated bilateral and unilateral data. Our simulation results show that the likelihood ratio-based and score-based tests, along with their associated confidence interval methods, demonstrate robust control of type I error and close-to-nominal coverage probabilities. We apply the proposed methods to real-world datasets of acute otitis media and myopic eyes to showcase their validity and applicability in clinical practice.