Significant Treatment Differences Research Articles

Early dental visit affects dental treatment in Korean preschool children born preterm: a nationwide population-based study

This study investigated the effect of early dental visit on subsequent dental treatments in preterm infants and whether there was a significant difference in dental treatment between children born preterm and full-term (FT). National data from the Health Insurance Review and Assessment Service in Korea were analyzed. Prescription codes related to dental treatments were collected. This study included 3,354,662 patients under age 6 years, who were categorized by gestational age: extremely preterm (EPT), very preterm (VPT), and late preterm (LPT). In the preterm group, the percentage of children with no dental visits was 63.87% although the preterm group visited the dentist earlier than the FT group (EPT = 2.84, VPT = 2.78, LPT = 2.52, FT = 3.9 years old). Glass ionomer and 1-visit pulpectomy were significantly higher in the preterm group than in the FT group (p < 0.001). Preschool children who had their first dental visit after age 2 years received any dental treatment earlier than those who visited the dentist before age 1 year (p < 0.001). Early dental visits in infants may delay the timing of dental treatments and reduce their severity, suggesting the importance of early dental screenings for efficient dental management in preterm infants.

Point prevalence, characteristics and treatment variations for preterm infants with bronchopulmonary dysplasia in China: a ‘snapshot’ study

ObjectiveThe incidence of bronchopulmonary dysplasia (BPD) is increasing, but data on its prevalence and management variations remain insufficient in China. The study aims to investigate its point prevalence and variations...

The Impact of Antitumor Treatment on Cancer Patients with COVID-19: A Systematic Review and Meta-Analysis

Background: Cancer is a chronic disease that can cause various complications, decrease the immune system, reduce quality of life, and even lead to death. In addition, the COVID-19 pandemic in various countries has had a significant adverse impact on patients. This study analyzed the impact of various antitumor treatments on cancer patients with COVID-19. Methods: This meta-analysis was conducted according to the PRISMA – P pathway. Source searches were conducted in PubMed, Cochrane Library, Research Gate, and Science Direct in cancer patients with COVID-19 receiving various types of antitumor treatment. Analysis was performed using RevMan V.5.3 software with the outcome of mortality rate and severe COVID-19. Results: Twenty-five observational studies met the inclusion criteria with a total of 21,940 patients. There was no significant difference in mortality rate (OR 1.08, 95% CI 0.99 – 1.18, p = 0.09), but there was a significant difference in severe COVID-19 (OR 1.19, 95% CI 1.02 – 1.39, p = 0.02). Immunotherapy provided the most significant worsening of both mortality rate (OR 1.39, 95% CI 1.17 – 1.64, p = 0.0001) and severe COVID-19 (OR 1.82, 95% CI 1.23 – 2.71, p = 0.003). There were no significant differences in other antitumor treatments. Conclusions: Antitumor treatment does not have a significant impact on mortality rate, but has a significant impact on worsening the degree of COVID-19. Among all the antitumor therapies that provide the highest potential for worsening is immunotherapy.

Abstract A106: Disparities in the presence of driver mutations and response to tyrosine kinase inhibitors in young patients with lung cancer

Abstract Background: A concerning number of young patients (&amp;lt;50 years old) have been diagnosed with advanced lung cancer in recent years, likely due to driver mutations. This study examined disparities in the presence of driver mutations and response to tyrosine kinase inhibitors (TKI) in young patients with lung adenocarcinoma. Methods: This retrospective study included 98 patients (18-50 years old) with lung adenocarcinoma treated at the University of Miami Sylvester Comprehensive Cancer Center (2004-2023). Data from 81 patients with genetic information were analyzed. Patient demographics, clinical characteristics, and outcomes were collected. Chi- square and Kaplan-Meier methods were used, and p-values &amp;lt; 0.05 were considered significant. Results: Among the 17 patients without biomarker testing, 88% were white, 64.7% female and 59% Hispanic. The mean age at diagnosis for the 81 patients with genetic data was 41. Most were never smokers (56%), female (67%), white (83%), and Hispanic (52%) with stage IV disease (64%). At data cutoff in June 2023, 43 (53%) patients were alive, with a mOS of 27 months. Of the 81 patients, 58 (71.6%) had at least one driver mutation. The most common mutations were EGFR (31%), ALK (27%), and ROS1 (6%). No differences in mutation expression were found by gender, race, or ethnicity. Among patients with an actionable mutation, there were no significant differences in treatment with a TKI by race (p=0.337), gender (p=0.347), or ethnicity (p=0.940). However, 50% of eligible Black patients were not treated with a TKI compared to 26% of white patients. TKI as first-line treatment did not significantly vary by race (p=0.551), gender (p=0.883), or ethnicity (p=0.062), but 53% of white patients received a TKI as first-line therapy compared to 33% of Black patients. At data cutoff, there were no differences in the number of patients still taking a TKI based on gender (p=0.616), race (p=0.665), or ethnicity (p=0.465), although 46% of Hispanic patients were still on treatment compared to 35% of non-Hispanic patients. PFS on a TKI was similar for race (p=0.352) and gender (p=0.258), however Hispanic patients with an actionable mutation had a significantly longer PFS on a TKI than non-Hispanic patients (p=0.019), but not after controlling for age (p=0.116). Conclusion: This study is among the first to analyze disparities in driver mutations and response to targeted therapy in young patients with lung adenocarcinoma. No significant differences were found in TKI treatment, TKI as first-line therapy, or current TKI use by gender, race, or ethnicity. Notable trends included a greater percentage of eligible Black patients not receiving TKIs and fewer Black patients receiving TKIs as first-line therapy, although the sample of Black patients was small. Hispanic patients had a significantly longer PFS on TKIs than non-Hispanics, but not after controlling for age. Further research is needed to evaluate these trends, particularly with a larger cohort of Black patients. Citation Format: Kyle Edwards, Brandon Rose, Gilberto Lopes, Estelamari Rodriguez, Coral Olazagasti. Disparities in the presence of driver mutations and response to tyrosine kinase inhibitors in young patients with lung cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A106.

Clinical and imaging manifestations of intracerebral hemorrhage in brain tumors and metastatic lesions: a comprehensive overview.

This observational study aims to provide a detailed clinical and imaging characterization/workup of acute intracerebral hemorrhage (ICH) due to either an underlying metastasis (mICH) or brain tumor (tICH) lesion. We conducted a retrospective, single-center study, evaluating patients presenting with occult ICH on initial CT imaging, classified as tICH or mICH on follow-up MRI imaging according to the H-Atomic classification. Demographic, clinical and radiological data were reviewed. We included 116 patients (tICH: 20/116, 17.24%; mICH: 96/116, 82.76%). The most common malignancies causing ICH were lung cancer (27.59%), malignant melanoma (18.10%) and glioblastoma (10.34%). The three most common stroke-like symptoms observed were focal deficit (62/116, 53.45%), dizziness (42/116, 36.21%) and cognitive impairment (27/116, 23.28%). Highest mICH prevalence was seen in the occipital lobe (mICH: 28.13%, tICH: 0.00%; p = 0.004) with tICH more in the corpus callosum (tICH: 10.00%, mICH: 0.00%; p = 0.029). Anticoagulation therapy was only frequent in mICH patients (tICH: 0.00%, mICH: 5.21%; p = 0.586). Hemorrhage (tICH: 12682 mm3, mICH: 5708 mm3, p = 0.020) and edema volumes (tICH: 49389 mm3, mICH: 20972 mm3, p = 0.035) were significantly larger within tICH patients. More than half of the patients with neoplastic ICH exhibited stroke-like symptoms. Lung cancer was most common in mICH, glioblastoma in tICH. While clinical presentations were similar, significant differences in tumor location and treatments were discernible.

Pertumbuhan dan hasil jamur merang (volvariella volvacea) pada berbagai media tanam limbah pertanian

Straw mushrooms are a food ingredient that is much sought after by the public because they have a delicious taste and are beneficial for health with a complete nutritional co mposition consisting of carbohydrates (8.7%); protein (26.49%); fat (0.67%); calcium (0.75%); phosphorus (30%); potassium (44.2%) vitamins and minerals. For the growth of straw mushrooms, they need nutrients which can be fulfilled by the planting medium which can come from agricultural waste. This research aims to determine the growth and yield of straw mushrooms on various types of agricultural waste growing media. This research was designed using a Completely Randomized Design (CRD) with 4 treatment levels, namely: P0 = 50 kg rice straw, P1 = 50 kg reeds, P2 = 50 kg corn cobs, P3 = 50 kg sugarcane bagasse. The research was repeated 4 times to obtain 16 treatments. The results of the study showed that the effect of significant differences in treatment was only found in the observation parameter of the number of fruiting bodies of straw mushrooms, while the other parameters did not show significant differences. The results of the observations showed that the planting media treatment with rice straw gave the best results with a fruit body number of 63.5 fruit bodies, a fruit body diameter of 3.05 cm, a fruit body height of 4.42 cm and a fruit body wet weight of 898 gr. The time for pinheads to appear on rice straw planting media is faster than other planting media

220. SHORT-AND LONG-TERM OUTCOMES OF ROBOT ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: A PROPENSITY SCORE-MATCHED STUDY

Abstract Background Conventional minimally invasive esophagectomy (C-MIE) for esophageal cancer has become widespread and standardized. In Japan, robot-assisted MIE (RAMIE) has been covered by national health insurance since 2018. However, the superiority of RAMIE over conventional MIE remains controversial. In this study, we will clarify the short-and long-term outcomes of RAMIE compared to C-MIE. Methods Short-term outcomes were compared using propensity score-matching (PSM) for C-MIE group (324 cases) and RAMIE group (101 cases) performed from 2010 to 2023. Long-term outcomes were compared using PSM for C-MIE group (313 cases) and RAMIE group (69 cases) up to 2021, when a minimum three-year observation period was available. Covariates for PSM were age, sex, tumor location, histological type, cT, cN, preoperative treatment, abdominal approach, and range of lymph node dissection. Results For short-term outcomes, 96 cases were included in each group after PSM. There were no significant differences in age, sex, tumor location, histological type, cT, cN, and preoperative treatment. Operative time was significantly longer in RAMIE group than in C-MIE group (overall procedure: 657 vs. 764 min, P&amp;lt;0.001; thoracic prpcedure: 306 vs. 411 min, P&amp;lt;0.001). Blood loss was significantly lower in RAMIE group than in C-MIE group (145 vs. 64 ml, P&amp;lt;0.001). The rate of recurrent laryngeal nerve palsy (Clavien-Dindo classification, Grade II or higher) was significantly lower in RAMIE group than in C-MIE group (10% vs. 0%, P&amp;lt;0.001). There were no significant differences in the rates of anastomotic leakage and postoperative pneumonia between both groups (P=0.159, 0.709). For long-term outcomes, 69 cases were included in each group after PSM. The 3-year overall survival rate was 70.8% in C-MIE group and 77.1% in RAMIE group, and the 3-year disease-free survival rate was 63.5% in C-MIE group and 58.8% in RAMIE group, both showing no significant difference (P=0.406, P=0.651). Conclusions RAMIE has the potential to reduce recurrent laryngeal nerve palsy compared to C-MIE and long-term outcomes for both procedures were comparable.

Do Otologists and Other Otolaryngologists Manage Single-Sided Deafness Differently?

The aim of this study was to survey the knowledge and treatment management practices for single-sided deafness (SSD) among different subspecialties of otolaryngology. A questionnaire was sent via Google Sheets to members of the Turkish and Egyptian Otorhinolaryngology Societies between December 2021 and February 2022. For the statistical analysis, the respondents were divided into 3 groups as otologists, non-otologists, and residents at the department of otolaryngology-head and neck department. There were no statistically significant differences between otologists and non-otologists in radiological imaging (child P = .469, adult P = .140) and preferred treatment method (child P = .546, adult P = .106). However, otolaryngologists showed significant differences in radiological evaluation (P <.001), vestibular evaluation (P = .000), and frequency of treatment options recommended for pediatric and adult SSD patients (P = .000). There were no significant differences in SSD diagnosis, treatment, and rehabilitation between otologists and non-otologists. However, when comparing pediatric and adult patients, there was a difference in the treatment management of SSD patients.

A higher incidence of chondral injuries on the medial femoral condyle in concomitant ACL ruptures, no significant difference in treatment:A systematic review.

The associated damage to articular cartilage in anterior cruciate ligament (ACL) injured patients is a well-recognized phenomenon; however, there is a relative paucity in the literature regarding the different treatment techniques and outcomes. The purpose of this systematic review was to identify patients treated for acute ACL rupture and associated cartilage injury, with interest in the surgical management of these chondral injuries and any difference in patient-reported outcome measures (PROMs) differing techniques. A systematic review was performed looking for treatment or management of International Cartilage Repair Society grade 3 or 4 articular cartilage injury at the time of ACLreconstruction. Seventeen studies fit the criteria, a total of 892 patients were included, 64.6% were male with a mean age of 33.7and the average time to follow-up was 41.7 months. 68.2% of the lesions were on the medial femoral condyle (MFC) with a mean lesion size of 3.9 cm2. Six different operative methods of dealing with chondral lesions were identified, there was no significant difference in PROMs between the techniques, although there was a significant difference between the preoperative and postoperative outcome measures. The systematic review found that chondral defects on the MFC are more common in concomitant ACL injuries, despite the pattern of bone bruising being more common on the lateral femoral condyle as reported in the literature. It also found no significant difference in the PROMs between the six different techniques identified for the concomitant management of ACL reconstruction and chondral defects. Level II.

Marijuana's Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study.

Studies have shown that chronic marijuana use is associated with increased vascular inflammation, endothelial damage, myocardial infarctions, strokes, arteritis, and cardiomyopathies; however, cannabis's effect on wound healing in immediate direct-to-implant (DTI) breast reconstruction is unknown. With the increasing prevalence of marijuana use, it is imperative to understand its effects on surgical outcomes. We performed a retrospective cohort study of consecutive patients in a quaternary-care breast cancer center undergoing immediate DTI reconstruction. Patient demographics, operative details, and surgical complications were extracted through chart review. Active cannabis use was defined as use within 12 weeks of operation. Univariate and multivariable analyses were performed. In total, 243 consecutive patients underwent immediate DTI reconstruction, and 12 reported active cannabis use. There were no significant differences in patient demographics, cancer treatment, or operative details. Active marijuana users demonstrated higher rates of cellulitis treated with IV antibiotics (P = 0.004), explantation for infection (P = 0.004), emergency department visits (P = 0.028), readmission (P = 0.037), takeback to the operating room in 90 days (P < 0.001), and overall major complications (P < 0.001). Multivariable analysis demonstrated that active marijuana users were more likely to experience cellulitis treated with IV antibiotics [odds ratio (OR) = 3.55, P = 0.024], takeback to the OR within 90 days of operation (OR = 4.75, P = 0.001), and major complications (OR = 2.26, P = 0.048). The consumption of cannabis in the perioperative setting is associated with increased rates of complications in patients undergoing immediate DTI reconstruction; however, an analysis with a larger patient population is needed to conclude that abstinence from its use should be highly encouraged.

Age-specific differences in breast cancer treatment between screen-detected and non-screen-detected breast cancers in women aged 40-74 years at diagnosis in Sweden 2008-2017.

We have recently demonstrated that screen-detected invasive breast cancers had more favourable tumour characteristics than non-screen-detected. The objective of the study was to analyse differences in breast cancer treatment between screen-detected and non-screen-detected cases by age at diagnosis, with and without adjustment for tumour (T) and nodal (N) status, within a nationwide, population-based mammography screening programme utilising register data. Data spanning 2008-2017 were collected from the National Quality Register for Breast Cancer. Multivariable logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for treatment disparities between screen-detected and non-screen-detected breast cancer. Among 46,481 women diagnosed with invasive breast cancer aged 40-74 and invited for mammography screening, significant differences in treatment were observed. Screen-detected cases showed higher likelihoods of partial mastectomy compared to mastectomy, endocrine therapy, and radiotherapy, whereas chemotherapy and antibody therapy were less likely compared to non-screen-detected cases. However, when adjusting for surgery type, screen-detected cases showed lower likelihoods of radiotherapy. Age at diagnosis significantly influenced treatment odds ratios, with interactions observed for all treatments except radiotherapy adjusted for surgery. Differences increased with age, except for endocrine therapy. Radiotherapy adjusted for surgery type showed no age-related interaction. Adjusting for T and N did not alter these patterns. In general, screen-detected cases received less aggressive treatment, such as mastectomy, chemotherapy, and antibody therapy, compared to non-screen-detected cases. Disparities increased with age, except for endocrine therapy and radiotherapy adjusted for surgery. Differences persisted after adjusting for T and N, suggesting that these factors cannot solely explain the results.

Effects of full-fat high-oleic soybean meal in layer diets on performance, egg quality and chemical composition

The utilization of full-fat high-oleic soybean meal in layer diets could lead to value-added poultry products. To test this idea, 336 hens were randomly assigned to 4 isonitrogenous (18.5% CP) and isocaloric (2,927 kcal/kg) formulated diets and fed the following diets for eight weeks: conventional control solvent-extracted defatted soybean meal (CON); extruded-expelled defatted soybean meal (EENO); full fat normal-oleic soybean meal (FFNO); or full fat high-oleic soybean meal (FFHO). Body weights (BW) were collected at week 0 and week 8. Eggs were collected daily, and the totals counted each week. Feed consumption was measured weekly, and egg quality was measured bi-weekly. Eggs were collected at wk 0 and wk 8 for fatty acid analysis. There were no significant treatment differences in any of the production parameters measured, BW, feed consumption, feed conversion ratio or egg production (P > 0.05). Eggshell strength was significantly greater in eggs produced from the EENO group as compared to the control (P < 0.01), while egg yolk color was significantly darker in eggs of the control and EENO treatment groups relative to the FFNO and FFHO treatments (P < 0.0001). Eggs produced by hens fed the FFHO diet had a 52% increase in monounsaturated n-9 oleic acid content (P < 0.0001) and reduced palmitic (P < 0.01) and stearic (P < 0.0001) saturated fatty acid levels as compared to the conventional controls. These results validate the utilization of FFHO as a value-added poultry feed ingredient to enrich the eggs and/or poultry meat produced.

Application of Music Therapy in Improving the Sleep Quality and Mental Health of Nurses with Circadian Rhythm Sleep Disorders Caused by Work Shifts.

To analyze the impact of using music therapy to improve the sleep quality and mental health of nurses who suffer from circadian rhythm sleep disorders. Our retrospective analysis included 360 nurses with circadian rhythm sleep disorders from 20 different departments who worked in Wuhan Third Hospital for more than 1 year from May 2022 to May 2023. A total of 180 nurses with circadian rhythm sleep disorders were classified as the control group (received melatonin receptor agonist Melatonin Receptor Type 2 [MT2]). The other 180 cases were classified into the observation group (received melatonin receptor agonist MT2 + music therapy). After six courses of treatment, the clinical efficacy, Self-Assessment Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index Scale (PSQI) score of the two groups of nurses were compared. Before treatment, no statistically significant differences in baseline treatment and SAS, SDS, and PSQI scores were found between the two groups. After treatment, the total effective rate of treatment in the observation group was 85.56%, which was significantly higher than the 50.56% in the control group (P < 0.001). After treatment, the SAS, SDS and PSQI scores of the observation group were lower than those of the control group (P < 0.05). The SAS, SDS and PSQI scores of both groups were lower after treatment than they were before treatment (P < 0.05). Implementing music therapy for nurses with circadian rhythm sleep disorders caused by shifts can improve sleep quality and reduce negative emotions. It is a clinical strategy with clinical application value and a certain promotion value.

Growth Performance of Neem (Azadirachta indica) Seedlings as Influenced by Organic and Inorganic Fertilizers

A pot experiment was carried out in the net house of the Department of Soil, Water and Environment, University of Dhaka. The aim of the study was to assess growth and yield performance of Neem seedlings with the different doses of organic and NPK fertilizers. Trichocompost (TC) was used as organic fertilizer. The treatments used in the experiment were: T1: Control (-OM and -NPK), T2: TC (10 ton/ha), T3: TC 5 ton/ha, T4: NPK 100% RDF, T5: NPK 80% RDF + TC 5 ton/h, T6: NPK 60% RDF + TC 5 ton/h, T7: NPK 40% RDF + TC 5 ton/h, T8: NPK 80% RDF + TC 10 ton/h, T9: NPK 60% RDF + TC 10 ton/h, T10: NPK 40% RDF + TC 10 ton/h. Pots were arranged in a Completely Randomized Design (CRD). Plant height and the number of leaves per plant were recorded at a 15-day interval. The tallest plant (78.87 cm) observed with the application of sole Trichocompost 5 ton/ha. Incremental dose of TC and inorganic fertilizer reduces the height of plant. The maximum no. of leaves ( 51.67) was found with NPK 60% RDF + TC 5 ton/h at the stage of 90 days and the next highest amount of leaves (44.67) with NPK 80% RDF + TC 10 ton/h at 90 days after. The lowest height (12.52 cm) and leaf number/plant (8.33) were recorded in control. Maximum fresh and dry weights (root, bark, and leaf) were 17.19 g/plant and 6.24 g/plant, respectively, found in T8: (NPK 80% RDF + TC 10 ton/h). The best growth performance of seedlings was observed in T8: NPK, 80% RDF, and TC 10 ton/h .The research indicated that there was no significant treatment difference on nutrient uptake by the neem seedlings. Biodivers. Conserv. Bioresour. Manag. 2024, 10(1): 81-90

The Use of Imaging to Quantify the Impact of Seed Aging on Lettuce Seed Germination and Seedling Vigor.

The decline in seed quality over time due to natural aging or mishandling requires assessing seed vigor for resilience in adverse conditions. Accelerated aging (AA) methods simulate seed deterioration by subjecting seeds to high temperatures and humidity. Saturated salt accelerated aging (SSAA) is an AA method adopted for small seeds like lettuce (Lactuca sativa). In this study, we subjected seeds of two lettuce cultivars ('Muir' and 'Bauer') to SSAA by sealing them in a box containing 40 g/100 mL of a sodium chloride (NaCl) solution in a dark growth chamber at 41 °C for 24, 48, and 72 h with a control. We monitored their vigor using embedded computer cameras, tracking the projected canopy size (PCS) daily from sowing to harvest. The cultivar 'Muir' exhibited consistent PCS values across the treatments, while 'Bauer' showed PCS variations, with notable declines after prolonged aging. The germination rates dropped significantly after 48 and 72 h of SSAA. A nonlinear regression model revealed a strong relationship between PCS and shoot dry weight across harvests and cultivars (R2 = 0.93, RMSE = 0.15, p < 0.001). The research found that the projected canopy size and shoot dry weight increased over time with significant differences in treatments for the cultivar 'Bauer' but not for 'Muir,' with the canopy size being a strong predictor of dry weight and no significant impact from the SSAA treatments. This study highlights cultivar-specific responses to aging and demonstrates the efficacy of our imaging tool in predicting lettuce dry weight despite treatment variations. Understanding how aging affects different lettuce varieties is crucial for seed management and crop sustainability.

Vedolizumab for the prevention of intestinal acute GVHD after allogeneic hematopoietic stem cell transplantation: a randomized phase 3 trial

Acute graft-versus-host disease (aGVHD) of the lower gastrointestinal (GI) tract is a major cause of morbidity and mortality in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). Vedolizumab is a gut-selective anti-α4β7 integrin monoclonal antibody that reduces gut inflammation by inhibiting migration of GI-homing T lymphocytes. The efficacy and safety of vedolizumab added to standard GVHD prophylaxis (calcineurin inhibitor plus methotrexate/mycophenolate mofetil) was evaluated for prevention of lower-GI aGVHD after unrelated donor allo-HSCT in a randomized, double-blind, placebo-controlled phase 3 trial. Enrollment closed early during the COVID-19 pandemic with 343 patients randomized (n = 174 vedolizumab, n = 169 placebo), and 333 received ≥1 intravenous dose of 300 mg vedolizumab (n = 168) or placebo (n = 165) and underwent allo-HSCT. The primary end point was met; Kaplan–Meier (95% confidence interval) estimated rates of lower-GI aGVHD-free survival by day +180 after allo-HSCT were 85.5% (79.2–90.1) with vedolizumab versus 70.9% (63.2–77.2) with placebo (hazard ratio, 0.45; 95% confidence interval, 0.27–0.73; P < 0.001). For the 5 key secondary efficacy end points analyzed by day +180 after allo-HSCT, rates of lower-GI aGVHD-free and relapse-free survival and grade C–D aGVHD-free survival were significantly higher with vedolizumab versus placebo. No significant treatment differences were found for the other key secondary end points of non-relapse mortality, overall survival and grade B–D aGVHD-free survival, respectively. Incidence of treatment-related serious adverse events analyzed in patients receiving ≥1 dose of study treatment (n = 334) was 6.5% (n = 11 of 169) vedolizumab versus 8.5% (n = 14 of 165) placebo. When added to standard calcineurin inhibitor-based GVHD prevention, lower-GI aGVHD-free survival was significantly higher with vedolizumab versus placebo. ClinicalTrials.gov identifier: NCT03657160.

The importance of antibiotic treatment duration in antimicrobial resistance.

Antimicrobial resistance (AMR) poses a significant threat to global health, leading to increased deaths from drug-resistant infections and escalates healthcare costs. Often termed a "silent pandemic," AMR occurs when pathogens become resistant to antimicrobial drugs, enabling their proliferation and spread. Inappropriate antibiotic usage is a major contributor to this phenomenon, which also extends to fungal infections. In particular, the duration of antibiotic therapy is a crucial aspect, with evidence suggesting that prolonged use can heighten bacterial resistance and harm the human microbiota. In fact, studies comparing short-term versus long-term antibiotic therapies show no significant difference in traditional treatments. In addition, therapeutic drug monitoring allows personalized antibiotic regimens, optimizing dosage and duration to minimize resistance and adverse effects. As a result, clinicians should regularly reassess treatment effectiveness, utilizing techniques like antibiotic timeout and de-escalation therapy to avoid prolonged antibiotic use and mitigate resistance. All these strategies are crucial to prevent and counter the phenomenon of antimicrobial resistance.

Screening for Breast Cancer Risk: An Analysis of Under-recognized Risk Factors and Comparison of Interventions.

Recognition of patients at high risk (HR) for breast cancer allows earlier screening and opportunities for risk reduction. We compare patients referred to our breast clinic as HR vs referrals for other reason (ROR) and found to be HR. We evaluate under-recognized factors and treatment differences. A retrospective chart review of patients found to be HR but referred for any reason to our breast clinic from July 2012 to December 2022 was performed. Referral reason, demographics, hormonal history, family history, and other risk factors were evaluated and compared (HR vs ROR). While other risk models were used for screening, Gail and Tyrer-Cuzick version 7 (TCv7) were used for comparison. Breast imaging received, hormonal therapy, and genetics referral evaluations were compared. 195 patients were referred to our breast team, 113 (58%) were referred as HR while 82 (42%) were ROR. Average age was 47 years old. 175 (91%) were Caucasian. 74 (65.5%) were referred for genetic testing, and 32 (26%) tested positive for a genetic mutation (n = 10, 12% ROR). 67 (35%) were recommended chemoprevention (n = 32, 16.4% took chemoprevention). 6 (3.1%) underwent prophylactic mastectomies and 163 (85%) had supplemental breast imaging. Comparison of HR vs ROR did not show significant differences in hormonal factors or treatments received; however, TCv7 was higher in the group referred as HR (P < .001). Our study showed that HR patients are more commonly referred secondary to family history but undergo similar treatments as those ROR. Accessibility to screening tools and education of risk factors, especially in minorities and those not otherwise being screened, may help better recognize HR.

Effect Of Variations In Concentration And Length Of Soaking Leaf Extract Moringa (Moringa Oleifera) To Bioavaibility Content Nutrition And Response Antioxidant Flour Bucket (Artocarpus Communist) As Material Raw Making Biscuit MP-ASI

The Effect of Varying Concentrations and Soaking Time of Moringa Oleifera Leaf Extract on the Bioavailability of Nutritional Content and Antioxidant Response of Breadfruit Flour (Artocarpus Communis) as Raw Material for Making MP-ASI Biscuits. The first 2 years are characterized by very rapid physical and social development and growth which is influenced by food and nutritional intake. The aim is to analyze the effect of variations in concentration and soaking time of Moringa leaf extract on the bioavailability of nutritional content in making MP-ASI biscuits. The research used a multi-factor Completely Randomized Design (CRD). Factor x variation of Moringa leaf extract concentration 0%; 10%; 20% and 30% and the y factor is the soaking time for 6 hours; 12 hours and 18 hours, each treatment was repeated 3 times. Data Analysis Using Analysis of Variance (ANOVA). significant differences in treatment in DMRT analysis. The research results show that the treatment with a concentration of Moringa leaf extract of 30% with a soaking time of 18 hours because the average shows an increase in the antioxidant response and good nutritional content, the antioxidant response is 77.51 ppm (strong), vitamin A 356.08 μg/100, iron (Fe) 9.03 mgFe/ 100. For protein, carbohydrates, fat, water and ash, the best results were obtained from a combination treatment of 30% Moringa leaf extract with a soaking time of 6 hours, namely, 10.13% protein, 41.43% carbohydrates, 8.71% fat, 4.95% water and 1.64% ash. There is an influence of variations in concentration and soaking time on the response of antioxidants, protein, carbohydrates, fat, in MP-ASI biscuits as shown by the ρ value 0.000 &lt; α 0.05.

Influence of mineral source and inclusion levels of iron, copper, and zinc on the oxidative stability of extruded cat food

This study aimed to compare inorganic sources (sulfates) and chelated organic sources (proteinates) of minerals on the oxidative stability and shelf-life of extruded cat food. Five complete foods were formulated, including a negative control without supplementation of iron (Fe), copper (Cu), or zinc (Zn). The other formulations were obtained by supplementing the negative control formulation with these microminerals in organic or inorganic form at one (1x) or two (2x) times the FEDIAF (2021) requirement level for adult cats. The effects of supplementation on oxidative stability and shelf-life were determined before and after extrusion and during the 365-day storage period. The levels of fatty acids and synthetic antioxidants (BHA and BHT) were significantly lower after extrusion (P < 0.05). While inorganic and organic mineral sources did not differ, the negative control retained higher levels of fatty acids and synthetic antioxidants compared to mineral sources and levels. After extrusion, saturated, monounsaturated, and polyunsaturated fatty acids were reduced by 22.82% ± 1.8%, 22.91% ± 1.9%, and 19.32% ± 2.5%, respectively, with no mineral source and level effects. The Concentrations of synthetic antioxidants were significantly lower after extrusion, with a retention of 49.72% in the negative control and 35.09% ± 1.23% in the other treatments. Storage studies showed that fatty acids declined over time without significant treatment differences (P > 0.05). As expected, the most evident change was that of polyunsaturated fatty acids. Synthetic antioxidant levels also lowered during storage, with significant differences among treatments (P < 0.05). The highest losses were observed in formulations supplemented with inorganic sources. These differences affected peroxide value, which was influenced by both supplementation level and source. At the end of 365 days of shelf life, the peroxide value in foods supplemented with inorganic minerals was 92.3% (1×) and 49.7% (2×) greater than in foods with the same level of organic minerals. The negative control formulation had the lowest peroxide value among all treatments. From this data, we can conclude that the source of the microelements Fe, Cu, and Zn does not influence the oxidative stability of cat food during the extrusion process; however, the inorganic sources (e.g., sulfates) favor the oxidation during storage, which may be attenuated using less reactive, organic trace mineral sources, such as proteinates.