Small Increase Research Articles

Long term remineralizing effect of casein phosphopeptide amorphous calcium phosphate in white spot lesions: A systematic review and meta-analysis.

White spot lesions (WSLs) appear as white, opaque areas on the teeth and are caused by a demineralization of the enamel. The purpose of this systematic review and meta-analysis was to determine whether casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has beneficial effects on WSLs and provides remineralizing benefits that are superior to those of placebo or no treatment. Following a thorough analysis of the literature across major online sources, 103 papers - 54 of which underwent in-depth evaluation- were found. We used inclusion and exclusion criteria to choose research articles that were appropriate for our review. 10 papers met this review's requirements and were subsequently included. As compared to the controls, CPP-ACP demonstrated increased efficacy in treatment of WSLs in terms of remineralisation and other parameters which included microhardness tests and enamel surface roughness. The forest plots present the results of meta-analyses comparing the effect of CPP-ACP versus control/other agents on white spot lesions (WSLs). In terms of odds ratios (OR), CPP-ACP showed a small increase in the odds of WSLs compared to control/other agents. In-vitro studies showed no significant difference in relative risk (RR) between CPP-ACP and control/other agents. Randomized control trials indicated a small increase in the risk of WSLs with CPP-ACP treatment, but the overall effect was not statistically significant. There was evidence to support the use of CPP-ACP over other agents for WSL prevention or treatment, but further research is needed to confirm these findings.

Spatio-temporal dynamics of vegetation over cloudy areas in Southwest China retrieved from four NDVI products

The Normalized Difference Vegetation Index (NDVI) is the most commonly used index for assessing vegetation. However, significant differences among various satellite datasets, complex terrain, and the impact of clouds on optical sensors limit vegetation change assessment based on NDVI. To address these issues, this study utilizes multi-source satellite data (GIMMS3g NDVI, CDR AVHRR NDVI, SPOT NDVI, and MODIS NDVI) to monitor vegetation dynamics at different time scales from 1990 to 2020 in Sichuan Province, China. The results indicate that over time, NDVI values from the four NDVI products in Sichuan Province have shown an upward trend. There are certain differences in the spatial distribution and spatial heterogeneity of the change rate of NDVI values among the four NDVI products at different time scales, and the differences are mainly concentrated in the Sichuan Basin (SB) and the Western Sichuan alpine plateau region (WS). Compared with the other three NDVI products, GIMMS NDVI has the highest value but the smallest increase during the study period. The SPOT NDVI value is the smallest, but the increase is relatively large. However, within the overlapping period of the four NDVI datasets, only the annual average of CDR AVHRR NDVI showed a downward trend (slope2000–2013 = −0.0001·a−1). The annual fluctuation of CDR AVHRR NDVI is the smallest, and compared to other NDVI datasets, its correlation with climate factors shows significantly weaker spatial variability. Moreover, the ability of CDR AVHRR NDVI to distinguish different vegetation land cover types is significantly poor (STD = 0.045). The findings of this study will provide a reference for further research on vegetation changes in Sichuan Province and NDVI reconstruction in cloudy areas.

Changes in well-being among socially isolated older people during the COVID-19 pandemic: An outcome-wide analysis

Older adults experienced major changes during the COVID-19 pandemic and ensuing restrictions, and it might be expected that those who were already socially isolated before the pandemic were particularly vulnerable. We apply an outcome-wide longitudinal design on 4,636 participants (mean age 66.8 y) from the English Longitudinal Study of Ageing, observed in 2018/19 and early (June/July 2020) and later (November/December 2020) in the pandemic. Social isolation is defined using an index including marital status, social contact, and social participation in 2018/19. Using mixed models, we compare changes in well-being, health, health behaviors, financial well-being, and Internet use, between isolated and nonisolated participants. From before to during the pandemic, isolated participants (29%) experienced smaller declines in life satisfaction and quality of life and a smaller increase in loneliness. They showed greater declines in smoking and physical activity and were more likely to remain worried about their future financial situation. They also did not change in their likelihood of regular Internet use, contrasting with nonisolated participants who increased in this regard. The groups followed a similar trend for general health and sleep quality (no change), depression and anxiety (increase), and expectations of future financial difficulties (decrease). Although isolated older adults generally show poorer outcomes than their socially connected counterparts, they were somewhat protected during the pandemic on some fronts. Our findings highlight the need to continually care for isolated older adults but also to be attentive in times of unexpected crises to those experiencing extreme changes related to necessary policy responses.

Exploring the impact of antenatal micronutrients used as a treatment for maternal depression on infant temperament in the first year of life.

Antenatal depression and maternal nutrition can influence infant temperament. Although broad-spectrum-micronutrients (BSM: vitamins and minerals) given above Recommended Dietary Allowances during pregnancy can mitigate symptoms of antenatal depression, their associated effects on infant temperament are unknown. One hundred and fourteen New Zealand mother-infant dyads (45 infants exposed to BSM during pregnancy (range of exposure during pregnancy: 12-182 days) to treat antenatal depressive symptoms (measured by Edinburgh Postnatal Depression Scale) and 69 non-exposed infants) were followed antenatally and for 12 months postpartum to determine the influence of in utero BSM exposure on infant temperament. The Infant Behavior Questionnaire-Revised: Very Short-Form assessed temperament at 4 (T1), 6 (T2) and 12 (T3) months postpartum via online questionnaire. Latent growth curve modeling showed BSM exposure, antenatal depression and infant sex did not statistically significantly predict initial levels or longitudinal changes in orienting/regulatory capacity (ORC), positive affectivity/surgency (PAS) or negative affectivity (NEG). Higher gestational age was positively associated with initial PAS, and smaller increases between T1 and T3. Breastfeeding occurrence was positively associated with initial NEG. Although not significant, BSM exposure exerted small, positive effects on initial NEG (β = -0.116) and longitudinal changes in ORC (β = 0.266) and NEG (β = -0.235). While BSM exposure did not significantly predict infant temperament, it may mitigate risks associated with antenatal depression. BSM-exposed infants displayed temperamental characteristics on par with typical pregnancies, supporting the safety of BSM treatment for antenatal depression.

Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England

BackgroundTobacco smoking affects women’s fertility and is associated with substantial risks of adverse pregnancy outcomes. This study explored trends by socioeconomic position in patterns of smoking, use of non-combustible nicotine products, and quitting activity among women of reproductive age in England.MethodsData come from a nationally representative monthly cross-sectional survey. Between October 2013 and October 2023, 197,266 adults (≥ 18 years) were surveyed, of whom 44,052 were women of reproductive age (18–45 years). Main outcome measures were current smoking, vaping, and use of nicotine replacement therapy (NRT), heated tobacco products (HTPs), and nicotine pouches; mainly/exclusively smoking hand-rolled cigarettes and level of dependence among current smokers; past-year quit attempts among past-year smokers; and success of quit attempts among those who tried to quit. We modelled time trends in these outcomes, overall and by occupational social grade (ABC1 = more advantaged/C2DE = less advantaged).ResultsSmoking prevalence among women of reproductive age fell from 28.7% [95%CI = 26.3–31.2%] to 22.4% [19.6–25.5%] in social grades C2DE but there was an uncertain increase from 11.7% [10.2–13.5%] to 14.9% [13.4–16.6%] in ABC1. By contrast, among all adults and among men of the same age, smoking prevalence remained relatively stable in ABC1. Vaping prevalence among women of reproductive age more than tripled, from 5.1% [4.3–6.0%] to 19.7% [18.0–21.5%], with the absolute increase more pronounced among those in social grades C2DE (reaching 26.7%; 23.3–30.3%); these changes were larger than those observed among all adults but similar to those among men of the same age. The proportion of smokers mainly/exclusively smoking hand-rolled cigarettes increased from 40.5% [36.3–44.9%] to 61.4% [56.5–66.1%] among women of reproductive age; smaller increases were observed among all adults and among men of the same age. Patterns on other outcomes were largely similar between groups.ConclusionsAmong women of reproductive age, there appears to have been a rise in smoking prevalence in the more advantaged social grades over the past decade. Across social grades, there have been substantial increases in the proportion of women of reproductive age who vape and shifts from use of manufactured to hand-rolled cigarettes among those who smoke. These changes have been more pronounced than those observed in the general adult population over the same period.

Atrial Shunt Device Effects on Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction

Although the results of A Study to Evaluate the Corvia Medical Inc IASD System II to Reduce Elevated Left Atrial Pressure in Patients with Heart Failure (REDUCE LAP-HF II) trial were neutral overall, atrial shunt therapy demonstrated potential efficacy in responders (no latent pulmonary vascular disease and no cardiac rhythm management device). Post hoc analyses were conducted to evaluate the effect of shunt vs sham stratified by responder status. To evaluate the effect of atrial shunt vs sham control on cardiac structure/function in the overall study and stratified by responder status. This was a sham-controlled randomized clinical trial of an atrial shunt device in heart failure with preserved ejection fraction (HFpEF)/HF with mildly reduced EF (HFmrEF). Trial participants with evaluable echocardiography scans were recruited from 89 international medical centers. Data were analyzed from April 2023 to January 2024. Atrial shunt device or sham control. Changes in echocardiographic measures from baseline to 1, 6, 12, and 24 months after index procedure. The modified intention-to-treat analysis of the REDUCE LAP-HF II trial included 621 randomized patients (median [IQR] age, 72.0 [66.0-77.0] years; 382 female [61.5%]; shunt arm, 309 [49.8%]; sham control arm, 312 [50.2%]). Through 24 months, 212 of 217 patients (98%) in the shunt arm with evaluable echocardiograms had patent shunts. In the overall trial population, the shunt reduced left ventricular (LV) end-diastolic volume (mean difference, -5.65 mL; P <.001), left atrial (LA) minimal volume (mean difference, -2.8 mL; P =.01), and improved LV systolic tissue Doppler velocity (mean difference, 0.69 cm/s; P <.001) and LA emptying fraction (mean difference, 1.88 percentage units; P =.02) compared with sham. Shunt treatment also increased right ventricular (RV; mean difference, 9.58 mL; P <.001) and right atrial (RA; mean difference, 9.71 mL; P <.001) volumes but had no effect on RV systolic function, pulmonary artery pressure, or RA pressure compared with sham. In the shunt arm, responders had smaller increases in RV end-diastolic volume (mean difference, 5.71 mL vs 15.18 mL; interaction P =.01), RV end-systolic volume (mean difference, 1.58 mL vs 7.89 mL; interaction P =.002), and RV/LV ratio (mean difference, 0.07 vs 0.20; interaction P <.001) and larger increases in transmitral A wave velocity (mean difference, 5.08 cm/s vs -1.97 cm/s; interaction P =.02) compared with nonresponders randomized to the shunt, suggesting greater ability to accommodate shunted blood through the pulmonary circulation enabling LA unloading. In this post hoc analysis of the REDUCE LAP-HF II trial, over 2 years of follow-up, atrial shunting led to reverse remodeling of left-sided chambers and increases in volume of right-sided chambers consistent with the shunt flow but no change in RV systolic function compared with sham. Changes in cardiac structure/function were more favorable in responders compared with nonresponders treated with the shunt, supporting the previously identified responder group hypothesis and mechanism, although further evaluation with longer follow-up is needed. ClinicalTrials.gov Identifier: NCT03088033.

Long-term effects of abatacept on atherosclerosis and arthritis in older vs. younger patients with rheumatoid arthritis: 3-year results of a prospective, multicenter, observational study

BackgroundWe aimed to reveal the effect of abatacept (ABT) on atherosclerosis in rheumatoid arthritis (RA) patients, 3-year efficacy for arthritis, and safety in a population of older vs. younger patients.MethodsIn this open-label, prospective, observational study, patients were stratified into four groups: younger (20–64 years old) and older (≥ 65 years) patients taking ABT (AY and AO) and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (CY and CO). Primary endpoints were change from baseline in mean intima-media thickness (IMT) of the common carotid artery, IMT max (bulbus, bifurcation, and internal and common carotid artery), and plaque score at Week 156. Disease activity, retention rate, and adverse effects were also evaluated.ResultsThe ABT group (AY + AO) tended to have smaller increases in mean IMT, max IMT, and plaque score than the csDMARD group (CY + CO) at Week 156, although the differences between groups were not statistically significant. Multivariate analysis showed significantly lower increases in plaque score with ABT than with csDMARDs, only when considering disease activity at 156 weeks (p = 0.0303). Proportions of patients with good or good/moderate European League Against Rheumatism response were higher in the ABT group, without significant difference between older and younger patients. No significant differences were observed in ABT retention rates between older and younger patients. Serious adverse effects, especially infection, tended to be more frequent with ABT than with csDMARDs, although no significant differences were found.ConclusionsABT may decelerate atherosclerosis progression and may be useful for patients with high risk of cardiovascular disease, such as older patients.Trial registration number:UMIN000014913.

Altered long-range functional connectivity in PTSD: Role of the infraslow oscillations of cortical activity amplitude envelopes

ObjectiveCoupling between the amplitude envelopes (AEs) of regional cortical activity reflects mechanisms that coordinate the excitability of large-scale cortical networks. We used resting-state MEG recordings to investigate the association between alterations in the coupling of cortical AEs and symptoms of post-traumatic stress disorder (PTSD). MethodsParticipants (n = 96) were service members with combat exposure and various levels of post-traumatic stress severity (PTSS). We assessed the correlation between PTSS and (1) coupling of broadband cortical AEs of beta band activity, (2) coupling of the low- (<0.5 Hz) and high-frequency (>0.5 Hz) components of the AEs, and (3) their time-varying patterns. ResultsPTSS was associated with widespread hypoconnectivity assessed from the broadband AE fluctuations, which correlated with subscores for the negative thoughts and feelings/emotional numbing (NTF/EN) and hyperarousal clusters of symptoms. Higher NTF/EN scores were also associated with smaller increases in resting-state functional connectivity (rsFC) with time during the recordings. The distinct patterns of rsFC in PTSD were primarily due to differences in the coupling of low-frequency (infraslow) fluctuations of the AEs of beta band activity. ConclusionsOur findings implicate the mechanisms underlying the regulation/coupling of infraslow oscillations in the alterations of rsFC assessed from broadband AEs and in PTSD symptomatology. SignificanceAltered coordination of infraslow amplitude fluctuations across large-scale cortical networks can contribute to network dysfunction and may provide a target for treatment in PTSD.

Effect of an Intensive Lifestyle Intervention on Circulating Biomarkers of Atrial Fibrillation-Related Pathways among Adults with Metabolic Syndrome: Results from a Randomized Trial.

Background: Lifestyles influence atrial fibrillation (AF) risk. Determining the effect of lifestyle interventions on blood concentrations of biomarkers of AF-related pathways could help understand AF pathophysiology and contribute to AF prevention. Methods: We studied 532 participants enrolled in the PREDIMED-Plus trial, a Spanish randomized trial conducted in adults (55-75 years) with metabolic syndrome and body mass index between 27-40 kg/m2. Eligible participants were randomized 1:1 to an intensive lifestyle intervention, emphasizing physical activity, weight loss, and adherence to an energy-reduced Mediterranean diet or to a control group. Serum biomarkers [carboxy-terminal propeptide of procollagen type I (PICP), high-sensitivity troponin T (hsTnT), high-sensitivity C reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)] were measured at baseline, 3 and 5 years after randomization. Mixed models were used to evaluate the effect of intervention on changes in biomarkers through year 5. Mediation analysis was performed to examine the proportion mediated by each component of the intervention. Results: At baseline, participants' mean age was 65, 40% were female, and 50% were assigned to the intervention. After five years, mean changes in log-transformed biomarkers were -0.01 (PICP), 0.20 (hsTnT), -0.17 (hsCRP), 0.12 (3-NT), and 0.27 (NT-proBNP). Compared to the control group, participants in the intervention group experienced greater decreases in hsCRP (-14%, 95% confidence interval (CI) -26%, 0%) or smaller increases in 3-NT (-16%, 95% CI -25%, -5%) and NT-proBNP (-12%, 95% CI -23%, 1%). The intervention had minimal impact on hsTnT (-3%, 95% CI -7%, 2%) or PICP concentrations (-2%, 95% CI -9%, 6%). The effect of the intervention on hsCRP was primarily mediated by weight loss (89% at year 5). Conclusions: Over five years, a dietary and lifestyle intervention for weight-loss favorably affected concentrations of hsCRP, 3-NT, and NT-proBNP, pointing to specific mechanisms in pathways linking lifestyles and AF.

Effects of Cochlear Implantation and Steroids on the Aging Guinea Pig Cochlea.

The objective was to determine the effects of older age on hearing preservation after cochlear implantation (CI), and whether steroids improve hearing preservation in older animals. We hypothesized greater hearing preservation would be observed in (1) young animals compared to older animals and (2) older animals receiving steroids compared to no steroids. The secondary objective was to assess levels of fibrosis utilizing optical coherence tomography (OCT). Experimental Animal Study. Laboratory. Three groups of guinea pigs: young (YCI; 8.5 ± 0.5 weeks; n = 10), old (OCI; 19.1 ± 1.0 months; n = 9) and old + steroids (OCI+S; 19.1 ± 1.0 months; n = 9) underwent CI. The OCI+S group received a steroid taper over 7 days starting 2 days before surgery to 4 days after. Auditory brainstem response (ABR) measurements were performed preoperatively and postoperatively. OCT imaging was performed to assess cochleae for extent of fibrotic tissue growth in the scala tympani. The YCI group had significantly better hearing preservation as measured by smaller increases in ABR thresholds [mean shift: 2.79 ± 0.66] compared to the OCI group [mean shift = 12.44 ± 5.6]. The OCI+S group had significantly better hearing preservation [2.66 ± 1.50] compared to the OCI group. No significant differences was seen in fibrosis across groups. Young animals and older animals that received steroids had better hearing after CI than older animals not given steroids, but hearing preservation was not correlated with the level of fibrosis assessed using OCT. This work is the first to investigate differences in hearing preservation by age in an animal model, and supports the protective effects of steroids on hearing preservation in older individuals.

Population-based surveillance of congenital anomalies over 40 years (1981–2020): Results from the Paris Registry of Congenital Malformations (remaPAR)

IntroductionRegistries of congenital anomalies (CAs) play a key role in the epidemiological surveillance of CAs. The objective was to estimate the prevalence of CAs and proportions of prenatal diagnosis, terminations of pregnancy for fetal anomaly (TOPFA) and infant mortality in the Paris Registry of Congenital Malformations (remaPAR) over 40 years, from 1981 to 2020. Material and methodsremaPAR records all births (live births, stillbirths ≥22 weeks of gestation and TOPFA at any gestational age) with CAs detected prenatally until the early neonatal period. We estimated the prevalence of CAs and proportions of prenatal diagnosis, TOPFA and infant mortality, overall and for a selected group of CAs in 3-year intervals. ResultsThe prevalence of CAs remained stable during the study period: 2.9 % of total births and 2.1 % of live births. Genetic anomalies were the most frequent subgroup (about 23 %), followed by congenital heart defects (about 22 %) and limb defects (about 20 %). Among non-genetic anomalies, the prevalence per 10,000 births was the highest for hypospadias (about 18 %) and the lowest for bilateral renal agenesis (about 1 %). Prenatal diagnoses increased from about 17 % in the 1980s to approximately 70 % in the most recent period (2018–2020), whereas the proportion of early TOPFA <16 weeks of gestation increased from 0.4 % to 14 %. Infant mortality ranged from 0 % for transverse limb reduction defects to 86 % for hypoplastic left heart syndrome. ConclusionThe overall prevalence of CAs was fairly stable in Paris from 1981 to 2020. Prenatal diagnoses substantially increased, accompanied by much smaller increases in TOPFA.

Optimizing the rate of straw returning to balance trade-offs between carbon emission budget and rice yield in China

Rice paddies are a prominent contributor to greenhouse gases (GHGs) emissions, accounting for 22 % of the overall agricultural methane (CH4) emissions. Although returning rice straw to the field can increase yield and soil organic carbon (SOC), the significant GHGs released during this process often negate these positive effects. Thus, understanding the impact of straw returning on the relationship between rice yield and GHGs is crucial for farming adaptation and climate change mitigation. This study aims to investigate the effects of varying straw returning rates on rice yield and GHGs in China and identify the optimal rates on a provincial scale. This study utilized county-level meteorological, soil, and field management data. The Dynamic Nitrogen and Carbon Model (DNDC) model was used to simulate the impacts on rice yield, GHGs, and SOC changes under different straw returning rates in China from 2010 to 2022, including no straw, 1/3, 2/3, and full straw returning. The results showed that 1/3, 2/3, and full straw incorporation increased rice yield per unit area by 1.07 %, 2.25 %, and 3.26 % for single rice cropping, 1.10 %, 2.24 %, and 3.52 % for early rice, and 1.92 %, 3.91 %, and 5.95 % for late rice, respectively. Compared with no straw returning, the total SOC content (0–50 cm) increased by 3.88 % (78.07 Tg), 7.75 % (156.09 Tg), and 11.65 % (234.62 Tg) under 1/3, 2/3, and full straw returning, respectively. However, the total GHGs were increased by 23.32 %, 43.50 %, and 61.48 % for 1/3, 2/3, and full straw incorporation compared to no straw returning. While the overall benefits of straw returning varied across regions, in certain areas like northeastern China, Xinjiang, and Yunnan, an increase in straw returning rates leads to a significant increase in yield with a relatively smaller increase in GHGs. This can be attributed to factors such as lower temperatures, decreased SOC, and lower soil pH, restricting CH4 production. Conversely, in regions with higher soil pH, such as north China and the Sichuan Basin, as well as in warmer southern areas, the increase in GHGs is quite pronounced. In summary, implementing straw returning significantly increases rice production and SOC but simultaneously increases GHGs. In China, the most widespread utilization of rice straw remains straw returning. We have summarized the average impact of straw returning on yield, SOC, and GHGs, and proposed straw returning rates tailored to the comprehensive benefits in different regions, to enhance the carbon sequestration and emission reduction rate of rice straw returning.

Pediatric tuberculosis in Mexico and the COVID-19 phenomenon: Past and present.

In endemic regions, tuberculosis in children constitutes a bigger fraction of total cases as compared to those in low endemic regions, regardless of the implications, this phenomenon has been historically neglected. Pediatric tuberculosis has an insidious onset and quickly develops into disseminated disease and the young are at a special risk for dissemination. Some studies suggest that measures to contain adult tuberculosis are not enough to manage tuberculosis in children, meaning that pediatric tuberculosis needs dedicated attention. Children are harder to diagnose than adults, because collecting samples is difficult, and their bacterial yield is low. In endemic countries, such as Mexico, where contact with Mycobacterium tuberculosis is common, immunological tests are inconsistent, especially in immunocompromised children. With the disruption of Mexican healthcare services by the COVID-19 pandemic, there is an uncertainty of how the situation has evolved, current data about tuberculosis indicates a drop in the national report of cases: 15.4 per 100,000 persons in 2021, compared with pre-COVID 2019 17.7 per 100,000 persons, a small increase in mortality: 1.7 per 100,000 in 2021 compared with 2019 1.6 per 100,000, a drop in treatment success: 80.4% in 2021 compared with 85.4% in 2019, and a decrease in national vaccination rates: an estimate of 86.6% children between 1 and 2 years-old were vaccinated in 2021 compared with 97.3% reported national rate in 2018-2019. There is a need for new research on regions with high tuberculosis incidence, to clarify the current situation of pediatric tuberculosis and improve epidemiological surveillance.

Effect of Ferric Carboxymaltose Versus Low-Dose Intravenous Iron Therapy and Iron Sucrose on the Total Cost of Care in Patients with Iron Deficiency Anemia: A US Claims Database Analysis.

Iron deficiency is the most common cause of anemia. We compared the effect of ferric carboxymaltose (FCM), low-dose intravenous (IV) iron (LDI), and iron sucrose on total cost of care in patients with iron-deficiency anemia (IDA) from a US health plan perspective. We conducted a retrospective claims analysis using the IQVIA PharMetrics Plus database. Patients with index (first) claims of FCM and LDI and a medical claim associated with IDA between 1 January 2017 and 31 December 2019 were included. Monthly total healthcare and inpatient and outpatient costs after receiving index IV iron for patients in the treatment cohorts were compared using a generalized linear model with gamma distribution and log-link. The overall study cohort included 37,655 FCM, 44,237 LDI, and 27,461 iron sucrose patients. Mean per-patient-per-month numbers of IV iron infusions for FCM, LDI, and iron sucrose were 0.20, 0.34, and 0.37, respectively. Compared with baseline, the FCM group had greater reductions in the number of hospital admissions and smaller increases in the number of outpatient visits in the 12 months post-IV iron therapy than LDI and iron sucrose, translating to significantly lower total healthcare cost (post-index adjusted cost ratio for total cost: 0.96 and 0.92, respectively; both P < 0.0001). Higher drug acquisition cost of FCM relative to LDI and iron sucrose was offset by significantly lower inpatient and outpatient costs in the 12 months post-IV iron therapy. These results support the economic value of FCM for patients with IDA receiving IV iron therapy.

Associations of Early Gut Microbiome and Metabolome with Growth and Body Composition of Preterm Infants Within the First 6 Months.

Objectives: This study aimed to explore the associations of growth and body composition with gut microbiome and metabolome in preterm infants. Materials and Methods: A prospective cohort study including 73 human milk-fed very preterm infants was conducted. During hospitalization, fecal samples were collected to detect microbes and metabolites using 16S rRNA gene sequencing and liquid chromatography-mass spectrometry. Growth and body composition indices were measured at term equivalent age (TEA) and 6 months of corrected age (CA). Associations of the fecal microbiome and metabolome profiles with growth and body composition indices, as well as their changes, were analyzed. Results: A higher abundance of Streptococcus was associated with a lower fat-free mass (FFM) z-score at 6 months of CA (p = 0.002) and a smaller increase in FFM z-score from TEA to 6 months of CA (p = 0.018). Higher levels of 3'-sialyllactose and 6'-sialyllactose (6'-SL) in feces were correlated with a lower z-score of percentage body fat (PBF) (p = 0.018 and 0.020, respectively) and a lower z-score of fat mass (p = 0.044 and 0.043, respectively) at 6 months of CA. A higher level of 6'-SL in feces was correlated with a greater increase in FFM z-score from TEA to 6 months of CA (p = 0.021). Conclusions: This study sheds light on the role of specific microbial-host interactions in metabolic changes in preterm infants, indicating the potential role of sialylated human milk oligosaccharides in optimizing body composition.

Thermal analysis and structure optimization of wavy microchannel with combining ribs of porous layer and solid wall in multi objective genetic algorithm

The combining rib of porous layer and solid wall is set in wavy microchannel heat sink to enlarge heat transfer area and convection with smaller increase in flow resistance, in which the consumption of pump power relates to the ratios of wave amplitude to length or to width and the thickness of porous layer due to vortices generation while coolant passing through channel. The local thermal equilibrium occurs in porous layer, and the Forchheimer-Brinkman-Darcy relations were used to describe the flow inside porous ribs. The effects of channel-to-pitch width ratio, width ratio of porous layer to pitch and microchannel height on its cooling performance are investigated, and the parameter of figure of merit (FOM) is defined to evaluate thermo-hydraulic performance in wavy microchannel. Besides, the multi objective genetic algorithm method is employed to optimize structure parameters in wavy microchannel to obtain better performances, in which the increase in thermal resistance from 0.062 K/W to 0.166 K/W together with consumption of pump power decreasing from 0.00416 W to 0.00185 W can be obtained in the Pareto front set, and it relates to the heat dissipation in convection between coolant and bottom surface or vertical side ribs. Compared to wavy microchannel with solid rib, the 37.61% and 16.67% decreases respectively in thermal resistance and consumption of pump power occur in the case with optimal combining rib of porous layer and solid wall.

Stiffening of double-shelled fullerene molecules under uniaxial strains

Onion-like fullerenes (OLFs) have spherical and tunable shell structures that make them perfect solid lubricants, but their molecular mechanical properties are largely unknown as they are extremely difficult to measure. In this computational study, double-shelled OLFs C60@C180, C80@C180, C60@C240 and C80@C240 are subject to uniaxial elastic strains to obtain their mechanical response. Compressive and tensile elastic moduli are calculated using density functional theory with van der Waals correction. We found that the tensile elastic moduli of the single- and double-shelled fullerenes are always larger than the compressive ones by about 50% to 100%. Inserting C80 into C180 causes an increase in compressive elastic modulus from 96.8 GPa to 178.6 GPa, while inserting C60 into C240 cause much smaller increases. The key factor that determines the stiffening effects is the relative sizes of the inner and outer shells.

Effects of Repeated High-Intensity Effort Training or Repeated Sprint Training on Repeated High-Intensity Effort Ability and In-Game Performance in Professional Rugby Union Players.

Glaise, P, Rogowski, I, and Martin, C. Effects of repeated high-intensity effort training or repeated sprint training on repeated high-intensity effort ability and in-game performance in professional rugby union players. J Strength Cond Res 38(5): 932-940, 2024-This study investigated the effects of repeated high-intensity efforts (RHIE) training compared with repeated sprint exercise (RSE) training on RHIE ability (RHIEa) and in-game performance in professional rugby union players. Thirty-nine, male, professional, rugby union players were randomly assigned to 3 training groups (RHIE training, RSE training, and control). Repeated high-intensity effort ability and high-intensity effort characteristics (including sprints, acceleration, and contact efforts) during official games were measured before and after a 10-week specific (RHIE, RSE, or control) training period. The results of this study showed that concerning RHIEa, both the RHIE and RSE training significantly increased the players' average sprint velocity ( p < 0.001, d = -0.39 and p < 0.001, d = -0.53 respectively), average sled push velocity (ASPV; p < 0.001, d = -0.81 and p = 0.017, d = -0.48 respectively), and RHIE score ( p < 0.001, d = -0.72 and p < 0.001, d = -0.60 respectively). Repeated high-intensity effort training trended in a smaller increase in average sprint velocity than RSE training, a larger increase in ASPV, and a similar increase in RHIE score. Concerning in-game high-intensity efforts, both the RHIE and RSE training produced significant improvements in the number of sprints ( p = 0.047, d = -0.28 and p < 0.001, d = -0.47 respectively), total distance ( p < 0.001, d = -0.50 and p = 0.002, d = -0.38 respectively), the number of accelerations ( p < 0.001, d = -0.37 and p = 0.003, d = -0.32 respectively), and contact rate ( p < 0.001, d = -0.97 and p = 0.020, d = -0.28 respectively). Conversely, the magnitude of the increase in contact rate was almost twice as high in RHIE compared with RSE training. To conclude, the findings of this study were that both RSE and RHIE training are effective methods for developing RHIEa and in-game high-intensity efforts in professional rugby union. In practical applications, as the gains in certain abilities and game performance data differed depending on the training method chosen, we suggest that coaches choose the most appropriate method according to the profile of the players, their position, and the style of play they want to develop.

A population-based time-series analysis of opioid agonist treatment dispensed during pregnancy.

Identifying effective opioid treatment options during pregnancy is a high priority due to the growing prevalence of opioid use disorder across North America. We assessed the temporal impact of three population-level interventions on the use of opioid agonist treatment (OAT) during pregnancy in Ontario, Canada. This was a population-based time-series analysis to identify trends in the monthly prevalence of pregnant people dispensed methadone and buprenorphine. The impact of adding buprenorphine/naloxone to the public drug formulary, the release of pregnancy-specific guidance and the start of the COVID-19 pandemic were assessed. The study was conducted in Ontario, Canada between 1 July 2013 and 31 March 2022, comprising people who delivered a live or stillbirth in any Ontario hospital during the study period. We identified any prescription for methadone or buprenorphine dispensed between the estimated conception date and delivery date and calculated the monthly prevalence of OAT-exposed pregnancies among all pregnant people in Ontario. Overall, rates of OAT during pregnancy have declined since mid-2018. Methadone-exposed pregnancies decreased from 0.46% of all pregnancies in Ontario in 2015 to a low of 0.16% in 2022. In the primary analysis, none of the interventions had a statistically significant impact on overall OAT rates; however, in the stratified analyses, there was a small increase in buprenorphine after the formulary change [0.006%, 95% confidence interval (CI) = 0.0032-0.0081, P < 0.0001] and a decrease in buprenorphine after the release of the 2017 guidelines (-0.005%, 95% CI = -0.0080 to -0.0020, P = 0.001) and the start of the COVID-19 pandemic (-0.003%, 95% CI = -0.0054 to -0.0006, P = 0.015). Despite changes in guidance and funding, opioid agonist treatment during pregnancy has been declining in Ontario, Canada since 2018.

Prior implantation of hydrogen as a mechanism to delay helium bubbles, blistering, and exfoliation in titanium

This study explores the delaying of the formation of helium bubbles and blisters in pure titanium by hydrogen pre-implantation. Titanium, implanted with helium (40 KeV, 5 × 1017 ions/cm²), exhibited large bubbles that cause exfoliation after heat treatment, whereas hydrogen pre-implantation inhibited bubble growth at room temperature and reduced the exfoliation after heat treatment.In the samples pre-implanted with hydrogen, we found evidence of helium diffusion delay by: (a) a fourfold reduction in bubble pressure (b) faceted cavities in the samples (c) a smaller increase in titanium lattice parameters (d) a 16-fold reduction in average bubble size and a sixfold reduction in bubble area fraction (e) a more than twofold decrease in exfoliation (f) a tendency toward the formation of larger bubbles as a result of heat treatment. We believe that it is reasonable to assume that the inhibition of helium diffusion between tetrahedral interstitial lattice sites takes place because of the occupation of the intermediate octahedral sites by hydrogen atoms.Evidence for the opposite effect, that is inhibition of the diffusion of hydrogen in the presence of helium, is found in the retention of hydrogen in the specimens at elevated temperatures. This retention allowed the existence of titanium hydride after heat treatment at 680 °C. The present study sheds light on the intricate interplay between hydrogen and helium in titanium, providing insights into mechanisms that can potentially mitigate helium-induced damage in materials.