D3 Group Research Articles

Assessment of Laparoscopic Spleen-Preserving Hilar Lymphadenectomy for Advanced Proximal Gastric Cancer Without Invasion Into the Greater Curvature

The survival benefit of laparoscopic total gastrectomy combined with spleen-preserving splenic hilar lymphadenectomy (LSTG) for locally advanced proximal gastric cancer (APGC) without invasion into the greater curvature remains uncertain. To compare the long-term and short-term efficacy of LSTG (D2 + No. 10 group) and conventional laparoscopic total gastrectomy (D2 group) for patients with APGC that has not invaded the greater curvature. In this open-label, prospective randomized clinical trial, a total of 536 patients with clinical stage cT2 to 4a/N0 to 3/M0 APGC without invasion into the greater curvature were enrolled from January 2015 to October 2018. The final follow-up was on October 31, 2021. Data were analyzed from December 2021 to February 2022. Eligible patients were randomized to the D2 + No. 10 group or the D2 group. The primary outcome was 3-year disease-free survival (DFS). The secondary outcomes were 3-year overall survival (OS) and morbidity and mortality within 30 days after surgery. Of 526 included patients, 392 (74.5%) were men, and the mean (SD) age was 60.6 (9.6) years. A total of 263 patients were included in the D2 + No. 10 group, and 263 were included in the D2 group. The 3-year DFS was 70.3% (95% CI, 64.8-75.8) for the D2 + No. 10 group and 64.3% (95% CI, 58.4-70.2; P = .11) for the D2 group, and the 3-year OS in the D2 + No. 10 group was better than that in the D2 group (75.7% [95% CI, 70.6-80.8] vs 66.5% [95% CI, 60.8-72.2]; P = .02). Multivariate analysis revealed that splenic hilar lymphadenectomy was not an independent protective factor for DFS (hazard ratio [HR], 0.86; 95% CI, 0.63-1.16) or OS (HR, 0.81; 95% CI, 0.59-1.12). Stratification analysis showed that patients with advanced posterior gastric cancer in the D2 + No. 10 group had better 3-year DFS (92.9% vs 39.3%; P < .001) and OS (92.9% vs 42.9%; P < .001) than those in the D2 group. Multivariate analysis confirmed that patients with advanced posterior gastric cancer could have the survival benefit from No. 10 lymph node dissection (DFS: HR, 0.10; 95% CI, 0.02-0.46; OS: HR, 0.12; 95% CI, 0.03-0.52). Although LSTG could not significantly improve the 3-year DFS of patients with APGC without invasion into the greater curvature, patients with APGC located posterior gastric wall may benefit from LSTG. ClinicalTrials.gov Identifier: NCT02333721.

Iron Infusions, Their Reactions and Efficacy Related to Dosing - a Single Center Retrospective Study

Background: Intravenous (IV) iron infusions are associated with a variety of adverse drug reactions (ADRs) including anaphylactic reactions. The Commonly used IV iron formulations are Iron sucrose (Venofer), Ferric carboxymaltose (Injectafer), Sodium ferric gluconate complex (Ferrlecit), and others. Iron sucrose has been approved by the FDA (Food and Drug Administration) for patients with iron deficiency who also have kidney disease. It is also often used off-label for iron deficiency anemia on its own. In our facility, multiple ADRs were noted with Venofer compared to other formulations. Hence, we aimed to study: 1. If altering the dose of Venofer will result in a lesser incidence of allergic reactions. 2. To determine if one preparation of IV iron has a higher incidence of adverse events than another. 3. To evaluate the efficacy after 6 to 8 weeks of completion of iron infusions, by comparing the response to various dosages and formulations. Methods: This is a retrospective chart review of 274 patients ages 18-92 who received at least one dose of Intravenous Iron at Einstein Medical Center Montgomery Outpatient Infusion Center from 01/01/21 to 10/31/21. Patients were divided into two groups based on the Venofer dosing schedule. Group D1 included patients that received any IV iron formulation from January to May 2021. In this group, Venofer dosing was 400mg x 1 followed by 300mg x2. Multiple ADRs were noticed in group D1 hence Group D2 was created. This group included patients that received any IV iron formulation from June to October 2021, where Venofer dosing was changed to 300mg x 3 doses or 300mg x 2 followed by 400mg. We collected data on age, gender, race, preparation, strength, pregnancy status, prior history of allergies and transfusion reactions, adverse drug reactions, the timing of reaction, total doses received, pre/post-medications provided to prevent or treat a reaction, outcomes of reaction, hemoglobin, iron studies before and after the infusions. Patient characteristics in both D1 and D2 groups were well balanced. Data were analyzed and summarized in descriptive measures. Efficacy of intravenous iron treatment was measured as a rise in Hemoglobin by 2gm/dl. Results: Out of 120 patients in group D1, 71 patients (59.2%) received Injectafer, out of these, 12 patients (16.9%) had ADRs, the most common reaction was hypotension, and 1 patient had an anaphylactic reaction requiring Emergency Room (ER) visit. Responders in this group were 28/71(39.4%). 10/71 (14.1%) were lost to follow-up. 48 patients (40%) received Venofer, out of which 11 patients (22.9%) had ADRs, the most common being pain in the back, and 2 patients required ER visits. Responders to the infusion in this group were 11/48 (22.9%) with 10/48 (20%) lost to follow-up. 1 patient (0.8%) received ferumoxytol, with no ADRs to report. In the D2 group, which involved a total of 154 patients, 76 patients (49.3%) received Injectafer, out of which 14 patients (18.4%) had ADRs, again the most common being hypotension, and 2 patients required an ER visit. Responders in this group were 29/76 (38.1%) and 10/76 (13.2%) were lost to follow-up. 77 patients (50%) received Venofer, out of which 9 patients (11.7%) had ADRs, the most common being hypotension and this group has not had any ER visits. Responders to the infusion in this group were 36/77(46.8%) and 9/77 (11.7%) were lost to follow-up. 1 patient (0.6%) received Ferumoxytol with no ADRs. [See Table 1]. Conclusions: Injectafer was overall the most used iron formulation in our institution. It was associated with more ADRs when compared to Venofer, including anaphylactic reactions. The most common ADR was hypotension with Injectafer, and back pain with Venofer. We found that Venofer dosing with 400mg x 1 followed by 300mg x2 was associated with the highest incidence of ADRs. Both strategies of Venofer dose modification with 300mg x 3 and schedule modification, 300x 2 followed by 400mg had greater efficacy and lesser frequency of ADRs as compared to Venofer 400mg followed by 300mg x2. Other studies have shown the benefit of Venofer in non-renal disease patients with iron deficiency. Although our study was not planned to demonstrate this outcome, our data may suggest that Venofer is beneficial for this group of patients. This should be looked into with further studies. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Dietary DHA Enhanced the Textural Firmness of Common Carp (Cyprinus carpio L.) Fed Plant-Derived Diets through Restraining FoxO1 Pathways.

Omega-3 fatty acids have a positive effect on the muscle textural firmness of fish, while the intrinsic mechanism is poorly understood. To investigate the potential mechanism of textural modification caused by dietary docosahexaenoic acid ( DHA) in common carp (Cyprinus carpio L.), three plant-derived diets with varying DHA levels (0%, 0.5%, 1%, D1-D3) were prepared to feed juveniles (initial weight 15.27 ± 0.77 g) for 8 weeks, and the muscular texture, fibers density, and transcriptome were analyzed. The results showed that the growth performance, muscular DHA content, fibers density, and texture of the fish fed diets D2 and D3 were significantly ameliorated compared with the fish fed diet D1. The muscular transcriptome profiles indicated that the up-regulated genes of fish fed dietary DHA mainly in response to muscle proliferation, as well as the FoxO pathway, were significantly enriched in the D2 and D3 groups. Consistent with this, the Quantitative Real-Time PCR (qRT-PCR ) assays indicated that the expression of myogenic regulatory factors (myog, myod, mrf4, mrf5) was up-regulated in the high-DHA groups. Additionally, the expression of foxo1 (inhibitor of myofiber development) mRNA was down-regulated, while its negative regulatory pathway (MAPK and PI3K) was activated in the D2 and D3 groups. The results suggested that the DHA supplementation is beneficial to modifying the muscular textural firmness of common carp fed plant-derived diets, which could be attributed to the inhibition of FoxO1 pathways.

Effect of vitamin D3 supplementation on cellular immunity and inflammatory markers in COVID-19 patients admitted to the ICU

Vitamin D as an immunomodulator has not been studied in patients with severe COVID-19. This study aimed to estimate the efficacy of vitamin D3 supplementation on cellular immunity and inflammatory markers in patients with COVID-19 admitted to the intensive care unit (ICU). A single-center, double-blind, randomized, placebo-controlled pilot trial was conducted (N = 110). Patients were randomly assigned to receive a weekly oral dose of 60,000 IU of vitamin D3 followed by daily maintenance doses of 5000 IU (n = 55) or placebo (n = 55). Primary outcomes were lymphocyte counts, natural killer (NK) and natural killer T (NKT) cell counts, neutrophil-to-lymphocyte ratio (NLR), and serum levels of inflammatory markers on 7th day of treatment. On day 7, patients in the vitamin D3 group displayed significantly higher NK and NKT cell counts and NLR than those in the placebo group did. The mortality rate (37% vs 50%, P = 0.16), need for mechanical ventilation (63% vs 69%, P = 0.58), incidence of nosocomial infection (60% vs 41%, P = 0.05) did not significantly differ between groups. Vitamin D3 supplementation, compared with placebo, significantly increased lymphocyte counts, but did not translate into reduced mortality in ICU.Trial Registration: ClinicalTrials.gov Identifier: NCT05092698.

Biomechanical Comparison and Three-Dimensional Analysis of Cement Distribution Patterns for Different Pedicle Screw Designs.

The purpose of this study to explore strategies for reducing cement leakage during cement-augmented pedicle screw fixation, we compared the cement distribution patterns and biomechanical strengths of different types of cement-augmented fenestrated screws and traditional cement-augmented techniques. We compared five screw groups in this study: (1) Cannulated screws (Cann); (2) distal one-hole screws (D1); (3) distal two-hole screws (D2); (4) middle two-hole screws (M2); and (5) traditional screws with a traditional cement injection technique (Trad). The screws were inserted into cancellous bone blocks using a controlled, adequate cement injection pressure (1.6–2.0 kg), and an appropriate cement viscosity. Center to screw tip distance, three-dimensional distribution, and pull-out strength for cement were compared between groups. The average distance between the cement center and the screw tip was highest in the M2 group, suggesting a higher risk of cement leakage into the spinal canal. The Trad group had the highest migration distance in the z-axis, also reflecting a higher risk of leakage into the spinal canal. The D1 group had the highest pull-out strength (253 ± 48.82 N and 797 ± 58.31 N) in bone blocks representing different degrees of osteoporosis, and the D2 group had the second highest pull-out strength in the severe osteoporosis model. Overall, D1 screws appeared to be the best option for optimizing biomechanical function and minimizing the risk of cement leakage into the spinal canal in patients with osteoporotic bone undergoing spinal surgery.

The Benefit of Optimal Dietary Lipid Level for Black Seabream Acanthopagrus schlegelii Juveniles under Low-Salinity Environment.

The present study was aimed at evaluating the regulatory effects of dietary lipid levels on growth performance, osmoregulation, fatty acid composition, lipid metabolism, and physiological response in Acanthopagrus schlegelii under low salinity (5 psu). An 8-week feeding trial was conducted in juvenile A. schlegelii with an initial weight of 2.27 ± 0.05 g, and six isonitrogenous experimental diets were formulated with graded levels of lipid: 68.7 g/kg (D1), 111.7 g/kg (D2), 143.5 g/kg (D3), 188.9 g/kg (D4), 239.3 g/kg (D5), and 269.4 g/kg (D6), respectively. Results indicated that fish fed with diet containing 188.9 g/kg lipid significantly improved growth performance. Dietary D4 improved ion reabsorption and osmoregulation by increasing the concentrations of Na+, K+, and cortisol in serum and activities of Na+/K+-ATPase as well as expression levels of osmoregulation related to gene expression levels in the gill and intestine. The expression levels of long chain polyunsaturated fatty acid biosynthesis-related genes were dramatically upregulated when dietary lipid levels increased from 68.7 g/kg to 189.9 g/kg with levels of docosahexaenoic (DHA), eicosapentaenoic (EPA), and DHA/EPA ratio being highest in the D4 group. When fish fed dietary lipid levels from 68.7 g/kg to 188.9 g/kg, lipid homeostasis could be maintained by upregulating sirt1 and pparα expression levels, whereas lipid accumulation was observed in dietary lipid levels of 239.3 g/kg and over. Fish fed with high dietary lipid levels resulted in physiological stress related to oxidative stress and endoplasmic reticulum stress. In conclusion, based on weight gain, the optimal dietary lipid requirement of juvenile A. schlegelii reared at low-salinity water is 196.0 g/kg. These findings indicate that the optimal dietary lipid level can improve growth performance, n-3 LC-PUFA accumulation, and osmoregulatory ability and maintain lipid homeostasis and normal physiological functions of juvenile A. schlegelii.

Effect of Vitamin D3 Treatment on Genes Expression of Corticotrophin Releasing Hormone (CRH), CRH Receptor 1 (CRH-R1) and Connexin-43 (CON-43) in PHM1-41 Cell Line that Induced by Hypoxia

Introduction: Hypothalamic-Pituitary-Adrenal (HPA) axis activity is one of pathophysiologic mechanism that caused preterm labor. Biologic maternal stress, for instance hypoxia condition, is one of the causes that can trigger preterm birth occasion through the activation of HPA axis. It increases Corticotrophin Releasing Hormone (CRH), CRH receptor 1 (CRH-R1), and Connexin-43 (CON-43) as the trigger of the contraction process. Vitamin D as a source of Ca2+ ion is needed for myometrium smooth muscle’s concentrations and relaxation mechanism. The aim of this study was to determine the effect of vitamin D3 in PHM1-41 cell line. Materials and Methods: The human smooth muscle uterine myometrium cell line PHM1-41 as an in vitro model experimental subject, treated by hypoxia oxidative stress condition and added by vitamin D3 (5, 10, 50 and 150 nM). The dichlorodihydrofluorescein diacetate (DCFDA) fluorescent was used to measure the level of intracellular reactive oxygen species (ROS). In addition, RNA of treated PHM1-41cells was isolated for analyzing gene expressions such as CRH, CRH-R1, and CON-43 as a profile of contractility regulation. Results: ROS level effectively decrease in the cells that treated by 150 nM vitamin D3 group compared to the control hypoxia cell group (7.16 ± 0.23 and 19.49 ± 1.76, respectively). Expression of CRH, CRH-R1, and CON-43 genes are also decrease by treated with 150 nM vitamin D3 to the cells. Pearson (parametric) correlation analysis evidenced a negative correlation between the vitamin D3 additional treated to the lower of ROS level, CRH, CRH-R1, and CON-43 genes expression on PHM1-41 cell line that induced by oxidative stress condition. Conclusion: The concentration of 150 nM vitamin D3 was a prominent potency to prevent the incidence of preterm labor.&#x0D; HIGHLIGHTS&#x0D; &#x0D; Hypothalamic-Pituitary-Adrenal (HPA) axis is one of the causes of preterm birth that marked by high level of intracellular ROS leads to increasing of Corticotrophin Releasing Hormone (CRH) which has significant role in aterm and preterm labor&#x0D; PHMI-41 cells can describe the Corticotrophin Releasing Hormone (CRH), CRH receptor 1 (CRH-R1), and Connexin-43 (CON-43) genes expression level so it was used as model of human pregnancy condition&#x0D; Vitamin D3 is one of antioxidant agent that can decrease ROS level also CRH, CRH-R1, and CON-43 genes expression on PHM1-41 cell especially at doses of 150 nM which shown a prominent potency to prevent the preterm labor incidence&#x0D; &#x0D; GRAPHICAL ABSTRACT

The Feasibility of Choosing D4 Embryo Transfer-Analysis of Nanomaterials Affecting the Outcome of Frozen-Thaw Embryo Transfer.

FET is to resuscitate the endometrium and transfer the embryo into the uterus after the endometrium is ready. The quality of transferred embryos is an important factor affecting the outcome of assisted reproductive technology. This paper aims to explore the feasibility of D4 frozen-thaw embryo transfer and analysis of related factors affecting the outcome of freeze-thaw embryo transfer. A retrospective analysis of the clinical data of 2925 patients who received frozen-thaw embryo transfer (FET) in the Department of Reproductive Medicine, General Hospital of Northern Theater Command from January 1, 2017 to July 31, 2019. Including the woman's age, body mass index (BMI), endometrial thickness on the day of transplantation, number of embryos to be transferred, and type of embryos to be transferred. A single factor, multivariate logistic regression and nomogram were used to analyze the influence of different factors on the clinical outcome of FET. Nanomedicines and related nanomedicines are rapidly developing and establishing their importance in embryo transfer. This paper uses nanomaterials to explore the feasibility of D4 frozen-thawed embryo transfer. The woman's age, endometrial thickness on the day of transplantation, BMI, the number of embryos transferred, and the type of embryos transferred all affect the outcome of FET. The pregnancy rate of the D5 and D4 transplantation groups was, respectively, higher than that of the D3 transplantation group, with statistically significant differences. In the FET cycle, the age of the woman, endometrial thickness on the day of transplantation, the number of embryos transferred, and the type of embryos transferred are all independent factors influencing the outcome of FET. D5 blastocyst is the easiest to get pregnant, and that has the best clinical outcome which is better than the D6 blastocyst group; D4 morula and D5 blastocyst FET have little difference in clinical pregnancy outcomes, but both of them are significantly better than D3 cell embryos, so D4 morula can be considered for transplantation in the FET cycle. In conclusion, whether it is a patient who has failed the fresh cycle transplantation or the whole embryo freezing cycle whose transplantation is canceled due to high hormone levels on the transplantation day, FET is required.

Evaluation of the effect of local administration of PRP vs vitamin D3 on the rate of orthodontic tooth movement and the associated external apical root resorption.

BackgroundIncreased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological agents to accelerate tooth movement has mostly been conducted on animals and there is no reported research conducted on humans comparing the effects of Vitamin D3 and Platelet Rich Plasma (PRP) in the same subjects using a split mouth technique.ObjectivesTo determine and compare effects of local injection of PRP and Vitamin D3 on the rate of tooth movement. Also, to assess association of external apical root resorption with the use of PRP, Vitamin D3 and compare it to a control group.Materials & methods11 subjects who diagnosed with Class I bi-maxillary malocclusion and who gave informed consent were recruited in the study. The patients were randomly divided using split mouth design and each quadrant served as either experimental or control group one. At the beginning of retraction phase, Vitamin D3 and PRP were injected to the randomly assigned quadrants while the contralateral side served as a control. The amount of space closure in 4 months was measured from distal surface of canine to mesial surface of 2nd premolar. Root resorption was assessed using CBCT taken at the beginning and at the closure of retraction phase.ResultsMean rate of tooth movement was higher in PRP and Vitamin D3 groups compared to their controls. In the PRP group, the increased rate of tooth movement was observed throughout the study interval, but in the Vitamin D3 group it was only seen in first two months. Also, the PRP group demonstrated a higher rate of tooth movement compared to Vitamin D3 group. Root resorption was lesser in both experimental groups. Among the teeth assessed, lateral incisor showed maximum root resorption and canine the least.ConclusionsPRP is a more efficient pharmacological agent compared to Vitamin D3 for accelerating tooth movement.

Assessment and Analysis of Stock Market Integration Among the Countries of the D8 Group

The D8 group pursues different goals, and one of the most important ones is in the field of economy and economic development of the member countries. The present study thoroughly assesses financial integration and its effective variants. Due to the relatively low physical capital interruption and the more intrinsic consumption fluctuations, developing economies benefit from financial integration. Four criteria have been used to assess the financial integration among the D8 group: foreign assets, foreign debts, volume criteria, and investment criteria. The data is based on Eviews software, and the least-squares method (EGLS) for 2000-2019 has been analyzed. The present study results confirm the effect of financial development and international trade integration on financial integration, and between the two, based on the estimated model coefficients, the impact of international trade integration on financial integration is more significant. Also, among the three criteria of financial development, the development of the banking sector is not a good measure of the financial development in countries and has less of an impact on D8 Group's financial integration.

Comparison of Intraperitoneal Dexamethasone, Dexmedetomidine, and Dexamethasone–Dexmedetomidine Combination on Postoperative Nausea, Vomiting, and Analgesics Requirement after Gynecological Laparoscopy

Background: Female patients who undergo gynecological laparoscopic surgery are more likely to suffer from postoperative nausea and vomiting (PONV). The study aimed to probe and investigate the effectiveness of intraperitoneal administration of dexamethasone, dexmedetomidine, and combination in reducing the incidence of PONV and postoperative analgesic requirements in laparoscopic hysterectomies. Materials and Methods: One hundred ninety-two female patients undergoing laparoscopic hysterectomies were randomly assigned to four groups. Anesthesia was identical in each group. Patients in the group D1 received dexamethasone 8 mg, group D2 received dexmedetomidine 1 μg/kg, group D3 received dexamethasone 8 mg + dexmedetomidine 1 μg/kg combination, and group D4 received 20 mL normal saline intraperitoneally at the end of the surgery, before trocar removal. The primary outcome was the incidence of PONV experienced by the patients within 24-h postoperative period. Results: In the first 24 h postoperatively, the incidence of PONV was significantly reduced in D1, D2, and D3 groups compared with D4 (P = 0.001); however, there were no significant differences among the three groups. The requirement for rescue antiemetic and rescue analgesic was similar among the groups but significantly decreased compared with the control group (group D4) (P = 0.002 and P = 0.0003, respectively). Conclusion: Intraperitoneal administration of dexamethasone, dexmedetomidine, and a combination of dexamethasone–dexmedetomidine in laparoscopic hysterectomies significantly reduces both PONV and postoperative analgesics requirements compared with the control group.

Effects of Dexmedetomidine Pretreatment, Posttreatment, and Whole-Course Pumping on Myocardial Damage during Cardiac Valve Replacement.

To compare the effects of dexmedetomidine (DEX) pretreatment, posttreatment, and whole-course pumping on myocardial protection during cardiac valve replacement.One hundred and twenty patients undergoing cardiac valve replacement were randomly divided into the follow groups: DEX pretreatment (D1 group), DEX posttreatment (D2 group), DEX whole-course pumping (D3 group), and Control (C group). The concentrations of cardiac troponin I (cTnI), malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α), rate of spontaneous heart rebound after aortic opening, time to heart rebound, incidence of arrhythmia, and use of sufentanil and vasoactive drugs were recorded.Compared with group C, the concentrations of cTnI, MDA, and TNF-α in the D1, D2, and D3 groups were lower, especially in the latter. The time to heart rebound was prolonged in all three groups (P < 0.05). The rate of automatic rebound was increased (P < 0.05) while the incidence of arrhythmia was decreased (P < 0.05) in all groups compared with group C. Group D3 had the highest rate of automatic rebound and the lowest incidence of arrhythmia. Compared with groups C and D2, the use of sufentanil and dopamine was lower in groups D1 and D3 (P < 0.05), especially in the latter.During cardiac valve replacement, DEX pretreatment, posttreatment, and whole-course pumping could have myocardial protective effects. The latter showed better effects.

Persistent or new symptoms 1 year after a single high dose of vitamin D3 in patients with moderate to severe COVID-19.

PurposeThe aim of this study was to investigate the reported persistent or new symptoms 1 year after a single dose of 200,000 IU of vitamin D3 and hospitalization in patients with moderate to severe COVID-19.MethodsThis is a post-hoc, exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial from two hospitals in São Paulo, Brazil, registered in ClinicalTrials.gov, NCT04449718. Discharged patients were followed for up to 1 year and evaluated by telephone interviews at 6 and 12 months. The primary and secondary outcomes were previously published. These post-hoc exploratory secondary outcomes are the persistent or new symptoms and quality of life (QoL) at the post-viral stage of COVID-19. Generalized estimating equations (GEE) for repeated measures with Bonferroni’s adjustment were used for testing outcomes.ResultsBetween 2 June and 27 August 2020, we randomized 240 patients of which 144 were included in this study [the vitamin D3 (n = 71) or placebo (n = 73) group]. The mean (SD) age was 54.3 (13.1) years, and body mass index (BMI) was 32.4 (6.5) kg/m2. Fever demonstrated a significant main effect of time (P < 0.001) with a reduction from baseline to 6 (52–0) and 12 months (52–0). No significant differences between groups were observed for fever, cough, fatigue, fever, myalgia, joint pain, runny nose, nasal congestion, sore throat, hypertension, diabetes, cardiovascular disease, rheumatic disease, asthma, chronic obstructive pulmonary, chronic kidney disease, QoL, and new or persistent symptoms up to 1-year of follow-up.ConclusionThe findings do not support the use of 200,000 IU of vitamin D3 compared to placebo for the management of persistence or new symptoms, and QoL reported by moderate to severe patients after hospitalization for COVID-19.

Dietary fructooligosaccharide and Bacillus licheniformis on growth performance, digestive enzyme, immune indices, and antioxidant capacity of common carp (Cyprinus carpio)

A feeding trial of eight weeks was conducted to investigate the effects of dietary fructooligosaccharide (FOS), Bacillus licheniformis (B. licheniformis) and synbiotic in common carp (Cyprinus carpio). 360 fish averaging 12.5 ± 0.5 g (mean ± SD) were randomly divided into four groups in triplicate. D1 was the control group, feeding the basal diet. Diet 2, 3, 4 (D2, D3, D4) were test groups, adding 0.3% FOS, 1 × 107cfu/g B.licheniformis, and 0.3% FOS with 1 × 107cfu/g B.licheniformis to the basal diets (33.16% crude protein, 6.52% crude lipid and 4.93% ash), respectively. The results showed that the growth parameters such as weight gain, specific growth rate and protein efficiency rate were significantly higher in D4 group compared with the control group. The Feed conversion ratio in D2 and D4 groups had lower values compared to the control group. The intestinal digestive enzymes including protease and lipase were significantly higher in D4 group than that of the control group. On the other hand, aspartate aminotransferase and alanine aminotransferase activities, triglyceride and cholesterol content in the D4 group were significantly decreased compared with D1 group. Furthermore, lysozyme, acid phosphatase activities, and plasma complements (C3 and C4) levels in fish fed D3 and D4 diets were significantly higher than the control group. Additionally, the antioxidant status was improved, that coincided with an increase in superoxide dismutase and catalase activities, Total antioxidative capacity as well as a decrease in malondialdehyde levels in plasma. Overall, these results indicated that dietary supplementation of either individually or in combination (synbiotic) could improve growth, the immune indices, and antioxidant function of Cyprinus carpio. The combinational group showed the better result.

Biochemical indices, gene expression, and SNPs associated with salinity adaptation in juvenile chum salmon (Oncorhynchus keta) as determined by comparative transcriptome analysis.

Chum salmon (Oncorhynchus keta) migrate from freshwater to saltwater, and incur developmental, physiological and molecular adaptations as the salinity changes. The molecular regulation for salinity adaptation in chum salmon is currently not well defined. In this study, 1-g salmon were cultured under 0 (control group, D0), 8‰ (D8), 16‰ (D16), and 24‰ (D24) salinity conditions for 42 days. Na+/K+-ATPase and Ca2+/Mg2+-ATPase activities in the gill first increased and then decreased in response to higher salinity environments where D8 exhibited the highest Na+/K+ATPase and Ca2+/Mg2+-ATPase activity and D24 exhibited the lowest. Alkaline phosphatase (AKP) activity was elevated in all salinity treatment groups relative to controls, while no significant difference in acid phosphatase (ACP) activity was observed across treatment groups. De novo transcriptome sequencing in the D0 and D24 groups using RNA-Seq analysis identified 187,836 unigenes, of which 2,143 were differentially expressed in response to environmental salinity (71 up-regulated and 2,072 down-regulated). A total of 56,020 putative single nucleotide polymorphisms (SNPs) were also identified. The growth, development, osmoregulation and maturation factors of N-methyl-D-aspartate receptors (nmdas) expressed in memory formation, as well as insulin-like growth factor 1 (igf-1) and igf-binding proteins (igfbps) were further investigated using targeted qRT-PCR. The lowest expression of all these genes occurred in the low salinity environments (D8 or D16), while their highest expression occurred in the high salinity environments (D24). These results provide preliminary insight into salinity adaptation in chum salmon and a foundation for the development of marker-assisted breeding for this species.

EFFECTS OF MATERNAL VITAMIN D3 LEVELS DURING PREGNANCY ON PORK QUALITY CHARACTERISTICS OF OFFSPRING PIGS

Introduction. Maternal vitamin D3 levels have long lasting consequences on meat quality and growth performance. The present study was conducted to investigate maternal vitamin D3 status in sows during pregnancy on meat quality attributes, chemical composition, and low field nuclear magnetic resonance (LF-NMR) T2 relaxation times of longissimus dorsi muscle in offspring pigs.&#x0D; Materials and methods. A total of 27 sows (41st day of pregnancy) were randomly allotted to low (LD), normal (ND), and high (HD) dietary vitamin D3 groups (containing 200, 800 and 3200 IU of vitamin D3/kg experimental diet, respectively). In each group were 3 replicates with 3 sows per replicate. From parturition to weaning, all lactating sows fed the ND diet. At 150 days of age, six offspring pigs in each group (2 offspring pigs with similar body weight per replicate, gender balanced) were selected and slaughtered to evaluate pork quality characteristics.&#x0D; Results and discussion. The results showed that maternal vitamin D3 supplementation decreased L*, b* value, shear force, cooking loss, T21 and T22 relaxation times, while increased a* value, pH value, water holding capacity (WHC), crude protein (CP), crude fat (CF), calcium (Ca), and phosphorus (P) content in longissimus dorsi muscle of offspring pigs. These results demonstrated that high-dose maternal vitamin D3 level could improve meat quality characteristics of offspring pigs, and it will provide a scienfific basis for the early nutritional regulation of offspring prok quality.&#x0D; Conclusions. The findings indicated that maternal vitamin D3 supplementation has positive effects on quality characteristics of longissimus dorsi muscle, and improved eating quality of meat in offspring pigs.

210.5: Differential Immunogenicity of mRNA-1273 Versus BNT162b2 as a Third Vaccine Dose for Solid Organ Transplant Recipients Seronegative After Two BNT162b2 Doses.

Introduction: There is no consensus as to the optimal SARS-CoV-2 vaccination sequence in solid organ transplant recipients (SOTRs). Anti-spike antibody response to the two-dose BNT162b2 mRNA vaccine series is poor in SOTRs, and it is possible that the higher-dose mRNA-1273 vaccine could improve immunogenicity in suboptimal responders, who are at high risk for SARS-CoV-2 infection. Methods: We evaluated 114 SOTRs who tested negative on an anti-spike antibody assay after two doses of BNT162b2 and had a third dose (D3) of either homologous BNT162b2 or heterologous mRNA-1273 vaccine. The proportion of seroconversion [WW1] at 1 month post-D3 was compared between groups using Fisher’s exact testing. Additionally, the rate of high-titer response at 1 month post-D3, defined as achieving an antibody level associated with neutralizing capacity versus the ancestral SARS-CoV-2 variant (≥250 binding antibody units), was analyzed using multivariable Poisson regression with robust standard error, adjusting for mycophenolate (MMF) use, age, and years since transplant. Results: Overall, 99 SOTRs received homologous BNT162b2 D3 and 15 received heterologous mRNA-1273 D3. There was no significant difference in age (median 65 [IQR 50-71] vs 63 [58-68] years), sex (59% vs 69% female), time since transplant (median 4 [IQR 2-10] vs 7 [2-15] years), or MMF use (84% vs 80%) between BNT162b2 and mRNA-1273 D3 groups, though calcineurin inhibitor use differed (88% vs 67%, p=0.03). Seroconversion at 1 month post-D3 was similar between BNT162b2 and mRNA-1273 D3 groups (52% vs 53%, p>0.99). However, the mRNA-1273 D3 group was significantly more likely to develop high-titer response at 1 month post-D3 (17% vs 47%, p=0.02). After adjusting for demographic and transplant characteristics, the mRNA-1273 D3 group was 2.71-fold more likely to develop high-titer response at 1 month post D3 (incidence rate ratio [95% CI] 2.71 [1.30-5.64], p=0.008). Conclusion: In SOTRs without initial response to two-dose BNT162b2 vaccination, a heterologous mRNA-1273 D3 showed similar seroconversion rates (~50%) to homologous BNT162b2 D3, but was significantly more likely to generate high-titer responses. Further directions include assessment of COVID-19 breakthroughs among vaccine regimens, as well as exploring the neutralizing capacity and durability of antibody response to heterologous platforms.ASTS Jon Fryer Resident Scientist Award. National Institute of Diabetes and Digestive and Kidney Diseases: T32DK007732 (Dr. Chang), T32DK007713 (Dr. Alejo), K01DK101677 (Dr. Massie), K01DK114388-03 (Dr. Levan), and K23DK115908 (Dr. Garonzik-Wang). National Institute of Allergy and Infectious Disease: K23AI157893 and U01AI138897 (Dr. Werbel) and K24AI144954 (Dr. Segev).

Effect of Black Soldier Fly (Hermetia illucens L.) Fat on Health and Productivity Performance of Dairy Cows.

Simple SummaryWhat is interesting in terms of unlocking the potential of insects is their fuller and more versatile use. Insect larvae contain large amounts of protein and fat. The fat of Hermetia illucens larvae is primarily rich in lauric acid. Lauric acid represents a promising nutritional strategy to improve animal health and productivity. The experimental data we obtained indicate the possibility of using the insect fat for the nutrition of milking cows. The milk production and milk quality of the cows were improved by optimising digestive processes and improving body defenses. The use of fat of Hermetia illucens larvae can serve as an alternative to traditionally used fats of animal and plant origin, as well as preparations of biologically active substances, which will provide a sustainable resource for the diets of agricultural animals in the future.Due to the intensive development of technologies for obtaining protein, energy feed and biologically active supplements from insects, the feasibility and effectiveness of introducing these products into the rations of farm animals require further study. This research aims to study the possibility and effects of feeding dairy cows fat from the larvae of the black soldier fly (BSFLF). The composition and properties of the BSFLF have been studied. The research of the fatty acid composition of BSFLF showed a high content of saturated fatty acids, including 58.9% lauric acid. The experiment was performed on black-and-white cows at the beginning of lactation (control, D0 (n = 12) vs. experimental D10 (n = 12) and D100 (n = 12) groups, 10 and 100 g/head/day BSFLF, respectively. There was no negative effect of BSFLF feeding on the process of feed digestion. The pH of the rumen content decreased (6.80 ± 0.07 & 6.85 ± 0.09 vs. 7.16 ± 0.06, p < 0.05), with an increase in the number of infusoria (0.27 ± 0.03&0.37 ± 0.09 vs. 0.18 ± 0.03 g/100 mL, p = 0.16); there was an increase in the concentration of VFA in the rumen content of animals of the experimental groups by 2.1 (p < 0.05) and 3.81 (p < 0.01) (8.66 ± 0.46 & 10.37 ± 0.42 vs. 6.56 ± 0.29) mmol/100 mL. The average daily milk yield of Group D10 cows over the experimental period (d17–d177) was slightly higher than the control (by 4.9%, p = 0.24 vs. Group D0). At the same time, Group D100 cows showed a significant increase in natural-fat milk compared to controls (by 8.0%, p < 0.05 vs. Group D0) over the same experiment period. Analysis of the fatty acid composition of the milk of the experimental animals showed some changes in the fatty acid composition of milk under the influence of BSFLF feeding; these changes were especially noticeable in Group D10. Thus, it was found that feeding dairy cows BSFLF at different dosages leads to better indicators of pre-gastric digestion and productivity.

The influence of morphologic grading and COS protocol on the outcomes of Day 5 versus Day 6 single fresh blastocyst transfers: a retrospective analysis of clinical outcomes from one center experience.

The purpose of this study was to evaluate whether the blastocyst morphologic grading and the protocol of controlled ovarian stimulation (COS) would influence pregnancy outcomes, aiming to provide guidance when choosing blastocyst transfer. The clinical data of 612 patients who received single fresh blastocyst transfer for first cycle, as well as the data of 253 patients who had already delivered were analyzed retrospectively. The patients were divided into two groups according to blastocyst formation time (D5 or D6). The following subgroup analyses were performed: (i) the morphologic grading of blastocyst and (ii) the protocol of COS. We observed that D5 single embryo transfer (SET) were associated with higher clinical pregnancy rate (CPR, 59.04% vs. 31.73%, P < 0.001) and live birth rate (LBR, 43.90% vs. 24.04%, P < 0.001) than D6 SET following fresh cycle. Patients in D5 group experienced more good blastocysts transfer (45.47%vs. 13.46%, P < 0.001) and less poor blastocysts transfer (9.64%vs. 45.19%, P < 0.001) than patients in D6 group. As to early stage and good quality blastocysts, the CPR and LBR were similar between D5 and D6 group. GnRH antagonist protocol had a demonstrable inferiority comparing with the early-follicular-phase long-acting GnRH-agonist long protocol (EFLL) or the mid-luteal-phase long-acting GnRH-agonist long protocol (MLLL) with regard to the CPR and LBR in D6-SET group. The analysis found that ovarian reserve of patients in D6-SET group was comparatively worse than that of patients in D5-SET group and D6-SET patients represented a subgroup of infertility patients usually having relatively poor embryo quality. The results should be interpreted with caution as the very low numbers in the respective group limited the use of statistical tests and the real significance values.

Cholecalciferol Supplementation Does Not Affect the Risk of HIV Progression, Viral Suppression, Comorbidities, Weight Loss, and Depression among Tanzanian Adults Initiating Antiretroviral Therapy: Secondary Outcomes of a Randomized Trial

BackgroundObservational studies suggest that blood concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with morbidity, viral suppression, and mortality among adults living with HIV. ObjectivesWe evaluated the effect of cholecalciferol (vitamin D3) supplementation on the risk of HIV disease progression, HIV-1 viral suppression, comorbidities, weight change, and depression among HIV-infected individuals that were initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania. MethodsWe conducted a randomized, double-blind, placebo-controlled trial of vitamin D3 supplementation among 4000 HIV-infected adult men and nonpregnant women initiating ART with insufficient serum 25(OH)D concentrations (<30 ng/mL). Participants were randomly assigned to receive either weekly 50,000-IU doses for 4 wk followed by daily 2000 IU vitamin D3 until 1 y or a matching placebo regimen given in weekly followed by daily doses until 1 y. Participants were followed up at weekly visits for the first month followed by monthly visits thereafter. We conducted intent-to-treat analyses to assess the effect of vitamin D3 supplementation on the secondary trial outcomes of HIV progression or death, viral suppression, comorbidities, change in BMI, >10% weight loss, incident wasting, and depression. ResultsDuring follow-up, 345 participants (17.2%) in the vitamin D3 group and 371 participants (18.6%) in the placebo group experienced HIV disease progression or death and there was no difference in risk between groups (RR: 0.91; 95% CI: 0.79, 1.06). Vitamin D3 supplementation did not affect the risk of an unsuppressed HIV-1 viral load (>1000 copies/mL) after 6 mo (RR: 1.10; 95% CI: 0.87, 1.41) and there was also no effect on change in BMI, risk of >10% weight loss, wasting, comorbidities, and depression (P values >0.05). ConclusionsVitamin D supplementation did not affect the risk of HIV progression, viral suppression, common morbidities, weight-related indicators, or depression among adults initiating ART in Tanzania.This trial was registered at clinicaltrials.gov as NCT01798680.