EB Group Research Articles

162. Comparison of Clinical Risk Factors, Outcomes and Molecular Epidemiology of ESBL and non-ESBL Enterobacterales Bacteremia in Solid Organ Transplant Recipients

Abstract Background Infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales are associated with adverse outcomes in recipients of solid organ transplants (SOTr). This study aims to elucidate the risk factors, outcomes, and molecular epidemiology associated with ESBL Enterobacterales bacteremia (ESBL EB) in abdominal SOTr.Table 1:Risk Factors, Clinical Characteristics and Outcomes Methods This observational cohort study was performed on abdominal SOTr with ESBL EB (cases) and non-ESBL EB (controls) at Henry Ford Health between August 2014 and February 2023. We performed whole genome sequencing on all blood isolates; sequencing libraries were created using +QIAGEN QIAseq FX DNA Library Kit according to manufacturer’s instructions and sequenced on Illumina NextSeq 2000. Fastq files were used to determine the distribution of traits and resistance genes using the 1928 Platform. Demographic, risk factors, clinical characteristics, outcomes and molecular sequence data were evaluated. Primary outcome was 30-day mortality.Figure 1:Percentage of E. coli isolates with resistome mutations Results 56 patients were included: 31 (55%) cases and 25 (45%) controls. Liver and kidney transplant recipients were 28 (58%) and 18 (32%). Median age was 65 years and 54% were female. Risk factors for ESBL EB included liver transplant recipients (p < 0.001), second surgery < 30 days (p=0.01), primary graft dysfunction (p=0.02), and acute rejection < 3 months prior to BSI (p=0.001) (Table 1). Both 30-day (p=0.001) and 90-day (p=0.015) mortality were higher in the ESBL EB group. ST131 (57%) and ST410 (21%) were the predominant sequence types identified in ESBL E. coli isolates. Among ESBL K. pneumoniae, ST16, ST39, ST45, and ST219 were common. Resistome analysis identified β-lactam mutations in all isolates (figure 1 and figure 2). Additional resistance genes that were not phenotypically expressed in ESBL isolates were identified.Figure 2:Percentage of K. pneumoniae isolates with resistome mutations Conclusion Our study demonstrates the high mortality associated with ESBL EB in SOTr and highlights the risk factors and molecular characteristics of these infections. Clinical significance of the additional resistance genes identified needs further investigation. These findings provide insights for targeted management strategies in this high-risk population. Disclosures Mayur Ramesh, MD, AstraZeneca: Advisor/Consultant|Moderna: Advisor/Consultant|Pfizer: Advisor/Consultant

Fetal echogenic bowel may be related to intestinal microbiota: A prospective cohort study.

The purpose of the current study was to determine the difference in intestinal microbiota after delivery between healthy fetuses and fetuses with hyperechogenic bowel during the second trimester and the relationship between fetal echogenic bowel and microbiota. Fourteen healthy fetuses (control group), 13 fetuses with echogenic bowel (EB group), and seven fetuses with echogenic bowel and other abnormalities (C-EB group) were selected. The first meconium after delivery was collected for 16S rRNA sequencing. A total of 1 222 131 high-quality sequences were generated after sequencing optimization of all samples. Each sample contained an average of 35 945 high-quality sequences and 2036 operational taxonomic units (OTUs). There was no significant difference in the Shannon, Simpson index among the three groups. At the genus level, the abundance of Escherichia coli/Shigella in the EB and C-EB groups was significantly lower than the control group, while the abundance of Staphylococcus, Methylobactrium, and Curvibacter in the EB group was significantly higher than the other groups. There was a difference in abundance of Gammaproteobacteria, Fusobacteria, Enterobacteriaceae, and E. coli in the EB and C-EB groups. The formation of echogenic bowel may be related to the microbiota.

Reproductive outcomes in Holstein heifers synchronized with timed-AI protocols that provide for a lengthened proestrus.

This study compared reproductive outcomes among two protocols for synchronization of ovulation that provide for a lengthened proestrus with the conventional oestradiol-based protocol currently used for timed-AI (TAI). Holstein heifers (13-15 months) at one location were assigned randomly to one of three TAI protocols. Heifers (n = 150) in the 7-day oestradiol benzoate (EB) group received a progesterone device (Cue-Mate) and 2 mg EB on Day 0; 500 μg of cloprostenol (PGF) and Cue-Mate removal on Day 7; 1 mg of EB on Day 8 and TAI on Day 9 (54 h after Cue-Mate removal). Heifers (n = 150) in the 5-day CO-Synch (CO) group received a Cue-Mate and 100 μg of gonadotropin-releasing hormone (GnRH) on Day 2; Cue-Mate removal and PGF (twice, 12 h apart) on Day 7; and GnRH along with TAI on Day 10 (72 h after Cue-Mate removal). Heifers (n = 150) in the J-Synch (JS) group received a Cue-Mate and 2 mg of EB on Day 1; PGF and Cue-Mate removal on Day 7; GnRH and TAI on Day 10 (72 h after Cue-Mate removal). Heifers were inseminated by one technician with frozen-thawed conventional semen from one of four commercially available sires. Plasma progesterone (P4) concentrations (ng/mL) were determined at Cue-Mate removal and TAI. Ovarian ultrasonography was done in a subset of 217 heifers at the initiation of protocols, at Cue-Mate removal; TAI; and 7 days after TAI. Approximately, 28 and 50 days after TAI pregnancy status was determined by ultrasonography. Mean (±SEM) plasma P4 concentration at Cue-Mate removal was greater (p < .01) in CO (6.02 ± 0.2) and JS (6.51 ± 0.2) compared to EB heifers (4.53 ± 0.2). Mean (±SEM) plasma P4 concentration at TAI was lowest in the JS (0.28 ± 0.05), intermediate in CO (0.46 ± 0.02), and greatest in EB heifers (0.66 ± 0.05, p < .01). The diameter of the ovulatory follicle (mean ± SEM) was the smallest in the JS group compared to that in the CO and EB groups (15.8 ± 0.5; 13.9 ± 0.5; and 12.7 ± 0.5 mm for EB, CO and JS, respectively). More (p < .01) heifers in the JS group had their oestrous cycle synchronized (50.0, 78.8 and 82.4% for EB, CO and JS groups), and were pregnant at 28 (40.3, 51.3 and 63.3% for EB, CO and JS groups) and 50 days after TAI (32.6, 46.0 and 60.0% for EB, CO and JS groups). In summary, heifers subjected to the J-Synch TAI protocol had lower P4 at TAI, and better overall response to hormonal treatments, which resulted in increased P/AI at 28 and 50 days after TAI compared to those heifers subjected to either a 7-day EB protocol or a 5-day CO-synch protocol.

Effect of Polishing Systems on the Surface Roughness and Color Stability of Aged and Stained Bulk-Fill Resin Composites.

The aim of this study is to investigate how two different polishing techniques affect the color stability, surface roughness, and changes in surface morphology of aged and coffee-stained bulk-fill resin composites. A total of 112 disc-shaped samples were prepared using Omnichroma Flow Bulk (OB), Charisma Bulk Flow One (CB), Estelite Bulk Fill Flow (EB), and Estelite Sigma Quick (control). Samples were divided into two subgroups (n = 16) and aged using thermocycling. A profilometer was used to measure the surface roughness (Ra) and a spectrophotometer was used for color stability (ΔE00). The EB group had the highest Ra values both before aging (disc: 0.23 ± 0.05, twist: 0.42 ± 0.05) and after aging (discs: 0.28 ± 0.04, twist: 0.46 ± 0.05). The OB group had the highest ΔE00 values before and after aging (discs: 3.06 ± 0.54, twist 3.05 ± 0.41) and the highest after coffee-staining (discs: 3.75 ± 0.70, twist: 3.91 ± 0.57). Re-polishing reduced the ΔE00 values in all materials but did not restore all to clinically acceptable levels. According to the results of this study, it can be concluded that the surface roughness and color stability of resin composites are notably influenced by the polishing technique, aging process, and coffee staining. Specimens that were polished using the multi-stage Super-Snap discs consistently exhibited smoother surfaces across all bulk-fill resin composites compared to those polished with the two-stage Diacomp plus Twist.

Early attentional processing and cortical remapping strategies of tactile stimuli in adults with an early and late-onset visual impairment: A cross-sectional study.

Neuroplastic changes appear in people with visual impairment (VI) and they show greater tactile abilities. Improvements in performance could be associated with the development of enhanced early attentional processes based on neuroplasticity. Currently, the various early attentional and cortical remapping strategies that are utilized by people with early (EB) and late-onset blindness (LB) remain unclear. Thus, more research is required to develop effective rehabilitation programs and substitution devices. Our objective was to explore the differences in spatial tactile brain processing in adults with EB, LB and a sighted control group (CG). In this cross-sectional study 27 participants with VI were categorized into EB (n = 14) and LB (n = 13) groups. They were then compared with a CG (n = 15). A vibrotactile device and event-related potentials (ERPs) were utilized while participants performed a spatial tactile line recognition task. The P100 latency and cortical areas of maximal activity were analyzed during the task. The three groups had no statistical differences in P100 latency (p>0.05). All subjects showed significant activation in the right superior frontal areas. Only individuals with VI activated the left superior frontal regions. In EB subjects, a higher activation was found in the mid-frontal and occipital areas. A higher activation of the mid-frontal, anterior cingulate cortex and orbitofrontal zones was observed in LB participants. Compared to the CG, LB individuals showed greater activity in the left orbitofrontal zone, while EB exhibited greater activity in the right superior parietal cortex. The EB had greater activity in the left orbitofrontal region compared to the LB. People with VI may not have faster early attentional processing. EB subjects activate the occipital lobe and right superior parietal cortex during tactile stimulation because of an early lack of visual stimuli and a multimodal information processing. In individuals with LB and EB the orbitofrontal area is activated, suggesting greater emotional processing.

Analysis of Clinical Features, Prognostic Characteristics and Gene Mutations of the EB Subtype of Primary Myelodysplastic Syndrome Patients with Myelofibrosis

Objective ：This study aims to analyze the clinical features, prognostic characteristics and gene mutations of the primary myelodysplastic syndrome with myelofibrosis (MDS-MF) patients, to compare the differences and impact of MF on MDS-EB group and MDS-Non-EB group, ultimately to improve the cognition of MF on MDS-EB group. Methods ：From January 1, 2013 to February 1, 2020, 417 newly diagnosed primary MDS patients in the first affiliated hospital of Zhejiang University with bone marrow (BM) biopsy examination were included. They were divided into two groups (MDS-EB group and MDS-Non-EB group) according to 2016 WHO MDS classification.BM was reassessed on whether associated with fibrosis in grade MF0,1,2,3. (2005 European Myelofibrosis Network criteria). The clinical features, prognosis characteristics and gene alterations were analyzed between the MDS-EB group and MDS-Non-EB group retrospectively. Results ： ① MF was confirmed in 46.3％（193/417）cases of all the MDS patients, of which 66.3％（128/193）were MF-1 , 25.9％（50/193）were MF-2 and 7.8%(15/193) were MF-3 respectively. Compared with MDS-MF0 group, MDS-MF were significantly associated with worse OS(P=0.035) and worse PFS(p&amp;lt;0.001). ② There was 174 cases of MDS-EB and 243 cases of MDS-Non-EB. The proportion of MF in MDS-EB group was 54.0%(94/174) and significantly higher than in MDS-Non-EB group 40.7%（99/243）(p=0.010).The distribution of MF grade was also differently significant between the two groups(p=0.048). The clinical features analysis showed that there is higher level of C-reactive Protein (CRP), higher level of serum lactate dehydrogenase (LDH) and higher level of β2-microgram in the peripheral blood in the MF(MF1,2,3) group than in the MF0 group, regardless of whether it was in the EB group or the non-EB group. The difference was statistically significant (ALL p value&amp;lt;0.05). ③The impact of MF on MDS-EB patients and MDS-Non-EB patients has different significances concerning OS, PFS and t-AML. As far as the OS prognostic factor, no matter the comparison of MF0, 1,2,3 four groups, the comparison MF1,2,3 three groups, the comparison of MF0-1 with MF2-3, all showed that MF was an adverse prognostic factor in the EB-MF group (All p value &amp;lt;0.05), and it also showed the adverse impact related with the grade of MF, but none of any in the MDS-Non-EB group (All p value&amp;gt;0.05)(Figure1). Comes to the PFS, it showed the MF on MDS-Non-EB was an inferior factor when compared MF+(MF1,2,3) to MF-(MF0)(p=0.0097), but not between the comparison MF1,2,3 groups(p=0.96) and none of the MDS-EB groups（p=0.31 and 0.092 respectively）. The incidence of MF was related with a higher rate of t-AML not only in MDS-EB group but also in MDS-Non-EB group compared with MF0, no matter compared the MF+(MF1,2,3) with MF-(MF0) but also the comparison of MF0,1,2,3) (All P value &amp;lt; 0.001). ④ In the MDS-EB cohort, 66 patients in the MF-(MF-0) group completed Next-generation-sequencing (NGS) test, and 61 patients in the MF+ (MF1,2,3) group completed NGS testing. It seems that the incidence of gene mutation has no difference between the two groups. We conducted univariate COX regression analysis about the 30 genes (which were suggested in the NCCN guideline 2020) with OS, PFS and t-AML in the MDS-EB-MF cohort. The results showed that TP53, Nras, WT1 was related to the worse OS; U2AF1, Niras and TP53 was related to worse PFS and GATA2, IDH2, TP53, STAG2 was related to t-AML. Conclusion: MDS-MF has unique laboratory and clinical characteristics, act as an independent risk factor for shorter OS and worse PFS in the MDS-MF patients in our large cohort. In this study, we retrospectively analyzed 417 primary MDS cases in our hospital and analyzed the impact of MF on MDS-EB group and MDS-Non-EB group respectively. Our results showed the MF has a worse OS on the MDS-EB-MF group than the MDS-EB-MF0 group but no impact on MDS-Non-EB cohort. It was also consistent with the 5th edition of the WHO Classification of Haemato-lymphoid Tumors guidelines in which MDS-f was listed as a subtype concerning MDS with fibrosis concomitant with 5-19% blast cells in bone marrow or 2-19% blast cells in peripheral blood. The NGS sequencing showed TP53, Nras, WT1 was related to the worse OS; U2AF1, Niras and TP53 was related to worse PFS and GATA2, IDH2, TP53, STAG2 was related to t-AML.As far as we know, this is the first analysis of bone marrow fibrosis in MDS-EB patients. We need more research to help us understand the MDS-f subtype.

Plasma estradiol profile after administration of different types of estradiol esters in acyclic mares.

Although the use of different estradiol esters has been extensively studied in hormonal protocols in cows, such information is lacking in mares. The present study aimed to assess the effects of treatment with the same doses and administration frequency of estradiol cypionate, estradiol benzoate and 17β estradiol on plasma estradiol (E2) concentrations of acyclic mares and correlate the E2 profile to the endometrial edema score. Sixteen treatments were performed in 14 mares randomly divided into three groups: EB (n=5), EC (n=5) and 17β (n=6), receiving 10mg on day 0 (D0), 6mg on D1 and 4mg on D2 of estradiol benzoate, estradiol cypionate, and estradiol 17β, respectively. Blood samples, rectal palpations and ultrasound evaluations were performed once daily, starting before the first estradiol treatment (D0) until edema disappearance or D8. Moderate to high edema was observed in all groups 24h after the first estradiol administration. Edema persisted above score 2 until D7, D5 and D4 in groups EC, EB and 17β, respectively. Higher edema was found on D2 in EB group compared to 17β, on D6 and D7 in EC compared to 17β, and on D8 in EC compared to EB (p≤0.05). Maximum E2 concentrations were detected on D1 in groups: EB, showing a sharp decrease from D2 to D3 (p<0.0001); and 17β, where no differences were observed between treatment days (p≥0.05). In the EC group, maximum concentrations were observed on D2, which remained high from D2 to D4 compared to the other days (p<0.0001). Plasma concentration of E2 was higher in EB than the other groups on D0 and D1, and EB>EC>17β on D2. Plasma E2 concentrations and edema score were positively correlated, being moderate in groups EB and EC and weak in the 17β group. In conclusion, the most pronounced plasma E2 concentration was observed in EB group 24h after the administration of the first dose. Estradiol concentrations peaked 48h after EC administration, while a distinct peak was not observed in a 24h interval evaluation in the 17β group. Moreover, high edema does not necessarily reflect on high E2 concentrations in acyclic mares.

Transcriptome and hypoxia-responsive gene expression analyses reveal the physiological reaction to acute hypoxia and reoxygenation in Epinephelus coioides

Dissolved oxygen (DO) is crucial for fish farming, and when fish experience hypoxic stress, negative effects such as the disruption of normal physiological activities, a decline in aerobic swimming ability, and feeding restriction will occur. In this study, healthy Epinephelus coioides individuals were subjected to hypoxic (DO = 0.6 ± 0.1 mg/L) and reoxygenation treatments (DO = 6.0 ± 0.1 mg/L), with a normoxic group (DO = 6.0 ± 0.1 mg/L) set as the control. Transcriptome sequencing (RNA-seq) was performed on the brains of E. coioides in hypoxia-sensitive (EBW), hypoxia-tolerant (EBS), and normoxic control (CB) groups. In total, 1174 differentially expressed genes (DEGs) were screened from the three groups. KEGG analysis revealed several pathways, including the HIF-1 signaling pathway, and immune-related pathways such as MAPK signaling, microRNAs (miRNAs), and oxidative phosphorylation pathways enriched in the EBS group, and cAMP signaling pathway enriched in the EBW group. Moreover, a variety of significant hypoxia-responsive DEGs involved in energy metabolism and immune reactions were identified in the EBS and EBW groups. qRTPCR analysis showed that the key DEGs HIF-1α, LDH-A, PPARα, PNP, RAB13, DDIT4, TNF-1, and ALDOA were significantly upregulated in the brain tissues of E. coioides under acute hypoxic stress and that their expression returned to normoxic levels after reoxygenation, indicating that they provided energy to the organism and regulated severe damage and lesions appearing in the brains of E. coioides during hypoxic stress to prolong the survival time of the organism. Altogether, these results suggest that hypoxia disrupts the expression patterns of multiple genes in E. coioides and that these genes may participate in resistance and adaptation to hypoxia in the organisms by regulating apoptosis, proliferation, differentiation, and energy metabolism.

Hyperimmune egg yolk antibodies developed against Clostridium perfringens antigens protect against necrotic enteritis

Necrotic enteritis (NE) is a widespread infectious disease caused by Clostridium perfringens that inflicts major economic losses on the global poultry industry. Due to regulations on antibiotic use in poultry production, there is an urgent need for alternative strategies to mitigate the negative effects of NE. This paper presents a passive immunization technology that utilizes hyperimmune egg yolk immunoglobulin Y (IgY) specific to the major immunodominant antigens of C. perfringens. Egg yolk IgYs were generated by immunizing hens with 4 different recombinant C. perfringens antigens, and their protective effects against NE were evaluated in commercial broilers. Six different spray-dried egg powders were produced using recombinant C. perfringens antigens: α-toxin, NE B-like toxin (NetB; EB), elongation factor-Tu (ET), pyruvate:ferredoxin oxidoreductase, a mixture of 4 antigens (EM-1), and a nonimmunized control (EC). The challenged groups were either provided with different egg powders at a 1% level or no egg powders (EN). The NE challenge model based on Eimeria maxima and C. perfringens dual infection was used. In Experiments 1 and 2, the EB and ET groups exhibited increased body weight gain (BWG; P < 0.01), decreased NE lesion scores (P < 0.001), and reduced serum NetB levels (P < 0.01) compared to the EN and EC groups. IgY against NetB significantly reduced Leghorn male hepatocellular cytotoxicity in an in vitro test (P < 0.01). In Experiment 3, the protective effect of the IgYs mixture (EM-2) against C. perfringens antigens (NetB and EFTu) and Eimeria antigens (elongation factor-1-alpha: EF1α and Eimeria profilin: 3-1E) was tested. The EM-2 group showed similar body weight, BWG, and feed intake from d 7 to 22 compared to the NC group (P < 0.05). On d 20, the EM-2 group showed comparable intestinal permeability, NE lesion scores, and jejunal NetB and collagen adhesion protein levels to the NC group (P < 0.05). In conclusion, dietary mixture containing antibodies to NetB and EFTu provides protection against experimental NE in chickens through passive immunization.

The CREPE Score: A Predictive Tool for Third-Generation Cephalosporin-Resistant Enterobacterales Pneumonia in Community Settings.

To evaluate risk factors and develop a prediction score for community-acquired pneumonia caused by third-generation cephalosporin-resistant Enterobacterales (3GCR EB-CAP). A retrospective study was conducted by reviewing the medical records of patients hospitalized with community-acquired pneumonia caused by Enterobacterales (EB-CAP) between January 2015 and August 2021 at Srinagarind Hospital, Khon Kaen University, Thailand. Logistic regression was used to analyze clinical parameters associated with 3GCR EB-CAP. The coefficients of significant parameters were simplified to the nearest whole number for a prediction score, called the CREPE (third-generation Cephalosporin Resistant Enterobacterales community-acquired Pneumonia Evaluation). A total of 245 patients with microbiologically confirmed EB-CAP (100 in the 3GCR EB group) were analyzed. Independent risk factors for 3GCR EB-CAP included in the CREPE score were (1) recent hospitalization within the past month (1 point), (2) multidrug-resistant EB colonization (1 point), and (3) recent intravenous antibiotic use (2 points for within the past month or 1.5 points for between one and twelve months). The CREPE score had an area under the receiver operating characteristic curve (ROC) of 0.88 (95% CI 0.84-0.93). Using a cut-off point of 1.75, the score had a sensitivity and specificity of 73.5% and 84.6%, respectively. In areas with high prevalence of EB-CAP, the CREPE score can assist clinicians in selecting appropriate empirical therapy and reducing overuse of broad-spectrum antibiotics.

A new type of elastic fixation, using an encircling and binding technique, for tibiofibular syndesmosis stabilization: comparison to traditional cortical screw fixation

BackgroundThe distal tibiofibular syndesmosis (DTS) is a complex fibrous joint that contributes to the stability and weight-bearing function of the ankle. As such, repair of DTS injury is required, providing fixation strength while maintaining ankle range of motion. The aim of this study was to compare a new elastic fixation technique, using an encircling and binding technique, for DTS stabilization, compared to the traditional cortical bone screw fixation.MethodsThis was a retrospective analysis of 67 patients treated for a DTS injury at our hospital, between June 2019 and June 2021. Of them, 33 were treated with encircling and binding (EB group) and 34 using a cortical screw (CS group). The following outcomes were compared between groups: time to inferior tibiofibular fixation; length of hospital stay; time to partial weight bearing; time to complete weight bearing; complications; imaging data; and functional scores.ResultsSuccessful stabilization was achieved in all cases, with a mean follow-up period of 15.78 ± 2.97 months. Time to fixation and time to partial and complete weight bearing were shorter for the EB than that for the CS group. The length of hospital was not different between groups. With regard to complications, a superficial infection developed in one patient in each group, with wound healing achieved after active treatment. Screw fracture occurred in two patients in the CS group. At 3 months post-surgery, the American Foot Surgery Association Ankle-Hindfoot score (AOFAS) was higher and the pain score lower for the EB than that for the CS group, but with no between-group difference at the final follow-up. On imaging, the tibiofibular clear space and tibiofibular overlap were not different between groups.ConclusionsDTS fixation using encircling and binding yielded better clinical and functional outcomes than did cortical screw fixation at 3 months post-surgery, with no difference at the final follow-up. This novel fixation technique provides firm fixation, combined with earlier return to postoperative exercise and recovery of ankle function.

Epidermolysis bullosa in oral health: clinical manifestations and salivary alterations.

To evaluate clinical manifestations of EB on the oral mucosa and alterations in salivary flow. Sociodemographic and clinical data were obtained from EB individuals. The salivary flow analysis was performed in EB and in non-EB patients. Fischer's exact test was applied to the qualitative variables, and the Mann-Whitney test was applied to the quantitative data. A total of 11 cases of EB were evaluated, and 3 types of EB were diagnosed (recessive dystrophic-RDEB; junctional-JEB; and simplex-EBS). Only individuals with RDEB or JEB showed the oral manifestation of the disease. The most affected sites were the lips (54%), hard palate (36%), and oral mucosa (27%). Ulcer and ankyloglossia were diagnosed in all RDEB cases. Regarding salivary flow, an intragroup comparison revealed an increase in stimulated versus unstimulated collection in the control sample (p = 0.0064). The EB group showed no difference (p = 0.6086). We also observed no differences in salivary volume between the control and EB groups (p = 0.7117 and p = 0.5557, unstimulated and stimulated flows, respectively). No oral manifestations were observed in EBS subjects. It is unclear whether individuals with EB are predisposed to manifest hyposalivation. Severe cases of EB show broad alterations in the oral mucosa, whereas the saliva needs to be better evaluated.

Free weight training vs. elastic band training

The aim of this study was to assess the effectiveness of two resistance training (RT) programs (free weight [FW] and elastic band [EB]) on velocity variables (handball throwing velocity [HTV] and maximal theoretical velocity [V0]) using load-velocity (L-V) relationship modelling. Both programs lasted 6 weeks and consisted of performing bench press and overarm dumbbell pull-over using free weights (FW group) or elastic bands (EB group). Nineteen male sports science students were randomly assigned to EB (n=10) or FW group (n=9). Both RT programs increased HTV and V0, although the increment was greater in the FW (&amp;gt;2 m·s-1) compared to the EB group (&amp;lt;1 m·s-1). RT programs had selective effects on the strength variables being FW more effective in increasing 1-repetition maximum, while EB in increasing maximal isometric force. Very large correlations were observed between two-point (L-V relationship modelled through two pairs of L and V data) and multiple-point methods (L-V relationship modelled through six pairs of L and V data) (V0: r=0.96; HTV: r=0.93). All coefficients of variation showed high validity both for V0 and HTV (≤6.2%). Altogether, FW training should be used for increasing the velocity of the throwing performance, while the two-point method for following training-induced changes.

Risk Factors Indicating Difficulty During Gastric Endoscopic Submucosal Dissection for Inexperienced Endoscopists: A Retrospective Study.

Factors that may make endoscopic submucosal dissection (ESD) difficult for operators have been evaluated according to results based on the performance of experienced endoscopists. This study aimed to verify the predictors of difficult gastric ESD for ESD beginners. From January 2015 to December 2021, 466 superficial gastric neoplasms were treated with ESD at Showa University Hospital. Excluding 103 lesions that performed ESD by experts who experienced more than 80 ESDs, a total of 363 lesions were included. The lesions were divided into two groups according to the ESD performance experience of the operator:ESD beginner (EB; ESD experience≤30 cases) and ESD intermediate (EI; ESD experience 31-80 cases) groups. Relationships between difficult ESD (having at least one of the following: procedure time>60 min, incomplete resection, change of operator, and occurrence of severe complications) and clinicopathological findings of the lesion were analyzed. The complete resection rates and the difficult ESD rates in the EB and EI groups were 99.3%, 94.8%, and 61.2%, 50.7%, respectively. In the EB group, univariate analysis showed that difficult ESD rate was significantly higher in the non-lower third lesions, the lesser curvature lesions, and cancerous lesions. In the EI group, univariate analysis showed that difficult ESD rate was significantly higher in lesion with ≥20 mm size, lesser curvature lesions, lesions with ulcers, and submucosal cancers. Multivariate analysis showed that the lesser curvature location and cancerous histology in the EB group and ≥20 mm lesion size, the lesser curvature location and submucosal invasion in the EI group were independent predictors of difficult ESD. The lesser curvature location is recognized as independent ESD difficulty factor for both beginners and intermediates.Cases with lesions located in the lesser curvature should not be selected for gastric ESD training by beginners.

The impact of Er:YAG laser combined with fluoride treatment on the supragingival plaque microbiome in children with multiple caries: a dynamic study

BackgroundAs a minimally invasive tool for caries prevention tool, the pulsed erbium:yttrium-aluminum-garnet (Er:YAG) laser is being used in a large number of studies. Microorganisms are extremely vital in the occurrence and development of dental caries. However, the impact of Er:YAG laser irradiation combined with fluoride on the dynamic microbial changes that occur in dental plaques is still uncertain. In this study, we examined the effect of an Er:YAG laser combined with fluorine on supragingival microbial composition and diversity in children with multiple caries.MethodsIn this study, dental plaque samples (n = 48) were collected from 12 children with over 8 filled teeth. Supragingival plaques from left mandibular molars before (CB) and after fluoride treatment (CA) and right mandibular molars before (EB) and after fluoride+Er:YAG laser treatment (EA) were collected from each patient. In CB and EB groups, the samples were collected just before the treatments. In CA and EA groups, the samples were collected 1 month after treatments. Then, all specimens were subjected to 16S rRNA high-throughput sequencing to investigate the changes in microbial composition and diversity in mandibular molar supragingival plaques before and after fluoride or fluoride+Er:YAG laser treatment.ResultsThe dental plaque microbial diversity was higher in the EA group than in the EB group (baseline levels), and the microbial composition changed in EA group compared with EB group (P < 0.05). The levels of microorganisms associated with caries occurrence, including Proteobacteria, Fusobacteria, and Bacteroidetes, declined, while the levels of Faecacterium, Fastidiosipila, Vibrio, and Shewanella increased in EA group compared with EB group. The declines in Firmicutes, Streptococcus, Fusobacterium, and Veillonella levels were significantly lower in the EA group than in the CA group.ConclusionThe combined application of the Er:YAG laser and fluoride may be more effective than using fluoride alone in reducing the proportion of cariogenic bacteria, increasing the diversity of plaque microorganisms, and further promoting the microecological balance.

Comparison of Estradiol Cypionate, Estradiol Benzoate and Gonadotropin-Releasing Hormone in Fixed-Time Artificial Insemination in Multiparous Murrah Buffaloes

The present study was aimed to evaluate the efficiency of estradiol cypionate, estradiol benzoate and gonadotropin-releasing hormone during fixed-time artificial insemination (FTAI) protocols in multiparous Murrah buffaloes. A total of 35 buffaloes were used between September and November 2021 and subjected to a synchronization protocol. On day 0, insertion of an intravaginal progesterone device (CIDR, 1.38 g) was made with intramuscular (i/m) injection of estradiol benzoate (EB, 2 mg); On day 9: CIDR removed with i/m injections of Dinoprost (12.5 mg) and eCG (400 IU), and then buffaloes were randomized into three treatment group: 1) EB 1 mg on day 10 (n=13). 2) estradiol cypionate (EC) 1 mg on day 9 (n=12), and 3) Buserelin acetate (GnRH) 0.0105 mg on day 10 (n=10). The estrus signs observed during the FTAI (56 h after CIDR withdrawal) and conception rate at 90 days after FTAI were recorded. The conception rates were 61.5, 58.3 and 60.0% for EB, EC and GnRH treatment groups, respectively. There was no significant difference between the treatment groups for conception rate and signs of estrus. Therefore, it was concluded that all three treatments can be efficiently used during estrus synchronization protocol with FTAI in multiparous Murrah buffaloes.

Impact of Exercise Training at Different Intensity Levels on Cardiac Function and Exercise Capacity in Patients with Chronic Heart Failure: A Prospective Cohort Study.

To investigate training at different intensity levels on cardiac function, exercise capacity, and health-related quality of life in patients with chronic heart failure. This prospective cohort study enrolled patients with chronic heart failure at Beijing Rehabilitation Hospital, Beijing, China from January 2018 to January 2020. Participants received conventional therapy (non-exercise group) or therapy plus cycle ergometer exercises at an intensity of 80% anaerobic threshold (EA group) and Δ50% power above anaerobic threshold (EB group) for 12 weeks. The primary outcome was peak oxygen uptake. Forty-five patients (15/group) completed the study without serious complications. Exercise training at an intensity of Δ50% power above anaerobic threshold had better effects on exercise capacity than exercise at an intensity of 80% anaerobic threshold, as shown by a greater improvement in peak oxygen uptake (20.3 ± 4.1 vs 16.8 ± 3.2 mL/min/kg), peak O2 pulse (12.5 ± 2.3 vs 10.1 ± 2.1 mL/beat), and peak workload (123.1 ± 26.9 vs 102.8 ± 29.5 W) in patients with chronic heart failure (all p < 0.001). Exercise improved the 6-min walk test distance (control: 394.0 ± 74.1; EA: 481.4 ± 89.4; EB: 508.9 ± 92.5 m; p < 0.001) and health-related quality of life (control: 40.7 ± 12.3; EA: 16.2 ± 8.6; EB: 11.5 ± 6.4; p < 0.001). Compared with an intensity of 80% anaerobic threshold, exercise training at an intensity of Δ 50% power above anaerobic threshold was safe and had better effects on cardiac function, exercise capacity, and health-related quality of life.

Histopathological evaluation of a retinoic acid eluting stent in a rabbit iliac artery model

This study aimed to evaluate the safety and efficacy of innovative retinoic acid (RA) eluting stents with bioabsorbable polymer. Sixty stents divided in ten groups were implanted in the iliac arteries of 30 rabbits. Two polymers (“A”, poly (lactic-co-glycolic acid) and “B”, polylactic acid), and three doses (“Low”, “Medium” and “High”) of RA (groups: AL, AM, AH, BL, BM, BH) were used on cobalt chromium stents (Rontis Corporation), one group of bare stent (C), one group (D) of Everolimus eluting stent (Xience-Pro, Abbot Vascular), and two groups of Rontis Everolimus eluting stents coated with polymer A (EA) and B (EB). Treated arteries were explanted after 4 weeks, processed by methyl methacrylate resin and evaluated by histopathology. None of the implanted stents was related with thrombus formation or extensive inflammation. Image analysis showed limited differences between groups regarding area stenosis (BH, D and EB groups had the lower values). Group BH had lower intimal mean thickness than AH (105.1 vs 75.3 μm, p = 0.024). Stents eluting RA, a non-cytotoxic drug, were not related with thrombus formation and had an acceptable degree of stenosis 4 weeks post implantation. RA dose and type of polymer may play role in the biocompatibility of the stents.

Transcriptomic and biochemical analyses revealed the improved growth, lipid metabolism, and flesh quality of grass carp (Ctenopharyngodon idellus) by dietary Eucommia ulmoides bark and leaf supplementation.

The objective of this study was to investigate the dietary effects of Eucommia ulmoides bark and leaf (EB, EL) supplementation on the growth, lipid metabolism, flesh quality, and transcriptome of grass carp (Ctenopharyngodon idellus). EB and EL were individually added to the basal diet (control) at concentrations of 20 g/kg and 40 g/kg, respectively, and then the three diets were fed to grass carp (59.7 ± 0.3 g) for 60 d. The results showed that the weight gain was improved, and the feed conversion ratio was decreased by supplementation with EB and EL (P < 0.05). Compared to the control, the EB and EL groups showed higher flesh hardness; water-holding capacity; and collagen, docosahexaenoic acid (DHA), and n-3 polyunsaturated fatty acids (n-3PUFAs) contents and lower mesenteric lipid and muscle crude lipid contents (P < 0.05). Moreover, dietary EB and EL supplementation increased the activities of superoxide dismutase and glutathione peroxidase and decreased the contents of malondialdehyde and protein carbonyl in flesh (P < 0.05). In muscle transcriptome profiling, a total of 979, 1980 differentially expressed genes (DEGs) were identified, and 29, 199 Gene Ontology (GO) terms and 13, 39 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were significantly enriched in the EB and EL groups, respectively. Some key pathways and genes involved in promoting growth, lipid metabolism and flesh quality were obtained, including mTOR and PPAR signaling pathways, muscle cytoskeleton- and extracellular matrix-related genes (myosin and collagen), etc. Overall, dietary EB and EL supplementation improved the growth, lipid metabolism, and flesh quality of grass carp, and several potential pathways and genes were identified behind the improvement mechanism of EB and EL supplementation.

Influence of Dietary Inclusion of Exhausted Bergamot By-Product in Pigs on Animal Performance, Fatty Acid Profile and Oxidative Stability of Meat and Meat Products.

Simple SummaryThe pharmaceutical industry is increasingly interested in the extraction of phenolic compounds from bergamot pulp, which becomes less available for use in animal feeding. On the other hand, the extraction of phenol compounds generates a new bergamot by-product characterized by a low moisture content and a small concentration of phenolic compounds which are residual after extraction. In light of the above, the aim of the present study was to investigate the effect of supplementation of exhausted bergamot by-product in pigs’ performance and on the quality of meat and meat products.An investigation was carried out on the effect in pig diet of supplementation with exhausted bergamot by-product, stemming from pharmaceutical industry after extraction of phenolic compounds, on growth performance and on the quality of meat and meat products. Twenty pigs were assigned to two dietary treatments and fed a conventional concentrate (control) or a concentrate including exhausted bergamot by-product at the level of 15% on a DM basis (EB). No significant differences between dietary treatments were found for final weight (p = 0.243), carcass weight (p = 0.679), dry matter intake (p = 0.321). In EB pork, the proportion of docosapentaenoic acid was significantly increased (p < 0.05); it tended to have a greater proportion of n-3 PUFA (p = 0.09), and the n-6/n-3 PUFA ratio was lower in EB treatment (p = 0.01). In salami from EB pigs fed, the proportion of α-linolenic acid and the total n-3 PUFA were higher than in the control group (p < 0.001). In salami, the TBARS value was lower after 5 days of storage (p < 0.001) in the EB group. Therefore, the present results suggest that the inclusion of exhausted bergamot by-product in pig diet resulted in a qualitative improvement of meat and meat products.