TC Group Research Articles

Role of insulin receptor substrate-1 polymorphism rs2943641 in the pathogenesis of type 2 diabetes mellitus in the Iraqi population

Insulin receptor substrate-1 is the first and key substrate of the insulin receptor, act as a multisite docking protein for various effector molecules. It is encoded by the IRS-1 gene, which is found on chromosome 2q36.3 in humans. Insulin receptor substrate is an effective insulin signaling agent that plays a key role in preserving the cell’s basic function, any polymorphism in the IRS genes acts as a competitive insulin receptor inhibitor. A total of 150 healthy men as control and 200 diabetic patients participated in this study; it is across-sectional study, patients were chosen while seeking medical care in the outpatient clinic. This study investigates the association of IRS-1 rs2943641 to the pathogenesis of type 2diabetes mellitus in Iraqi males. This study was conducted to study the association of SNP rs2943641[TT(minor allele type), TC(heterozygous alleles type) and CC(major allele type)] to the pathogenesis of type 2diabetes mellitus according to the logistic regression method which demonstrates that there is a significant association between TC and CC allele groups to the pathogenesis of T2DM. In conclusion, genetic polymorphism of IRS-1 rs2943641 is associated with the pathogenesis of T2DM in Iraqi male.

Association of TSHR gene single nucleotide intronic polymorphism with the risk of hypothyroid and hyperthyroid disorders in Yazd province

The present study was carried out, for the first time, to evaluate the association of rs2268458 polymorphism, biochemical and environmental factors on hypothyroid and hyperthyroid disorders in thyroid patients and healthy individuals in Yazd province, Iran. In this study, blood samples were collected from a total of 100 cases, including 60 hypothyroid, 20 hyperthyroid and 20 normal individuals. DNA was extracted from blood samples and the rs2268458 single nucleotide intronic polymorphism was evaluated using Restriction Fragment Length Polymorphism PCR (RFLP-PCR). The results have shown that 59 individuals were homozygote (TT), 40 cases were heterozygote (TC) and one homozygote (CC) case. Of 59 TT homozygote cases, 25 cases were hypothyroid females and 7 hypothyroid male patients. While, heterozygote TC group consisted of 20 hypothyroid females and 7 hypothyroid male cases. Furthermore, only 1 (CC) homozygote male hypothyroid patient was observed in this study. The hyperthyroid population consisted of 7 (TT) homozygote hyperthyroid female cases, 8 (TC) heterozygote hyperthyroid female cases, 3 (TT) homozygote hyperthyroid male cases and 2 (TC) heterozygote hyperthyroid male cases. According to our study, heterozygote cases (TC) showed less severe symptoms, while homozygote cases (TT) showed no serious symptoms and the (CC) homozygote case showed severe thyroid abnormalities. So, it can be concluded that the TSHR-related rs2268458 polymorphism is associated with hypothyroidism and hyperthyroidism in the male and female populations of Yazd Province, Iran and C allele can be a risk factor for some physio-biochemical and hormonal imbalance in the thyroid disorder patients.

Effect of traditional Chinese exercise combined with massage on pain and disability in patients with lumbar disc herniation: A multi-center, randomized, controlled, assessor-blinded clinical trial.

BackgroundHerniation of the nucleus pulposus caused by disc degeneration and other reasons can cause low back pain and disability. In China, traditional Chinese exercises (TCEs) and traditional Chinese massage (TCM) are widely used to improve symptoms of pain and disability in patients with lumbar disc herniation (LDH). The safety and efficacy of combination therapy have not been studied.ObjectivesTo assess the effect of traditional Chinese exercise combined with massage vs. traditional Chinese massage alone on pain, disability, lumbar mobility and gait performance in patients with LDH.MethodsMulti-center, randomized clinical trial conducted at 4 hospitals in China and enrolling 272 patients with LDH. Participants were randomly assigned to TCEs plus TCM group or TCM alone group. The combined therapy group received 18 Tai Chi training sessions (30-min sessions 3 times a week) and regular TCM treatments over 6 weeks. The control group received TCM therapy alone and was instructed to maintain their usual daily physical activity. Outcome variables measured included Visual Analog Scale (VAS), Short Form of McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI), lumbar spine range of motion (ROM) and gait performance.ResultsAmong the 272 randomized participants, 259 completed the study. The mean VAS score was 51.77 mm at baseline in the TCEs plus TCM group, and 50.93 mm for the TCM alone group. The reduction in the VAS score at week 6 was greater in the TC group than in the TCM group with a mean difference of 4.05 (95% CI, 2.15–5.95; P < 0.001), and the ODI score with between-group differences of 3.57 points (95% CI, 2.84–4.30 points; P < 0.001). Similar significantly different results were observed in SF-MPQ, walking speed, cadence, and lumbar ROM. No serious adverse events were reported throughout the study period.ConclusionCompared with TCM alone, TCEs combined with TCM treatment performed better in reducing pain and improving disability. The combination therapy could be considered a valuable treatment option for LDH patients, with potential therapeutic utility for middle-aged and elderly patients with LDH.

The impact of deiodinase type II gene on the therapeutic response to levothyroxine in a sample of Iraqi hypothyroidism patients

BackgroundThere is a clinical observation in the local population of hypothyroid patients that many patients still have symptoms and disease-complaints even after they treated with levothyroxine as a replacement therapy. Deiodinase type II enzyme play a central role in the conversion of thyroxin to the active form triiodothyronine. This study searches the effect of rs225014; 274 T>C single nucleotide polymorphism (SNP) of deiodinase type II (DIO2) gene on the clinical response to levothyroxine replacement therapy in Iraqi hypothyroidism patients. MethodologyIn this cross –sectional study, one hundred fifty Iraqi female patients with primary hypothyroidism of the age of 40 and above, who were treated with levothyroxine were recruited. Thyroid hormones were assessed and the genetic analysis to detect rs225014 SNP was done using the tetra primers amplification refractory mutation system-polymerase chain reaction technique. ResultsThe genotypes distribution of rs225014; 274 T>C SNP was 22(14.66 %), 19 (12.66 %) and 72(72.66 %) as TT, TC and CC, respectively. Total T4 was significantly higher in TC carriers than in CC carriers, while there were no significant differences in the levels of TSH, total T3, free T3 and free T4 in TT, TC and CC groups of patients. The TC group also had significantly higher fasting serum insulin and homeostatic model assessment for insulin resistance (HOMA-IR) than the carriers of CC genotype. ConclusionsSince the rs225014 SNP of DIO2 gene is not associated with the most of the thyroid hormones levels, it could not affect the response to levothyroxine treatment in our sample of Iraqi hypothyroidism patients. Although this SNP cannot be excluded from being related to the hypothyroidism because the homozygous mutant type (CC) of it is the most frequent genotype in our sample of Iraqi hypothyroidism patients. Since TC genotype is associated with elevated levels of fasting serum insulin and HOMA-IR, it could have an impact in developing insulin resistance and type 2 diabetes mellitus.

Salivary Microbiome Profile of Diabetes and Periodontitis in a Chinese Population.

AimThere is a bidirectional association between diabetes and periodontitis. However, the effect of diabetes on the periodontitis salivary microbiota has not been elucidated. The aim of this study was to determine the effect of the presence of diabetes on the microbiota among Chinese patients with periodontitis.Materials and MethodsUnstimulated whole saliva samples were collected from the periodontitis with diabetes group (TC), chronic periodontitis group (CP), and periodontally healthy and systemically healthy group (H) by spitting method. Bacterial genomic DNA was PCR-amplified at the V4 variable region of 16S rRNA gene. The library was constructed according to the obtained sequence results, and biological analysis and statistical analysis were carried out. Functional prediction of three groups of microbial communities was performed by the PICRUSt algorithm.ResultsThere was no significant difference in bacterial diversity between the TC and CP groups. Compared with the H group, the TC group and CP group presented a higher diversity of salivary flora. Firmicutes, Streptococcus, Haemophilus, Veillonella, and Haemophilus parainfluenzae dominated the H group. Corynebacterium, Leptotrichia, Dialister, Comamonas, Capnocytophaga, Catonella, Filifactor, Campylobacter, Treponema, Campylobacter concisus, Prevotella oralis, and Porphyromonas gingivalis were significantly enriched in the TC and CP groups. Among them, Treponema and P. oralis were the most abundant in the TC group. The PICRUSt results showed that many pathways related to cell motility and functional metabolism of the salivary microbial flora changed in the TC group and the CP group.ConclusionsDiabetes was not the main factor causing the altered diversity of salivary microbiota in patients with periodontitis; however, the presence of diabetes altered the abundance of some microbiota in saliva.

Fertility and prognosis assessment between bleomycin/etoposide/cisplatin and paclitaxel/carboplatin chemotherapy regimens in conservative treatment of malignant ovarian germ cell tumor: a multicenter and retrospective study (096)

Objectives: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (TC) chemotherapy regimens on fertility and prognostic outcomes among patients with malignant ovarian germ cell tumor (MOGCT) who received fertility-sparing surgery (FSS). Methods: The study included 213 women with MOGCT who underwent FSS. We performed a 3:1 propensity score matching between the BEP and TC groups. The Chi-square test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS), and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factors of DFS. Results: A total of 185 (86.9%) patients underwent BEP chemotherapy, and 28 (13.1%) patients underwent TC chemotherapy. The median age was 22 years (range: 8-44 years), and the median follow-up was 63 months (range: 1-191 months). Fifty-one (29.3%) patients had a pregnancy plan, 43 (84.3%) patients got pregnant, and 35 (81.4%) patients delivered successfully. Fourteen (6.6%) patients experienced recurrence, and four (1.9%) patients died. In the before and after matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during pregnancy status, and live birth between BEP and TC groups (p >0.05). Also, there were no significant differences in DFS and OS between BEP and TC groups (p >0.05). The clinical staging is the only risk factor of postoperative recurrence (HR: 21.3, p <0.001). Conclusions: There was no significant difference between the effects of BEP and TC regimens on the fertility and prognosis of MOGCT patients who received FSS. The TC regimen seems to be a viable alternative to the BEP regimen for MOGCT patients. Objectives: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (TC) chemotherapy regimens on fertility and prognostic outcomes among patients with malignant ovarian germ cell tumor (MOGCT) who received fertility-sparing surgery (FSS). Methods: The study included 213 women with MOGCT who underwent FSS. We performed a 3:1 propensity score matching between the BEP and TC groups. The Chi-square test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS), and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factors of DFS. Results: A total of 185 (86.9%) patients underwent BEP chemotherapy, and 28 (13.1%) patients underwent TC chemotherapy. The median age was 22 years (range: 8-44 years), and the median follow-up was 63 months (range: 1-191 months). Fifty-one (29.3%) patients had a pregnancy plan, 43 (84.3%) patients got pregnant, and 35 (81.4%) patients delivered successfully. Fourteen (6.6%) patients experienced recurrence, and four (1.9%) patients died. In the before and after matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during pregnancy status, and live birth between BEP and TC groups (p >0.05). Also, there were no significant differences in DFS and OS between BEP and TC groups (p >0.05). The clinical staging is the only risk factor of postoperative recurrence (HR: 21.3, p <0.001). Conclusions: There was no significant difference between the effects of BEP and TC regimens on the fertility and prognosis of MOGCT patients who received FSS. The TC regimen seems to be a viable alternative to the BEP regimen for MOGCT patients.

Multicenter observational study on optimal regimen of neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, and peritoneal cancer (328)

Multicenter observational study on optimal regimen of neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, and peritoneal cancer (328)

A comparison of two chemotherapy regimens in advanced, recurrent, or metastatic salivary gland carcinoma.

The efficacy of chemotherapy in locally advanced, recurrent, and metastatic salivary gland carcinomas (LA-R/M SGCs) is still undefined. We aimed to compare the efficacy of two chemotherapy regimens in LA-R/M SGC. This prospective study compared paclitaxel (Taxol) plus carboplatin (TC) versus cyclophosphamide, doxorubicin, plus cisplatin (CAP) regimen in terms of overall response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), and overall survival (OS). Between October 2011 and April 2019, 48 patients with LA-R/M SGCs were recruited. The ORRs of first-line TC and CAP regimens were 54.2% and 36.3%, respectively (P = 0.57). The ORRs in recurrent and de novo metastatic patients were 50.0% and 37.5% for TC and CAP, respectively (P = 0.26). The median PFS of TC and CAP arms were 10.2 and 11.9 months, respectively (P = 0.91). In the subanalysis, patients with adenoid cystic carcinoma (ACC) had longer PFS in the TC arm (14.5 vs. 8.2 months, P = 0.03), irrespective of the tumor grade (low grade: 16.3 vs. 8.9 months, high grade: 11.7 vs. 4.5 months; P = 0.03). The median OS rates were 45.5 and 19.5 months for TC and CAP groups, respectively (P = 0.71). For patients with LA-R/M SGC, there was no significant difference between first-line TC and CAP in terms of ORR, PFS, and OS.

P768: GUADECITABINE (SGI-110) VS. TREATMENT CHOICE (TC) IN RELAPSED/REFRACTORY(R/R) MYELODYSPLASTIC SYNDROME (MDS), RESULTS OF A GLOBAL, RANDOMIZED, PHASE 3 STUDY.

Background: Guadecitabine (G) is a next-generation hypomethylating agent (HMA), administered as a small-volume subcutaneous (SC) injection, designed with the potential to overcome pharmacokinetic resistance to first-generation HMAs (decitabine and azacitidine). Preliminary guadecitabine phase 2 data in r/r MDS showed an overall survival of almost 12 months (Garcia-Manero,G, et al; Lancet Haematol http://dx.doi.org/10.1016/S2352-3026 [19]30029-8) leading to the ASTRAL-3 study. Aims: Compare overall survival of guadecitabine to that of TC consisting of low-dose cytarabine (LDAC), intensive chemotherapy (IC), or best supportive care (BSC). Secondary objectives included multiple standard assessments of response and safety. Methods: Subjects with r/r MDS or Chronic Myelomonocytic Leukemia (CMML) who had progressed or failed to respond after 6 full cycles of standard HMA therapy were randomized 2:1 between guadecitabine (60 mg/m2) SC Days 1-5 every 28 days vs. a pre-selected TC (BSC, IC, or LDAC). Stratification was by disease, disease burden (>10% bone marrow blasts or not, geography, and pre-selected TC option). Primary endpoint was overall survival (OS) and the study was designed with ~90% power to detect a hazard ratio of 0.68 (approximately 2.8 month difference in median survival). Results: 417 MDS/CMML subjects were randomized to G or TC (G:277, TC: 140). Demographics and disease status were reasonably balanced across the groups (see Table 1 below) as was percentage of commonly associated genetic mutations (TET2, DNMT3A, SF3Baa, RUNX1, and TP53). Median guadecitabine exposure was 4 cycles and 3 cycles for TC. Neither overall survival (G: median 9.1 months, TC: median 8.3 months, p=0.61, HR:0.94 with 95% CI: [0.74-1.19]) nor leukemia-free survival (LFS) (G: median 5.7 months, TC: median 5.9 months; p=0.38) demonstrated a significant difference between the two groups and subgroup analyses did not suggest a difference between guadecitabine and any of the different TC options or different genetic mutations. Transfusion dependence for 8 weeks was similar with 32.1% and 22.4% of the G group and 37.9% and 20.0% of the TC group being platelet transfusion or red blood cell transfusion independent, respectively. Safety was consistent with known profiles of the respective agents with the G group having a slightly higher overall incidence of adverse events (AE) (99.3% vs 92.6% for TC) and grade 3 or higher AE (92.2% vs 70.5% for TC). The AEs with the highest incidence in subjects who received guadecitabine were febrile neutropenia (38.5 vs 18.9% for TC), pneumonia (34.4% vs 18.9% for TC), neutropenia (34.1% vs 15.6% for TC), and thrombocytopenia (32.2% vs 21.3% for TC). Image:Summary/Conclusion: This large, global, randomized phase 3 study did not demonstrate superiority of guadecitabine over Standard TC in MDS/CMML patients who were refractory or relapsed following full course of prior HMA treatment.

Early castration in foals: Consequences on physical and behavioural development.

The impact of very early castration of foals has not yet been studied despite the many positive effects observed in dogs and cats. The objective of the study was to compare castration at 3 days and 18months and assess their subsequent morphological and behavioural development. This was a randomised, blinded clinical study. Twenty-two Welsh ponies underwent either early (3-day old, EC group, n=11) or traditional (18-month old, TC group, n=11) castration. Animals were followed up to 3 years of age. All ponies were castrated using a primary closure technique under general anaesthesia. Weight and morphometric measurements were monitored monthly from birth until 8 months of age in both groups. Then, measurements were taken every 3 months until 2 years of age and then every 6 months until 3 years of age. Temperament tests were performed on all animals when they were 1- and 3-years old. No differences were observed between the EC and TC groups in terms of physical development from birth until 40months of age or in terms of temperament and behaviour at either 1 or 3 years of age. The study included only one breed (Welsh ponies) and only 22 animals that were castrated before 2 years of age, precluding comparison with castration performed at older ages. We demonstrate that early castration at 3 days does not interfere with morphological or behavioural development.

Efficacy evaluation of albumin-bound paclitaxel combined with carboplatin as neoadjuvant chemotherapy for primary epithelial ovarian cancer

ObjectiveThis study aimed to compare the efficacy of albumin-bound paclitaxel combined with carboplatin (Nab-TC) with that of traditional solvent-based paclitaxel combined with carboplatin (TC) as neoadjuvant chemotherapy (NAC) regimens for primary epithelial ovarian cancer.MethodsEighty patients with advanced primary epithelial ovarian cancer admitted for treatment at the Harbin Medical University Cancer Hospital from January 2015 to January 2020 were retrospectively selected. All patients underwent surgery after 1–4 courses of NAC with Nab-TC or TC regimen. Among the patients included for study, 40 patients in each group.ResultsThe ORR in Nab-TC group was better compared to TC group (45% vs 40%), but the difference was not significant (P = 0.651). While the reduction rate of CA-125 value in the Nab-TC group was significantly better (P < 0.05). The postoperative complication rate such as postoperative blood transfusion (5% vs 35%) and postoperative infusion of human albumin (25% vs 55%) were significantly lower relative to the TC group. The median progression-free survival of the Nab-TC group was significantly longer relative to the TC group (20 months vs 13 months, P = 0.012), and the patient’s quality of life was also better in the Nab-TC group (P < 0.05). Our study demonstrated that Nab-TC regimen and R0 represented the independent prognostic factors.ConclusionThe efficacy of the Nab-TC regimen as NAC for advanced primary epithelial ovarian cancer was non-inferior to that of the TC regimen along with a lower incidence of adverse reactions, a longer PFS and a higher quality of life, supporting its therapeutic value in the clinic.

Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance.

Background: Due to the low physical fitness of the frail elderly, current exercise program strategies have a limited impact. Eight-form Tai Chi has a low intensity, but high effectiveness in the elderly. Inspired by it, we designed an exercise program that incorporates eight-form Tai Chi, strength, and endurance exercises, to improve physical fitness and reverse frailty in the elderly. Additionally, for the ease of use in clinical practice, machine learning simulations were used to predict the frailty status after the intervention. Methods: For 24 weeks, 150 frail elderly people completed the experiment, which comprised the eight-form Tai Chi group (TC), the strength and endurance training group (SE), and a comprehensive intervention combining both TC and SE (TCSE). The comparison of the demographic variables used one-way ANOVA for continuous data and the chi-squared test for categorical data. Two-way repeated measures analysis of variance (ANOVA) was performed to determine significant main effects and interaction effects. Eleven machine learning models were used to predict the frailty status of the elderly following the intervention. Results: Two-way repeated measures ANOVA results before the intervention, group effects of ten-meter maximum walking speed (10 m MWS), grip strength (GS), timed up and go test (TUGT), and the six-minute walk test (6 min WT) were not significant. There was a significant interaction effect of group × time in ten-meter maximum walking speed, grip strength, and the six-minute walk test. Post hoc tests showed that after 24 weeks of intervention, subjects in the TCSE group showed the greatest significant improvements in ten-meter maximum walking speed (p < 0.05) and the six-minute walk test (p < 0.05) compared to the TC group and SE group. The improvement in grip strength in the TCSE group (4.29 kg) was slightly less than that in the SE group (5.16 kg). There was neither a significant main effect nor a significant interaction effect for TUGT in subjects. The stacking model outperformed other algorithms. Accuracy and the F1-score were 67.8% and 71.3%, respectively. Conclusion: A hybrid exercise program consisting of eight-form Tai Chi and strength and endurance exercises can more effectively improve physical fitness and reduce frailty among the elderly. It is possible to predict whether an elderly person will reverse frailty following an exercise program based on the stacking model.

Reduced asymmetry of the hand knob area and decreased sensorimotor u-fiber connectivity in middle-aged adults with autism

Individuals with autism spectrum disorder (ASD) frequently present with impairments in motor skills (e.g., limb coordination, handwriting and balance), which are observed across the lifespan but remain largely untreated. Many adults with ASD may thus experience adverse motor outcomes in aging, when physical decline naturally occurs. The ‘hand knob’ of the sensorimotor cortex is an area that is critical for motor control of the fingers and hands. However, this region has received little attention in ASD research, especially in adults after midlife. The hand knob area of the precentral (PrChand) and postcentral (PoChand) gyri was semi-manually delineated in 49 right-handed adults (25 ASD, 24 typical comparison [TC] participants, aged 41–70 years). Using multimodal (T1-weighted, diffusion-weighted, and resting-state functional) MRI, we examined the morphology, ipsilateral connectivity and laterality of these regions. We also explored correlations between hand knob measures with motor skills and autism symptoms, and between structural and functional connectivity measures. Bayesian analyses indicated moderate evidence of group effects with greater right PrChand volume and reduced leftward laterality of PrChand and PoChand volume in the ASD relative to TC group. Furthermore, the right PoC-PrChand u-fibers showed increased mean diffusivity in the ASD group. In the ASD group, right u-fiber volume positively correlated with corresponding functional connectivity but did not survive multiple comparisons correction. Correlations of hand knob measures and behavior were observed in the ASD group but did not survive multiple comparisons correction. Our findings suggest that morphological laterality and u-fiber connectivity of the sensorimotor network, putatively involved in hand motor/premotor function, may be diminished in middle-aged adults with ASD, perhaps rendering them more vulnerable to motor decline in old age. The altered morphology may relate to atypical functional motor asymmetries found in ASD earlier in life, possibly reflecting altered functional asymmetries over time.

Elliptical and linear relationships with rumen temperature support a homeorhetic trajectory for DMI during recovery of feedlot cattle exposed to moderate heat load.

Most feedlot animals in Australia experience 2 to 3 moderate heat waves during summer. This study aimed to gain understanding of the physiological drivers in response to and during recovery from such events with a view to designing strategies to ensure rapid and safe recovery. Two hypotheses were tested during thermal challenge and recovery in climate-controlled rooms (CCR): firstly, the feedlot steer on a grain-based diet mounts appropriate physiological responses during moderate heat load and in recovery so that its performance and physiology state after recovery is not different to the feed restricted thermoneutral (FRTN) steer. Secondly, commonly used indicators of increased heat load, e.g., respiration rate (RR), panting score (PS), body surface temperatures (ST), and water consumption (WC), reflect rumen temperature (RT) during thermal challenge and recovery at the level of daily means. In this study, 36 Angus steers (live weight (LW) 451.5 ± 22.6 kg) made up 3 cohorts of 12 animals that sequentially underwent the CCR phase. For this 18-d phase, the steers were allocated to either a moderate heat load treatment (thermally challenged, TC, n = 18) or a FRTN treatment (n = 18). The TC group underwent 3 periods, Pre-Challenge (4 d, temperature humidity index (THI) range of 68 to 71), Challenge (7 d, THI 73 to 84 with diurnal cycling), and Recovery (7 d, THI 68 to 71). The FRTN group were held at thermoneutral conditions in the CCR (THI 66.9 ± 0.3), and each animal was offered an amount of feed was based on the feed intake of its LW matched TC pair. Thus, as DMI fell in the TC group during Challenge, feed restriction was imposed on the FRTN group. The data were collected by trained observers were DMI, RT, RR, PS, body STs (forehead, shoulder, leg, rump), and WC. Challenge induced a heat stress response in the TC group with reduced DMI and LW, and elevated RT, RR, PS, body STs, and WC (P < 0.001). These measures were unchanged or reduced in the FRTN group (P < 0.001). At the end of Recovery, the TC and FRTN groups had converged on most measures including LW. Daily mean RT of both groups showed strong linear relationships with THI, RR, PS, head ST, and WC (P ≤ 0.0022) but opposing elliptical relationships with DMI; that is, as DMI fell with increasing RT for the TC group, DMI increased with rising RT for the FRTN group. In all, the feedlot steers in this study demonstrated sufficient homeorhetic capacity to adjust to moderate heat load and recover from it.

Comparison of Neoadjuvant Chemotherapy Efficiency in Advanced Ovarian Cancer Patients Treated With Paclitaxel Plus Carboplatin and Intraperitoneal Bevacizumab vs. Paclitaxel With Carboplatin.

ObjectiveThis study evaluated the role of neoadjuvant chemotherapy (NACT) with bevacizumab intraperitoneal perfusion in advanced ovarian cancer (AOC).MethodsIn this study, 80 patients with advanced epithelial ovarian cancer (stage IIIc or IV) who received NACT at the Central Hospital of Zhuzhou between February 2019 and October 2020 were enrolled. Patients were randomized to receive paclitaxel plus carboplatin (TC) or TC plus intraperitoneal perfusion of bevacizumab (TCB). The effect of chemotherapy was assessed following two cycles of chemotherapy. Cancer antigen 125 (CA125), tumor size, ascites volume, bleeding volume, duration of operation, surgical satisfaction rate, complication rate, and residual tumor were assessed to monitor response to chemotherapy.ResultsTreatment with TCB regimen significantly reduced serum levels of CA125 and ascites volume (p < 0.001). Meanwhile, the TCB group had significantly lower intraoperative blood loss and shorter operation time (p < 0.001). Most importantly, patients treated with TCB regimen had a higher surgical satisfaction rate (p < 0.01). Moreover, the incidence of postoperative wound infection, hypoproteinemia, abdominal distension, and fever was lower in the TCB group compared with the TC group. Assessment of adverse reactions during chemotherapy showed no severe complications between the two groups.ConclusionsThe results demonstrated that the TCB regimen is superior to the TC regimen alone in the treatment of AOC. These findings could help improve the surgical satisfaction rate, provide more effective treatment strategies to prolong progression-free survival and reduce postoperative complications, and promote surgical recovery in AOC.

The effect of 24-week belimumab treatment withdrawal followed by treatment restart in patients with SLE: an open-label, non-randomised 52-week study

BackgroundTreatment goals for patients with systemic lupus erythematosus (SLE) include minimising disease activity and reducing the risk of flares. Although belimumab is effective at reducing disease activity and risk of severe flares, it was previously unknown what the clinical effects were upon treatment discontinuation. The objective of this study was to assess the impact of temporary withdrawal of intravenous (IV) belimumab in patients with SLE.MethodsThis multicentre, open-label, non-randomised, 52-week study (GSK Study BEL116027; NCT02119156) recruited patients with SLE and stable low disease activity, of whom those on belimumab 10 mg/kg IV plus standard therapy either discontinued belimumab for 24 weeks and then restarted belimumab 10 mg/kg IV every 4 weeks (q4w) for 28 weeks (treatment holiday [TH] group), or continued on belimumab 10 mg/kg IV plus standard therapy q4w for 52 weeks (treatment continuation [TC] group). The primary endpoint was median time to first Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) Flare Index flare. Secondary and other endpoints included rate of any flare, time to severe flare, time to renal flare and rebound (SELENA-SLEDAI score exceeding parent study baseline). Data on rebound phenomenon in patients with any disease level of SLE who had permanently withdrawn from further belimumab treatment (long-term discontinuation group [LTD]) were also assessed. Safety was assessed.ResultsThe primary endpoint was not evaluable in the TH (n = 12) and TC (n = 29) groups as fewer than half of patients flared. Unadjusted flare rates per patient-year were 1.0 during treatment discontinuation and 0.3 during treatment restart (0.6 overall) in the TH group and 0.6 in the TC group; there were no severe or renal flares. No TH patients rebounded; 2 (6.9%) TC patients rebounded; 2 (5.1%) patients in the LTD group rebounded. There were no new safety signals.ConclusionsTwenty-four-week belimumab discontinuation did not appear to increase the risk of flares or rebound in patients with low SLE disease activity; flare rates were low in both groups. Further studies may help to fully determine the effect of belimumab discontinuation.Trial registrationClinicalTrials.gov, NCT02119156. Registered on April 21, 2014.

Evaluation of dermatoscopic findings of alopecia areata and tinea capitis in pediatric patients.

Pediatric patients often reveal localized alopecic foci on the scalp. The essential point upon approaching a child with localized alopecia is distinguishing the two most common causes, alopecia areata and tinea capitis, as their treatments are entirely different. Although potassium hydroxide examination is the preferred method for their clear distinction, dermatoscopy is also emerging as a rapid diagnostic tool. This study aimed to assess and compare the dermatoscopic findings of alopecia areata and tinea capitis. Enrolled in this study were 34 children with tinea capitis and 21 children with alopecia areata admitted to a single-center outpatient clinic between 2017 and 2021. The authors confirmed all children's diagnoses by an integrative evaluation of clinical features, potassium hydroxide examination results, and treatment response patterns. Clinical features and the variables of interest (dermatoscopic findings) were investigated through the medical records and the baseline dermatoscopic images. The most common dermatoscopic finding within the tinea capitis cohort was comma hairs, detected in 33 (97.1%) of the patients. Other findings of the tinea capitis group included squamation (n=31, 91.2%), broken and dystrophic hairs (n=30, 88.2%), corkscrew hairs (n=24, 70.6%), zigzag hairs (n=18, 52.9%), and pigtail hairs (n=9, 26.5%). The most common dermatoscopic finding within the alopecia areata cohort was exclamation mark hairs (n=13, 61.9%), that was followed by black dots (n=9, 42.9%), yellow dots (n=8, 38.1%), vellus hairs (n=6, 28.6%), and broken and dystrophic hairs (n=5, 23.8%). Among the detailed evaluation of dermatoscopic findings of tinea capitis and alopecia areata patients, the only overlapping feature was dystrophic and broken hairs that could be present in both diseases; but were more common within the TC group than within the AA group (88.2% vs. 23.8%).

Biodegradation and Immunological Parameters of Polyurethane-Based Tissue Adhesive in Arterial Microvascular Anastomoses-A Long-Term In Vivo Study.

In microsurgical anastomosis, non-synthetic fibrin-based adhesives have predominantly shown superior properties to synthetic cyanoacrylates, but they have hardly any clinical application. This study aims to investigate the local and systemic effects of synthetically produced biodegradable adhesive VIVO when used in microsurgical anastomosis. VIVO is used in two different anastomosis procedures in the common carotid artery in a rat model: VIVO in addition to a temporary catheter (VIVO TC) and VIVO with a custom-shaped memory nitinol stent (VIVO SM). Conventionally sutured anastomoses serve as controls (C). Tissue response is assessed by in vivo fluorescence imaging and histological examination. The systemic effects of biodegradation are measured using hematologic parameters and serum levels of transaminase activity and lactate dehydrogenase. Finally, the degree of local adhesion of the different anastomotic procedures is evaluated. Fluorescence imaging shows reduced inflammatory blood flow in the VIVO TC group. Histological analysis of the anastomosed vessels also reveals significantly more inflammation in C than in the two adhesive groups. The severity of VIVO adhesions proves acceptable, and no histotoxic effects of VIVO are detected. The data demonstrate that the synthetic tissue adhesive VIVO is a reliable and-compared to sutures-tissue-friendly adhesive for microsurgical anastomoses.

A randomized control trial employing infraorbital nerve stimulation as a neural distractor during nasopharyngeal swab.

With the global COVID-19 pandemic, nasopharyngeal swabbing has become commonplace and can occasionally cause discomfort, tearing, and anxiety. To evaluate whether using a neural distraction device during nasopharyngeal swabbing can mitigate patient discomfort. Participants were randomized into nasal swab with vibration first (treatment-control or Tc) or nasal swab without vibration first (control-treatment or Ct). Then the swab was repeated with the opposite technique. The vibration device was used to stimulate the infraorbital nerve at the midpupillary line, while a nasopharyngeal swab was performed according to CDC protocol. After each swab, participants filled out a survey to assess pain, discomfort, and tearing. This procedure was replicated on the contralateral nostril for a total of 4 swabs and 4 surveys. Thirty-four subjects were included in the analysis. In the Ct group, there was a median 1.0-point decrease in pain with the use of vibration (95% CI [-1.8, -0.3], P = 0.0117), 2.5-point decrease (95% CI [-3.0, -0.8], P = 00039) in discomfort, and a 1.0-point decrease (95% CI [-2.6, -0.2] P = 0.0303) in tearing when the vibratory device was used. In the Tc group, there was a median 2.0-point decrease in pain with vibration (95% CI [ -2.7, -1.1], P < 0.0001), 2.3-point decrease in discomfort (95% CI [-3.1, -1.5], P < 0.0001), and a 1.5-point decrease in tearing (95% CI [-2.5, -0.5], P = 0.0037) when vibration was used. Vibratory stimulation of the infraorbital nerve is safe and effectively reduced pain, discomfort, and tearing during nasopharyngeal swab. Vibration is a reasonable option to minimize patient discomfort during COVID-19 or other microbiological testing.

The interactive effects of exercise training and functional feeds on the cardiovascular performance of rainbow trout (Oncorhynchus mykiss) at high temperatures.

The cardiovascular performance of salmonids in aquaculture can be impaired by acute climate warming, posing risks for fish survival. Exercise training and functional feeds have been shown to be cardioprotective in mammals but their action on the fish heart and its upper thermal performance has not been studied. To investigate this, rainbow trout were trained at a moderate water velocity of 1 body length per second (bl s−1) for 6 h per day, either alone or in combination with one of two functional feed-supplements, allicin and fucoidan. After 6 weeks of exercise training and feeding, maximum heart rate and the temperature coefficient of heart rate were significantly higher in the trained fish as compared to untrained ones. There was a slight increase in hematocrit in trained control fish reared on a normal diet (TC group) compared to untrained fish fed with the same diet (CC). This implies that exercise training enhanced oxygen delivery to trout tissues via an increase of cardiac blood flow in warm water. However, cardiac thermal tolerance was not affected by exercise training or feeding, except from the temperature of peak heart rate which was higher in the trained group fed with fucoidan supplement (TF) as compared to the untrained group fed with same diet (CF). Allicin supplement caused a significant reduction in the maximum heart rate and the temperature coefficient of heart rate, especially in trained fish, while fucoidan supplement did not cause any effect on heart rate. No differences were observed in growth performance among groups. However, fish fed with fucoidan-supplemented diet had a slight reduction in feed conversion efficiency. We suggest further investigations to understand the antagonistic effect of allicin supplemental feeding and exercise training on cardiovascular performance. More studies are also required to investigate if other exercise training intensities could increase cardiac thermal tolerance.