Treatment Research Articles

Long-Term Outcomes in Patients With Locally Advanced Rectal Cancer Following R1 Resection After Either Induction Chemotherapy and Chemoradiotherapy or Chemoradiotherapy Alone

IntroductionTotal neoadjuvant treatment (TNT) with induction chemotherapy (ICT) followed by chemoradiotherapy (CRT) has improved long-term outcomes for patients with locally advanced rectal cancer (LARC). However, long-term outcomes have not been investigated for patients with incomplete (R1) resection separately. This study investigates overall survival (OS), disease-free survival (DFS) and local and distant recurrence rates in patients with R1 resection after preoperative treatment with ICT and CRT or CRT. Patients and methodsFrom the NORD database 689 patients with LARC who received treatment between 2006 and 2017 were screened for inclusion. All patients with R1 resection were included. ICT consisted of at least 1 cycle of capecitabine and oxaliplatin (CAPOX) and was followed by radiotherapy concomitant with capecitabine. ResultsAmong 46 patients with R1 resection, 27 (59%) received both ICT and CRT, and 19 (41%) patients received CRT. The 5-year OS was 44% (95% CI, 26%-63%) (ICT + CRT) versus 37% (95% CI, 15%-59%) (CRT) (P = .25) and 5-year DFS was 44% (95% CI, 26%-63%) (ICT + CRT) versus 32% (95% CI, 11%-53%) (CRT) (P = .22). The local recurrence rates showed a small nonstatistical significant difference in local control in the ICT group: 15% compared to 26% in the CRT group (P = .22). Distant recurrence rates were similar: 41% (ICT + CRT) versus 47% (CRT) (P = .48). ConclusionThere was no significant difference in OS, DFS or local and distant recurrence rates between patients who received ICT + CRT versus patients who received CRT only.

PSX-27 Growth performance and immune response dynamics in weaned lambs with subclinical Haemonchus contortus parasite infection

Abstract Parasite infections, particularly from Haemonchus contortus, hinder sheep production in Canada by reducing weight gain and immunity. Current diagnosis and treatment methods rely on observing symptoms and the blind administration of anthelmintic drugs, resulting in escalating costs and the development of drug-resistant parasites. This study aimed to identify the exact time-point when subclinical H. contortus parasite infection affects growth performance and triggers an immune response. A total of 60 Rideau Arcott ewe lambs (~7-8 mo old), confirmed to be parasite-free, were randomly assigned in a 2 x 2 factorial design assessing inoculation treatment (TRT): oral inoculation (IN) with a solution containing 5,000 L3 strain of H. contortus or sham inoculation (CT) using water solution as control; and drench (DRENCH) administration: oral drench (D), 28-days post-inoculation, with a combination of 0.08% ivermectin solution (200 mcg per kg of BW; Durvet®) and 10% oral suspension of fenbendazole (2.5 mL per 50 kg of BW; Safe-guard®), or water solution (non-drenched, ND), resulting in four treatment groups: IN-D, IN-ND, CT-D, and CT-ND (n=15/treatment). Lambs were equally assigned to four feedlot pens (two replicates/treatment) for 57 days (d) with ad libitum access to a grain-based total mixed ration and water. Animals were individually weighed (BW) and blood sampled on days -1 and 0 (baseline), as well as on days 7, 21, 28, 35, 42, 56, and 57 post-inoculations (DAY); average daily gain (ADG) was calculated for the entire experimental period. White blood cells count (WBC) was used as an indicator of infection and red blood cell count (RBC) as indicator of anemia. Data was analyzed using a mixed-effects model including TRT, DRENCH, DAY (and their interactions) as fixed effects. Overall, CT lambs were heavier (TRT effect; P < 0.05) and had a tendency of greater (TRT effect; P = 0.08) ADG than IN lambs. The IN lambs had a tendency of greater (TRT*DAY; P = 0.07) WBC on d 7 than CT lambs. Additionally, IN-ND had lower (TRT*DRENCH; P < 0.05) WBC than IN-D lambs (1.9 and 2.0 ± 0.042 x 109/L, respectively). A significant (TRT*DRENCH*DAY; P < 0.01) interaction was found on RBC. The CT-D had lower (P < 0.05) RBC on d 7 and greater (P < 0.05) on d 28, 35, 42, and 57 than IN-ND as well as on d 28 than IN-D. Furthermore, CT-ND had greater (P < 0.05) RBC on d 21, 28 and 35 than IN-D and from d 21 to 57 than IN-ND. The IN-D had greater (P < 0.01) RBC from d 35 to 57 than IN-ND. These findings suggest compromised growth in both drenched and non-drenched infected groups. Infection slightly peaked in the infected lambs on d 7 post-inoculation, but drench administration was effective at mitigating overall infection by day 21 and the anemia by day 35.

The impact of an enhanced recovery after surgery protocol for major head and neck oncologic surgery on postoperative complications and adjuvant treatment delivery.

The Commission on Cancer (CoC) recently introduced a quality metric to optimize time between major head and neck surgery and adjuvant treatment (TAT) ≤6 weeks, as TAT delay adversely impacts patient survival. This study evaluates whether enhanced recovery after surgery (ERAS) for this population reduces the rate of postoperative complications, length of stay (LOS), and TAT. Patients undergoing larynx or oral cavity resection with free flap reconstruction, ERAS, and adjuvant treatment after 2018 were compared to a historical pre-ERAS cohort. Patients underwent surgery at a single-institution tertiary referral center for complex head and neck oncology. Differences between groups were compared by chi-square, Fisher's exact, or Wilcoxon rank-sum test. TAT >6 weeks was evaluated with univariate and multivariable logistic regression. Thirty-nine pre-ERAS patients were compared to 39 ERAS patients. No demographic differences existed between groups. LOS was improved with ERAS (p = 0.005). ERAS patients were discharged to home and returned to their activities of daily living (ADL) earlier (p = 0.004, 0.001). ADL recovery was associated with on-time TAT ≤42 days on univariate analysis (OR 1.36, 95% CI 1.13-1.63, p = 0.001). TAT delay was less frequent with ERAS (51.3% vs. 69.2%), but this was not significant after multivariable logistic regression (p = 0.11). ERAS decreases LOS and returns advanced head and neck cancer patients to their ADL sooner. Postoperative ADL recovery independently predicts on-time adjuvant treatment. Still, compliance beyond 50% with the TAT ≤6 weeks CoC quality metric remains a major treatment barrier.

Effects of postbiotic products from Saccharomyces cerevisiae fermentation on lactation performance, antioxidant capacities, and blood immunity in transition dairy cows

This study aimed to evaluate the effects of dietary supplementation with different types of Saccharomyces cerevisiae fermentation products (SCFP) on lactational performance, metabolism, acute phase protein response, and antioxidant capacities in dairy cows from -21 to 56 d in milk (DIM). One hundred and 80 multiparous Holstein dairy cows were blocked by parity, expected calving date, pre-trial body condition score, and previous 305-d ME yield, and then randomly assigned to 1 of 3 dietary treatments: basal diet (CON; n = 60), basal diet supplemented with 40 g/d of SCFP1 (XPC; n = 60; XPC, Diamond V, Cedar Rapids, IA), and basal diet supplemented with 19 g/d of SCFP2 (NTK; n = 60, NutriTek®, Diamond V, Cedar Rapids, IA). Blood (n = 15, 13 and 12 in the CON, XPC and NTK groups, respectively) was sampled at -7 ± 3, + 3, + 7, + 21, and + 28 d, and milk samples (n = 19, 18 and 15 in the CON, XPC and NTK groups, respectively) was sampled during 1-8 wk from a subset of cows from -21 to 56 d relative to calving. Data were analyzed using the MIXED procedure in SAS (SAS Institute Inc.). All data were subjected to repeated measures ANOVA. Dietary treatment (TRT), time, and their interaction (TRT × time) were considered as fixed effects and cow as the random effect. Cows fed XPC and NTK had greater energy-corrected milk (ECM). Supplementing NTK increased milk fat content and yield, and 3.5% fat-corrected milk (FCM) yield compared with CON. Milk urea nitrogen (MUN) was lower in XPC cows than CON. SCFP supplementation decreased plasma β-hydroxybutyrate (BHB), ceruloplasmin (CER), haptoglobin (HPT), and interleukin-1β (IL-1β) concentrations, whereas increased plasma phosphorus (P) concentrations. In addition, cows fed NTK showed lower creatinine (CR) and cortisol (COR) concentrations but increased plasma calcium (Ca) and myeloperoxidase (MPO) concentrations than those in the CON cows. In addition, cows fed NTK and XPC both had reduced plasma concentrations of serum amyloid-A (SAA) at 3 DIM of lactation compared with CON fed cows. Furthermore, SCFP cows had greater concentrations of plasma glucose (GLU) and calcium (Ca) than CON cows at 7 DIM, and greater concentrations of plasma phosphorus (P) at 21 DIM. Between different SCFP type fed groups, plasma concentrations of nonesterified fatty acids (NEFA), MDA, creatinine (CR), SAA, and HPT were lower in cows fed NTK compared with cows fed XPC at 7 DIM. Overall, our results indicate the potential benefits of supplementing SCFP in transition dairy cows by modulating immunity, liver metabolic function and supporting ECM yield. The results also suggest that NutriTek at 19 g/d appears to support the performance and health of dairy cows better compared with XPC at 40 g/d, based on improved metabolic and inflammatory status during the transition period.

Alder‐Longo Method Derived Cationic Porphyrin‐Based Porous Polymer as Physical Antibacterial Agent for the Bacteria‐Infected Wound Synergy Therapy

AbstractThe widespread of drug‐resistant genes has greatly exacerbated the difficulty for the effectively tre atment of diseases associated with bacterial infections. The ineffectiveness of antibiotics poses great challenges to the development of new antimicrobial agents, especially those does not cause bacterial resistance. Herein, a cation porous organic polymer (CPOP) denoted as BDPP, was facilely prepared via the Alder‐Longo method skipping the tedious porphyrin‐bearing monomer synthesis procedure. The repeated porphyrin units endowed excellent photoactivity with the porous skeletons, and the inherent cations significantly improved the binding ability of BDPP with the bacterial cell membrane. As a result, the as‐synthesized POPs could be used as a physical broad spectrum sterilization agent, amalgamating the cation and photothermal therapy to exert synergistic amplified antibacterial effects. In vivo assay demonstrated BDPP with good biocompatibility, could also significantly promote the healing of wounds with bacteria‐infection. This work paves a facile way for the rational construction of material‐based antibacterial agent for the bacteria inactivation.

PS-1 An evaluation of sodium salicylate in the periparturient management of the sow

Abstract Mortality continues to trend higher in highly prolific sows in the U.S., with the periparturient period being the time of greatest loss (Eckberg, 2021). Sodium salicylate (NaSal) is a nonsteroidal anti-inflammatory drug (NSAID) similar to aspirin, which is used to manage pre-eclampsia-related pregnancy complications in humans (Roberge et al. 2017). The objectives of this experiment were: 1) Collect farrowing data for scoring periparturient health; and 2) Evaluate the impact of NaSal on periparturient health and inflammation. A total of 47 parity 1 and 2 females (PIC 1050) were utilized with a starting body weight (BW) of 214.3kg ± 14.7 SD. Sows were blocked by BW on d 105 gestation and parity and randomly assigned to one of two treatment groups. The treatments were: control (CON) n = 23; or treatment (TRT) n = 24. TRT consisted of NaSal (Oral-Pro, Aurora Pharmaceutical, Northfield, MN) administered via water 3 d pre-farrow to 5 d post-farrow, with a target dose of 50 mg NaSal/kg BW. At d 106 of gestation and weaning, BW, back fat (BF), and body condition by caliper (BCS) were measured. Sows were assigned a farrowing ease score of 1-4 (1 - easy to 4 - extremely difficult) based on duration, restless activity, savaging, and assistance required. Data were analyzed using the GLM procedure in SAS, with sow serving as the experimental unit and LSMeans testing for differences among means. Average farrowing duration for both groups was 335.5 min ± 144.2 SD. Farrowing ease score for all sows was assessed as a mean of 2.28 with 47% scored as difficult (Score 3 to 4). Treatment improved farrowing ease score (TRT avg: 1.9; CON avg 2.7; P < 0.01) and reduced savaging severity and frequency (TRT: 5 sows, 1 severe; CON: 8 sows, 7 severe; P < 0.05). TRT sows (24/24) successfully weaned litters compared with CON sows (20/23). All sows assigned a 1 or 2 score (25/25) weaned litters compared with sows assigned 3 or 4 (19/22). In conclusion, farrowing difficulty contributes to the need for greater care of highly prolific sows. Supplementation of NaSal during the periparturient period may improve farrowing ease and health outcomes.

200 Effects of zinc oxide removal and different nutritional plans on the growth performance, health, and behavior of nursery pigs from different genetic lines

Abstract This study was conducted to investigate the impacts of the removal of zinc oxide (ZnO) supplemented at pharmaceutical levels and different nutritional plans on the growth performance, health, and behavior of nursery pigs from different genetic sire lines. A total of 1,440 newly weaned barrows and gilts were housed into nursery pens with 30 pigs/pen (0.25m2/pig). Pigs were assigned to eight groups following a randomized complete block design arranged on a 2 x 2 x 2 factorial arrangement [Genetic sire line: PIC 337 or PIC 800; ZnO supplementation: 0 or 2,500 ppm; nutritional plan: Control (PIC recommendation) or Treatment (TRT)]. Pigs were fed in three dietary phases (P1:7 d; P2: 21 d; P3: 21 d). The nutrient levels of the TRT for each phase consisted of reduced crude protein (P1: 21 vs. 18.43%; P2: 20.80 vs. 18.73%), SID Lys (P1: 1.40 vs. 1.20%; P2: 0.35 vs. 1.20%), net energy (P1: 2,450 vs. 2,352 kcal/kg; P2: 2,450 vs. 2,377 kcal/kg) and lactose levels (P1: 15 vs. 7%; P2: 7 vs. 5%), and use of calcium formate instead of calcium carbonate for both P1 and P2, and pigs receiving the same diet in P3. Health and behavior were assessed through ear lesion (weekly during P3) and fecal (weekly during P1 and P2) scoring, mortality/removals, and medication control. Growth performance was assessed by individually weighing pigs and recording feed disappearance every week throughout the experimental period. Data were analyzed using a generalized linear model considering pen as the experimental unit. Models included treatments and their interactions as fixed effects, and block and pen within block as the random terms. Pigs fed ZnO showed greater (P < 0.05) overall average daily gain (ADG; 495 vs. 456 g/d) and average daily feed intake (ADFI; 681 vs. 633 g/d); and decreased (P < 0.05) diarrhea incidence (DI; 3.64 vs 10.21%) at d 14 after weaning and mortality/removals (2.31 vs. 5.11%) compared with pigs fed no ZnO. No significant differences were detected between the nutritional plans for performance traits (P > 0.05); however, pigs fed the TRT had less (P < 0.05) DI (7.54 vs. 11.43%) at d 7 after weaning than pigs fed the control nutrition plan. Regarding the genetic sire lines, PIC 337 pigs showed greater (P < 0.05) overall body weight (26.1 vs. 25.4 kg), ADG (486 vs. 465 g/d) and ADFI (666 vs. 648 g/d); and decreased (P < 0.05) mortality/removals (2.54 vs. 4.66%) and DI (6.92 vs. 12.41%) at d 7 after weaning compared with PIC 800 pigs. In summary, PIC 337 pigs fed ZnO under the control nutritional program showed greater growth performance during the nursery period. This study reaffirmed the benefits of ZnO fed to nursery pigs during the post-weaning period; however, since different countries are banning or reducing the use of ZnO, nutritional strategies should be considered to not negatively impact the health and subsequent performance of nursery pigs.

Personal versus therapist perioperative music intervention: a randomized controlled trial.

Music interventions can alleviate patient anxiety and improve post-surgical satisfaction. However, it remains uncertain whether personal music preferences affect efficacy. The authors tested whether personal music intervention with patient-selected songs played ad libitum is more effective than standard therapist-designed treatment with classical music. A prospective, parallel-group, single-blinded, randomized controlled trial with 229 participants (aged 18-60years) previously scheduled for elective surgery. Data analyses followed a modified intention-to-treat principle. The patients were randomized into three groups: Standard care without music (Control), therapist-designed classic music treatment (TT), or personal music intervention with patient-selected songs played ad libitum by the patient (PI). All patients received standard post-anaesthesia care, and music intervention was started upon arrival at the post-anaesthesia care unit. Primary outcomes were anxiety and overall satisfaction at discharge. In contrast, secondary outcomes were systolic blood pressure during music intervention, the sleep quality of the night after surgery, and the occurrence of postoperative nausea and vomiting within the first 24 h after surgery. Compared with therapist-designed music treatment, personal intervention decreased systolic blood pressure (T 0 : 124.3±13.7, 95% CI:121-127.7; T 20min : 117.6±10.4, 95% CI:115-120.1; T 30min : 116.9±10.6, 95% CI:114.3-119.4), prevented postoperative nausea and vomiting (Control: 55.9%, TT: 64.6%, PI: 77.6%), including severe postoperative nausea (VAS score>4; Control: 44.1%; TT: 33.8%; PI: 20.9%) and severe emesis (Frequency≥3, Control: 13.2%; TT: 7.7%; PI: 4.5%). None of the treatments affected sleep quality at night after surgery (Median, Q1-Q3, Control: 3, 1-3; TT: 3, 1-4; PI: 3, 1-3.5). Personal, but not therapist, music intervention significantly prevented anxiety (Control: 36.4±5.9, 95% CI:35.0-37.9; TT: 36.2±7.1, 95% CI: 34.4-37.9; PI: 33.8±5.6, 95% CI: 32.4-35.2) and emesis (Control: 23.9%; TT: 23.4%; PI: 13.2%) and improved patient satisfaction (Median, Q1-Q3, C: 8, 6-8; TT: 8, 7-9; PI: 8, 7-9). Personal music intervention improved postoperative systolic blood pressure, anxiety, nausea, emesis, and overall satisfaction, but not sleep quality, as compared to therapist-designed classic intervention.

Effect of post-processing and variation of the building angle of Ti-6Al-4 V disks obtained by selective laser melting: A comparison of physical, chemical and mechanical properties to machined disks

Additive Manufacturing (AM) is driving the development of dental implants with freedom of design, material savings, and predictable properties. The modification of a single parameter, and post-processing treatments affects the final macro and microstructure. The aim was to evaluate the effect of changing the building angle, using the Selective Laser Melting (SLM) technique, on the physical, chemical, and mechanical properties and to compare them with sanded manufacturing surfaces and machined surfaces, with and without chemical surface treatment. There were 8 groups of Ti-6Al-4 V discs (Ø 10 mm×2 mm), classified as machined (M), machined with acid-alkali treatment (TM), SLM 0° (AM0), SLM 0° with sanding (SAM0), SLM 45° (AM45), SLM 45° with sanding (SAM45), SLM 90° (AM90), and SLM 90° with sanding (SAM90). The tests used were Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDS), roughness, wettability, surface free energy, X-ray diffraction (XRD), and Vickers hardness. The normality of the data was checked using the Shapiro-Wilk test followed by Kruskal-Wallis and ANOVA, with Dunn and Tukey post-tests, with a significance level of 5%. SEM revealed angle dependence in the number of unmelted powder particles and topographical heterogeneity, and EDS reported the elemental composition of the base alloy. AM90 showed the highest wettability among the manufactured groups, and the chemical surface treatment increased the wettability of the machined sample (p<0.001). In the roughness analysis, the higher the building angle, the higher the surface roughness . Sanding provided homogeneity in roughness, wettability, surface free energy, and microhardness. It was concluded that the production routes, change in angle, sanding and surface treatment affect the macro and microstructure of titanium surfaces. Changing the building angle influenced all of the topographical characteristics of the material, a parameter that can be changed and improved that is important for determining properties.

Management strategies for common viral infections in pediatric renal transplant recipients.

Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort. Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes. Hence, prevention, early detection, and prompt treatment of such infe ctions are of paramount importance. Among all viral infections, herpes viruses (herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus), hepatitis B and C viruses, BK polyomavirus, and respiratory viruses (respiratory syncytial virus, parainfluenza virus, influenza virus and adenovirus) are common in kidney transplant recipients. These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome. Recent advances in tech nology and antiviral therapy have improved management strategies in screening, monitoring, adoption of prophylactic or preemptive therapy and precise trea tment in the immunocompromised host, with significant impact on the outcome. This review discusses the etiology, screening and monitoring, diagnosis, pre vention, and treatment of common viral infections in pediatric renal transplant recipients.

Orthodontic awareness amongst middle school teacher sand parents of twin cities.

To compare the level of awareness towards orthodontic treatment among parents and teachers of middle school children. The cross-sectional study was conducted from July 2021 to May 2022 in the middle schools of Rawalpindi and Islamabad, Pak istan, after approval from the ethics review committee of the Foundation University College of Dentistry and Hospital, Foundation University, Islamabad. Those included were middle school teachers and parents of students studying in middle schools. Data was collected using a validated questionnaire that had 6 demographic and 5 sur vey ques tions. The fo rm was digiti zed for easy dissemination a mong parents. Data was analysed us ing SPSS 23. Of the 240 subjects, 120(50%) each were parents and teachers. Overall, there were 165(68.75%) females and 75(31.25%) males. Level of education and professional exposure were not significantly different between teachers and parents (p>0.05). There was no difference in the level of education and professional work experience between th e parents and teacher (p>0.05). Teachers showed a higher level of awaren ess than parents towards the role of orthodontist in tooth alignment (p=0.013), associated habits with malalignment of teeth (p=0.003), and that the most appropriate age for tre atment wa s 10-15 years (p≤0.0 01). Teach ers were more likely of the opinion tha t facial disharmony is treatable than parents (odds ratio: 1.599, 95% confidence interval: 0.572-4.467). Teachers showed a higher level of awareness than parents regarding orthodontic treatment of children.

Therapeutic approaches for sickle cell disease by targeting BCL11A

Sickle cell disease (SCD) is one of the most serious diseases in the world caused by gene mutat ions. People with SCD have sickle-shaped red blood cells. BCL11A can inhibit the formation of γ-protein which can lead to the reduction of HbF,the reduction of the ability of hemoglobin to carry oxygen. Thus, d ecreasing the quantity of BCL11A can be a potential target to treat SCD.One of the potentially effective tr eatment approaches is to edit BCL11A genes with CRISPR technology.CRISPR is a gene-editing technolo gy,which can precisely and efficiently locate the treatment targets.With CRISPR technology,the gene expr ession of BCL11A can be blocked,and γ-protein can be switched to form more HbF.Hemoglobin levels for transporting oxygen can return to normal.This review introduces and summarizes the mechanisms to treat SCD andtheir limitations.Previous research papers revealed that the treatments of SCD are one-dimension al and these treatments just can inhibit disease.Fundamental problems of SCD remain to be solved.

Effect of dietary almond hull on growth performance, nutrient digestibility, fecal microbial, fecal score, and noxious gas emission in growing pigs

In a 42-day study, 195 growing pigs (Landrace × Yorkshire × Duroc) weighing 23.83 ± 1.95 kg were randomly divided into three treatments, each with 13 replicates and 5 pigs (3 barrows and 2 gilts) per pen. The treatments were control (CON)—basal diet, and basal diet with 3% and 6% almond hull as treatment (TRT) 1 and 2, respectively. The results show a significant increase ( p &lt; 0.05) in average daily gain (ADG) and average daily feed intake (ADFI) for both treatment 1 and treatment 2 by week 6 when compared to the control group. This improvement in ADG and ADFI exhibits a consistent trend ( p &lt; 0.10) throughout the overall trial period in comparison to the control group. Additionally, there is a tendency for enhanced gain-to-feed ratio (G:F) at the end of week 6 ( p &lt; 0.10) in comparison to the control group and remained constant ( p &gt; 0.05). No significant impact ( p &gt; 0.05) on nutrient digestibility and fecal microbiota was observed. However, NH3 gas showed a tendency to decrease ( p &lt; 0.10). Results suggested that almond hulls could improve growth and reduce ammonia gas without adverse effects on digestion, microbiota, and fecal score.

National Trends in the Us e of Herbal Medicines for the Treatm ent of Hypertens ion Among Adults in Mongolia from Four Cross-Sectional Surveys in 2005, 2009, 2013, and 2019

Background: The use of herbal and combined herbal and conventional treatments in people with chronic diseases, such as hypertension, is important. The aim of the present study was to assess national trends in using traditional medicines for the treatment of hypertension among adults in Mongolia from four cross-sectional surveys in 2005, 2009, 2013 and 2019. Methods: Cross-sectional data were analysed from 5,657 persons (15-64 years) of known hypertensives that participated in the 2005, 2009, 2013 or 2019 Mongolia STEPS surveys. Those who knew their hypertension status were asked about the past two weeks of intake of any drug (medication) for increased blood pressure prescribed by a doctor or other health worker, and the current intake of any herbal or traditional remedy for elevated blood pressure. Logistic regression was employed to assess the associations between sociodemographic and comorbid factors and herbal use and concurrent herbal and conventional treatment. Results: The prevalence of known hypertensives slightly increased from 19.0% in 2005 to 23.7% in 2019. The prevalence of current conventional treatment for hypertension among known hypertensives significantly decreased from 74.5% in 2005 to 40.1% in 2019. The proportion of current herbal treatment for hypertension among known hypertensives was overall 6.3% and decreased significantly from 11.7% in 2005 to 9.0% in 2019. The prevalence of current herbal and conventional treatment for hypertension among known hypertensives was overall 4.4%, and significantly decreased from 9.9% in 2005 to 6.0% in 2019. In the 2005 survey, the prevalence of herbal use was significantly higher among those with 12 or more years of education (p&lt;0.01) and urban residence (p&lt;0.001), while in the study years 2009, 2013 and 2019, no significant differences were found in terms of educational level and residence status and prevalence of herbal use. In adjusted logistic regression analysis, inadequate fruit and vegetable consumption decreased the odds and older age increased the odds of herbal use and/or concurrent herbal and conventional treatment for hypertension among hypertensives. Conclusion: The prevalence of herbal and/or conventional treatment of hypertension among hypertensives has decreased among Mongolian adults over a 15-year period. Considering significant levels of herbal treatment in combination with conventional treatment for hypertension, negative drug-herb effects can be expected, and appropriate actions of health systems may be needed.

Evaluation of Culture and Sensitivity Guided Antibiotic Selection in Eradication of Helicobacter pylori

Abstract Background Helicobacter pylori exhibits antibiotic resistance with regional differences. Antibiotics resistance is the main cause of eradication failure in H. pylori infection, thus our study aimed to evaluate the efficiency of standard triple therapy vs. Antibiotic -culture with susceptibility-based therapy and success rate of each in helicobacter pylori eradication. Methods This study was conducted on 100 patients with dyspepsia undergoing Upper GI Endoscopy in Gastroenterology department at Ain shams university hospital in the period between june2018 and june2019, the volunteered patients were divided into groups A and B. Group A patients received 2 weeks of pantoprazole 40 mg bid +two Antibiotics according to each patient’s result of culture and sensitivity, while Group B patients received 2 weeks of standard triple therapy PPI 40 mg bid + Amoxicillin 1 g bid + Clarithromycin 500 mg bid Results that patients of group A according to their culture and sensitivity results showed Significant increase in number of isolates sensitive to levofloxacin (26) than those resistant to it (14) with p-value 0.1(HS), Significant number of isolates resistant to clarithromycin (36) than those sensitive to it (14) with p-value o.011 and (HS), also Significant increase in number of isolate resistant to amoxicillin (40) than those sensitive to it (10) with p-value 0.003(HS) and finally significant increase in number of isolate resistant to metronidazole (40) than those sensitive to it (10) with p -value 0.003(HS). H. pylori results 4 weeks post treatment in groups A and B showed that there was a Significant number of positive helicobacter pylori patients 4 weeks post tr eatment in group B (30) than in group A (7) with p- value &amp;lt;0.01 (HS) and Significant number of negative helicobacter pylori patients 4 weeks post treatment in group A(43) than in group B (20) with p- value &amp;lt;0.01 (HS). Conclusion 43 of group (A) patients (86%) showed successful helicobacter pylori eradication after culture guided antibiotic therapy. Only 20 of group (B) patients (60%) showed successful h. pylori eradication after standard triple therapy. The study showed high resistant rates of h. pylori to clarithromycin and amoxicillin and metronidazole and gradually increasing resistance against levofloxacin. Countries like Egypt seem to have a high clarithromycin resistance, and a large-scale clinical trial is needed to choose the first -line therapy for eradication of H. pylori infection.

Intramuscular fat formation in fetuses and the effect of increased protein intake during pregnancy in Hanwoo cattle

Understanding adipocyte development in fetus during bovine pregnancy is important for strengthening fattening technology. Additionally, nutritional level of dams during pregnancy has the potential to improve offspring growth and fat development. The purpose of this study is to evaluate the intramuscular adipocyte development and expression level of related genes in bovine fetus, and the effect of increased crude protein (CP) intake during pregnancy on the growth performance and carcass characteristics of male offspring. Eighty six pregnant Hanwoo cows (average body weight, 551.5 ± 51.3 kg, age 5.29 ± 0.61 y) were used. Fetuses were collected at 90, 180 and 270 d of gestation from 18 pregnant Hanwoo cows. The remaining 68 pregnant cows were randomly assigned to 2 feeding groups. The control (CON) group was provided the standard protein diet (n = 34), and treatment (TRT) group was provided a diet with a 5% increase in CP intake (n = 34). Male offspring were divided into two groups according to protein treatment of the pregnant cows: CON male offspring (CON-O) and TRT male offspring (TRT-O). Intramuscular adipocytes were found in the fetal skeletal muscle after 180 days of gestation. Male calf’s birth weight increased in the TRT group compared to that in the CON group (&lt;italic&gt;p &lt;/italic&gt;&amp;lt; 0.002). The final body weight (&lt;italic&gt;p&lt;/italic&gt; &amp;lt; 0.003) and average daily gain (&lt;italic&gt;p &lt;/italic&gt;&amp;lt; 0.019) of male offspring were significantly higher in TRT-O than in CON-O. The feed conversion ratio was also improved by 10.5% in TRT-O compared to that in CON-O (&lt;italic&gt;p &lt;/italic&gt;&amp;lt; 0.026). Carcass weight was significantly higher in the TRT-O group than that in the CON-O group (&lt;italic&gt;p &lt;/italic&gt;&amp;lt; 0.003), and back fat was thicker in the TRT-O group (&lt;italic&gt;p&lt;/italic&gt; = 0.07). The gross receipts and net income were higher in TRT-O than in CON-O (&lt;italic&gt;p&lt;/italic&gt; &amp;lt; 0.04). Thus, fetal intramuscular fat can be formed from the mid-gestation period, and increased CP intake during pregnancy can increase net income by improving the growth and carcass weight of male offspring rather than intramuscular fat.

Transcranial Electromagnetic Wave Treatment: A Fountain of Healthy Longevity?

Most diseases of older age have as their common denominator a dysfunctional immune system, wherein a low, chronic level of inflammation is present due to an imbalance of pro-inflammatory cytokines over anti-inflammatory cytokines that develops during aging (“inflamm-aging”). A gerotherapeutic that can restore the immune balance to that shared by young/middle-aged adults and many centenarians could reduce the risk of those age-related diseases and increase healthy longevity. In this perspectives paper, we discuss potential longevity interventions that are being evaluated and compare them to a novel gerotherapeutic currently being evaluated in humans—Transcranial Electromagnetic Wave Treatment (TEMT). TEMT is provided non-invasively and safety through a novel bioengineered medical device—the MemorEM—that allows for near complete mobility during in-home treatments. Daily TEMT to mild/moderate Alzheimer’s Disease (AD) patients over a 2-month period rebalanced 11 of 12 cytokines in blood back to that of normal aged adults. A very similar TEMT-induced rebalancing of cytokines occurred in the CSF/brain for essentially all seven measurable cytokines. Overall inflammation in both blood and brain was dramatically reduced by TEMT over a 14–27 month period, as measured by C-Reactive Protein. In these same AD patients, a reversal of cognitive impairment was observed at 2 months into treatment, while cognitive decline was stopped over a 2½ year period of TEMT. Since most age-related diseases have the commonality of immune imbalance, it is reasonable to postulate that TEMT could rebalance the immune system in many age-related diseases as it appears to do in AD. We propose that TEMT has the potential to reduce the risk/severity of age-related diseases by rejuvenating the immune system to a younger age, resulting in reduced brain/body inflammation and a substantial increase in healthy longevity.

Antiviral Activity of Biosynthesized Silver Nanoparticles from Pomegranate (Punica granatum L.) Peel Extract against Tobacco Mosaic Virus.

Tobacco mosaic virus (TMV) is a major pathogen affecting tomato plants worldwide. The efficacy of silver nanoparticles (Ag-NPs) mediated by Punica granatum biowaste peel extract in mitigating the negative impact of TMV infection on tomato growth and oxidative stress was investigated through scanning electron microscopy (SEM), transmission electron microscopy (TEM), UV-Visible (UV-Vis) spectrophotometer, X-ray Diffraction (XRD), dynamic light scattering (DLS), zeta potential, energy-dispersive X-ray spectroscopy (EDX), and Fourier-transform infrared spectra (FTIR). Results of SEM analysis of green Ag-NPs revealed the presence of condensed spherical or round NPs with diameters ranging between 61 and 97 nm. TEM confirmed the SEM results and showed round-shaped Ag-NPs with an average size of 33.37 ± 12.7 nm. The elemental analysis (EDX) of prepared Ag-NPs revealed the presence of elemental Ag as a major peak (64.43%) at 3-3.5 KeV. The FTIR revealed several functional groups on the prepared Ag-NPs, for which three treatment strategies for Ag-NP applications were evaluated in the greenhouse study and compared to inoculated TMV and control plants: pre-infection treatment (TB), post-infection treatment (TA), and dual treatment (TD). The results showed that the TD strategy is the most effective in improving tomato growth and reducing viral replication, whereas all Ag-NP treatments (TB, TA, and TD) were found to significantly increase expression of the pathogenesis-related (PR) genes PR-1 and PR-2, as well as polyphenolic compounds, HQT, and C4H genes compared to control plants. In contrast, the flavonoid content of tomato plants was not affected by the viral infection, while the phenolic content was significantly reduced in the TMV group. Furthermore, TMV infection led to a significant increase in oxidative stress markers MDA and H2O2, as well as a reduction in the enzymatic activity of the antioxidants PPO, SOD, and POX. Our results clearly showed that the application of Ag-NPs on TMV-infected plants reduces virus accumulation, delays viral replication in all treatments, and greatly enhances the expression of the CHS gene involved in flavonoid biosynthesis. Overall, these findings suggest that treatment with Ag-NPs may be an effective strategy to mitigate the negative impact of TMV infection on tomato plants.

15 Unique yeast-derived prebiotic supports joint health and reduced systemic inflammation in senior horses

Senior horses are commonly afflicted with inflammation-related conditions including chronic or acute joint inflammation, and chronic low-grade systemic inflammation, or “inflamm-aging.” Reducing inflammation, where appropriate, may improve the quality of life and performance of senior horses. To that end, the objective of this trial was to determine whether supplementation of a unique yeast-derived prebiotic (ActivAge®(AA)) to senior horses would promote reduced joint and systemic inflammation. Aged Quarter horses (n = 10; mean age ± SEM = 21.3 ± 1.2yr; mean BW ± SEM = 587.5 ± 10.9kg; mean BCS ± SEM = 6.3 ± 0.2) were utilized in a crossover trial. Horses were randomly assigned to either a control (CON) or treatment (TRT) group. Horses in both groups were offered 4.54 kg/d Purina® Equine Senior® (CP = 14.5%, Ca = 0.76%, P = 0.61%). Horses were offered 1.25% BW as local grass hay (CP = 14.6%, Ca = 0.60%, P = 0.30%) daily. Horses were additionally offered 0.45 kg/d of a pellet containing AA (TRT) or not (CON). Daily ration was split into 2 equal feedings at 0700 and 1300 daily for 42d per period with a 28d washout period during which no TRT or CON pellet was offered. All horses had ad libitum access to fresh clean water and white salt. Serum samples were obtained via jugular venipuncture approximately 2hr post feeding every 2wk foranalysis of the acute phase protein, serum amyloid A (SAA; SAA-Vet, Eiken Chemical Co.). On d42 horses underwent a joint inflammation challenge. Briefly, 1mL of a sterile saline solution containing 0.5ng lipopolysaccharide from E. coli 055:B5 (Sigma-Aldrich) was injected into the radiocarpal joint. The contralateral joint was used as a control with only sterile saline injected. Synovial fluid was collected aseptically immediately before injection and at 5, 24, and 48hr post injection. All data were analyzed via ANOVA utilizing a MIXED procedure in SAS 9.4. Horses in the TRT group had no increase in SAA during supplementation while horses in CON increased by approximately 37% by d42 for a trt x time interaction (P < 0.001). Horses in the CON group in both the control and challenged joint had higher AUC for interleukin-6 (P = 0.02) and tumor-necrosis factor α (P = 0.01) than TRT horses. Interleukin-6 and TNFa were analyzed via species-specific colorimetric assays (RD Systems). Taken together, these data indicate that ActivAge® supplementation reduced systemic inflammation in senior horses while also supporting these horses during a joint inflammation challenge.

Effect of a Saccharomyces cerevisiae Postbiotic Feed Additive on Salmonella Enteritidis Colonization of Cecal and Ovarian Tissues in Directly Challenged and Horizontally Exposed Layer Pullets.

Determining the efficacy of feed-additive technologies utilized as pre-harvest food-safety interventions against Salmonella enterica may be influenced by factors including, but not limited to, mechanism of action, experimental design variables, Salmonella serovar(s), exposure dose, route, or duration in both controlled research and real-world field observations. The purpose of this study was to evaluate the dietary inclusion of a Saccharomyces cerevisiae fermentation-derived postbiotic (SCFP) additive (Diamond V, Original XPC®) on the colonization of cecal and ovarian tissues of commercial pullets directly and indirectly exposed to Salmonella Enteritidis (SE). Four hundred and eighty commercial, day-of-age W-36 chicks were randomly allotted to 60 cages per treatment in two identical BSL-2 isolation rooms (Iowa State University) with four birds per cage and fed control (CON) or treatment (TRT) diets for the duration of study. At 16 weeks, two birds per cage were directly challenged via oral gavage with 1.1 × 109 CFU of a nalidixic-acid-resistant SE strain. The remaining two birds in each cage were thus horizontally exposed to the SE challenge. At 3, 7, and 14 days post-challenge (DPC), 20 cages per group were harvested and sampled for SE prevalence and load. No significant differences were observed between groups for SE prevalence in the ceca or ovary tissues of directly challenged birds. For the indirectly exposed cohort, SE cecal prevalence at 7 DPC was significantly lower for TRT (50.0%) vs. CON (72.5%) (p = 0.037) and, likewise, demonstrated significantly lower mean SE cecal load (1.69 Log10) vs. CON (2.83 Log10) (p = 0.005). At 14 DPC, no significant differences were detected but ~10% fewer birds remained positive in the TRT group vs. CON (p > 0.05). These findings suggest that diets supplemented with SCFP postbiotic may be a useful tool for mitigating SE colonization in horizontally exposed pullets and may support pre-harvest food-safety strategies.