EF Group Research Articles

Menstrual cycle phase differences in myofiber damage and macrophage infiltration following electrical stimulation-induced muscle injury.

The purpose of this study was to examine the effects of menstrual cycle phase on myofiber injury, regenerative events and inflammation after electrical-stimulation (ES) induced myofiber damage. 28 premenopausal women (21.3 ± 2 yrs) were randomized into an early follicular (EF; N=14) or late follicular (LF; N = 14) group. After menstrual cycle tracking and phase confirmation, subjects underwent 200 electrically stimulated eccentric muscle contractions one week after providing a muscle biopsy. 7 days post-ES, subjects provided a final biopsy. Primary outcomes included: serum estradiol, indirect markers of muscle damage, direct indicators of myofiber necrosis and regeneration, satellite cell number, and macrophage infiltration. Women in the LF group had higher serum estradiol (122.1 ± 23.4 vs. 81.7 ± 30.8 pg/ml; P<0.001)compared to the EF group on the day of ES. Whereas the EF group recovered baseline maximal isometric strength by 4 days post-ES, the LF group did not. Only women in the LF group showed significant and consistent evidence of myofiber necrosis and regeneration pre- to post-ES. Despite showing more evidence of myofiber damage, women in the LF group also experienced reduced total and CD206+ macrophage infiltration relative to the EF group. Satellite cell quantity increased significantly post-ES in both groups, with no differences between groups. Collectively, the data suggest that the high estrogen LF phase may be associated with increased susceptibility to myofiber injury while also limiting the subsequent intramuscular inflammatory response.

Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction.

The global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF). This observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific. Based on the left ventricular EF, patients were categorized as HFrEF (< 40%), HFbnEF (40-60%), and HFsnEF (> 60%). Mortality and the incidence of adverse events were investigated. Of the 11,141 patients analyzed, HFrEF, HFbnEF and HFsnEF accounted for 74%, 22%, and 4%, respectively. Patients with a higher EF were more likely to be older, female, and obese. Hypertension and atrial fibrillation were the most common in HFsnEF. Systolic blood pressure was lower and natriuretic peptide levels were higher in the lower EF groups. Mortality was lowest in HFbnEF (7.7 per 100 patient-years follow-up in HFrEF, 5.8 in HFmrEF, and 6.0 in HFsnEF). Similarly, hypotension and acute kidney injury were the least frequent in HFbnEF. Incidence of elevated serum potassium levels was similar between the groups. In this analysis of large-scale EHR, ARNI was mainly used in HFrEF and HFbnEF, consistent with previous randomized trials and pooled analyses. Adverse events were less common in HFbnEF.

Tibial Plafond Fractures Type C: Open Reduction and Internal Fixation versus External Fixation by Ilizarov: (A Systematic Review)

Abstract Background Tibial Plafond Fractures affect weight-bearing articular surface and comprise &amp;lt; 1% of all lower extremity fractures. Such fractures are due to rotational or axial-loading forces as a result of high-energy trauma. Plafond means ceiling or dome. The Talus has tibial plafond as a dome or ceiling and articulates with the distal tibia with its smooth surface. Rotational force may produce spiral fractures; it may be extra-articular or intra-articular. Usually, rotational forces produce less soft tissue injuries whereas axial compressive forces produce intra-articular fractures with more soft tissue injuries. Aim of the Work to compare open reduction internal fixation (ORIF) and external fixation by Ilizarov in patients with pilon fracture type C and to clarify which method is better in terms of reduction and union results and major complications. Patients and Methods After ethical committee approval, this Systematic review was conducted on Patients aged with 18 years or older with tibial plafond fractures of type C according to the AO/OTA classification including Studies and published papers between January 2000 and January 2022. This systematic review was conducted on human subjects in different literatures collected from different medical websites between January 2000 and January 2022 in which we involved clinical and/or functional outcomes in ORIF versus Ilizarov fixation for operative treatment of tibial plafond fracture type C according to the AO/OTA classification with follow up period of at least 6 months. Five Studies literature (Four retrospective and one Prospective) that involved 250 patients, fulfilled the study criteria and were included in this study. Results As regards the time till surgery and healing, the current systematic review revealed that there was statistically significant increase in the time till surgery (days) in ORIF group (11.75 ± 2.67) versus EF group (6.95 ± 3.14) (p-value &amp;lt;0.001) and non-significant increase in the time to union (days) in ORIF group (48.10 ± 44.11) than EF group (41.73 ± 37.53) (p-value = 0.287). The current study results revealed that the Range of Ankle Motion showed a statistically significant increase in the mean dorsiflexion and plantarflexion in ORIF group than EF group (p- value &amp;lt;0.001). As regards complications, Analysis of the complications (nonunion, malunion, superficial, deep infections, Osteomyelitis and Arthritis) revealed a statistically significant increase in the percentage of patients with complications in EF group compared to ORIF group (p value &amp;lt;0.001) with significant difference in rates of malunion (p = 0.034) and superficial infection (p = 0.012) between ORIF and EF for treatment of TPF. Although the risk of deep infection was higher in the EF group, it was not found to be statistically significant (p = 0.811). Conclusion this study provides an overview of functional outcome and complications after common surgical strategies for management of tibial plafond fractures. Both ORIF and CEF are acceptable treatment options for management of TPF; however, functional levels vary substantially. External fixation results in the higher rate complications of malunion, superficial infection and decreased range of motion compared to Open reduction and internal fixation, while Open reduction and internal fixation was associated with significant bad functional outcome and delayed time to healing and surgery. Post-traumatic arthritis deep infection and non-union rates were comparable in both groups. The results reported here can aid patients and their surgeons in the decision for operative treatment.

Prevalence, Characteristics, and Treatment Strategy of Different Types of Heart Failure in Patients With Nonvalvular Atrial Fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia in patients with heart failure (HF). Epidemiological data regarding HF in patients with AF are lacking. We describe the epidemiology, clinical features, treatment strategies, and in-hospital outcomes in patients with AF and HF. Patients with HF and nonvalvular AF in the Improving Care for Cardiovascular Disease in China-AF cohort from February 2015 to December 2019 were included. Patients were stratified by left ventricular ejection fraction into HF with reduced EF, HF with mildly reduced EF, and HF with preserved EF groups. The primary outcome was the occurrence of hospitalization for major adverse cardiovascular events, including death, cardiogenic shock, cardiac arrest, and stroke. Overall, 16 562 patients with AF and HF were included (mean age: 72.35±11.07 years; 46.1% female). HF with preserved EF (63.1%) accounted for the largest proportion, followed by HF with mildly reduced EF (19.0%) and HF with reduced EF (17.9%). Different HF subtypes in patients with AF had unique baseline demographic and clinical characteristics after multinomial logistic regression analysis. Compared with the HF with preserved EF group, hospitalization for major adverse cardiovascular events was increased in the HF with mildly reduced EF group (odds ratio=1.55 [95% CI, 1.18-2.03]) and HF with reduced EF group (odds ratio 1.60 [95% CI, 1.21-2.13]) after adjusting for confounders. In this large Chinese AF registry, the distribution of HF differed from the non-AF population. Patients with AF with different types of HF have unique demographic and clinical characteristics. Occurrence rates of in-hospital outcomes were higher in patients with HF with mildly reduced EF and patients with HF with reduced EF compared with the HF with preserved EF group. URL: http://www.clinicaltrials.gov; Unique identifier: NCT02309398.

Biochemical indices of patients with enteric fever and pancreatitis: A comparative cross-sectional study

ObjectiveEnteric fever (EF), a potentially fatal febrile illness, is prevalent in developing countries. Elevated levels of lipase and amylase in serum, typically associated with acute pancreatitis (AP), have been observed in patients with EF. The elevated enzymes in both conditions may lead to diagnostic confusion and care delays. This study aimed to determine biochemical indices that are peculiar to EF and AP. MethodsA cross-sectional comparative study was conducted at the Korle-Bu Teaching Hospital, Ghana. Volunteers were categorized into three groups: EF (n = 32), AP (n = 30) and healthy controls (n = 31). A standard questionnaire was used to collect socio-demographic and clinical information from the participants. Blood and stool samples were obtained, followed by biochemical analysis: total amylase, lipase, pancreatic amylase, serum elastase 1, hepatic enzymes, calcium, magnesium, phosphate, stool colour, stool pH, and stool fat presence. ResultsThe AP group displayed higher total amylase, lipase, elastase-1, alkaline phosphatase, aspartate aminotransferase, and gamma-glutamyl transferase levels compared to the EF and control groups (p < 0.05 respectively). Elastase 1 levels were found to be high in all AP participants, whereas no elevations were observed in the EF group. Positive associations were observed in the AP and EF groups for lipase vs total amylase (ρ = .543, p = 0.001; ρ = .543, p = 0.001 for both). ConclusionsElevated levels of total/pancreatic amylase and lipase were found to be indicative of a patient with AP and EF. Further, elastase-1 was found to be a good biomarker to distinguish between AP and EF.

External fixation as definitive treatment or external fixation followed by early fixation in open fractures of the tibial shaft: A descriptive study

IntroductionTreatment options for open tibial shaft fractures include external fixation with or without early conversion to internal fixation. ObjectivesThe aim of this study was to describe 1) early conversion to internal fixation and definitive external fixation and 2) in case of conversion, to identify risk factors for complications. MethodsSeventy-two external fixations of open fractures of the tibial shaft (Gustilo classification, 7 fractures (9.7 %) grade I, 25 fractures (34.7 %) grade II, 40 fractures (55.6 %) grade III (31 grade IIIA and 9 grade IIIB)) were included in a continuous non-randomised study. Thirty-three fractures without infection signs were converted to internal fixation at a mean time of 40.5 +/-15 days (IF group). External fixation was maintened in the remaining 39 fractures (EF group). ResultsIn the “IF” group, the union rate was 69.7 % at 6.3 +/-3.6 months (3–16). All patients had complete union at 16 months, requiring 2.8 +/-0.8 reoperations. Fixation with external fixation only (“EF” group) showed a union rate of 51.3 % at 8.9 +/-4 (5–22) months and 96 % at 16 months after 3.7 +/-0.9 reoperations. Superficial infection (12.1 %; p = 0.011) and numerous surgeries (2.76; p = 0.004) were found to be risk factors for deep infection. Time to wound closure >7 days (p = 0.049), time to reoperation >28 days (p = 0.00), numerous surgeries (2.76; p = 0.004) and deep infection (6.1 %; p = 0.027) were found to be union failure factors. ConclusionEarly conversion of external fixation to internal fixation is an effective option to achieve bone union of open tibial fractures in selected patients.

Pregnancy and Luteal Responses to Embryo Reinsertion following Embryo Flushing in Donor Mares.

The effect of embryo reinsertion immediately after embryo flushing was studied. In Experiment 1, eight mares were used during 32 cycles (8 cycles in each group). For the first two groups, inseminated mares were flushed 8 days after ovulation and prostaglandin F2α was not administered: in group EF-ET (embryo flushing and embryo transfer) the embryo was reinserted in the same donor mare, while in the EF group, no further procedure was performed. In the third group (ET), non-inseminated mares (recipients) received a Day 8 embryo. Progesterone concentration was measured before EF/ET and 72 h after in the three groups. In Experiment 2, twelve mares were used during 17 cycles in two groups, EF-ET (n = 11) and ET (n = 6), as in Experiment 1, except that every mare was flushed 24 h after embryo transfer to retrieve the embryo. Fewer pregnancies resulted after transfer in EF-ET cycles (0/8, 0%) than in the ET group (6/8, 75%). Progesterone concentration decreased significantly (p = 0.05) 72 h after EF-ET but not in EF or ET cycles (p > 0.1). Three mares from the EF-ET showed full luteolysis and signs of endometritis. In Experiment 2, more (5/6; p = 0.08) grade 1 embryos were recovered in the ET compared to the EF-ET group (3/7); 4 embryos were graded 3-4 (were broken or had signs of degeneration) in the EF-ET group but none in the ET group. In both groups, capsule fragments were obtained as indicative of the presence of a recently destroyed embryo in the EF-ET (n = 3) and ET (n = 1) groups. Positive bacterial cultures were obtained in 2/11 and 1/6 embryo flushes from the EF-ET and ET groups, respectively.

Stress indicators in dairy cows adapting to virtual fencing.

Virtual fencing (VF) enables livestock grazing without physical fences by conditioning animals to a virtual boundary delimited with an audio tone (AT) and an electric pulse (EP). The present study followed the adaptation process of lactating dairy cows to a VF system with changing virtual boundaries and investigated its impact on animal welfare. Twenty cows were divided into stratified groups (2× VF; 2× electric fencing, EF) of five individuals. Each group grazed half-days in a separate EF paddock of comparable size during 3d of acclimation (P0), followed by 21, 14, 14, and 7d of experimental treatment (P1 to P4). At the start of the trial, all cows were equipped with an IceQube pedometer (Peacock Technology Ltd, Stirling, UK) and a VF collar (Nofence AS, Batnfjordsøra, Norway). During P0, cows were accustomed to their first paddock with a deactivated virtual boundary and wearing the sensors. In P1 to P4, an active virtual boundary for the VF groups, and a second EF for the EF groups was set up parallel to an outer EF within their paddock. Throughout the trial, the sensors continuously tracked cow positions and activity behavior at 15-min intervals. From P1 onwards, the VF collars additionally recorded each AT and EP per cow with a georeferenced time stamp. During P0 to P4, daily feed intake, body weight, and milk yield were recorded in the barn. A total of 26 milk samples were collected per cow to determine milk cortisol levels. Behavioral observations were conducted for 2h on day 23 to record agonistic behaviors, vocalizations, and excretions. The total number of stimuli per cow ranged from 37 to 225 ATs (mean ± SD: 1.9 ± 3.3 per day) and 3 to 11 EPs (mean ± SD: 0.1 ± 0.7 per day) throughout the trial. The maximum number of EPs per day was 8 for an individual cow and occurred once on D1. Mean EP/AT decreased by 55% during the first three half-days of grazing and with each paddock change from 0.2 EP/AT in week 1 to 0.03, 0.02, and 0 EP/AT in weeks 4, 6, and 8, respectively. Linear and generalized mixed effects models revealed that milk yield and cortisol, feed intake, body weight, and activity and lying behavior did not significantly differ between VF and EF groups. A higher number of agonistic behaviors were observed in the VF groups when the VF system was activated. However, due to the short observation periods only few contacts were observed in total. Overall, all cows adapted to the VF system without evidence of lasting adverse effects on animal welfare.

#182 : Pharmacokinetics of Ovarian Stimulation for Projected Poor Responder Patients in IVF. A Randomised Trial Comparing a Corifollitropin Alfa Agonist Flare Protocol with a Corifollitropin Alfa Antagonist Protocol

Background &amp; Aims: Approximately 10% of patients have a sub-optimal response to controlled ovarian stimulation. Many different protocols for superovulation have been developed for this group of patients but the optimal approach for “poor responder” patients is yet to be determined. Use of corifollitropin alfa (Elonva) in a flare (EF) protocol is a novel approach to ovarian stimulation for predicted poor responder patients. We hypothesised that the unique pharmacokinetic and pharmacodynamic profiles of corifollitropin alfa would maximise FSH exposure and follicular recruitment in the critical early follicular phase due to the initial suprathreshold release of bioactive FSH in the initial 2-3 days of exposure to Elonva, in combination with the ‘flare’ of endogenous FSH release. Method: Twenty-one women aged 31-41 were identified as predicted poor responder patients according to the Poseidon criteria. Each participant was randomised to treatment with Elonva/Synarel flare or Elonva/Orgalutran antagonist. Serum FSH and E2 were measured daily for five days following injection of Elonva. The study was approved by the Southeastern Sydney HREC. Results: Serum FSH concentrations were significantly higher at each time point in the EF group when compared with the antagonist group (p=0.022). Peak FSH two days after injection of Elonva, was also significantly higher 27 vs 11 IU/L. Serum E2 concentrations were also significantly higher in the EF group at each time point (p=0.039). On day seven of stimulation, E2 concentrations were 3000 vs 1850 pmol/L. Conclusion: The corifollitropin alfa agonist flare protocol produces significantly higher FSH and E2 concentrations than a standard corifollitropin alfa antagonist protocol for projected poor responder patients, with reduced patient burden for a group who may need multiple ovarian stimulation cycles to achieve a pregnancy. A larger RCT is required to study embryology and pregnancy outcomes, costs and patient burden.

Untargeted metabolomics revealed the product formation rules of two fermented walnut milk

ABSTRACT This study employed untargeted metabolomics to reveal the changes in the metabolic profile of walnut milk under two different processing methods. The walnut milk of the control group was not treated, which was fermented through L. plantarum in F group, while the walnut milk after proteolysis was fermented in EF group. The results showed that fermentation gradually reduced the pH of walnut milk to 4.70 and 3.61 in F and EF group respectively, for viable count which are 2.9 × 109 CFU/mL and 9.3 × 109 CFU/mL. The antioxidant activity of EF group is significantly higher than Con group (p < 0.05). Through UHPLC-Q-TOF MS and multivariate statistical analysis, the identified metabolites were mainly lipids and lipid-like molecules, as well as organic acids and derivatives. Compared with fermented walnut milk, fermentation after proteolysis significantly increased the functional metabolites contained in walnut milk which are included in antibacterial, antioxidant, anti-inflammatory.

Evaluation of regulatory capacity of three lactic acid bacteria on the growth performance, non-specific immunity, and intestinal microbiota of the sea cucumber Apostichopus japonicus

Lactic acid bacteria (LAB) have been extensively used as probiotics in aquaculture. However, probiotic effects of different inter-generic strains of LAB on sea cucumber Apostichopus japonicus are still poorly understood. Here, sea cucumber were fed with five diets for 63 days, including a basal diet (the control, C group), a florfenicol diet (15 mg/kg; the positive control, FL group) and three LAB diets, i.e., the basal diets supplemented with Lactobacillus plantarum W2 (LP group), Enterococcus faecium LYB (EF group) and Pediococcus acidilactici Nj (PA group) at the dose of 1 × 1010 CFU/kg diet, respectively. A stimulation test with inactivated Vibrio splendidus was then performed and characterized immune responses of sea cucumber over 168 h. The results showed that all three LAB significantly enhanced the growth performance of sea cucumber, with the LP diet showed the best growth-promoting effect. The LP and PA diets significantly increased coelomocyte phagocytic, respiratory burst, superoxide dismutase, alkaline phosphatase, acid phosphatase, catalase, and lysozyme activities. The LP and EF diets significantly up-regulated the intestinal immune genes (Aj-p105, Aj-p50, Aj-rel, and Aj-lys) expression levels, while PA diet did not significantly up-regulate the Aj-p50 gene expression level. Meanwhile, all three LAB significantly enhanced intestinal immune response. Florfenicol diet significantly decreased phagocytic and alkaline phosphatase activities, down-regulated the Aj-lys gene expression, and suppressed intestinal immune response. L. plantarum W2 significantly increased the diversity of the intestinal microbiota in sea cucumber, and the P. acidilactici Nj significantly improved both the diversity and richness. A higher relative abundance of Actinobacteriota, norank_f_Rhodobacteraceae, and Sedimentitalea was observed in the LP, EF, and PA groups, respectively, while a lower relative abundance of Firmicutes was showed in the FL group. All three LAB improved the stability of the intestinal microbial networks and up-regulated the functional pathways of intestinal microbiota associated with amino acid metabolism. However, florfenicol reduced microbial network stability and significantly inhibited the intestinal microbiota functions. In conclusion, L. plantarum W2, E. faecium LYB, and P. acidilactici Nj can be effectively used as probiotics in sea cucumber aquaculture. Among them, L. plantarum W2 exhibited the best effect on sea cucumber when the growth performance, non-specific immunity, and intestinal microbial structure and functions were considered collectively.

Early outcomes of chronic anal fissure treatment using the lateral internal sphincterotomy method without excision (randomized trial NCT05117697)

PURPOSE OF THE STUDY: improvement of the treatment of chronic anal fissure results.PATIENTS AND METHODS: the study included 70 patients randomized by random number generation into 2 groups: 30 patients underwent lateral internal sphincterotomy (main group, LIS), and 40 patients underwent LIS in combination with the excision of the fissure (EF) (control group, LIS + EF).RESULTS: the pain intensity both after stool and during the daytime in the main group (LIS) has been significantly lower than in the control group (LIS + EF) (p &lt; 0.05). The median duration of the patients’ temporary disability in the LIS group was 6 (4; 9) days, in the LIS + EF group — 17 (9; 23.5) days (p = 0.04). On day 15, the defect has epithelialized in 12/30 (40%) patients of the main group (LIS) and none (0/40) in the control group (LIS + EF) (p = 0.00001), on day 30 — in 22/30 (73.3%) and 2/40 (5%) (p = 0.00001), on day 45 — in 26/30 (87%) and 20/40 (50%) (p = 0.002), and on day 60 — in 28/30 (93.3%) and 38/40 (95%) (p = 1.0), respectively. On the day 30 after surgery, 3/30 (10%) patients of the main group and 15/40 (37.5%) of the control group had complaints regarding passing gas (p = 0.01), on day 60 — anal sphincter insufficiency (ASI) persisted in 1/30 (3%) patients in the LIS group and in 3/40 (7.5%) patients in the LIS + EF group (p = 0.63). Excision of the fissure in 5.4 (1.4–20.9) times increases the chance of developing ASI on day 30 of the postoperative period (p = 0.015) and 52 (10.2; 268.3) times increases the chance of non-healing of the defect during this period (p = 0.000002) and 6.5 (1.9; 22) times on the day 45 (p = 0.003), in comparison with the LIS only.CONCLUSION: refusal to excise the anal fissure during its surgical treatment and perform the lateral internal sphincterotomy only can reduce the intensity of postoperative pain syndrome, the rate of postoperative complications and reduce the time of epithelialization of the anoderm defect.

The effect of an internal, external and holistic focus on the learning of a soccer shooting task in male children

The benefits of an external focus in motor learning have been well-established in adults, but findings in studies with children have been far more variable. Recent research also suggests that a holistic focus of attention may also enhance motor learning relative to an internal focus, but few studies have tested this strategy with children. Therefore, this study aimed to determine the effect of an internal (IF), external (EF), holistic focus (HF) and no focus control condition on the learning of a soccer shooting task in male children. Male participants ( N = 60) between the ages of 9 and 11 completed 60 acquisition trials shooting at a low target at a distance of 7 m while focusing on an assigned cue. After 48 h, participants returned for a 10-trial retention test and a 10-trial transfer test shooting from a distance of 8 m. Results showed that the EF group was more accurate than control throughout acquisition ( p = .027). In retention, all focus groups were more accurate than control ( p's &lt; .001), and an EF trended toward being more accurate than in IF ( p = .059). In transfer, all focus groups were more accurate than control ( p's &lt; .001), and EF was more accurate than HF ( p = .009). To our surprise, a clear benefit of an EF and HF relative to an IF was not observed. Future work should consider whether this may be due to the nature of the cues selected, or if there are other constraints that may influence when children do or do not benefit from an EF and HF.

THE ASSOCIATION BETWEEN SERUM SOLUBLE ST2 CONCENTRATION AND SOME CLINICAL AND SUBCLINICAL INDICES IN PATIENTS WITH CHRONIC HEART FAILURE

Objectives: To investigate the level of serum soluble ST2 (sST2) and its association with some clinical and subclinical indices in patients with chronic heart failure (HF). Methods: A prospective cohort study was performed on 116 patients diagnosed with chronic HF at the Cardiology Department, Military Hospital 103, Hanoi and Cardiology Department, 19-8 Hospital - Ministry of Public Security, Hanoi, Vietnam, and 40 control patients at General Health Examination Department, Military Hospital 103, Hanoi from November 1, 2019 to September 30, 2022. Serum sST2 was measured using an enzyme-linked immunosorbent assay. Results: The mean age (± standard deviation) of patients with chronic HF was 68.3 (± 15.9) years, with 57.8% of the total patients who showed their age was &gt; 65 years. The median serum sST2 level in the group of patients with chronic HF (median: 5.89 ng/mL) was significantly higher than those in the control group (median: 2.39 ng/ml) (p &lt; 0.05). Serum sST2 level increased as LVEF decreased, with the highest level in HF with reduced EF patient group, followed by HF with mildly reduced EF, and HF with preserved EF groups. Serum sST2 level had a significant, positive correlation with heart rate in chronic HF patients. The serum sST2 level in the group of NYHA class IV was significantly higher than those in the group of NYHA class III and II (p &lt; 0.05). Conclusion: The level of serum sST2 increased in chronic HF patients. Serum sST2 level associated with left ventricular ejection fraction, and NYHA classification in chronic HF patients.

A Study of Iron Profile in Patients with Heart Failure with Preserved and Reduced Ejection Fraction

Background: Heart failure is a complex clinical syndrome that results from any structural of functional impairement of ventricular filling or ejection of blood leading to cardinal manifestations of dyspnoea, fatigue, and fluid retention. In developed countries, the prevalence of known heart failure is generally estimated at 1% to 2% of the general adult population.&#x0D; Heart failure is a major cause of morbidity and mortality worldwide. Iron deficiency (ID) with or without anemia has been commonly associated with HF. In view of this, the current study was undertaken to assess the iron profile in patients with heart failure (HF).&#x0D; Objectives: This study aims at studying the prevalence, clinical correlates fuctional significance of iron deficiency in heart failure patients and to highlight the importance of iron deficiency in heart failure.&#x0D; Materials and Methods: In this study, we have taken 60 patients who are above 18 years diagnosed to have heart failure, 30 patients had preserved ejection fraction, 30 patients had reduced ejection fraction, BNP, ECG, 2DECHO, haemogram, iron profile were done. This study is being undertaken to evaluate the prevalance of iron deficiency in heart failure with preserved or reduced ejection fraction, Correlating iron levels with stage of heart failure , Correlating iron levels with length of stay in hospital.&#x0D; Results: 22 patients of 30 patients in preserved ejection fraction group had iron deficiency. 23 patients of 30 patients in reduced ejection fraction had iron deficiency. The mean serum iron levels of the study participants with length of stay in hospital between 1-5 days, 6 – 10 days and 11 – 15 days were found to be 28.99 ± 17.55, 31.82 ± 17.15 and 35.37 ± 23.58 respectively. The association was found to be statistically significant between with length of stay in hospital and serum iron levels of the study participants.&#x0D; The mean serum iron levels of the study participants in stage B, stage C and Stage D of heart failure were found to be 30.21 ± 20.57, 30.23 ± 17.02 and 20.63 ± 18.28 respectively. The association between stages of heart failure and serum iron levels of the study participants was not found to be statistically significant.&#x0D; Conclusion and Interpretation: In this study 73.33% in preserved EF group and 76.66% in reduced EF group had iron deficiency. The association was found to be statistically significant between with length of stay in hospital and serum iron levels of the study participants. The association between stages of heart failure and serum iron levels of the study participants was not found to be statistically significant.

Early feeding leads to molecular maturation of the gut mucosal immune system in suckling piglets.

Diet-microbiota-host interactions are increasingly studied to comprehend their implications in host metabolism and overall health. Keeping in mind the importance of early life programming in shaping intestinal mucosal development, the pre-weaning period can be utilised to understand these interactions in suckling piglets. The objective of this study was to investigate the consequences of early life feeding on the time-resolved mucosal transcriptional program as well as mucosal morphology. A customised fibrous feed was provided to piglets (early-fed or EF group; 7 litters) from five days of age until weaning (29 days of age) in addition to sow's milk, whereas control piglets (CON; 6 litters) suckled mother's milk only. Rectal swabs, intestinal content, and mucosal tissues (jejunum, colon) were obtained pre- and post-weaning for microbiota analysis (16S amplicon sequencing) and host transcriptome analysis (RNA sequencing). Early feeding accelerated both microbiota colonisation as well as host transcriptome, towards a more "mature state", with a more pronounced response in colon compared to jejunum. Early feeding elicited the largest impact on the colon transcriptome just before weaning (compared to post-weaning time-points), exemplified by the modulation of genes involved in cholesterol and energy metabolism and immune response. The transcriptional impact of early feeding persisted during the first days post-weaning and was highlighted by a stronger mucosal response to the weaning stress, via pronounced activation of barrier repair reactions, which is a combination of immune activation, epithelial migration and "wound-repair" like processes, compared to the CON piglets. Our study demonstrates the potential of early life nutrition in neonatal piglets as a means to support their intestinal development during the suckling period, and to improve adaptation during the weaning transition.

Correlation of Warm Handoffs Versus Electronic Referrals and Engagement With Mental Health Services Co-located in a Pediatric Primary Care Clinic

ObjectiveTo analyze the correlation of referral mechanism—warm handoff or electronic referral and attendance at behavioral health appointments in an outpatient pediatric primary care setting. MethodsA retrospective cohort study was conducted in an inner-city pediatric primary care clinic from January 2019 to December 2019. Adolescent patients who screened positive for depression or anxiety were referred to a Licensed Master Social Worker (LMSW) either via a warm handoff (WH group, n = 148) or an electronic referral (EF group, n = 180). The EF group was contacted by the LMSW via telephone to schedule an appointment. Multiple logistic regression was used to analyze the correlation of type of referral, age, gender, race/ethnicity, primary language, and time between referral and first contact with attendance at three appointments. ResultsThe WH group was more likely to engage with mental health services compared to the EF group (odds ratio = 3.301, 95% confidence interval = 1.850–5.902, p = .002) while age, gender, race/ethnicity, and primary language had no correlation. Within the EF group, those who were contacted by the LMSW within 3 days (1–3 days group) were more likely to attend appointments (odds ratio = 2.680, 95% confidence interval = 0.414–8.219, p = .040). There was no difference in attendance in the WH group and the 1–3 days group (p = .913) DiscussionA warm handoff between primary care providers and behavioral health clinicians is significantly correlated with engagement with behavioral health services for adolescents who screen positive for depression or anxiety. Contact with the family within 3 days of referral is significantly correlated with engagement compared to a longer duration between referral and family contact.

Outcome of treatment of intra-articular distal end radius fractures by volar locking plate versus bridging external fixator augmented by single K-wire through radial styloid

Background: Distal radius fractures are common injuries occurring more frequently than any other fracture, and remain one of the most frequent skeletal injuries treated by orthopaedic or trauma surgeons. They are considered the most common fracture of the upper extremity. The use of percutaneous pin fixation, external fixation devices that permit distraction and palmar translation, low-profile internal fixation plates and implants, arthroscopically assisted reduction, and grafting techniques including bone-graft substitutes all have contributed to improving fracture stability and outcome. Methods: This is a prospective study consisting of 30 patients, who were treated with volar locking plate or K-wire augmented external fixation for intra-articular commented distal radius fractures (AO type C) at Rajendra institute of medical sciences between November 2020 and January 2023. The 15 patients were treated with open reduction using the volar approach and locking plate were used while 15 patients were treated with closed reduction under fluoroscopy, distraction with the external fixator (Joshi type external fixator) along with K-wire fixation for additional stability used. Result: The ORIF with plating group showed better functional outcomes in Green and O'Brien compared to ex fix group. The radiographic results in the ORIF group were more favorable than in the EF group. Conclusions: We found that both ORIF with plating and external fixation represent treatment choices for distal radius fractures. ORIF had better functional and radiological outcomes according to Green and O'Brien and Sarmiento scoring systems when compared to external fixation. ORIF had less incidence of complications compared with external fixation.

Residual low-frequency hearing after early device activation in cochlear implantation

PurposeThe cochlear implant (CI) is a standard treatment for patients with severe to profound hearing loss. In recent years, early device activation of the sound processor after 2–3 days following surgery has been established. The aim of this study is to evaluate the residual hearing of CI patients with substantial preoperative low-frequency hearing after early device activation over a period of 12 months.MethodsResults were compared between an early fitted group (EF) with device activation to less than 15 days after CI surgery and a control group (CG) with device activation after 3–6 weeks. In total, 57 patients were divided into EF group (n = 32), and CG (n = 25). Low-frequency residual hearing and speech recognition in quiet and in noise were compared over an observation period of 12 months.ResultsNo significant difference (p > 0.05) in the residual low-frequency hearing PTAlow between EF and CG was found, neither preoperatively (EF 33.2 dB HL/CG 35.0 dB HL), nor postoperatively (EF 46.8 dB HL/CG 46.2 dB HL). In both groups, postoperative residual hearing decreased compared to preoperative and remained stable within the first year after CI surgery. Furthermore, both groups showed no significant differences (p > 0.05) in speech recognition in quiet and in noise within the first year.ConclusionEarly device activation is feasible in CI patients with preoperative low-frequency residual hearing, without an additional effect on postoperative hearing preservation.

Fluoride and Calcium Release from Alkasite and Glass Ionomer Restorative Dental Materials: In Vitro Study

This study evaluated the effect of pH and temperature on the ion (F- and Ca2+) release of a resin-based material containing alkaline fillers and a self-setting high-viscous glass ionomer cement. Disks were prepared according to manufacturers' instructions for both materials: the EF group (Equia Forte HT filling, GC) and the CN group (Cention N, Ivoclar). Specimens were immersed in 50 mL buffer solution with three different pHs (4.8, 6.8, and 8.8), and stored at 0°, 18°, 37°, and 44 °C. After 24 h, 7 d, and 28 d, cumulative F- and Ca2+ releases were analyzed by chromatography and mass spectrometry, and pH was measured. Both materials showed minimal changes in pH with final values after 28 d of 5.17 ± 0.56 for CN and 5.12 ± 0.24 for EF. In all experimental conditions, the percentages of ion release were higher for EF than for CF. In particular, both materials showed a significant difference in temperature in F- release. Regardless of the pH values, the highest Ca2+ ion release was after 28 days, with a significant difference in temperature for CN and EF. Within the limit of this study, the temperature storage influenced ion release and the high-viscous glass ionomer showed the maximum values.