Significant Decrease Research Articles

Outcomes following the adoption of standard parenteral nutrition in preterm infants: a whole-population non-concurrent control study

ObjectiveTo evaluate the impact of a quality improvement project of the adoption of standard parenteral nutrition (SPN) in preterm infants.DesignRetrospective, multicentre, whole-population, non-concurrent control study using data from the UK...

Production and Evaluation of Peanut Butter Prepared with Peanut Shells

Background:: Innovative application of processing is an emerging trend in food production. Objective:: The present study was conducted to produce peanut butter and evaluate the physical, chemical, and sensory properties of the product, to which the outer shells of peanuts were added in different proportions (5, 10, 15%) to reduce the calories of the product by reducing the fat content in the peanut butter as well as benefiting from the shells as a residue secondary to the peanut seeds. Methods:: The chemical composition of the prepared sample, along with bioactive determination Using HPLC, microbial testing, Aflatoxin content, and sensory evaluation, have been done for the prepared peanut butter using standard methods. Results:: The chemical composition of the peanut outer shell powder was characterized by the highest value of fiber (46.6%), followed by total carbohydrates and protein (23.25%, (12.54%) respectively. The produced peanut butter showed that the total carbohydrate resulted in the highest value (23.25%), followed by fat (42.21) and protein (28.12%). Substitution at 5, 10, and 15% peanut outer shell resulted in a non-significant difference concerning protein. At the same time, the lipid content showed a significant decrease compared to the control. A similar trend was found concerning total carbohydrate-to-fat content. Total fiber increased to 1.5 & 2.08, and 2.6 times as high as the content parallel to dietary fiber, while β-Carotene decreased significantly due to the substitution level. The substitution level decreased energy (cal) by about 203.58, 730.093, 562.86, 545.19, and 526.66, respectively, compared with the control. A slight increase was found in the mineral content due to the substitution, except for the calcium increases at 15%. DPPH and ABTS% increased in parallel with the substitution level, which was in line with total phenols and flavonoids. Flavonoid fraction resulted in nariagin (94.72 QE), the major flavonoid, followed by lutein (82.23 QE). Meanwhile, phenolic compounds were described with pyrogallol (68.31 GAE) (as the main compound, followed by chlorogenic (780.76 GAE). The fatty acid composition showed that oleic and linoleic were predominant in all treatments. Bacterial, yeast, and mold counts appeared after three months of storage (20 ± 2°C). Aflatoxin was not detectable in the sample of the peanut outer shells and peanut butter samples. Sensory characteristics showed approximately the same score for all treatments except that of 15% substitution, which resulted in a significant decrease in all parameters compared with the control. Conclusion:: This study reported that 5%, followed by 10% of peanut outer shells, were the most suitable levels for making peanut butter, improving the nutritional value by increasing the percentage of fiber and antioxidants in peanut shells, leading to better quality products and shelf life.

Alterations in CD4+ T Cell Cytokines Profile in Female Patients with Hashimoto's Thyroiditis Following Vitamin D Supplementation: A Double-blind, Randomized Clinical Trial.

Hashimoto's thyroiditis (HT) is an autoimmune disease characterized by the destruction of thyroid cells through immune processes involving T helper (Th)1 cytokines. This clinical trial investigates the impact of vitamin D supplementation on serum cytokine levels and gene expression in CD4+ T cells from HT patients, aiming to understand its effects on Th-1, Th-2, Th-17, and regulatory T (Treg) cell-associated factors. Female patients were randomly assigned in a double-blind design to either a vitamin D-supplemented group, which received cholecalciferol (1, 25(OH)2D3) at a dose of 50,000 IU, or the placebo group, which received a weekly placebo for a duration of three months. Serum cytokine levels were assessed using enzyme-linked immunosorbent assay (ELISA), while genes' expression levels were measured using real-time PCR. Serum 25-hydroxyvitamin D and levels exhibited a significant increase following vitamin D supplementation, in comparison to the placebo group. Additionally, the vitamin D supplementation resulted in a significant elevation of serum calcium (Ca) levels compared to baseline. In the vitamin D group, there was a significant decrease in both serum levels and expression of the interleukin (IL)-17 gene when compared to baseline, although no statistical difference was observed between the placebo and vitamin D groups. The gene expression of transforming growth factor-beta (TGFβ) was significantly increased in the vitamin D group compared to baseline, with no significant difference between the two study groups. Vitamin D treatment had no effect on serum levels of interferon-gamma (IFNϒ) and IL-4. While the gene expression of IL-4 in the vitamin D group did not exhibit a statistically significant increase, the level of GATA3 transcription factor increased significantly when compared to the placebo group. The expression of IFNϒ and transcription factors, T-bet, RORc, and forkhead box protein 3 (FOXP3) in genes did not show significant changes following vitamin D supplementation. The findings suggest that vitamin D supplementation may hold potential benefits for autoimmune diseases, such as HT. However, further longitudinal clinical trials are necessary to gain a more comprehensive understanding of the specific effects of vitamin D on HT.

Surgical experience in adults with Ebstein's anomaly: Long-term results.

The aim of this study was to review late results of the surgical treatment of Ebstein's anomaly with reconstruction and replacement in adults. Medical records of 28 consecutive patients operated on between 1991 and 2014 were reviewed retrospectively. Surgical repair was performed in 19 (67.9%) patients (Hardy: two, Danielson: three, modified Danielson: six, Carpentier: three, Kay annuloplasty reinforced with ring: two), whereas tricuspid valve replacement was performed in nine patients (32.1%). Primary long-term outcomes consisted of right ventricular function, survival and freedom from re-operation. We evaluated the additional impacts of residual tricuspid insufficiency and type of surgery on survival. In-hospital mortality rate was 7.1% (n = 2) due to low cardiac output status and sepsis. Patients showed a significant postoperative decrease in tricuspid regurgitation (p < 0.001), right atrial size (p < 0.001) and pulmonary hypertension (p = 0.002). The mean follow-up time was 140 ± 71.4 months, with a median of 126 months (105 - 192). Late mortality occurred in two patients and there was no significant difference in terms of survival based on residual tricuspid insufficiency (p = 0.57) and type of surgery (p = 0.094). Overall survival rates were 89.3, 85.4, 85.4 and 68.3% at five, 10, 15 and 20 years, respectively. Although complex leaflet reconstruction techniques have evolved to achieve a more physiological and durable repair, both approaches can be performed safely on specific patients and can be alternated, with acceptable rates of survival and re-operation.

Asymmetric Dimethylarginine (ADMA) in Cardiovascular Disease, Cardiac Ischemia/reperfusion Injury, and Ischemic Non-obstructive Coronary Artery Disease: Biochemical and Pharmacological Implications

: Several studies have shown that high plasma concentrations of asymmetric dimethylarginine (ADMA), a known endogenous competitive inhibitor of endothelial nitric oxide synthase (eNOS), correlate with the severity of coronary artery disease (CAD), with worsening of cardiac ischemia/reperfusion (I/R) injury and coronary atherosclerosis. It is believed that it may be an important risk factor for myocardial infarction. ADMA, when in high concentrations, can determine a significant decrease in the synthesis and bioavailability of NO (Nitric oxide) and therefore alter the mechanisms of regulation of coronary vasodilation and vasomotor function of epicardial coronary arteries. Higher serum ADMA concentration is associated with worsening of post-ischemic remodeling since coronary angiogenesis, vasculogenesis, and collateral coronary growth are seriously impaired. In addition, there are reasons to believe that elevated plasma ADMA levels are related to the development of diseases affecting coronary microcirculation, such as ischemic non-obstructive coronary artery disease (INOCA). With the aim of providing the pharmacologist engaged in the design and discovery of new ADMA-lowering drugs with a complete examination of the subject, in this review, we discuss the most important studies related to the correlations between serum ADMA levels and cardiovascular diseases mentioned above. In addition, we critically discuss the main aspects of enzymology, synthesis, and metabolism of ADMA as a prerequisite for understanding the molecular mechanisms through which high concentrations of ADMA could contribute to promoting cardiovascular diseases. ADMA represents a new target for pharmacological modulation of cardiovascular endothelial function and therefore, there is a possibility of using selective pharmacological ADMA lowering drugs in cardiovascular disease with endothelial dysfunction and high plasma ADMA levels.

Dynamic processes in behavioral activation therapy for anhedonic adolescents: Modeling common and patient-specific relations.

Behavioral activation (BA) is a brief intervention for depression encouraging gradual and systematic re-engagement with rewarding activities and behaviors. Given this treatment focus, BA may be particularly beneficial for adolescents with prominent anhedonia, a predictor of poor treatment response and common residual symptom. We applied group iterative multiple model estimation (GIMME) to ecological momentary assessment (EMA) treatment data to investigate common and person-specific processes during BA for anhedonic adolescents. Thirty-nine adolescents (Mage = 15.7 years old, 67% female, 81% White) with elevated anhedonia (Snaith-Hamilton Pleasure Scale) were enrolled in a 12-week BA trial, with weekly anhedonia assessments. EMA surveys were triggered every other week (2-3 surveys per day) throughout treatment assessing current positive affect (PA) and negative affect (NA), engagement in pleasurable activities and social interactions, anticipatory pleasure, rumination, and recent pleasurable and stressful experiences. A multilevel model revealed significant decreases in anhedonia, t(25.5) = -4.76, p < .001, over the 12-week trial. GIMME results indicated substantial heterogeneity in variable networks across patients. PA was the variable with the greatest number (22% of all paths vs. 11% for NA) of predictive paths to other symptoms (i.e., highest out-degree). Higher PA (but not NA) out-degree was associated with greater anhedonia improvement, t(25.8) = -2.22, p = .035. Results revealed substantial heterogeneity in variable relations across patients, which may obscure the search for common processes of change in BA. PA may be a particularly important treatment target for anhedonic adolescents in BA. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Analysis of heart rate variability during emergency flight simulator missions in fighter pilots

IntroductionManaging emergency situations in different simulated flight segments can entail a workload that could affect the performance of military pilots. The aim was to analyse the modifications in neurovegetative balance...

First dose optimization study on freezing Anatolian buffalo semen

The main objective of sperm production centers is to produce as many straws as possible from the obtained ejaculates using the optimal dilution rate. To this end, this study is the first to evaluate the effect of different semen extender rates on Anatolian buffalo semen quality. Ejaculates were collected by artificial vagina from three Anatolian buffalo bulls. These ejaculates were divided into three aliquots and filled into 0.25 ml straws with soy-based extenders at concentrations of 35, 25, and 15 million sperm/straw (n=105). The straw samples of different sperm concentrations were frozen. The quality of sperm was evaluated after thawing (37 °C, 30 sec) and following the thermoresistance test (37 °C, 3 h). The post-thaw total motility and progressive motility values were similar between the groups. However, following the thermoresistance test, there was a significant decrease in total motility in the 35 million sperm/straw group, and the progressive motility was significantly higher in the 25 million sperm/straw group. There was no statistically significant difference between the groups in terms of sperm kinetic parameters, except for VSL after thawing, as well as VAP and LIN values following the thermoresistance test. The overall mean PMAI and STR values were the highest in the 25 million sperm/straw group. In conclusion, it is recommended to dilute the Anatolian buffalo semen at a concentration of 25 million/0.25 ml when freezing it with a soy-based semen extender. In addition, it is considered that soy-based extenders compensate for cryo-damage to sperm motility for a short time, and the thermoresistance test should be applied for objective evaluation in dose optimization studies.

Articulate Chemotherapeutic Strategies for the Development of Effective Drugs against a Fatal Disease, Visceral Leishmaniasis.

Visceral Leishmaniasis (VL) control relies mainly on chemotherapy in the absence of no effective vaccines. However, available anti-VL drugs are limited in number, having toxicity issues, adverse reactions, low efficacy, and resistance observed against antileishmanial. A significant decrease in efficacy (~tenfold increase in dosage and duration) was reported against the usual treatment with Pentavalent antimonials (the most recommended antileishmanial drug discovered 90 years ago). Amphotericin B is the second line of treatment but limits wider use due to its high cost. Pentamidine is another anti-VL drug, but its therapeutic efficacy has decreased significantly in different areas. These conventional therapeutics for VL have become almost outdated due to a significant increase in therapeutic failure in terms of percentage. Due to this, the search for an effective future anti-VL drug spans several decades, and now it is in high demand in the current situation. Some conventional therapeutics are modified, but they are also not satisfactory. Therefore, this article aimed to discuss conventional and modified therapeutics while emphasizing innovative chemotherapeutic measures against VL that could speed up the slow pace of antileishmanial drugs and overcome the drug resistance problem in the future.

The analysis of age dynamics of causes of mortality of population of elderly age groups as reserve of maintaining population of older able-bodied age

The article analyzes age dynamics of initial causes of death according to records in medical death certificates of population of older age groups. Materials and methods. The records of causes of death of 34.914 persons aged 60 years and older were used as primary source of information. The initial cause of death was determined according to the ICD-10 rules. The rate of registration by reason of death was calculated as intensive value per 100 deaths in concrete age and sex group. Each cause was coded according to the ICD-10 rules (revision 2014-2016). The belonging to group was determined by first character (letter) in four-digit code that corresponded to the Class. On the basis of analysis of structure of causes of death, the group A of causes that included five Classes of ICD-10, determined 81.4% of all deaths in population aged 60 years and older. Two Classes: "Diseases of the circulatory system" (Class IX) and "Neoplasms" (Class II) determine in all studied age groups more than a half of all deaths (from 55% to 71% of males and from 59% to 67% in females) and namely they determine mortality rate in older age groups. There are no gender differences in age characteristics of registration rate in these groups (p > 0.05), however age dynamics differ. In case of diseases of circulatory system initial cause of death is increase rate of registration at increasing of age. In case of neoplasms at increasing of age decrease of registration rate as initial cause of death is established. At that, rate of decline is higher than rate of increase that determines certain decrease of structural significance of combined contribution of these two groups of causes at increasing of age. The Group B of causes, including three Classes of ICD-10 "Respiratory diseases" (Class X), "Diseases of the digestive system" (Class XI) and "Diseases of the nervous system" (Class VI), determined in overall 11.9% of all deaths in population aged 60 years and older. The age dynamics of causes of death of population of older age groups exists for certain groups of causes and it should be considered in organizing medical care of population of older age groups.

The Effect of Chronic Administration of Amphetamine-Type Stimulants on Oxidative Stress and Inflammation in Wistar Rats

تهدف هذه الدراسة إلى تحديد تأثير التناول المزمن للمنشطات من نوع الأمفيتامين بجرعات متفاوتة على الالتهاب والإجهاد التأكسدي في فئران ويستار. تم إعطاؤهم ميثيلفينيديت وتم تقسيمهم إلى 4 مجموعات علاجية. علاوة على ذلك ، تم إجراء تجميع عشوائي بسيط لتقسيم العينات إلى 5 مجموعات ، تتكون كل مجموعة من 9 فئران. تضمنت هذه المجموعات الفئران التي أعطيت فقط الماء المقطر كعناصر تحكم ، بالإضافة إلى تلك التي أعطيت ميثيلفينيديت بجرعات 10 مجم / كجم من وزن الجسم ، و 20 مجم / كجم من وزن الجسم ، و 40 مجم / كجم من وزن الجسم لمدة 4 أسابيع كمجموعات تجريبية. ثم تم إجراء التحليل الإحصائي باستخدام GraphPad Prism لمقارنة تأثيرات الإجهاد التأكسدي والالتهاب الجهازي و BDNF والذاكرة المكانية لفئران Wistar. أدى الاستخدام المزمن للمنشطات إلى انخفاض كبير في مستويات الجلوتاثيون بيروكسيديز وكذلك زيادة في إطلاق IL-6 وعامل نخر الورم ألفا مقارنة بمجموعة التحكم. بناءً على النتائج ، لعبت المسارات المتورطة في الضعف الإدراكي ، والتي كانت مرتبطة باستخدام المنشطات من نوع الأمفيتامين ، دورًا في معالجة التأثير الضار لتعاطي المخدرات والأمراض المصاحبة لها.

Metabolomics Reveal the Chemical Characteristic of Cigar Tobacco Leaves During Air-Curing Process

Air-curing is a critical process in the production of cigar tobacco leaves. This process involves the vital degradation and transformation of macromolecular substances into micromolecular chemical compounds. In this study, three different varieties of tobacco leaves harvested from the Wuzhishan and Danzhou areas of Hainan, China were used as materials. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was employed to investigate the chemical changes before and after air-curing in the metabolites. Metabolic analysis revealed significant stepwise alterations in the tobacco leaf metabolome during the air-curing process. A total of 172 differential metabolites were identified as significant contributors in the biosynthesis pathways of flavonoids, flavone, flavonol, and other secondary metabolites, among the total analyzed 1841 metabolites obtained from the tobacco leaves. Notably, the contents of flavonoid metabolites, including kaempferol, rutin, chlorogenic acid, and quercetin, exhibited a significant decrease throughout the air-curing period. Correlation analysis indicated a strong association between the biosynthesis of flavonoids and the contents of chlorogenic acid and kaempferol, suggesting their role in regulation the formation of yellow and brown colors in tobacco leaves. These findings provide valuable insights for future investigations into the quality, commercial value, and chemical properties of cigar tobacco.

Time-Restricted Feeding (16/8)

This study aimed to investigate the effects of 8-hour time-restricted feeding (TRF) on body weight, biochemical parameters, diet quality, and eating behavior in overweight females. In the TRF group, there was a statistically significant decrease in body weight, body mass index, and waist and hip circumference (P &lt; .05). Furthermore, there was a statistically significant greater decrease in blood glucose, insulin, cholesterol, and low-density lipoprotein cholesterol in the TRF group (P &lt; .05). TRF did not affect eating behavior or diet quality (P &gt; .05), but it led to a decrease in fiber intake (P &lt; .05). These findings suggest that consuming food within an 8-hour window may facilitate weight loss in individuals with obesity. Longitudinal studies with larger samples are needed to confirm this.

Perturbations in gut microbiota composition in osteoporosis: a systematic review and meta-analysis.

Osteoporosis (OP) is a chronic bone metabolic disease, which causes a great social and economic burden. The gut microbiota (GM) has become a recent topic of interest in the role of many disease states. Changes in the GM are correlated with the maintenance of bone mass and bone quality. However, research results in this field remain highly controversial. We performed a mate-analysis to explore and compare the alterations of GM in OP patients. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we comprehensively searched the databases of PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, CBM, and Wanfang. In addition, we applied the Stata 17.0 software for data analysis. Bias controls were evaluated with the Newcastle-Ottawa scale (NOS), funnel plot analysis, and Egger's and Begg's tests. This research ultimately considered 16 studies, which included the fecal GM data of 2340 people (664 with OP and 1676 healthy controls). The pooled estimate showed an increase of borderline significanceon ACE index in patients with OP compared with control participants (SMD = 1.05; 95% CI 0.00-2.10; P = 0.05). There were no significant differences in Chao1, Shannon and Simpson indices. At the phylum level, no significant differences were observed between the OP patients and HCs in the overall analysis. At the genus level, the relative abundance ofBlautia presented a decrease of borderline significance between OP and the control group (SMD = -0.32, 95% CI -0.65 to -0.00, P = 0.05). This systematic review and meta-analysis suggests that patients with OP may exhibit dysbiosis in their gut microbiota, characterized by a reduction in certain anti-inflammatory butyrate-producing bacteria and an enrichment of pro-inflammatory bacterial populations.

The Development of International Tourists During The Pandemic: The Perception of Local Tourists

The Covid-19 pandemic has hampered various kinds of activities, especially in the world of tourism. Based on data on international tourist visits to Indonesia in August, it experienced a significant decrease of 89.22%. The Deputy for Destination and Infrastructure Development of the Ministry of Tourism and Creative Economy (Kemenparekraf) predicts that international tourist visits to Indonesia only occupy the number 4 million people, which before the pandemic occupied the figure of 18 million visitors. The purpose of this study is to find out the perception of local tourists towards the development of international tourists during the pandemic, the method used is to conduct interviews with local tourists randomly in the Barru district. The analysis method used is descriptive qualitative to explain the research results obtained. The result of this study is that the decline in tourism visitors has a significant impact on people's income, especially in Barru district, but this, it can reduce the spread of the Covid-19 virus that is sweeping the world.

Metabolic interplay between Proteus mirabilis and Enterococcus faecalis facilitates polymicrobial biofilm formation and invasive disease.

Polymicrobial biofilms play an important role in the development and pathogenesis of CAUTI. Proteus mirabilis and Enterococcus faecalis are common CAUTI pathogens that persistently co-colonize the catheterized urinary tract and form biofilms with increased biomass and antibiotic resistance. In this study, we uncover the metabolic interplay that drives biofilm enhancement and examine the contribution to CAUTI severity. Through compositional and proteomic biofilm analyses, we determined that the increase in biofilm biomass stems from an increase in the protein fraction of the polymicrobial biofilm matrix. We further observed an enrichment in proteins associated with ornithine and arginine metabolism in polymicrobial biofilms compared to single-species biofilms. We show that L-ornithine secretion by E. faecalis promotes arginine biosynthesis in P. mirabilis, and that disruption of this metabolic interplay abrogates the biofilm enhancement we see in vitro and leads to significant decreases in infection severity and dissemination in a murine CAUTI model.

Use of Mesenchymal Stem Cells in Experimental Ovarian Damage.

Bisphenol-A (BPA) has a well-proven deleterious effect on the hypothalamicpituitary- gonadal axis. The current study investigated the therapeutic potentials of mesenchymal stem cells (MSCs) in a murine model of BPA-induced ovarian damage. Fifty adult female rats were divided into: Group 1; control group, Group IIa, IIb: rats were given oral gavage of BPA (25 and 50 mg/Kg body weight respectively) on a daily basis for 15 days, and Group IIIa, IIIb; rats were intravenously treated with of MSCs (106 cells) after receiving the last dose of BPA as in group II. Plasma and ovarian tissue levels of Malondialdehyde (MDA) and gonadal axis hormones were assessed. Apoptosis was evaluated by TUNNEL assay and by apoptosis markers (FAS, FASL, Caspase 3, SLTM). A histological examination of ovarian tissue was also conducted. BPA resulted in a significant elevation in plasma levels of LH, FSH, and ovarian tissue levels of MDA and a significant decrease in estradiol and progesterone. All genetic and protein markers of apoptosis were elevated in BPA treated group with decreased oestrogen receptor expression in the ovarian tissue. Increased apoptotic cells were confirmed by TUNEL assay. A high dose of BPA was able to increase the number of atretic follicles in the ovarian tissue whereas the numbers of primordial, primary, secondary and Graafian follicles were decreased. All the laboratory and histological abnormalities were ameliorated by treatment with MSCs. The antioxidant and anti-apoptotic effects of MSCs could possibly explain the ability of this therapeutic modality to ameliorate BPA-induced-ovarian damage.

Changes in systemic cancer therapy in Australia during the Delta and Omicron waves of the COVID-19 pandemic (2021-2022): a controlled interrupted time series analysis.

Australian lockdowns in response to the initial coronavirus disease 2019 (COVID-19) outbreak in 2020 were associated with small and transient changes in the use of systemic cancer therapy. We aimed to investigate the impacts of the longer and more restrictive lockdowns in the Australian states of New South Wales (NSW) and Victoria during both the Delta subvariant lockdowns in mid-2021 and the Omicron subvariant outbreak in late 2021/early 2022. Population-based, controlled interrupted time series analysis. We conducted a national observational study using de-identified records of government-subsidised cancer medicines dispensed to a random 10% sample of Australians between July 2018 and July 2022. We used controlled interrupted time series analysis to investigate changes in the dispensing, initiation and discontinuation of all cancer medicines dispensed to residents of NSW and Victoria, using the rest of Australia as a control series. We used quasi-Poisson regression to model weekly counts and estimate incidence rate ratios (IRRs) for the effect of (each) the Delta phase lockdown and the Omicron outbreak on our systemic cancer therapy outcomes. Between July 2018 and July 2022, cancer medicines were dispensed 592 141 times to 33 198 people in NSW and Victoria. Overall, there were no changes to the rates of dispensing, initiation or discontinuation of antineoplastics during the Delta phase lockdowns. In both states during the Omicron outbreak, there were significant decreases in the dispensing of antineoplastics (NSW IRR 0.89; 95% confidence interval [CI] 0.84, 0.93. Victoria IRR 0.92; 95% CI 0.88, 0.96) and in the initiation of endocrine therapy (NSW IRR 0.85; 95% CI 0.74, 0.99. Victoria IRR 0.78; 95% CI 0.65, 0.94), and no changes in the discontinuation of any systemic cancer therapy. The 2021 lockdowns and 2021/2022 Omicron outbreaks in NSW and Victoria had significant impacts on the dispensing, initiation and discontinuation of systemic cancer therapies, however, the overall effects were minimal. The impacts of lockdowns were less significant than the Omicron outbreaks, suggesting COVID-19 infection, health system capacity, and patient and community concerns were important factors for treatment changes.

Impact of alcohol control policy on hemorrhagic and ischemic stroke mortality rates in Lithuania: An interrupted time series analysis.

Given the causal impact of alcohol use on stroke, alcohol control policies should presumably reduce stroke mortality rates. This study aimed to test the impact of three major Lithuanian alcohol control policies implemented in 2008, 2017 and 2018 on sex- and stroke subtype-specific mortality rates, among individuals 15+ years-old. Joinpoint regression analyses were performed for each sex- and stroke subtype-specific group to identify timepoints corresponding with significant changes in mortality rate trends. To estimate the impact of each policy, interrupted time series analyses using a generalized additive mixed model were performed on monthly sex- and stroke subtype-specific age-standardized mortality rates from January 2001-December 2018. Significant average annual percent decreases were found for all sex- and stroke subtype-specific mortality rate trends. The alcohol control policies were most impactful on ischemic stroke mortality rates among women. The 2008 policy was followed by a positive level change of 4,498 ischemic stroke deaths per 100,000 women and a negative monthly slope change of -0.048 ischemic stroke deaths per 100,000 women. Both the 2017 and 2018 policy enactment timepoints coincided with a significant negative level change for ischemic stroke mortality rates among women, at -0.901 deaths and -1.431 deaths per 100,000 population, respectively. Hemorrhagic stroke mortality among men was not affected by any of the policies, and hemorrhagic stroke mortality among women and ischemic stroke mortality among men were only associated with the 2008 policy. Our study findings suggest that the impact of alcohol control policies on stroke mortality may vary by sex and subtype.

Super-Resolution Ultrasound Imaging for Monitoring the Therapeutic Efficacy of a Vascular Disrupting Agent in an Animal Model of Breast Cancer.

Evaluate the use of super-resolution ultrasound (SRUS) imaging for the early detection of tumor response to treatment using a vascular-disrupting agent (VDA). A population of 28 female nude athymic mice (Charles River Laboratories) were implanted with human breast cancer cells (MDA-MB-231, ATCC) in the mammary fat pad and allowed to grow. Ultrasound imaging was performed using a Vevo 3100 scanner (FUJIFILM VisualSonics Inc) equipped with the MX250 linear array transducer immediately before and after receiving bolus injections of a microbubble (MB) contrast agent (Definity, Lantheus Medical Imaging) via the tail vein. Following baseline ultrasound imaging, VDA drug (combretastatin A4 phosphate, CA4P, Sigma Aldrich) or control saline was injected via the placed catheter. After 4 or 24 hours, repeat ultrasound imaging along the same tumor cross-section occurred. Direct intratumoral pressure measurements were obtained using a calibrated sensor. All raw ultrasound data were saved for offline processing and SRUS image reconstruction using custom MATLAB software (MathWorks Inc). From a region encompassing the tumor space and the entire postprocessed ultrasound image sequence, time MB count (TMC) curves were generated in addition to traditional SRUS maps reflecting MB enumeration at each pixel location. Peak enhancement (PE) and wash-in rate (WIR) were extracted from these TMC curves. At termination, intratumoral microvessel density (MVD) was quantified using tomato lectin labeling of patent blood vessels. SRUS images exhibited a clear difference between control and treated tumors. While there was no difference in any group parameters at baseline (0 hour, P > .09), both SRUS-derived PE and WIR measurements in tumors treated with VDA exhibited significant decreases by 4 (P = .03 and P = .05, respectively) and 24 hours (P = .02 and P = .01, respectively), but not in control group tumors (P > .22). Similarly, SRUS derived microvascular maps were not different at baseline (P = .81), but measures of vessel density were lower in treated tumors at both 4 and 24 hours (P < .04). An inverse relationship between intratumoral pressure and both PE and WIR parameters were found in control tumors (R2 > .09, P < .03). SRUS imaging is a new modality for assessing tumor response to treatment using a VDA.