Prevention Study Research Articles

Epigenetic age acceleration is related to cognitive decline in the elderly: Results of the Austrian Stroke Prevention Study.

Epigenetic clocks, quantifying biological age through DNA methylation (DNAmAge), have emerged as potential indicators of brain aging. As the variety of DNAmAge algorithms grows, consensus on their efficacy in predicting age-related changes is lacking. This study aimed to explore the intricate relationship between diverse DNAmAge algorithms and structural and cognitive markers of brain aging. Within a cohort of 796 elderly patients (mean age, 65.8 ± 7.9 years), we scrutinized 11 DNAmAge algorithms, including Horvath, Hannum, Zhang's clocks, PhenoAge, GrimAge, DunedinPACE, and principal component (PC)-based PCHorvath, PCHannum, PCPhenoAge, and PCGrimAge. We evaluated their association with baseline cognition and cognitive decline, assessed through follow-up evaluations at three (T1) and six (T2) years postbaseline. Additionally, we examined their relationship with structural magnetic resonance imaging markers of brain aging, including white matter. Zhang's clock was the best predictor of decline in memory (β = -0.04) and global cognition (β = -0.03), whereas PCGrimAge was the best predictor of speed decline (β = -0.17). The DNAmAge algorithms were the second-best predictors in explaining cognitive variability after education in memory and global cognition (R2 partial = 1.66% to 2.82%) and the best predictors for speed decline (R2 partial = 2.13%). PC-trained DNAmAge algorithms outperformed their respective original version. DNAmAge algorithms are strong and independent predictors of cognitive decline in the normal elderly population and explain additional variability in cognitive decline beyond that accounted for by conventional risk factors.

Identifying proximal humerus fractures: an algorithmic approach using registers and radiological visit data.

The aim of this study was to investigate how reliably proximal humerus fractures can be identified from different administrative datasets without manual review. Using the national medical registers, namely the Care Register for Health Careand the Register for Primary Health Care Visits, as well as the regionalradiological image archive PACS, we developed algorithms for automated identification of proximal humerus fractures. In addition to these sources, we used data from patient records as well as from the self-reports gathered by the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) to establish a gold standard of fractures for validating the algorithms. This gold standard included proximal humerus fractures for a cohort of 11,863 post-menopausal women living in the Kuopio region between 2004 and 2022. We report the national registers' yearly accuracy in identifying proximal humerus fractures. During the studied 19-year period, the registers' coverage initially improved but then settled at 75%. We show that the image archive provides almost complete coverage of radiographs for the fracture cases, but excluding false positives poses a challenge. In addition, we propose a simple approach that combines register and radiography visit data to improve the accuracy of automated fracture identification. Our algorithm improves the coverage from 74 to 81% and reduces the false discovery rate from 8 to 7% compared to the traditional register analysis. The proposed approach enables a more reliable way of identifying proximal humerus fractures from administrative data. This study contributes to the objective of automatically tracking all types of fragility fractures in large datasets.

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2024 American Heart Association Scientific Sessions.

Focused review highlighting ten select studies presented at the 2024 American Heart Association (AHA) Scientific Sessions. Included studies assessed effects of intensive blood pressure control in patients with type 2 diabetes (BPROAD); decision support system for physicians to optimize early lipid lowering therapies after acute coronary syndrome (ZODIAC); efficacy and safety of zerlasiran, a short interfering RNA targeting lipoprotein(a) (ALPACAR); efficacy and safety of muvalaplin an oral disrupter of the assembly of lipoprotein(a) particles (KRAKEN); safety and efficacy of obicetrapib in patients with heterozygous familial hypercholesterolemia (BROOKLYN); efficacy and safety of lerodalcibep, a third generation PCSK9 inhibitor in heterozygous familial hypercholesterolemia subjects (LIBerate-HeFH_OLE); personalized app-based coaching to improve physical activity in patients with HFpEF compared to standard care (MyoMobile); semaglutide to improve cardiovascular outcomes in patients with a history of coronary artery bypass surgery and overweight or obesity (the SELECT trial); efficacy and safety of plozasiran in adults with genetically or clinically defined familial chylomicronemia syndrome at high risk of acute pancreatitis (PALISADE); and transcriptomic signatures and predictors of evolocumab added to maximum statin therapy based on intra-coronary plaque characteristics (YELLOW III). Research presented at the 2024 AHA Scientific Sessions emphasized innovative strategies in cardiovascular disease prevention and management.

Experimental study of medical staff thermal comfort and patient prevention of intraoperative hypothermia in the operating rooms based on medical and engineering

Experimental study of medical staff thermal comfort and patient prevention of intraoperative hypothermia in the operating rooms based on medical and engineering

Abstract DP55: Recurrent Stroke in Patients with Cryptogenic Stroke and Left Ventricular Injury: The Cardiac Abnormalities in Stroke Prevention and Recurrence (CASPR) study

Abstract DP55: Recurrent Stroke in Patients with Cryptogenic Stroke and Left Ventricular Injury: The Cardiac Abnormalities in Stroke Prevention and Recurrence (CASPR) study

An Updated Review on the Alarming Epidemic of the Monkeypox Virus

: After the COVID-19 pandemic, the world has been vulnerable due to another virus called monkeypox. Monkeypox is a very uncommon zoonotic infectious condition that occurs in both human and non-human primates with similar clinical characteristics as smallpox along with remarkable epidemic potential because of the increasing existence of human outbursts in recent scenarios. The increasing number of cases of this virus is developing curiosity among the people, hence scientists are aiming to become aware of various pathological characteristics and management of this virus before it becomes an epidemic. Currently, the monkeypox outbreak is a trending headline and has increased as an alarming tone after continuous upcoming cases. Previous studies revealed that the first human suspected case was found on September 1, 1970, when a 9-month-old baby was admitted to the Basankusu Hospital in the Democratic Republic of Congo. It is hard to distinguish monkeypox from the smallpox virus therefore, laboratory testing is the technique of disease identification and monitoring. Various new approaches and vaccines are being positioned for the prevention and clinical management of monkeypox through the entanglement of metallic and organic nanocarriers. However, more researchers suggested that virology and ecology of the virus in endemic areas is essential to recognize and avoid further worldwide occurrence of this virus. On behalf of an exhaustive literature survey, We are providing a rationalizing overview of monkeypox in the context of its present global outbreak, as well as its symptoms, prevention, treatment, assessment, and clinical studies.

Evidence for alpha-synuclein aggregation in older individuals with hyposmia: a cross-sectional study.

Synuclein pathology in neurodegenerative diseases, such as Parkinson's disease (PD) and Dementia with Lewy bodies (DLB), begins years before motor or cognitive symptoms arise. Alpha-Synuclein seed amplification assays (α-syn SAA) may detect aggregated synuclein before symptoms occur. Data from the Parkinson Associated Risk Syndrome Study (PARS) have shown that individuals with hyposmia, without motor or cognitive symptoms, are enriched for dopamine transporter imaging (DAT) deficit and are at high risk to develop clinical parkinsonism or related synucleinopathies. α-syn aggregates in CSF were measured in 100 PARS participants using α-syn SAA. CSF α-syn SAA was positive in 48% (34/71) of hyposmic compared to 4% (1/25) of normosmic PARS participants (relative risk, 11.97; 95% CI, 1.73-82.95). Among α-syn SAA positive hyposmics 65% remained without a DAT deficit for up to four years follow-up. α-syn SAA positive hyposmics were at higher risk of having DAT deficit (12 of 34) compared to α-syn SAA negative hyposmics (4 of 37; relative risk, 3.26; 95% CI, 1.16-9.16), and 7 of 12 α-syn SAA positive hyposmics with DAT deficit developed symptoms consistent with synucleinopathy. Approximately fifty percent of PARS participants with hyposmia, easily detected using simple, widely available tests, have synuclein pathology detected by α-syn SAA. Approximately, one third (12 of 34) α-syn SAA positive hyposmic individuals also demonstrate DAT deficit. This study suggests a framework to investigate screening paradigms for synuclein pathology that could lead to design of therapeutic prevention studies in individuals without symptoms. The study was funded by the U.S. Department of Defense, the Helen Graham Foundation and the Michael J. Fox Foundation for Parkinson's Research.

Introducing the suicide prevention trials database: A publicly available data repository of suicide prevention studies.

Healthcare, research, policy, and legislative stakeholders need timely, accurate, and detailed information on the effectiveness and potential harms of suicide prevention approaches. We created the Suicide Prevention Trials Database (SPTD) to provide a centralized, publicly accessible, detailed database of harmonized study-level suicide prevention clinical trial data. We searched for randomized controlled trials (RCTs) of suicide prevention published from 1980 to 2023. Over 300 data variables were extracted from each RCT. We identified a total of 140 unique RCTs in 180 articles. Most of the included RCTs compared two treatment arms (92%), and the remainder compared three arms (88%). Nearly half of the RCTs reported on Behavioral Interventions (49%), followed by Care Management, Follow-up, or Monitoring (16%). Typically, the comparator condition was Treatment as Usual (53%). Interventions were most often delivered in person (61%) in an individual format (79%). The SPTD provides efficient, accurate, up-to-date access to a comprehensive suicide prevention trials database, which can be utilized by a range of stakeholders. It can reduce the time required for high-quality systematic reviews and provides researchers, administrators, and funders with current data on the state of the literature.

Impact of CT-angiography derived plaque characteristics on cardiac events in patients with a negative invasive fractional flow reserve.

Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR>0.80) and had intracoronary imaging defined vulnerable plaque. Coronary computed tomography angiography (CTA)-defined high risk plaque (HRP) is known to predict future cardiac events. We hypothesized that CTA defined HRP would identify which FFR-negative patients were at greatest risk of future cardiac events. We examined 373 consecutive CCS patients undergoing CTA followed not more than 90days later by invasive FFR. Cardiac events were defined as cardiac death, non-fatal acute coronary syndromes, and ischemia-driven revascularization. Clinical follow-up was performed in all patients at a median of 32months. Revascularization was performed in 131 of the 373 patients due to an FFR≤0.80 (Treat group), with the remaining 242 having revascularization deferred (Defer group) due to an FFR>0.80. In the Treat group the cardiac event rates between patients with and without HRP on CTA were similar (9.4% versus 10.1%, p=0.90), whilst in the Defer group they were higher in patients with HRP (21.1% versus 4.7%, Log-rank-p<0.0001). In multivariate Cox hazard analysis the presence of HRP (Hazard-ratio 12.79, 95%confidence-intervals: 3.57-45.83, p<0.0001) was an independent predictor for cardiac events in the Defer group. HRP on CTA was associated with future cardiac events in patients in whom revascularization was deferred due to a negative invasive-FFR (UMIN000054067; CAPTURE).

Pathomorphological and biochemical changes in the oral mucosa in simulated atrophy

Oral mucosa atrophy is a widespread phenomenon both in prosthetics and in the maxillofacial pathology, having apoptosis as a fundamental mechanism. Modeling of atrophy processes will allow to study its pathogenesis and optimize therapeutic measures. The aim of the study was to investigate the development of oral mucosa atrophy in an experimental model. The study was performed on 50 Wistar male rats, undergone 37% orthophosphoric acid oral mucosa applications. After 30 seconds’ exposure the defect of the integumentary epithelium was found. 40-second and 45-second exposure additionally provoked desquamation of the stratum corneum. A 50-second application enhanced infiltration, 90- seconds -aroused significant epithelial defects, lymphocytic infiltration of the lamina propria, and fibers’ rupture. The expression of the anti-apoptotic marker bcl-2 remained consistently low in all layers of the integumentary epithelium, regardless of the exposure’s time. The pro-apoptotic cell surface death receptor was positive (2+) in the basal and spiny layers of the epithelium, and in the intrinsic plate of the mucosa. The proposed model is valid, based on the apoptotic mechanisms and can be used in the study of prevention and treatment of atrophic processes in oral cavity, including caused by complete removable plate prostheses.

573. CD388, a Novel Drug-Fc Conjugate (DFC), Demonstrates Prophylactic Activity in an Influenza Human Challenge Model

Abstract Background Influenza is a significant cause of morbidity and mortality globally. CD388 is a multivalent conjugate of a dimeric zanamivir stably linked to a proprietary human IgG1 Fc fragment engineered for extended half-life. In preclinical and two Phase 1 studies CD388 has been shown to be safe. Here we describe a post-hoc analysis of prophylactic activity of CD388 against influenza disease in a Phase 2a human challenge study. Methods Healthy participants (18-55 yrs) were randomized to receive subcutaneous (SQ) CD388 or placebo. CD388 was administered 5 days before intranasal challenge with A/Perth/16/2009 (H3N2). A hemagglutinin inhibition assay (HAI) was performed at the onset of quarantine, on Day 0 (prior to inoculation) and on Day 28. A 4-fold increase in Day 28 HAI titer with respect to Day 0 titer was considered as confirmation of influenza infection. Participants completed a graded symptom scoring system 3 x daily. Symptomatic infection was defined as RT-PCR-confirmed (2 quantifiable measurements on ≥ 2 independent samples over 2 days) or culture confirmed (1 quantifiable TCID50 measurement) influenza infection from Day 1 (pm) to Day 8 (am) AND fever or ≥ 2 symptoms at a single time point or any symptom of grade ≥ 2 at a single time point. Prophylactic efficacy was assessed among participants who experienced a 4-fold increase in HAI titer. Results 28 participants received 150 mg of CD388 and 28 received placebo. 17 participants in the CD388 arm (60.7%) and 15 participants in the placebo arm (53.6%) had a 4-fold increase in the HAI titer on Day 28 (Table 1). Although these end-points were not powered, of those with the 4-fold change in HAI, the number of symptomatic participants was significantly lower in the CD388 arm (3/17, 17.6%) compared to placebo (9/15, 60%; p= 0.017), and among these symptomatic participants the median AUC TCID50 (log TCID50/mL x number of days) was significantly lower in the CD388 arm (6.1, min 3.3, max 9.7) compared to placebo (10.8, min 5.7, max 17; p=0.008, Table 1). Conclusion A single SQ dose of CD388 administered 5 days prior to influenza challenge was effective in preventing symptomatic disease. A Phase 2b clinical influenza prevention study for CD388 will begin in the Fall of 2024. Disclosures Ozlem Equils, MD, Cidara Therapeutics: Employee|Cidara Therapeutics: Stocks/Bonds (Public Company) Shawn Flanagan, PhD, Cidara Therapeutics: Salaried Employee|Cidara Therapeutics: Employee|Cidara Therapeutics: Stocks/Bonds (Public Company)|Cidara Therapeutics: Stocks/Bonds (Public Company) Sy-Shi Wang, Ph.D., Janssen Research &amp; Development LLC: Employee|Janssen Research &amp; Development LLC: Stocks/Bonds (Public Company) Johan Vingerhoets, PhD, Janssen Pharmaceutica NV: Stocks/Bonds (Public Company) Wilbert van Duijnhoven, n/a, Janssen Pharmaceutica NV: Employee|Janssen Pharmaceutica NV: Stocks/Bonds (Public Company) Alex James Mann, MSc, hVIVO: Employee Roxana E. Rojas, M.D., Ph.D., Janssen Research &amp; Development LLC: Employee|Janssen Research &amp; Development LLC: Stocks/Bonds (Public Company)|Johnson and Johnson: Stocks/Bonds (Public Company) Taylor Sandison, MD, MPH, Cidara Therapeutics Inc: Employee|Cidara Therapeutics Inc: Stocks/Bonds (Public Company)

Early Improvements With Atogepant for the Preventive Treatment of Migraine: Results From 3 Randomized Phase 3 Trials.

Three phase 3 trials demonstrated the efficacy and safety of atogepant in episodic migraine (EM) and chronic migraine (CM) across 12-week treatment periods. This analysis evaluates improvements in efficacy and functional outcomes in the first 4 weeks of treatment with the oral calcitonin gene-related peptide receptor antagonist, atogepant, for the preventive treatment of migraine. ADVANCE, ELEVATE, and PROGRESS were phase 3, multicenter, randomized, double-blind, placebo-controlled 12-week trials. ADVANCE and ELEVATE included participants aged 18-80 years with >1 year history of EM and 4-14 monthly migraine days (MMDs). ELEVATE required previous treatment failures to 2-4 classes of oral preventives. PROGRESS included participants aged 18-80 years with >1 year history of CM, ≥15 monthly headache days, and ≥8 MMDs. This analysis reports the atogepant 60 mg once daily (QD) and placebo treatment arms. Outcomes included efficacy endpoints (reporting a migraine day on day 1, change from baseline in weekly migraine days [WMDs] at weeks 1-4, and in MMDs in the first 4 weeks) and functional endpoints evaluated by the Activity Impairment in Migraine-Diary (AIM-D) at weeks 1-4 and the European Quality-of-Life 5-Dimension 5-Level (EQ-5D-5L) at weeks 1-2 and 4. The modified intent-to-treat population included the ADVANCE (atogepant, n = 222; placebo, n = 214), ELEVATE (atogepant, n = 151; placebo, n = 154), and PROGRESS (atogepant, n = 256; placebo, n = 246) studies. Atogepant-treated participants had greater reductions in the proportion of participants with a migraine day on day 1. The odds ratio compared with placebo was 0.39 (95% CI 0.23-0.67; p = 0.0006) in ADVANCE, 0.53 (95% CI 0.29-0.94, p = 0.031) in ELEVATE, and 0.63 (95% CI 0.43-0.93, p = 0.021) in PROGRESS. Atogepant treatment reduced WMDs at weeks 1-4 and MMDs in the first 4 weeks, and improved AIM-D and EQ-5D-5L at all assessed timepoints for weeks 1-4 compared with placebo. Atogepant 60 mg QD demonstrated superiority to placebo in efficacy and functional measures in the first 4 weeks of treatment across 3 preventive studies, 2 in EM and 1 in CM. ClinicalTrials.gov NCT03777059; NCT04740827; NCT03855137. Submitted: 12/13/2018; 02/02/2021; 02/25/2019. First patient enrolled: 12/14/2018; 03/05/2021; 03/11/2019 clinicaltrials.gov/ct2/show/NCT03777059. clinicaltrials.gov/ct2/show/NCT04740827 clinicaltrials.gov/ct2/show/NCT03855137. This study provides Class II evidence that atogepant 60 mg QD reduces migraine frequency and improves functional outcomes within 4 weeks of initiation in patients with EM and patients with CM.

Self-Management Strategies for Low Back Pain Among Horticulture Workers: Protocol for a Type II Hybrid Effectiveness-Implementation Study.

Low back pain (LBP) is highly prevalent and disabling, especially in agriculture sectors. However, there is a gap in LBP prevention and intervention studies in these physically demanding occupations, and to date, no studies have focused on horticulture workers. Given the challenges of implementing interventions for those working in small businesses, self-management offers an attractive and feasible option to address work-related risk factors and manage LBP. This study will (1) investigate the effectiveness of self-management strategies for nursery and landscape workers by comparing within-subject control and intervention periods and (2) determine if adoption and effectiveness differs between participants randomly assigned to review self-management videos only and those who also receive multimodal implementation support. We will also identify contextual factors impacting effectiveness and implementation. A pragmatic, mixed methods, hybrid effectiveness and implementation design will be used to compare back pain with work tasks, disability, medication and substance use, and psychological factors between a baseline control and intervention periods. We aim to recruit 122 English- and Spanish-speaking horticulture workers with back pain, 30 supervisors, and 12 focus group participants. Participants will review short video modules designed to increase awareness of opioid risk and introduce self-management and ergonomic choices and use 1 self-management and 1 ergonomic strategy for 10 weeks. They will be randomly assigned to 2 implementation groups: video modules only or video + multimodal personalized support (checklist guidance, review of video feedback for ergonomic problem-solving, and text message reminders). Questionnaires will be administered at 3-month time points: baseline, pre- and postintervention, and at 3 and 6 months. Qualitative analysis of field notes, open-ended comments, and focus groups will expand understanding of results with comprehensive documentation of the context, barriers and facilitators, and reasons for adoption. The project was funded on September 29, 2023 (Centers for Disease Control and Prevention National Institute of Occupational Health and Safety, CDC NIOSH; U54OH011230-07S1), as a core research grant for the Southeast Coastal Center for Agricultural Health and Safety. The design, creation, and editing of English and Spanish videos was completed in June 2024 after comprehensive formative evaluation. Enrollment began in June 2024 with anticipated completion in 2027. We hypothesize that both self-management interventions will result in reductions in work task pain and disability and that the video enhanced with multimodal personalized support will result in greater reductions than the video alone. If self-management is effective, mitigating pain positively impacts quality of life, productivity, and retention, while increasing the use of nonpharmacological alternatives to opioids addresses an important public health issue. Implementation aims will help inform reasons for results, barriers and facilitators, and potential for similar interventions in these and similar industries with physically challenging outdoor work. ClinicalTrials.gov NCT06153199; http://clinicaltrials.gov/study/NCT06153199. DERR1-10.2196/64817.

Parental psychosocial factors and children’s oral health-related quality of life: Data from a caries prevention study with phone-based support

BackgroundCaries burden in children disproportionately affects minority and socioeconomically disadvantaged populations. Severe early childhood caries requiring general anesthesia (GA) is a significant concern, with high caries relapse rates in subsequent years.AimTo examine associations between parental psychosocial factors, children’s caries burden, and oral health-related quality of life (OHRQoL), including group differences, following a phone-based parental support intervention for children treated under GA for severe Early Childhood Caries (ECC).MethodsData were collected during a randomized controlled trial examining a phone-based parental support program. Parental stress was assessed using the Swedish Parenthood Stress Questionnaire (SPSQ), dental fear was measured with the Corah Dental Anxiety Scale (CDAS), and dental attitudes were evaluated using the Dental Beliefs Survey (DBS-R). Children’s OHRQoL was assessed using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). The Total Observed Caries Experience index was used to calculate the child’s cumulative caries burden. Unadjusted analyses were performed using t-tests, with effect sizes calculated as Cohen’s d. A two-step path analysis examined how parental factors, intervention, and baseline caries influenced caries burden at a one-year follow-up, while also assessing caries burdens impact on children's well-being.ResultsAt the one-year follow-up, the intervention group demonstrated significantly improved OHRQoL with lower mean scores on the P-CPQ and FIS compared to the control group, indicating fewer oral health issues and less impact on family life. No statistical differences were found in parental stress, dental fears, or dental beliefs between groups. Path analysis identified baseline caries and treatment group as significant predictors of caries burden, while intervention group predicted better OHRQoL outcomes. The model explained 86.2% of caries burden variance and 12.9% of OHRQoL variance.ConclusionA phone-based parental support program significantly improved children’s OHRQoL, even with a higher caries burden in the intervention group at the one-year follow-up. Parental stress, dental fears, and attitudes showed no differences and did not predict caries burden. Preventing early childhood caries in high-risk groups remains challenging, highlighting the importance of preventive initiatives that empower parents and foster collaboration with key stakeholders to reduce severe ECC.Registered at https://clinicaltrials.gov/ Identifier: NCT02487043.

Integrated omics profiling of individual variations in intestinal damage to the soybean allergen in piglets.

A small number of soybean allergens [including Glycinin (11S) and β-Conglycinin (7S)] in the commercially available corn-soybean meal diet can still cause allergy in some weaned piglets, which may be the result of the interaction of genetic, and nutrition, but the specific mechanism is still unclear. In this study, 20 allergic piglets and 20 non-allergic piglets were selected from 92 weaned piglets by skin sensitization tests, which were used to examine the whole sequence genome. The indicators related to humoral and cellular immunity, transcriptomics, and metabolomics analysis were determined by randomly selecting 5 boars in the allergic group and non-allergic group and then performing a validation in vitro. The sensitization rate of soybean antigen in the corn-soybean meal diet was 21.74% and there was a gender difference with the sensitization rate of female pigs (31.34%) being higher than that of male pigs (13.23%). Moreover, the levels of inflammatory factors (IL-1β, IL-4, TNF-α) and antibodies (IgG, IgE, and specific IgG) in allergic piglets were significantly higher than those in non-allergic piglets (P < 0.05). Whole genome re-sequencing analysis revealed specific mutations in the exons and URT5 of TRAPPC2, PIR, CFP, and SOWAHD genes and showed significantly higher expression levels of related genes in the spleen of allergic piglets (P < 0.05). Transcriptome analysis identified IL17REL, CCL19, CD1E, CD1.1, etc. immune differential genes, metabolomics results showed that soybean antigen affected the utilization and metabolism of intestinal nutrients in piglets, mainly the digestion and absorption of protein and the synthesis and metabolism of amino acids. Transfection of CFP/TRAPPC2/CCL19 siRNA could partially alleviate the injury of RAW264.7 cells or IPEC-J2 cells induced by β-Conglycinin. Therefore, the individual differences in intestinal damage induced by soybean antigen protein in the corn-soybean meal diet are closely related to PIR, CFP, TRAPPC2, SOWAHD, and CCL19 genes. Soybean antigens affect the intestinal nutrient utilization and metabolism of piglets, which provides a scientific reference for the study of soybean antigen sensitization mechanisms, precision nutrition, disease prevention, and control of piglets, and also lays a foundation for human foodborne diseases.

A 10-Year Risk Assessment and Primary Prevention Study of Atherosclerotic Cardiovascular Disease Among Adult Patients in Saudi Arabia: A Cross-Sectional Study.

Background and Objectives: Cardiovascular diseases (CVDs), primarily driven by atherosclerosis, are the leading cause of mortality worldwide. In Saudi Arabia, the prevalence of atherosclerotic cardiovascular disease (ASCVD) poses a significant public health challenge. To estimate the 10-year ASCVD risk among adults in Al-Ahsa, Saudi Arabia, and identify prevalent risk factors such as age, gender, diabetes, hypertension, smoking, cholesterol, and preventive medication use. Materials and Methods: This cross-sectional study included 58,743 adults aged 35-75 years from the Al-Ahsa Health Cluster. The ASCVD risk was calculated using the ACC/AHA Pooled Cohort Equations. Statistical analysis identified predictors of high ASCVD risk. Results: Most participants (76.3%) were at low ASCVD risk (≤10%), 13.3% at borderline to intermediate risk (10-19%), and 10.4% at high risk (≥20%). Smoking, diabetes (39.6%), hypertension (40.8%), and male gender were key predictors of high ASCVD risk. High-density lipoprotein (HDL) was protective, reducing ASCVD risk by 3%. Among high-risk individuals, 29.7% used aspirin, and 58.3% used statins. Conclusions: While most adults in Al-Ahsa are at low ASCVD risk, a significant portion remains at elevated risk. Modifiable risk factors, including smoking, diabetes, and hypertension, combined with statin and aspirin adherence, highlight critical areas for targeted interventions to reduce the ASCVD burden in this population.

Hip Fracture Intervention Study for Prevention of Hypotension Trial: a Pilot Randomized Controlled Trial.

Hypotension during anesthesia for surgery for hip fracture is common and associated with myocardial injury, stroke, acute kidney injury, and delirium. We hypothesized that maintaining intraoperative blood pressure close to patients' preoperative values would reduce these complications compared to usual care. A pilot feasibility patient- and assessor-blinded parallel group randomized controlled trial. People with unilateral hip fracture aged ≥70 years with capacity to give consent before surgery were eligible. Participants were allocated at random before surgery to either tight blood pressure control (systolic blood pressure ≥80% preoperative baseline and mean arterial blood pressure ≥75 mm Hg) or usual care. Feasibility outcomes were protocol adherence, primary outcome data completeness, and recruitment rate. The composite primary outcome was myocardial injury, stroke, acute kidney injury or delirium within 7 days of surgery. Seventy-six participants were enrolled, and 12 withdrew before randomization. Sixty-four participants were randomized, 30 were allocated to control, and 34 to intervention. There was no crossover, all 64 participants received their allocated treatment, primary outcome was known for all participants. The composite primary outcome occurred in 14 of 30 participants in the control group compared with 23 of 34 participants in the intervention group (P = .09), relative risk 1.45 (95% confidence interval [CI], 0.93-2.27). A randomized controlled trial of tight intraoperative blood pressure control compared to usual care to reduce major postoperative complications after fractured neck of femur surgery is possible. However, the data would suggest a large sample size would be required for a definitive trial.

Defining Crime Prevention: A Study of Swedish Police Officers

Defining Crime Prevention: A Study of Swedish Police Officers Crime prevention is strongly promoted in many countries’ police organizations. However, lack of a clear, agreed definition of the concept could impede its effective implementation. This study addresses associated problems by exploring 15 Swedish police officers’ understanding and definitions of crime-preventive work to characterize their translation of the official definition of crime prevention into operational practice. It was found that the participants had highly heterogeneous understanding and translation of crime prevention but broadly recognized that it consisted of preventing the occurrence, continuation and/or repetition of crime. They also recognized four key types of activities: collaboration, fostering constructive community relations, increasing risks of crime detection and deterrence and cause analysis. The results highlight needs for more coherent definitions of crime prevention and associated strategies to avoid the diversity of interpretations hindering the implementation, evaluation and improvement of crime prevention efforts.

Combination therapy in arterial hypertension: how to personalize treatment

Combination therapy is necessary in approximately 70% of hypertensive patients to achieve adequate blood pressure control. Furthermore, fixed combinations have a documented clinical utility as they increase therapeutic adherence. The most effective combinations of antihypertensive drugs are those made with drugs that have a complementary effect on the blood pressure regulation systems. In other words, it is rational to combine drugs that block the renin-angiotensin system or the sympathetic nervous system with drugs that activate these systems. Therefore, with regard to antihypertensive efficacy, both the fixed combination ACE-inhibitor/calcium channel blocker and the fixed combination AT1 antagonist/calcium channel blocker are rational as they have an additive effect on blood pressure reduction and improve the tolerability of the individual molecules. However, the choice of a combination therapy should not be limited only to evaluating the efficacy on blood pressure levels, but a more important target is certainly the ability to reduce cardiovascular events. As regards calcium channel blockers, the molecule with the best evidence of clinical efficacy in randomized controlled studies is certainly amlodipine (VALUE, CAMELOT, PREVENT, CAPARES, ASCOT and ACCOMPLISH studies). Also as regards ACE-inhibitors, the use of ramipril is supported by a significant series of clinical studies (HOPE, micro-HOPE and AIRE). In accordance with their efficacy, both molecules are the most used in daily clinical practice. It is however necessary to underline that, among AT1 antagonists, the best scientific literature certainly supports the efficacy of candesartan (SCOPE, TROPHY, AMAZE, CALM and DIRECT studies) which should therefore be the reference molecule in clinical use. Therefore, the combinations of ramipril/amlodipine and candesartan/amlodipine represent a therapeutic opportunity of primary importance as they combine the ACE-inhibitor, AT1 antagonist and the calcium channel blocker with the best documentation of efficacy in randomized controlled trials.In conclusion, the support of the scientific literature indicates that the rational use of these combinations can certainly represent an optimal choice for the treatment of arterial hypertension according to the best criteria of therapeutic appropriateness.

Associations of blood pressure with white matter hyperintensities later in life; influence of short-term menopausal hormone therapy.

To assess the association of systolic and diastolic blood pressure (SBP and DBP) in recently menopausal women with white matter hyperintensity (WMH) volume later in life and determine whether short-term menopausal hormone therapy (mHT) modifies these associations. Kronos Early Estrogen Prevention Study (KEEPS) was a multicenter, randomized, double-blinded, placebo-controlled 4-year mHT trial (oral conjugated equine estrogens or transdermal 17β-estradiol). KEEPS continuation was an observational follow-up of the participants 10 years after the end of mHT. The associations between KEEPS baseline blood pressure (BP) with KEEPS continuation WMH volume were examined adjusting for covariates in model 1 (age, total intracranial volume, study site, mHT type) and model 2 (additionally conventional CVD risk factors). Interaction terms (BP × mHT type) were added into the linear regression models. The mean ± SD ages of participants were 53 (±2) years at KEEPS baseline and 67 (±2) years at KEEPS continuation. Elevated BP at KEEPS baseline was associated with greater WMH volume measured 14 years later (model 1: SBP: β = 0.01 [95% CI, 0.001-0.01] and DBP: β = 0.01 [95% CI, 0.003-0.03]) and after additionally adjusting for CVD risk factors (model 2). We did not find any evidence that mHT versus placebo modified these associations. Topographically, higher BP was associated with greater periventricular WMH in the frontal and parietal lobes. Our findings suggest the importance of maintaining normal BP in recently postmenopausal women with low CVD risk, irrespective of short-term mHT usage, to potentially reduce the risk of WMH later in life.