Pretreatment Period Research Articles

Impact of fermented bamboo powder on the morphology and physiology of the gastrointestinal tract in yellow-feather broiler chickens.

Bamboo powder, a novel ingredient, is gaining recognition for its potential as a dietary supplement in poultry feed. This study aimed to investigate the effects of fermented bamboo powder (FBP) on antioxidant status, gut hormone activities, intestinal digestive enzyme activities, gut morphological structure, gastrointestinal development, and the expression of nutritional transporter genes in dwarf yellow-feather broiler chickens. A total of 600 healthy 1-day-old chicks were allocated randomly into two groups, with 10 replicates per group and 30 chicks in each replicate. The control group was provided with a standard basal diet, whereas the experimental group received the same basal diet supplemented with 1.0, 2.0, 4.0, and 6.0 g/kg of fermented bamboo powder (FBP) in four phases: Phase I (days 1-22), Phase II (days 23-45), Phase III (days 46-60), and Phase IV (days 61-77). Phases I and II were categorized as the pretreatment period (days 0-45), while Phases III and IV represented the experimental period (days 46-77). Tissue samples were collected during Phase IV for further analysis. After 77 days of feeding, results revealed that FBP supplementation significantly enhanced the levels of gastrointestinal hormones (Glucagon-like peptide 1, Peptide YY, Cholecystokinin, and 5-hydroxytryptamine) in the duodenum, jejunum, and ileum. Similarly, the activities of digestive enzymes (protease, chymotrypsin, trypsin, and amylase) were significantly increased in the small intestine. It also improved gut morphology by increasing villus height, crypt depth, and goblet cell counts in the duodenum, jejunum, and ileum. Additionally, antioxidant enzyme activities (superoxide dismutase, glutathione peroxidase, and catalase) were significantly increased, while malondialdehyde content was significantly decreased in the jejunum. Additionally, FBP supplementation significantly enhanced gizzard development. Overall, FBP supplementation modulated gut hormones and enzymes, enhanced gut morphology and promoted antioxidant status and gene expression related to nutrient transport and antioxidant defenses in broiler chickens. These findings suggest that FBP has the potential as a beneficial dietary supplement in poultry feed.

Are Stabilisation Exercises Effective After Epidural Steroid Injection in Patients With Cervical Radiculopathy? A Prospective Randomised Controlled Trial.

Cervical radiculopathy is caused by dysfunction of nerve roots in the cervical spine. While many studies have assessed the effectiveness of interlaminar epidural steroid injection (ILESI) and stabilisation exercises separately for this condition, our study aims to evaluate the impact of different stabilisation exercise programmes following ILESI on treatment outcomes in radiculopathy patients. Sixty-two patients with cervical radiculopathy were randomised into three groups: cervical ILESI-only (CO), neck stabilisation group (NSG) and scapular stabilisation group (SSG). The CO group received only ILESI, while NSG and SSG underwent stabilisation exercises following ILESI. Outcomes were assessed using the Numerical Rating Scale (NRS) for neck and arm pain, the Neck Disability Index (NDI) for functionality and the Short Form-12 (SF-12) for quality of life at baseline, 1 and 3 months posttreatment. When NRS, NDI and SF-12 parameters were analysed in all groups, a statistically significant improvement was observed in the 1st and 3rd months compared to the pretreatment period. While the improvement in SF-12 physical parameters was significant in SSG and NSG in the 1st month compared to the pretreatment period, no significant difference was found in the CO group in the posttreatment periods. When the 1st and 3rd month results were analysed in NSG, a greater improvement was observed in terms of NRSNECK parameter in both evaluations compared to the other groups. Stabilisation exercise programme, especially neck stabilisation, should be included after ILESI treatment due to positive effects on treatment outcomes. To the best of our knowledge, our study is the first to investigate the effect of a stabilisation exercise programme after ILESI on treatment outcomes in patients with radiculopathy due to cervical disc herniation. It is a valuable study in terms of its prospective design, its specific and homogeneous patient population and its results. Our study will help clinicians when prescribing exercise programmes for these patients. NCT05307211.

P-1830. The First-in-Class Anti-Staphylococcal Antibiotic Afabicin Desphosphono is Not Associated With Clostridioides difficile Infection in an in vitro Human Gut Model

Abstract Background Antibiotic use is commonly associated with disruption of the healthy human gut microbiota (termed dysbiosis). Dysbiosis can diminish colonisation resistance and increase susceptibility to Clostridioides difficile infection (CDI). Use of the pathogen-specific anti-staphylococcal afabicin was not associated with dysbiosis in animals and healthy volunteers (Nowakowska et al, 2023). Here, we assessed whether this microbiota-sparing property of afabicin would limit CDI in a clinically reflective in vitro human gut model. Methods A well-established gut model was used as described previously (Baines et al, 2005). Four independent models were seeded with human fecal slurry (d0) and inoculated at d14 and d21 with C. difficile spores (107 CFU/mL). Two-week treatments were assessed beginning on d21 including (i) a CDI-positive control antibiotic levofloxacin (149.55 mg/L once daily), (ii) afabicin desphosphono high dose (35.7 mg/L twice daily [BID]), (iii) afabicin desphosphono mid dose (17.9 mg/L BID) and (iv) a vehicle control (1% DMSO BID). Endpoints for the model included facultative and obligate anaerobe counts, total viable and spore C. difficile counts and C. difficile toxin titre and were monitored daily until d63. Results Each of the afabicin desphosphono treated models displayed colonisation resistance and no evidence of C. difficile germination or toxin production for the duration of the study. Further, no relevant changes in major facultative and obligate anaerobe groups were observed, indicating limited dysbiosis, similar to the vehicle control. In contrast, following a pre-treatment period where colonisation resistance was demonstrated (i.e. no germination following C. difficile inoculation), levofloxacin treatment resulted in dysbiosis characterized most notably by reductions (∼5log10 CFU/mL) in facultative anaerobes including lactose fermenting Enterobacteriaceae. Dysbiosis caused by levofloxacin led to CDI including C. difficile germination and toxin production. Conclusion Findings from this study provide further support for the microbiota-sparing property of afabicin and suggest that limited off-target microbiota effects associated with afabicin treatment may reduce incidence of CDI when used clinically. Disclosures Charmaine Normington, PhD, Debiopharm International S.A.: Grant/Research Support Ricardo Chaves, n/a, Debiopharm International S.A.: Salary David Cameron, PhD, Debiopharm International S.A.: Salary Mark H. Wilcox, MD, Astra Zeneca: Advisor/Consultant|Debiopharm International S.A.: Advisor/Consultant|Debiopharm International S.A.: Grant/Research Support|Ferring: Advisor/Consultant|GSK: Advisor/Consultant|GSK: Honoraria|Nestle: Advisor/Consultant|Paion: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Phico therapeutics: Advisor/Consultant|QPex Biopharma: Advisor/Consultant|Seres: Advisor/Consultant|Seres: Grant/Research Support|Seres: Lecture Fees|Summit: Advisor/Consultant|Summit: Grant/Research Support|The European Tissue Symposium: Advisor/Consultant|The European Tissue Symposium: Grant/Research Support|Tillotts: Advisor/Consultant|Tillotts: Grant/Research Support|Tillotts: Lecture Fees|Vedanta: Advisor/Consultant Caroline Chilton, PhD, Debiopharm International S.A.: Grant/Research Support

Nonnegligible transition risks towards net-zero economy: Lessons from green finance initiatives in China.

Owing to critical policy significance, a growing body of literature has been predominantly concentrating on the social welfare benefits brought by green finance (GF) initiatives. However, there is a paucity of research that quantifies the economic costs of GF initiatives on carbon reduction, raising the increasing concerns about the irreconcilable climate-economy trade-offs. To end this, the present study systematically investigates the influence of GF initiatives on the carbon-related marginal abatement cost (MAC) using two competing hypotheses: regulatory versus technical effects. We first utilize an improved non-radial slacks-based measure analysis approach to determine the shadow price of CO2 emissions, and then identify the real impact of GF initiatives on the MAC of CO2 emissions using the progressive implementation of GF pilot programs as a quasi-natural design. To avoid non-parallel trends in pre-treatment periods and biased inference caused by the small number of units exposed, we utilize the newly developed synthetic DID approach to establish the causality. We find robust evidence that GF initiatives significantly increase the MAC of CO2 emissions by about 310 yuan per ton in affected pilots compared to the counterparts. We further uncover that GF initiatives have tenuous effects on decreasing the carbon abatement costs via the green innovation channel, the technical effect is largely overpowered by the regulatory effect, which substantially pushes up the carbon abatement costs, ultimately leading to a total rise in the carbon abatement costs. Overall, our study offers new insights into the previously under-explored cost side of GF initiatives on the real economy. In particular, we argue that GF regulation is one of the nonnegligible channels by which transition risks get embedded in net-zero economy.

Effects of autologous serum and artificial tears on corneal sensation and tear film stability in patients with mild to moderate xerophthalmia after cataract surgery.

We aimed to evaluate the effects of autologous serum plus artificial tears on corneal sensation and tear film stability in patients with mild to moderate xerophthalmia after cataract surgery. A total of 150 patients with mild to moderate xerophthalmia after one-time cataract surgery from March 2022 to September 2023 were selected and randomly divided into a control group (n = 75) and a study group (n = 75). The control group was treated with artificial tears (polyvinyl alcohol eye drops), while the study group was given autologous serum plus artificial tears. The treatment lasted for four weeks in both groups. The clinical efficacy was observed and adverse reactions were recorded. The clinical effective rate of the study group was higher than that of the control group (96.00% versus 86.67%) (χ2 = 4.127, P < 0.05). After four weeks of treatment, the corneal sensation was superior to that before treatment in both groups, and it was better in the study group than that in the control group (Z = 2.053, P < 0.05). In comparison with the pre-treatment period, the tear film break-up time (BUT) increased, while the corneal fluorescein staining (FL) score and levels of inflammatory factors tumor necrosis factor-α, interleukin-6 (IL-6) and IL-1β dropped in both groups after treatment, and the study group had longer BUT and a lower FL score than those of the control group (t = 6.492, 7.033, 7.140, 4.709 and 3.059, P < 0.05). The incidence rates of adverse reactions were similar between the two groups (χ2 = 0.132, P > 0.05). Autologous serum plus artificial tears can improve the corneal sensation and tear film stability and alleviate inflammatory responses without increasing adverse reactions in patients with mild to moderate xerophthalmia after cataract surgery.

Central administration of p234, kisspeptin antagonist, but not kisspeptin-10, reduces the power of epileptiform activity and slow EEG waves in male rats

ABSTRACT Introduction We aimed to investigate the effects of central kisspeptin-10 and p234 administration on basal brain activity and epilepsy-like conditions induced by 4-aminopyridine (4-AP), as well as their roles in the electrocorticogram (ECoG) power spectrum and EEG waves. Methods Thirty-five male Wistar rats were divided into five groups: sham,4-AP (2.5 mg/kg i.p.), kisspeptin-10 post-treatment (200 pmoli.c.v.), p234 post-treatment (1 nmol i.c.v.), and p234 pre-treatment (1 nmol i.c.v.). We performed 70 minutes of recordings (10 min baseline) for all groups under ketamine/xylazine (90/10 mg/kg) anesthesia. In the post-treatment groups, kisspeptin-10 or p234 injections were administered 20 minutes after epilepsy induction. In the pre-treatment group, p234 was injected after baseline recordings. Following a 20-minute pre-treatment period, 4-AP was administered. Results 4-AP alone induced epileptiform activity in all animals, reaching apeak after 30 minutes. Neither kisspeptin-10 nor p234 post-treatment affected 4-AP-induced epileptiform activity (p > 0.05). However, p234 pre-treatment reduced epileptiform activity (p < 0.05). Additionally, kisspeptin-10 did not alter the spectral analysis of the EEG bands or the power of the ECoG (p > 0.05). In contrast, p234 reduced the power of the ECoG and the slow bands (delta and theta) (p < 0.05). Conclusion We conclude that p234 pre-treatment has an inhibitory effect on neuronal excitability and epileptiform activity in the neocortex.

Effect of dry needling, ischemic compression and cross-taping of the masseter in patients with orofacial myofascial pain: a randomized comparative study.

Temporomandibular disorders, of multifactorial etiology, refer to a series of pathologies that affect the temporomandibular joint and the associated musculature of the orofacial region and are the result of alterations in the physiological relationships of the stomatognathic system, responsible for functions such as chewing, phonation and swallowing. They produce, among other symptoms, mainly pain, which affects the quality of life of the patients who suffer from them. To alleviate the discomfort of neuromuscular pathology in the orofacial region, various therapeutic strategies are employed, ranging from non-invasive to more invasive methods. The aim of the study was to compare the efficacy of three therapeutic methods (dry needling, ischemic compression and cross-taping) in reducing or relieving masseter pain in individuals with orofacial myofascial pain. A multicenter randomized comparative clinical trial was conducted in 60 subjects over 18 years of age, divided into three groups: dry needling, ischemic compression and cross-taping. Pain intensity was assessed, randomly, by a single blinded evaluator, according to the Numerical Pain Rating Scale in the pre-treatment period, immediately after, 1-2 weeks and one month later. Immediately after applying the therapies, there was a greater decrease in pain intensity in dry needling, followed by ischemic compression and a smaller decrease in the cross-taping technique (p < 0.0001; p = 0.0001; p = 0.0014, respectively). After 1-2 weeks, there was a noticeable increase in the dry needling technique, however, there was a decrease in pain in the cross-taping technique. After 1 month of application, both dry needling and ischemic compression showed a slight reduction in pain intensity, in contrast to the cross-taping group, which showed an increase in pain intensity. Dry needling and ischemic compression were more effective than cross-taping for immediate reduction of orofacial myofascial pain. Further short- and long-term research is needed to confirm these findings. clinicaltrials.gov, identifier (NCT0660604).

Diet supplementation with a mixture of essential oils: Effects on enteric methane emissions, apparent total-tract nutrient digestibility, nitrogen utilization, and lactational performance.

This study examined the effects of supplementing dairy cows with a mixture of essential oils on enteric CH4 emissions, apparent total-tract nutrient digestibility, N utilization, and lactational performance (production, components and efficiency). Thirty-two multiparous lactating Holstein cows were used in a randomized complete block design. Cows averaged (mean ± SD) 95 ± 15.4 DIM, 47.7 ± 4.51 kg milk yield, and 698 ± 68.2 kg BW, at the start of the experiment. The experiment consisted of a 3-wk pretreatment period (i.e., covariate), followed by a 3-wk adaptation to the experimental treatments, and a 10-wk period for data and sample collection. At the beginning of the study, milk yield and DIM data were used to block the cows into 16 blocks of 2 cows each. Subsequently, the blocks were adjusted based on milk yield and enteric CH4 emission data collected during the pretreatment period. Within each block, cows were assigned to 1 of 2 dietary treatments: (1) a basal diet supplemented with a placebo (control, no additive), or (2) a basal diet with the essential oil supplement (Agolin, 1 g/cow/d). The basal diet (i.e., total mixed ration) was composed of 69.3% forage (corn and alfalfa silage and grass hay) and 30.7% concentrate, on a dry matter (DM) basis, while the essential oil mixture consisted mainly of coriander seed oil, eugenol, geraniol and geranyl acetate. Twice daily, the essential oil supplement was thoroughly mixed with 50 g of a commercial protein supplement (i.e., carrier) and 500 g of the TMR and this premix (i.e., 550 g/meal) was offered to the cow before the basal diet. No interactions between the essential oil supplement and the sampling week were observed for any of the response variables. Dry matter intake, apparent total-tract nutrient digestibility and N balance were unaffected by feeding the essential oil supplement. Yields of milk, 4% FCM, and ECM were not modified by the experimental treatment. Neither feed efficiency (kg milk/kg DMI, kg 4% FCM/kg DMI, kg ECM/kg DMI) nor dietary N use efficiency in milk N secretion (i.e., g milk N/ g N intake) were affected by essential oil supplementation. Body weight change and BCS did not differ between cows fed the essential oil supplement versus cows fed the control. Daily enteric CH4 emissions, CH4 yield, and CH4 intensity averaged 498 g/d, 18.4 g/kg of DMI, and 11.0 g/kg of ECM, respectively, and were unchanged by essential oil supplementation. We conclude that supplementing cows fed a high-forage diet with 1 g/d of this essential oil mixture did not positively affect lactational performance, nutrient digestibility, and N utilization, or reduce enteric CH4 (emissions, yield, and intensity). More research is needed to identify the optimal dose of this essential oil mixture and elucidate how it may interact with the basal diet to improve the mixture's efficacy.

Examination of the effect of treatment of severe early childhood caries and fluoride varnish applications on salivary oxidative stress biomarkers and antioxidants

BackgroundSaliva contains a variety of biochemical compounds, including antioxidants, and serves as the body’s first line of defense against oxidative stress caused by free radicals. The aim of this study was to investigate the effects of dental treatments on salivary oxidative stress biomarkers in children aged 3–5 years with severe early childhood caries (S-ECC) compared to children without caries.MethodThis study was conducted on 20 children aged 3–5 years with severe early childhood caries (S-ECC) and 20 children without caries. Salivary oxidative stress biomarkers and antioxidants were measured after the initial examination (T0), after the end of restorative treatments (T1), and after fluoride varnish applications (T2). Post hoc Bonferroni test was used to compare normally distributed parameters between T0-T1-T2 times. Pearson correlation analysis was used to examine the relationships between parameters that conform to normal distribution. The Mann-Whitney U test was used to compare the parameters in the control and experimental groups. Significance was evaluated at the p < 0.05 level.ResultsThe mean dmft of the participants in the study group was 8.86 ± 14.5. Advanced oxidation protein products (AOPP), dityrosine (DT), kynurenine (KYN), advanced glycation end products (AGE), lipid hydroperoxides (LHP) and malondialdehyde (MDA) values decrease after the treatment of dental caries and protective fluoride varnish applications, while an increases in total thiol (TSH) and Cu/Zn-superoxide dismutase (Cu/Zn-SOD) values were observed after protective varnish applications compared to pre-treatment values. Antioxidant parameters at time T2 in the study group were statistically significantly higher than in the control group (p < 0.05). In the study group, there was no correlation between TSH and oxidative stress mediators in terms of changes at time T1 post-treatment compared to the pre-treatment period, while an inverse moderate relationship was found with AGE and LHP in terms of changes at time T2 post-treatment (p < 0.05).ConclusionsAn increase in salivary antioxidants was detected after dental restorations were completed and protective fluoride varnish application, while a decrease in oxidative stress markers was detected.Clinical relevanceFluoride varnish applications applied in the study group may further reduce the oral microbiome load and cause salivary oxidative stress markers to be significantly lower than in the control group.

Assessment of Attack Frequency in PFAPA Patients Based on Therapeutic Modalities.

This study aims to present the clinical characteristics of patients with PFAPA syndrome, and to compare the effects of corticosteroid usage, colchicine prophylaxis, and tonsillectomy on the frequency of attacks in patients with PFAPA syndrome. Patients aged between 6 months and 18 years presenting to our Paediatric Rheumatology clinic between 2017 and 2021 who were diagnosed with PFAPA syndrome and followed up for a minimum of 12 months were included in this study. The demographic and clinical characteristics of the patients, laboratory findings, attack durations, and treatments were recorded. Our study, comprised of 195 patients, included four groups: untreated (n = 58), corticosteroid (n = 43), colchicine (n = 62), and tonsillectomy (n = 32). There was no significant difference between the treatment groups in terms of attack frequencies before treatment initiation (p > 0.05). When attack frequencies before and after treatment initiation were observed, a decrease in attack frequency compared to the pre-treatment period was observed in the tonsillectomy group (from 12 to 3 attacks) (p < 0.001) and the colchicine group (from 12 attacks to 1 attack) (p < 0.001). It was noted that using steroids during three or more attacks increased attack frequency compared to the pre-treatment period (p < 0.0001). Tonsillectomy resulted in a more significant reduction in attack frequency compared to the colchicine group (p < 0.001). Using corticosteroids during an attack has been shown to effectively control attacks. However, the repeated use of corticosteroids increases the frequency of attacks. Colchicine prophylaxis leads to a reduction in attack frequency in the majority of cases. Tonsillectomy can successfully control the disease in most cases.

Clinical features and prognosis of children with multiple Takayasu's arteritis complicated with carotid artery occlusion

This study aimed to analyze the clinical characteristics and prognosis of Takayasu's arteritis (TA) with carotid artery occlusion in children. This study collected clinical data and follow-up information on the first diagnosis and treatment of c-TA combined with carotid artery occlusion in pediatric patients at the Children's Hospital affiliated with the Capital Institute of Pediatrics and Inner Mongolia Medical University Affiliated Hospital from 2013 to 2023. This study included four female patients with a mean age of (13.25±1.71) years old. The time from onset to diagnosis was (8.14±11.19) months. Their main clinical symptoms and signs were dizziness, headache, chest discomfort, aphasia, dyskinesia, impaired mobility of the limbs, hypertension, asymmetry of blood pressure in the limbs, vascular murmurs or tremors, weakened radial artery pulsation, and decreased muscle strength. All four children showed elevated levels of C-reactive protein and erythrocyte sedimentation rate. The medical imaging results showed that among the four patients, three had bilateral carotid artery occlusion, and one had unilateral carotid artery occlusion. There were three cases of cerebrovascular involvement, accompanied by arterial involvement in multiple parts of the body, mainly involving bilateral subclavian arteries, cephalic trunk arteries, bilateral renal arteries, bilateral iliac arteries, and middle cerebral arteries. Four children were effectively treated with glucocorticoids and immunosuppressants. These children were followed up for a period of (42.25±52.54) months, which showed that the original affected artery still had varying degrees of occlusion, with no progression from the pre-treatment period and no new arterial involvement. The condition of three children with pre-existing physical and language disorders gradually improved. In summary, children with c-TA combined with carotid artery occlusion can cause involvement of multiple blood vessels. Their clinical manifestations are mostly systemic symptoms and ischemia of corresponding supply organs caused by vascular lesions, which are prone to be combined with cerebral infarction, and their occluded blood vessels are difficult to recover.

Cardiovascular problems in rabbits in reference to hypothyroidism - a four-year retrospective study.

The effects of T4 are mainly manifested by positive ino- and chronotropism. The syndrome accompanying hypothyroidism in rabbits (impaired myocardial contractility and reduced ejection capacity) is caused by a deficiency of thyroid hormones - especially T4. The study group consisted of a total of 41 animals: 15 males and 26 females, ranging in age from 2 months to 8 years, with echocardiogram showing reduced fractional shortening (<30%), with normal results of heamatological and biochemical tests. Blood was collected in order to measure T4 level. Echocardiographic examinations were performed with two-dimensional (2D) imaging, M-mode measurements and the pulsed/colour-labelled Doppler technique. Statistical analysis was performed using Statistica 13.0. Correlations were determined: between serum thyroxine concentration and the value of the fraction of shortening in the groups: young animals (up to 5 years of age) and older animals, females and males, and sterilised and non-sterilised animals. Statistical analysis showed a positive correlation between T4 levels in the blood of the test animals and myocardial fractional shortening and heart rate and left-atrial to aortic ratio (LA/Ao) in the pre-treatment period. A positive correlation was also shown after dividing the patients into 2 groups based on their age (below 5 years vs. 5 years and over), sex (male and female rabbits) and fact of sterilization (yes/no). Our study unequivocally confirmed a positive correlation between the decreased serum T4 concentration and reduced fractional shortening, indicating decreased cardiac systolic function in hypothyroid rabbits.

Does China’s carbon emission trading scheme reduce CO[formula omitted] emissions? Comprehensive evaluation from synthetic control method using lasso

Although China’s carbon emissions trading scheme (ETS) serves as an effective and economically viable tool to mitigating carbon dioxide (CO2) emissions, challenges exists in accurately quantifying the ETS treatment effect. Focusing on improving the precision of evaluating the treatment effect, this study employs the synthetic control method using lasso (SCUL) to construct synthetic units for six pilot regions and makes a comparison with the synthetic control method (SCM). Based on seven predictor variables ranging from 2000 to 2017, we find that: (1) SCUL produces more accurate predictions than SCM before the intervention. SCUL generates synthetic CO2 emissions that seamlessly align with their actual counterparts throughout the pre-treatment period for six pilot regions. The average Cohen’s D values are notably lower than 0.25, standing at 0.052, 0.0314, 0.1501, 0.0412, 0.01, and 0.0346 for Beijing, Tianjing, Shanghai, Hubei, Guangdong, and Chongqing, respectively. In contrast, SCM achieves satisfactory pre-treatment fits only for Hubei, Guangdong, and Chongqing, exhibiting average Cohen’s D values of 0.2426, 0.1366, and 0.1624 respectively. (2) The in-place and in-time placebo tests implemented via SCUL both verifies the robustness of the results of SCUL. (3) SCUL and SCM yield similar results for Hubei, Guangdong, and Chongqing. This further supports the validity of SCUL’s conclusions. Additionally, SCUL offers insights into Beijing, Tianjin, and Shanghai that SCM fails to provide.

Involvement of bile acid in diarrhoea and therapeutic effect of colestimide in hereditary ATTR amyloidosis

Background Diarrhoea is one of the most serious complications in hereditary ATTR (ATTRv) amyloidosis. However, its precise pathomechanism remains unknown. The present study investigated the involvement of bile acid in diarrhoea along with the therapeutic effect of colestimide, a bile acid sequestrant, in ATTRv amyloidosis. Methods We prospectively enrolled 19 ATTRv amyloidosis patients (9 with refractory diarrhoea and 10 without diarrhoea) and 20 healthy individuals for measurements of serum 7a-hydroxy-4-cholesten-3-one (C4) levels. The patients with diarrhoea were then treated with oral colestimide (1.5 g twice daily) for 28 days. The frequency of diarrhoea and C4 level were evaluated before and after colestimide treatment. Results Mean serum C4 level was significantly higher in ATTRv patients with diarrhoea (62.3 ng/mL) than in ATTRv patients without diarrhoea (24.0 ng/mL, p = 0.03). Colestimide treatment significantly decreased mean diarrhoea frequency (pre-treatment period: 9.1 times/week, colestimide treatment period, 6.6 times/week, p = 0.04) and increased mean C4 level (before treatment: 66.2 ng/mL, after treatment: 187.1 ng/mL, p = 0.02). Conclusions Bile acid status was significantly associated with diarrhoea in ATTRv amyloidosis. Colestimide and other bile acid sequestrants may reduce diarrhoea frequency in afflicted patients.

Comparative evaluation of autologous dental bone powder and deproteinized bovine bone mineral allografts for oral implant bone deficits.

To compare the effectiveness of autologous dental bone powder grafts with deproteinized bovine bone mineral (DBBM) allografts in oral implant bone deficiency. Between January 2021 and January 2023, we enrolled 120 patients with inadequate bone for oral implantation, dividing them into an experimental group and a control group (60 each). The experimental group received autologous dental bone powder grafts, while the control group received DBBM allografts. Wound healing was assessed using the early healing index (EHI) with 5 days of closure as the baseline timeline, as Grade I: full closure without a fibrin line, Grade II: closure with a fibrin line, and Grade III: closure with fibrin covering the incision. Additional outcomes included buccal and palatal alveolar bone height, alveolar bone width at 3 (W1), 7 (W2), and 11mm (W3) below the top of the alveolar ridge, and bone density measured before and 3 months after tooth extraction. The altered shape of the alveolar bone at the extraction site was assessed at 3- and 6-months post-extraction. Implant success rate was also evaluated at 15 days and 1 month after implantation. Comparisons were made using independent t-tests, paired t-tests, χ² tests, and Z tests, as appropriate. The experimental group had a lower wound healing time and a greater prevalence of EHI categorization class I compared to the control group (P < 0.05). Three months after tooth extraction, there was no statistically significant difference in buccal and palatal alveolar bone heights between the experimental group and the pre-treatment measurements (P > 0.05). However, the control group showed a decrease in buccal and palatal alveolar bone heights compared to the pre-treatment period, while the experimental group had greater bone heights than the control group (P < 0.05). Three months after extraction, the widths of W1, W2, and W3 decreased in both groups. However, the experimental group maintained greater widths compared to the control group (P < 0.05). At 3 months post-extraction, both groups showed an increase in alveolar bone density at the extraction site. Notably, the experimental group had a higher bone density compared to the control group as well as new bone contour score of the alveolar bone at the extraction site (P < 0.05). However, at 6 months after extraction, there was no statistically significant difference in the new bone contour score of the alveolar bone at the extraction site between the two groups (P > 0.05). There was no significant difference in the implant success rate between the two groups. (P > 0.05). Autologous dental bone powder grafting promotes initial alveolar bone regeneration, enhances wound healing, and increases new bone density, providing favorable surgical conditions for dental implants. However, by 6 months, there was no significant difference in bone contour compared to DBBM allografts, indicating similar long-term clinical outcomes for both materials.

Effects of six antipsychotic drug treatment regimens on short-term heart rate variability in patients with schizophrenia.

Many antipsychotic drugs have cardiac side effects due to their pharmacological actions. Heart rate variability (HRV) analysis can be used as a potential indicator of cardiotoxicity in cases where a decrease in HRV occurs after the administration of antipsychotics such as clozapine. The purpose of this study was to explore the effects of 6 antipsychotic drug regimens on short-term HRV in patients with schizophrenia. Data from 164 patients with schizophrenia between January 2018 and June 2023 were retrospectively analysed. Based on the drug used for treatment, the patients were categorised into clozapine combination (clozapine combined with aripiprazole, risperidone or ziprasidone), clozapine alone, olanzapine, aripiprazole, ziprasidone or risperidone groups. Heart rate variability indices were calculated using time domain analysis, including the standard deviation of the RR intervals (SDNN), the root mean square of successive RR interval differences (RMSSD) and the percentage of successive RR intervals over 50ms (PNN50). Compared with the pretreatment period, the SDNN, RMSSD and PNN50 were significantly lower in the clozapine combination, clozapine, olanzapine and aripiprazole groups at the end of weeks 2 and 4 of treatment (P < 0.05). However, these indicators in ziprasidone and risperidone groups did not show this significant decrease (P > 0.05). The effects of clozapine combination and clozapine on HRV were greater than for olanzapine, aripiprazole, ziprasidone or risperidone. Attention should be paid to controlling the dosage of clozapine combination and clozapine and monitoring the patient's electrocardiogram during administration.

Short-Term Efficacy and Safety of Suvorexant and Lemborexant: A Retrospective Study.

Given the risks of long-term benzodiazepine use, safer alternatives like orexin receptor antagonists (ORAs) are needed for insomnia treatment. This study aims to compare suvorexant and lemborexant, focusing on early-stage sleep duration as an efficacy measure and fall incidence as a safety measure. We included patients admitted to our hospital between April 1, 2022and December 31, 2022, who were newly prescribed suvorexant or lemborexant, excluding patients taking other concomitant sleep medications or antipsychotics. Primary and secondary endpoints were sleep duration during the first three days after taking the medications and the incidence of falls, respectively. We analyzed data from 48 and 57 patients taking suvorexant and lemborexant, respectively. When compared with that in the pre-treatment period, sleep duration was significantly longer on days 2 and 3 in the suvorexant group, and on all three days in the lemborexant group. On day 1 of drug administration, the lemborexant group had a significantly longer sleep duration than the suvorexant group (5.10 ± 1.84 vs. 5.93 ± 1.90 h, respectively; P = 0.017). Zero (0.0%) and three (5.3%) falls occurred in the suvorexant and lemborexant groups, respectively (P = 0.248). Lemborexant exerted a potent inhibitory effect on orexin 2 receptors, which could explain the longer sleep duration experienced by patients taking this drug on the first day of treatment.

Efficacy and safety of dienogest on ovarian endometrioma

Objective: To observe the effects and safety of dienogest on the volume and symptoms of ovarian endometrioma (OMA). Methods: The clinical data of 75 patients with OMA who underwent treatment with dienogest (2 mg/day) at the First Affiliated Hospital of Nanjing Medical University from July 1st 2020 to March 31st 2024 were retrospectively analysed, mainly comparing the changes in the volume of OMA and the visual analogue scale (VAS) scores of endometriosis-related pain before and after the treatment, as well as observing the changes in the blood biological indicators, liver and kidney function, coagulation function and changes in breast. Results: The median cyst volumes of the OMA patients at 3, 6 and 12 months of dienogest treatment were 13.21 cm3 (volume reduction rate: 36.00%), 8.33 cm3 (volume reduction rate: 56.00%) and 4.10 cm3 (volume reduction rate: 77.62%), respectively, which were all significantly decreased from the pre-treatment period (all P<0.05). The VAS scores of pain of the OMA patients at 3, 6 and 12 months of dienogest treatment all were 0 mm. Blood cancer antigen 125 (CA125) and cancer antigen 19-9 (CA19-9) levels decreased progressively during treatment (all P<0.05). There were no statistical differences in the coagulation indexes, liver and kidney function indexes of the patients during dienogest treatment compared with those before treatment (all P>0.05). During the follow-up period, there were a few patients with changes in the growth sites or lesion category of the breast nodules, but there were no occurrence of breast cancer or precancerous lesions. Conclusion: Dienogest is effective in reducing OMA volume and alleviating endometriosis-related pain with few adverse effects.

How Effective is the Regional Joint Environmental Policy in China? Evidence from Inverse Difference-in-Differences

AbstractThis paper aims to evaluate the effects of the “2+26” policy launched by the Chinese government to improve air quality in Beijing–Tianjin–Hebei and its surrounding region. In order to evaluate such policy interventions, we propose a new inverse difference-in-differences (IDID) framework, which can identify the average quasi-causal effect under the inverse common trend condition. Using a baseline IDID regression model, we find that the “2+26” policy has a significant effect on improving the air quality, since the policy would reduce the value of Air Quality Index by 9.338 on average, if it had been implemented in the pre-treatment period. In the supplementary materials, we also investigate the co-existing spatial–seasonal policy effects by using several heterogeneous IDID regression models and show the remarkable long-run quasi-benefits over the quasi-costs of the “2+26” policy in Beijing and Tianjin through a cost–benefit analysis. Supplementary materials accompanying this paper appear online.

Effects of Mecobalamin on the Functional Outcomes of Complex Regional Pain Syndrome Type 1 of the Foot and Ankle.

Because of the unclear pathophysiology and the lack of consensus on the gold standard treatment of complex regional pain syndrome (CRPS), management requires a multidisciplinary approach, with the use of various treatment modalities. Nonetheless, no studies have ever been conducted to uncover the potential of mecobalamin as a treatment for CRPS type 1. Hence, the aim of this clinical trial was to evaluate the effects of mecobalamin on the functional outcomes of patients with CRPS type 1 of the foot and ankle, the total amount of pregabalin ingested, and the duration of pregabalin use in each patient. Forty-seven patients diagnosed with acute CRPS type 1 of the foot and ankle were recruited. Patients were randomly allocated into a control group (23 patients) and a mecobalamin group (24 patients), both receiving similar pain control medications and rehabilitation programs. Three divided doses of mecobalamin 1.5 mg/d were provided to the mecobalamin group for the first 3 months, whereas a placebo was administered to the control group. Data were collected from the pretreatment period, and from 1, 3, 6, and 12 months following the treatment. Both groups had similar demographics. The mean Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and FAAM-sport scores in the mecobalamin group at 3 months were 74.5 ± 17.9 and 56.3 ± 22.9, whereas the mean FAAM-ADL and FAAM-sport scores in the placebo group at 3 months were 62.2.5 ± 15.2 and 43.4 ± 14.9, respectively (P < .05). The 36-Item Short Form Health Survey (SF-36) mental health subscale after 3 months were 83.3 ± 9.5 points and 75.8 ± 12.6 points in the mecobalamin and placebo group, respectively (P < .05). However, at other time points of assessment (1, 6, and 12 months), the improvement in symptoms was not distinguishable between the 2 groups. Both the amount and duration of total pregabalin required to achieve similar improvements in pain scores were significantly lower in the mecobalamin group than the control group. This small study revealed an improvement of the functional outcomes in patients with CRPS type 1 of the foot and ankle who received mecobalamin instead of a placebo at 3 months that was not sustained at 6 and 12 months. We identified an average 39% total reduction in the amount of total pregabalin used in the mecobalamin group in the first 12 months.