Significant Reductions Research Articles

Real-World Use of Oral and Subcutaneous Semaglutide in Routine Clinical Practice in the UK: A Single-Centre, Retrospective Observational Study.

Semaglutide, the only glucagon-like peptide-1 receptor agonist (GLP-1 RA) available in subcutaneous and oral formulation for treatment of type 2 diabetes (T2D), has demonstrated clinically significant improvements in glycaemic control and weight in clinical trials. This study aimed to gain insights into the use of both formulations and evaluate their clinical effectiveness in a secondary care clinic in Wales. This was a retrospective observational analysis of adults with T2D initiated on oral or subcutaneous semaglutide. Changes from baseline in glycated haemoglobin (HbA1c), weight and other metabolic parameters were evaluated. At baseline, participants (n = 103) had a mean age of 57.3years, mean HbA1c of 79.1mmol/mol (9.38%), mean weight of 111.8kg and body mass index (BMI) of 39.6kg/m2 (no statistically significant differences between oral and subcutaneous groups). At 6-month follow-up, statistically significant improvements in HbA1c (- 19.3mmol/mol [- 1.77%] and - 20.8mmol/mol [- 1.90%]), body weight (- 9.0kg and - 7.2kg), and BMI (- 3.3kg/m2 and - 2.5kg/m2) were observed for oral and subcutaneous semaglutide, respectively. No statistically significant differences between the formulations were observed, and safety profiles were comparable. Both formulations of semaglutide provided clinically and statistically significant reductions in HbA1c and weight in real-world practice. Oral GLP-1 RA may offer a practical and effective option for the management of T2D.

Ingestão proteica e perda de peso em indivíduos com sobrepeso ou obesidade

Introduction: Food plays a central role in weight loss. However, there is the possibility of maximizing health efficiency during this process, depending on the ingested amount of each macronutrient. Objective: To evaluate the effect of protein intake on weight loss in overweight and obese individuals. Material and Methods: A systematic review of the literature was carried out, according to the PRISMA methodology, using the PubMed, Scopus and Web of Science databases. Articles that met the inclusion criteria were selected, resulting in 14 eligible articles out of 422 initially identified. Results: Studies revealed that groups with higher protein intake had greater weight and fat loss - 4 (28.57%) and 6 studies (42.86%), respectively. It was also found that, associated with this weight loss, in 2 studies (14.29%) there were significant reductions in LDL cholesterol, and in 1 study (7.14%), there was a reduction in the levels of the enzymes aspartate aminotransferase and alanine aminotransferase. Effects on satiety and appetite were analyzed in 4 studies (28.57%), with 2 (14.29%) reporting higher levels of satiety and better appetite control in the higher protein intake group. Conclusion: A higher protein intake may enhance beneficial effects on weight loss in overweight or obese individuals, however there is a need for further studies to support the occurrences analyzed in this review.

Combined Auranofin and Celecoxib Suppresses the Local Progression and Pulmonary Metastases of Osteosarcoma In Vivo.

Osteosarcoma (OS) is a rare malignant tumor with a poor survival rate. Our previous study reported that auranofin (AUR), a thioredoxin reductase inhibitor, suppresses OS pulmonary metastases; however, the local progression of OS is not affected, in vivo. Nonetheless, the development of augmentation therapy with AUR to inhibit OS local progression remains challenging. Celecoxib (CE), an anti-inflammatory drug, potently enhances the therapeutic activity of AUR against colon cancer. Consequently, this study investigated the combined effects of AUR and CE on OS local progression and pulmonary metastases, in vivo. C3H/HeSlc mice were implanted with the murine OS cell line, LM8. The mice were treated either with a vehicle control, AUR, or combination of AUR and CE (AUR-CE). The primary tumor size and weight were evaluated for the study duration and at resection, respectively. Hematoxylin and eosin and Ki-67 staining were performed to evaluate OS local progression and pulmonary metastases. Mice in the AUR-CE group showed statistically significantly suppressed tumor sizes and weights at the time of excision compared with those in the vehicle. The mice in the AUR group did not show a statistically significant effect. Histopathological analysis of the primary tumor revealed a statistically significant decrease of the Ki-67-positive cells in the AUR-CE group compared with the vehicle group. Histopathological and quantitative analyses demonstrated that the AUR and AUR-CE groups had statistically significant reductions in the development of OS pulmonary metastases compared with the vehicle group. The combination of AUR and CE significantly inhibited OS local progression and pulmonary metastases.

Performance and Exhaust Emissions from Diesel Engines with Different Blending Ratios of Biofuels

Fossil fuel extraction and utilization are associated with several environmental issues. This study examined how altering the blending proportions of mixed diesel/biodiesel/n-butanol fuels impacts combustion. Additionally, it delved into the functioning of diesel engines when utilizing these blended fuels as well as conventional diesel. A three-dimensional fluid dynamics simulation was constructed and corroborated against test outcomes obtained at 25%, 50%, 75%, and 100% loads. The findings indicated that the n-butanol addition enhanced the indicated thermal efficiency. At a 100% load, D70B30 (70% diesel + 30% biodiesel), D70B25BU5 (70% diesel + 25% biodiesel + 5%N-butanol), D70B20BU10, and D70B10BU20 exhibited 4.76%, 5.75%, 6.79%, and 8.71% higher indicated thermal efficiency values than D100 (100% diesel), respectively. The introduction of butanol enhanced the combustion environment within the combustion chamber. Compared with pure diesel, all blended fuels reduced hydrocarbon and carbon monoxide emissions across various loads. The blended fuels showed significant reductions in hydrocarbon emissions of 1%, 4%, 6%, and 15% compared with that of diesel under the 25% load, respectively.

The RAW wellbeing program for adolescents at risk of disengaging from education, employment, and training

ABSTRACT The purpose of this study was to evaluate the efficacy of the RAW Wellbeing program in vocational schools. This 6-week program aims to improve the mental distress and wellbeing of adolescents at-risk of not being in education, employment, or training (NEET). Participants were 57 senior students (23 females; mean age 16.19 years, SD = 0.89) attending two vocational schools in Queensland, Australia. Students completed two baseline surveys (week 0, week 4) before receiving the RAW Wellbeing program and two follow-up surveys (week 13, week 17). An interrupted time-series design evaluated the outcomes of the RAW program. Results revealed significant reductions in mental distress at 4 weeks follow-up and a significant increase in mental wellbeing post-intervention. No improvements in resilience, self-esteem, sense of belongingness, or functioning were found. A randomized controlled trial is now required to confirm the efficacy of the program on mental health, school, and NEET outcomes in a larger sample.

Regional trends in the moderate-to-vigorous intensity physical activity and screen time of Canadians before and during the COVID-19 pandemic.

During the COVID-19 pandemic, public health approaches and disease-transmission varied widely across Canadian regions. This may have led to different trajectories for moderate-to-vigorous intensity physical activity (MVPA) and screen time during this period. The purpose of this investigation was to describe age- and gender-specific regional trends in MVPA and screen time for Canadian youth (ages 12-17 years) and adults (ages 18+) from 2018 to 2021. Data was collected using the Canadian Community Health Survey, which includes representative data for 5 distinct regions: Atlantic Canada, Québec, Ontario, the Prairie Provinces, and British Columbia (BC). Participants aged 12+ in each region self-reported their total daily screen time, as well as MVPA in 5 domains: overall, recreational, school, occupational/household and active transportation. Results were compared for 2018 (pre-pandemic), January-March of 2020, September-December of 2020, and 2021 using repeated measures t-tests. Among youth, all regions except for Atlantic Canada and BC experienced significant reductions in the proportion of youth meeting MVPA recommendations in the fall of 2020 (all p <0.001), although these had returned to baseline for all regions except Ontario by 2021. Trends varied across regions among adults aged 18-64 years. In Québec, there was 7-percentage point reduction in the proportion of males meeting the MVPA recommendations in the fall of 2020 compared to 2018, while there was a 4-percentage point increase among females in 2021 (all p<0.05). In Ontario and the Prairie provinces, males saw a 4-percentage point decrease in activity recommendation adherence in 2021, when compared to 2018 (p<005). There were no other significant differences for any region when comparing the fall of 2020 or 2021 with 2018 (all p>0.05). Among adults aged 65+ years, significant increases in MVPA were observed in Atlantic Canada and the Prairies in the fall of 2020, and in Atlantic Canada, Québec and the Prairies in 2021 (all p<0.05). With limited exceptions, self-reported screen time increased significantly across regions and age groups for both males and females (all p < 0.05). MVPA levels of Canadians during the COVID-19 pandemic varied both by region and age group. Self-reported MVPA of Canadian youth dropped in most regions in the fall of 2020, before returning to pre-pandemic levels in 2021. Activity levels of Canadians aged 18-64 years were relatively stable during the pandemic and increased for Canadians aged 65+ in most regions. Differences in trajectories across genders observed at the national level were often less apparent in individual regions. Recreational screen use increased across all regions, ages and genders with very few exceptions. These results highlight the differences and similarities in activity and screen time trajectories across the Canadian population and suggest the need for additional research to identify best practices for promoting healthy movement behaviours during future pandemics.

Labor force effects of Medicaid and Marketplace expansions: Variation by gender, parental status, and household structure

AbstractWe revisit the Affordable Care Act (ACA)'s Medicaid expansion's labor market effects and build upon it by estimating effects of subsidized Marketplace insurance. Using American Community Survey data, we jointly model the effects of Medicaid and Marketplace expansion on labor force outcomes using simulated eligibility measures. Throughout our analysis, we focus on heterogeneity by gender, parental status, and single versus two‐headed households. Consequently, this is the first paper presenting labor outcomes of the ACA among women with children, an important group, which may be particularly responsive to increased flexibility in meeting income, childcare, and insurance needs. Even among women, we find little evidence that Medicaid eligibility reduced labor force participation. Any significant reductions among women are small in magnitude and not well corroborated by placebo tests. Alternatively, women with children gaining Marketplace eligibility had statistically significant reductions in labor force participation, reductions in hours, and increases in part‐time work.

School-based delivery of a dialogic book sharing intervention: a feasibility study of Books Together

IntroductionGrowing numbers of children enter mainstream education without the skills needed to prosper in the school environment. Without additional support, these children face poor long-term outcomes in terms of academic attainment, mental health difficulties and social problems. The aim of this study was to investigate the feasibility and acceptability of school-based delivery of the Books Together dialogic book sharing program to groups of parents, and to explore whether it impacts parent and child outcomes in order to facilitate school readiness.MethodsParents of children aged 3–5 years old (n = 16) were recruited from four North Wales primary schools. Video observations of parent/child interactions, a gaming format measure of expressive child language ability, parent-report measures of children’s behavior, and social-emotional ability and of their parental competence were collected pre- and post-intervention. Thematic analysis of interviews with parents and the school-based staff who delivered the program explored feasibility and acceptability of the program.ResultsSignificant post-intervention increases in observed positive parenting and child expressive language skills and significant reductions in observed negative parenting were found. Parents reported significantly higher rates of child prosocial behavior and social/emotional ability as well as improved parenting competency at follow-up. Thematic analysis showed that staff and parents were satisfied with the program and that it was feasible to deliver in a school environment.DiscussionThe Books Together program is a low-cost intervention that, when delivered by school-based staff, shows promise for increasing the use of parenting strategies that build children’s language and social/emotional skills associated with school readiness.

Simple coiling of middle meningeal artery embolization for chronic subdural hematoma: An inverse probability of treatment weighting matched cohort study.

Middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) has gained much attention in recent years. However, unintended embolization may occur when employing liquid embolic agents or particles. We present our clinical experience in simple coiling of MMAE to manage CSDH. Patients underwent either surgical evacuation or MMAE with simple coiling for CSDH were reviewed. Clinical and radiographic outcomes were assessed at admission, 1-month, and 6-month intervals. Two treatment groups were matched with inverse probability of treatment weighting. One hundred twelve patients were included, with 27 patients in MMAE group and 87 patients in surgery group. In MMAE group, significant reductions were observed in hematoma width (admission vs. 1-month, 2.04 [1.44-2.60] cm vs. 0.62 [0.37-0.95] cm, p < 0.001). The adjusted odds ratio (aOR) of surgical rescue rate (0.77 95%CI 0.13-4.47, p = 0.77), hematoma reduction (>50%) (0.21 95%CI 0.04-1.07, p = 0.06), and midline shift improvement rate (3.22, 95%CI 0.84-12.4, p = 0.09) had no substantial disparities between two groups at 1-month follow-up. In addition, no significant difference was noted between two groups in terms of hematoma reduction (>50%) at 6-month follow-up (aOR 1.09 95%CI 0.32-3.70, p = 0.89). No procedure-related complications were found in MMA embolization group. Simple coiling for MMA had comparable outcomes with surgical evacuation for CSDH. Our findings suggest that simple coiling can be an alternative choice for liquid agents or particles in MMA embolization for CSDH with acceptable safety.

Wastewater Treatment Utilizing Industrial Waste Fly Ash as a Low-Cost Adsorbent for Heavy Metal Removal: Literature Review

Wastewater discharges from industrial processes typically include elevated concentrations of contaminants, which largely consist of potentially harmful chemicals such as heavy metals. These contaminants are characterized by their slow rate of decomposition. Hence, the removal of these metallic ions from effluents poses a challenge. Among different treatments, the adsorption approach has considerable potential due to its ability to effectively eliminate both soluble and insoluble pollutants from effluent, even at lower levels of concentration. Of various wastes, fly ash (FA) material has been the subject of attention because it is abundant, has favorable qualities, and contains a high percentage of minerals. This review investigates multiple facets, with a specific focus on the application of FA, an industrial byproduct, as an adsorbent in removing heavy metals. A comprehensive examination was conducted on a range of concerns pertaining to the pollution caused by metallic ions, including the underlying causes, levels of contamination, health implications of heavy metals, and removal methods. Multiple factors were found to affect the adsorption process. Of all the factors, the pH value considerably influences the elimination of heavy metals. An acidic pH range of 2.5–4.5 was found to be optimal for achieving the highest possible elimination of As(V), Cu(II), Hg(II), and Cr(VI). The latter elimination rate reached 89% at the optimal pH level. Most heavy metals’ adsorption isotherms conformed to the Langmuir or Freundlich models, while the pseudo-second-order kinetics provided a satisfactory match for their removal. Using a raw FA, adsorption capacities were achieved in the removal of metallic ions, Ni(II), Pb(II), and Cr(VI), that ranged from 14.0 to 23.9 mg g−1. Meanwhile, the FA-zeolite showed a remarkable capacity to adsorb ions Mn(II), Ni(II), Cd(II), Cu(II), and Pb(II), with values ranging from about 31 to 66 mg g−1. The cost analysis showed that the treatment of FA is economically advantageous and may result in significant cost reductions in comparison to commercial adsorbents. In summary, FA is an inexpensive waste material with potential for water treatment applications and several other purposes due to its excellent chemical and mineralogical composition.

Lessons from Peru to reduce under-5 mortality: understanding program implementation and context

BackgroundHealth policymakers aiming to reduce under-5 mortality (U5M) often lack data regarding how successful interventions in other countries were implemented. The Exemplars in U5M Study identified countries that achieved significant reductions in amenable U5M. This case study in Peru used implementation research to explore the contextual factors and strategies that contributed to the successful implementation of key evidence-based interventions (EBIs).MethodsThis research utilized a hybrid implementation research framework and a mixed-methods approach to understand the factors associated with EBI implementation and the successful reduction of U5M between 2000–2015. A desk review of existing literature on EBIs and U5M in Peru was completed, and in-depth interviews were performed with key Peruvian informants to understand the implementation strategies employed and the contextual factors that facilitated or were barriers to success. For the purposes of this analysis, three EBIs were selected and evaluated: antenatal care visits (ANC), facility-based deliveries, and infant vaccination.ResultsBetween 2000–2015, the percent of mothers attending at least four antenatal care visits rose from 69% to 96.9%, and the percent of facility-based deliveries increased from 56 to 91%. Three doses of the tetanus/diphtheria/pertussis vaccine, widely acknowledged as a key global health indicator, reached 90% by 2015. Key informants noted that economic growth, financial reforms, strong national commitment to reduce poverty in Peru, and national prioritization of maternal and child health, were important contextual factors that contributed to the successful reduction of U5M. They noted key strategies that helped achieve success during the implementation of EBIs, including utilization of data for decision-making, adaptation driven by cultural sensitivity to address gaps in coverage, and a focus on equity and anti-poverty initiatives with the participation of government, civil society, and political parties to assure continuity of policies.ConclusionSeveral EBIs contributed to the successful reduction of U5M in Peru between 2000–2015. Strategies such as the focus on equity throughout the study period contributed to an increase in coverage of EBIs like ANC visits, facility-based deliveries and infant vaccination which worked to reduce U5M. Understanding how Peru successfully implemented programs that reduced preventable infant and child deaths could be useful to replicating this substantial public health success in other low- and middle-income countries.

Efficacy of metformin combined with vitamin D in the treatment of polycystic ovarian syndrome: A meta-analysis.

Polycystic ovary syndrome (PCOS), as an endocrine and metabolic disorder, affects approximately 6% -20% of women of childbearing age. This study aims to assess the therapeutic effects of Metformin combined with vitamin D in PCOS patients. Eight databases were searched to obtain randomized controlled trials, both domestically and internationally, on the effects of Metformin combined with vitamin D in patients with PCOS. Data analysis was performed using RevMan 5.3 software. Nine studies were ultimately included in this meta-analysis. Six studies reported the homeostatic model assessment for insulin resistance of the test group and the control group, which was significantly lower (SMD: -0.23; 95% Cl: -0.42,-0.04; P<0.05) than the control group, body mass index (BMI) (SMD: -1.86; 95% Cl: -2.77,-0.96; P<0.01), Serum 25 (OH) D (SMD: 14.28; 95% Cl: 12.26,16.29; P<0.01), testosterone (SMD: -0.11; 95% Cl: -0.15,-0.07; P<0.01) and regulated menstrual cycles (OR: 1.27; 95% Cl: 0.99,1.63; P=0.063). Our meta-analysis of nine trials demonstrates significant reductions in insulin resistance, BMI, and testosterone levels, along with increased serum vitamin D levels and improved menstrual cycle regulation after Metformin and vitamin D treatment. These findings suggest the potential of this combined therapy in managing the multifaceted aspects of PCOS.

Brief cognitive behavioural therapy for eating disorders symptomatology among a mixed sample of adolescents and young adults in primary care: A non-randomised feasibility and pilot study.

Brief and accessible therapies for people with an eating disorder is an important health target. Ten-session cognitive behavioural therapy (CBT-T) is a brief treatment evaluated in people with a non-underweight eating disorder. This study aimed to evaluate the feasibility and preliminary effectiveness of CBT-T for young people in primary care. This cohort pilot study used group (adolescents vs. young adults) by time (over four time points) Generalised Linear Mixed Model analysis. Participants included 13-25-year-olds attending an early intervention mental health service, receiving 10 sessions of CBT-T. Feasibility was assessed using recruitment, retention and satisfaction. Eating and other pathology measures were administered at baseline, weeks four and 10, and 12-week follow-up. Of the 63 commencing treatment, 38 completed 10 CBT-T sessions (60%). Most (94%) reported high treatment satisfaction. Significant reductions in eating pathology, depression and stress were found. Age group did not yield differences in CBT-T outcome, with large to very large effect sizes across outcome variables. Anxiety was associated with attrition. This study provides preliminary support for the use of CBT-T in primary care, across adolescence and early adulthood. Findings require replication in other clinical settings and comparison to other clinical approaches and control populations.

Efficacy of acellular xenogeneic dermal matrix graft in the treatment of multiple gingival recessions: systematic review and meta-analysis.

This study aimed to compare the efficacy of acellular xenogeneic dermal matrix graft (AXDM) compared to connective tissue graft (CTG) in treating multiple gingival recessions. A systematic search of electronic databases was conducted to identify randomized clinical trials (RCTs) that compared AXDM and CTG. The selected studies were subjected to bias risk assessment, data extraction, and meta-analyses. Parameters such as gingival recession height, width, mean percentage of root coverage, and complete root coverage were analyzed. Seven RCTs involving 146 patients were included. The meta-analyses indicated that CTG was statistically superior to AXDM in reducing gingival recession height at the final follow-up (mean difference: -0.104mm, 95% confidence interval [CI]: -0.180-0.028, p = 0.008) and width at the final follow-up (mean difference: -0.285mm, 95% CI: -0.541-0.030, p = 0.029). CTG also demonstrated a significantly higher mean percentage of root coverage at the 6-month follow-up (difference in means: -2.761mm, 95% CI: -4.932-0.590, p = 0.013) and a higher percentage of complete root coverage at the 6-month follow-up (odds Ratio [OR]: 0.598, 95% CI: 0.4-0.892, p = 0.012) compared to AXDM. However, there was no significant difference in the number of teeth with complete root coverage between CTG and AXDM (OR: 1.610, 95% CI: 0.983-2.636, p = 0.058) and aesthetic outcomes (mean difference: 0.148, 95% CI: -0.277-0.573, p = 0.494). CTG is more effective than AXDM in treating multiple gingival recessions. This is evidenced by significant reductions in gingival recession height and width, a higher mean percentage of root coverage, and a greater percentage of complete root coverage at the 6-month follow-up. In some clinical situations an alternative to CTG is required for the treatment of multiple gingival recessions. AXDM, despite presenting clinical outcomes that are not as satisfactory as CTG, can be used for this purpose.

Adaptation of a psycho-educational group programme to improve coping in dementia caregiving: a feasibility study with mixed-methods.

As the number of people living with dementia rapidly increases worldwide, the support provided by their informal caregivers remains key to the sustainability of most healthcare systems, this voluntary contribution representing 40% of the costs of dementia worldwide. Informal caregiving in dementia, however, is linked to long periods of chronic stress with frequent and serious negative consequences on the health and quality of life of the caregiver. A psycho-educational group intervention focusing on coping with the daily stress of dementia caregiving ("Learning to feel better… to help better"), developed in French-speaking Canada and showing broad effects on quality of life, was selected with the aim of 1) adapting it to a new cultural context (French-speaking Switzerland) based on identified facilitators and barriers, using a participative approach; and 2) conducting a feasibility study to evaluate whether the adapted programme showed similar or improved feasibility and effects compared to the original Canadian programme. A mixed-methods concurrent nested design was used to evaluate the feasibility and the effects on five quantitative core outcomes. Additional qualitative data helped document in depth the acceptability and impact of the intervention. We shortened the programme from 30 to 21h in total, which resulted in increased accessibility, in terms of facilitated recruitment of participants and inclusion of a broader range of informal caregivers. There were significant reductions in subjective burden (effect size: d = -0.32) and psychological distress (d = -0.48), as well as decreases in the stress reactions of informal caregivers related to the behaviour problems of the persons with dementia (d = -0.57). The qualitative results emphasized the usefulness of providing informal caregivers with structured procedures for efficiently tackling everyday challenges, and of enabling learning through a variety of channels and activities. Substantial improvements are associated with this 21-h group intervention, organised in 7 sessions of 3h each, focused on learning more efficient strategies to cope with the daily stress of dementia caregiving. This intervention empowered informal caregivers to master their daily challenges with more confidence, satisfaction and calm. ISRCTN13512408 (registration date 17.05.2021, retrospectively registered).

When not hitting your sales target is 'the end of the world': Examining the effects of rational emotive behaviour therapy on the irrational beliefs and emotional reactivity of UK-based sales professionals.

Against the backdrop of the COVID-19 pandemic, workplace wellbeing is a key priority for employers. Severe market and health conditions continue to bring inevitable problems that could be reduced with the application of psychological interventions to prevent mental and physical health issues, making this study a highly pertinent and valuable contribution to the field. This paper reports the effects of a rational emotive behaviour therapy (REBT) programme on the irrational beliefs and emotional reactivity of 56 office-based sales professionals located in the northwest region of the UK. A pre-test, post-test experimental design was utilised, and a mixed model ANOVA (repeated measures) was adopted to assess changes in mean differences concerning irrational beliefs and emotional reactivity at pre and post-test stages for the intervention group, in comparison to a control group. Results indicate that those in the REBT group reported significant reductions in irrational beliefs and emotional reactivity, whilst those in the control group reported no such changes. It is recommended that future research studies consider utilizing a mixed methods design and focus on a strategic collaboration of organisational and individual level interventions for improving the psychological wellbeing and performance of sales personnel.

Kidney protective effect of sitagliptin in 5-fluorouracil-challenged rats

The possible protective effect of sitagliptin (SIT) against nephrotoxicity induced by a single dose 5-fluorouracil (5-FU) (150 mg/kg, i.p.) was investigated in rats. SIT treatment (5 and 10 mg/kg/day, p.o.) was given for 7 days, starting 5 days before 5-FU administration. Both SIT doses caused significant reductions of serum creatinine and neutrophil gelatinase-associated lipocalin levels in rats received 5-FU. Both doses of SIT also significantly decreased malondialdehyde, tumor necrosis factor-α, interleukin-1β, nuclear factor-κB p65 (NF-κB p65), Bax/Bcl-2 ratio, and cleaved caspase-3 in kidneys of 5-FU-challenged rats. Additionally, SIT, at both doses, significantly increased renal total antioxidant capacity and nuclear factor erythroid 2related factor 2 (Nrf2) in rats received 5-FU. Besides, SIT markedly attenuated the 5-FU-induced histopathological kidney tissue injury in rats. It was concluded that SIT, at both doses, provided a significant nephroprotective effect in 5-FU-challenged rats, through its antioxidant, antiinflammatory, and antiapoptotic activities, and by modulating Nrf2 and NF-κB pathways.

Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?

Partial splenic embolization (PSE) has been suggested as an alternative to splenectomy in the treatment of hypersplenism. However, some patients may experience recurrence of hypersplenism after PSE and require splenectomy. Currently, there is a lack of evidence-based medical support regarding whether preoperative PSE followed by splenectomy can reduce the incidence of complications. To investigate the safety and therapeutic efficacy of preoperative PSE followed by splenectomy in patients with cirrhosis and hypersplenism. Between January 2010 and December 2021, 321 consecutive patients with cirrhosis and hypersplenism underwent splenectomy at our department. Based on whether PSE was performed prior to splenectomy, the patients were divided into two groups: PSE group (n = 40) and non-PSE group (n = 281). Patient characteristics, postoperative complications, and follow-up data were compared between groups. Propensity score matching (PSM) was conducted, and univariable and multivariable analyses were used to establish a nomogram predictive model for intraoperative bleeding (IB). The receiver operating characteristic curve, Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA) were employed to evaluate the differentiation, calibration, and clinical performance of the model. After PSM, the non-PSE group showed significant reductions in hospital stay, intraoperative blood loss, and operation time (all P = 0.00). Multivariate analysis revealed that spleen length, portal vein diameter, splenic vein diameter, and history of PSE were independent predictive factors for IB. A nomogram predictive model of IB was constructed, and DCA demonstrated the clinical utility of this model. Both groups exhibited similar results in terms of overall survival during the follow-up period. Preoperative PSE followed by splenectomy may increase the incidence of IB and a nomogram-based prediction model can predict the occurrence of IB.

Antisense oligonucleotide targeting hepatic Serum Amyloid A limits the progression of angiotensin II-induced abdominal aortic aneurysm formation

Background and aimsObesity increases the risk for abdominal aortic aneurysms (AAA) in humans and enhances angiotensin II (AngII)-induced AAA formation in C57BL/6 mice. We reported that deficiency of Serum Amyloid A (SAA) significantly reduces AngII-induced inflammation and AAA in both hyperlipidemic apoE-deficient and obese C57BL/6 mice. The aim of this study is to investigate whether SAA plays a role in the progression of early AAA in obese C57BL/6 mice. MethodsMale C57BL/6J mice were fed a high-fat diet (60% kcal as fat) throughout the study. After 4 months of diet, the mice were infused with AngII until the end of the study. Mice with at least a 25% increase in the luminal diameter of the abdominal aorta after 4 weeks of AngII infusion were stratified into 2 groups. The first group received a control antisense oligonucleotide (Ctr ASO), and the second group received ASO that suppresses SAA (SAA-ASO) until the end of the study. ResultsPlasma SAA levels were significantly reduced by the SAA ASO treatment. While mice that received the control ASO had continued aortic dilation throughout the AngII infusion periods, the mice that received SAA-ASO had a significant reduction in the progression of aortic dilation, which was associated with significant reductions in matrix metalloprotease activities, decreased macrophage infiltration and decreased elastin breaks in the abdominal aortas. ConclusionsWe demonstrate for the first time that suppression of SAA protects obese C57BL/6 mice from the progression of AngII-induced AAA. Suppression of SAA may be a therapeutic approach to limit AAA progression.

Evaluate The Effect of Coenzyme Q10 on The Prevention of Doxorubicin-Induced Acute Cardiotoxicity in Rats.

Objective: This study will evaluate the potential protective effects of coenzyme Q10 on DOX-induced cardiotoxicity in female rats, manifested by changes in biochemical parameters in tissue and serum samples histopathological differences, and compare their changes. Methods:24 female rats were divided into three groups based on weight. The first group received saline, the second group received a cumulative dose of 15 mg/kg of DOX via IP injection, and the third group was pre-treated with CoQ10 before receiving DOX. The data were analysed using a one-way ANOVA test with a Bonferroni post hoc test to compare the markers and histopathological changes in different groups. The GraphPad Prism version 8.1 was used to do the statistical analysis. Results: As indicated by a statistically significant increase (P&lt;0.0001) in TNFα and ICAM-1 level, doxorubicin-induced cardiotoxicity. Additionally, the level of GSH, SOD, and caspase-3 did not differ significantly between the DOX+CoQ10 group and the control group. Furthermore, lesions and histological alterations were induced by the substance. Significant reductions in cardiotoxicity were observed with the administration of coenzyme Q10, as indicated by notable increases (P&lt;0.0001) in SOD, GSH, and TNFα and significant decreases (P&lt;0.0001) in caspase 3 when compared to the DOX group. Also, the CMYO score and lesions exhibited a substantial improvement. Conclusion: In this investigation, coenzyme Q10 exhibited cardioprotective effects against DOX-induced damage to the mouse heart. This phenomenon potentially pertains to inhibiting and safeguarding against oxidative stress, the pathway of apoptosis, and the inflammatory response.