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Caffeine is an ergogenic substance that is consumed globally in many forms. The use of buccally absorbable formulations instead of gastrointestinal uptake has become increasingly popular over the years, especially when accelerated absorption with minimal gastrointestinal stress is desired. This study investigated the impact of five different formulations and administration routes of caffeine on the whole blood concentrations of caffeine, paraxanthine, and theobromine: caffeinated capsules, tablets, shots, pouches, and chewing gums. A uniform dose of caffeine (200 mg) was administered to 16 healthy recreational athletes (26.0 ± 2.1 years) using a randomized crossover design. Samples were taken in the form of dried blood spots at 16 different time points in a 2-hr timeframe after drug administration. The samples were analyzed using a validated liquid chromatography–tandem mass spectrometry method. The results for caffeine showed no significant differences in the overall bioavailability (area under the concentration–time curve), maximal concentration, and time to maximum concentration. However, when analyzing the bioavailability of caffeine in the first 5, 10, and 15 min, the liquid caffeine formulation was superior to other administered forms (p <.05). This indicates that caffeine solubility has a major influence on its absorption rate. In sports, the rate of caffeine absorption must be considered, not only when ingesting anhydrous caffeine, but also when choosing buccal absorption. These findings imply that general guidelines for ergogenic caffeine use should consider the formulation used and, accordingly, the corresponding route of absorption. [ABSTRACT FROM AUTHOR]

This study was designed to screen 6 lysosomal storage diseases (LSDs) in neonates using tandem mass spectrometry (MS/MS), and establish cutoff values for these LSDs with 3000 dried blood spots (DBS) samples. Cutoff values for α-L-iduronidase (IDUA), α-galactosidase (GLA), acid beta glucosidase (ABG), β-galactocerebrosidase (GALC), acid sphingomyelinase (ASM), and acid alpha glucosidase (GAA) were as follows: GLA, > 2.06 μmol/L·h; ABG, > 1.78 μmol/L·h; ASM, > 0.99 μmol/L·h; IDUA, > 1.33 μmol/L·h; GALC, > 0.84 μmol/L·h; and GAA, > 2.06 μmol/L·h. There were 30 positives in initial MS/MS screening test, and 15 samples were still positive with repeat testing. Their parents/guardians were recontacted and DBS samples were collected again for test. Only 1 child showed abnormal GAA enzyme activity after recontacting process, and was diagnosed with Pompe disease after genetic screening. Eventually, cutoff values of 6 specific enzyme activities were established and MS/MS is effective for early LSDs screening. [ABSTRACT FROM AUTHOR]

Summary: The clinical data analysis found that, compared with the traditional obesity index, the waist-weight ratio (WWR) has more advantages in predicting abnormal bone mineral density in subjects with type 2 diabetes. WWR may serve as a new predictive indicator for osteoporosis in T2DM patients. Purpose: This study was designed to explore the correlation between obesity-related indices and bone mineral density (BMD) and its influencing factors in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 528 patients with type 2 diabetes were recruited. Glucose tolerance, insulin stimulation, and blood biochemical tests were conducted on all participants. All subjects underwent dual-energy X-ray bone density testing and were grouped based on the bone density results. Results: Compared with those in the normal BMD group, the waist-to-body weight ratio (WWR) and weight-adjusted-waist index (WWI) in the osteopenia and osteoporosis groups were significantly greater, while body mass index (BMI) was significantly lower (P < 0.05). The logistic regression results showed that the WWR, WWI, and BMI were independently correlated with abnormal BMD in T2DM patients (P < 0.05). WWR and the WWI were negatively correlated with the T-value of bone density in various parts of the body, while BMI was positively correlated with the T-value of bone density (P < 0.05). The area under the working characteristic curve (AUC) for T2DM patients with abnormal bone mass predicted by the WWR [0.806, 95% CI = (0.770–0.843), P < 0.001] was greater than that for patients with other obesity indicators, such as the WWI and BMI. Conclusion: We found a positive correlation between the WWR and bone density in T2DM patients. Compared with other obesity indicators, such as BMI and WWI, the WWR has a stronger discriminative ability for T2DM patients with abnormal bone density. Therefore, more attention should be given to the WWR in T2DM patients. [ABSTRACT FROM AUTHOR]

Objectives: Excess dietary salt causes increased urinary calcium and this may lead to bone loss. We proposed to study the association between dietary salt intake and bone health in postmenopausal women from southern India. Methods: An observational study in which community‐dwelling postmenopausal women were recruited. Daily salt intake and urine calcium/creatinine ratio were assessed. Bone biochemistry and densitometric parameters such as bone mineral density (BMD), trabecular bone score (TBS) vertebral fractures, and bone strain index (BSI) were assessed using Dual Energy X‐Ray Absorptiometry (DXA). Results: A total of 383 postmenopausal women with a mean ± SD age of 59.8 ± 7.2 years and BMI of 25.2 ± 4.6 kg/m2 were recruited. Among the participants, 165/383(43.1%) had osteoporosis at any site and 21% had moderate–severe vertebral fractures. The BMD at lumbar spine and femoral neck, TBS and BSI were significantly (p < 0.001) lower and the CTx was significantly (p = 0.008) higher among women with high salt intake (7.2 g/day) as compared to those with salt intake of <7.2 g/day. The prevalence of osteoporosis, low TBS, high BSI, and moderate–severe vertebral fractures significantly increased across low to high salt‐intake categories. An ROC analysis showed that excess dietary salt was significantly associated with osteoporosis at any site with an AUC of 0.870 (95% CI: 0.832–0.907). On a multivariate analysis, excess salt intake conferred the highest odds of osteoporosis (OR: 2.296; 95% CI: 1.909–2.761). Conclusions: Excess dietary salt is associated with high urinary calcium and compromised bone health among postmenopausal women from southern India. This may be a modifiable risk factor in osteoporosis and warrants further research. [ABSTRACT FROM AUTHOR]

Introduction Exposure to high doses of ionizing radiation can result in hematopoietic acute radiation syndrome. Currently, there is no radiation medical countermeasure approved by the U.S. FDA which can be used before radiation exposure to protect exposed individuals. Here we aimed to evaluate the therapeutic potential of an aqueous suspension of synthetic genistein nanoparticles (BIO 300) as a radioprotectant in a pilot efficacy study using a nonhuman primate model of total body irradiation. Materials and Methods Eight rhesus macaques were divided into two groups; four received vehicle and four received BIO 300 Injectable Suspension 24 h before 5.8 Gy total-body irradiation. Survival, blood cell counts, blood chemistry, and clinical parameters were monitored over the 60 days of the study. Tissues were collected at necropsy 60 days post-irradiation or from animals that met unscheduled euthanasia criteria and subjected to histopathological analysis. Tissues analyzed included the duodenum, jejunum, ileum, sternum, lung, heart, liver, kidney, spleen, gut-associated lymphoid tissue, and urinary bladder. Results In this pilot study, all BIO 300 Injectable Suspension treated animals survived to day 60, while only 50% of the vehicle-treated animals survived. We found that BIO 300 Injectable Suspension did not mediate an improvement in blood cell counts (e.g. neutrophils, platelets, white blood cells). However, BIO 300 Injectable Suspension treated animals had a lower incidence of fever and febrile neutropenia, were able to better maintain their body weight post radiation exposure, and exhibited less anemia and faster recovery from anemia. Histopathological analysis revealed that BIO 300-treated animals had less irradiation-induced damage to the sternum and other tissues compared to vehicle controls. Conclusions BIO 300's mechanism of action is complex and protection against irradiation is attainable without much improvement in the complete blood count (CBC) profile. BIO 300's mechanism for radioprotection involves multiple biological pathways and systems. [ABSTRACT FROM AUTHOR]

Copyright of Lege Artis Medicine (LAM) is the property of LifeTime Media Kft. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: 2‐(2‐Nitro‐4‐trifluoromethylbenzoyl)‐1,3‐cyclohexanedione (NTBC) treatment of alkaptonuria (AKU) leads to increased blood tyrosine levels, causing skin issues and potentially sight‐threatening corneal keratopathy. Adherence to dietary management of NTBC‐induced tyrosinemia, a low‐protein diet with or without protein substitutes, can be difficult for patients. This 28‐day interventional study evaluated a low tyrosine casein glycomacropeptide (cGMP) protein substitute (TYR sphere)®, a 20 g protein equivalent, cGMP‐based protein substitute, in terms of adherence, palatability, usability, comparison to amino acid (AA)–based protein substitutes, gastrointestinal tolerance and metabolic control in adults with NTBC‐induced tyrosinaemia. Methods: Four adults (mean 61.1 years, range 53.3–69.3 years) with AKU and NTBC‐induced tyrosinaemia were recruited from the United Kingdom National Alkaptonuria Centre (NAC). The cGMP protein substitute was prescribed based on individual nutritional requirements, replacing ≥1 AA‐based protein substitute. Participants recorded product‐related data in study diaries, using five‐point Likert scales and daily and weekly logs. To determine metabolic control, prestudy blood tyrosine levels were compared to weekly blood spot tests during the study. Results: Median cGMP protein substitute adherence was 98%. Most participants rated palatability and usability positively, and preferred cGMP protein substitute to AA‐based products. There were no notable gastrointestinal changes, and metabolic control was maintained. Conclusions: cGMP protein substitute is a palatable and well‐tolerated option in the dietary management of AKU patients with NTBC‐induced tyrosinaemia. Key points: Alkaptonuria (AKU) treated with 2‐(2‐nitro‐4‐trifluoromethylbenzoyl)‐1,3‐cyclohexanedione (NTBC) induces tyrosinaemia that requires dietary management to prevent clinical consequences such as corneal keratopathy.A low tyrosine casein glycomacropeptide (cGMP)‐based protein substitute can be used to replace protein and other important nutrients where a protein restriction is indicated.The low tyrosine cGMP‐based protein substitute used in this study was well adhered to, with no notable effects on gastrointestinal tolerance and maintained metabolic control within acceptable parameters.Low tyrosine cGMP protein substitutes provide a viable, well‐tolerated alternative to traditional amino acid–based protein substitutes to help achieve treatment outcomes, of particular relevance should treatment begin earlier in life in the future. [ABSTRACT FROM AUTHOR]

This randomized controlled study assessed the feasibility, acceptability, and preliminary impact of the PrEP iT! mHealth intervention designed to improve PrEP adherence among young men who have sex with men (YMSM). A national sample of 80 YMSM in the U.S. (Mage = 25 years; 54% racial/ethnic minority), recruited through social media ads, were randomized to either the PrEP iT! or usual PrEP care conditions. Participants completed online surveys and submitted self-collected dried blood sample (DBS) data as measures of PrEP adherence. Differences in PrEP adherence across treatment arms and between participants with high versus low engagement in PrEP iT! were assessed. Retention was high at the three (94%) and six (93%) month assessment, and participants in PrEP iT! reported satisfactory acceptability of the intervention. There were no significant differences in self-reported or DBS-derived PrEP adherence between randomized groups. However, YMSM in the PrEP iT! group with high PrEP adherence (the equivalent of four or more doses/week through self-report and DBS-derived measures) demonstrated significantly higher engagement in the intervention than those with low PrEP adherence (the equivalent of 3 or fewer doses/week). Overall, the PrEP iT! intervention demonstrated strong feasibility and acceptability. The finding that high PrEP iT! intervention engagement was associated with protective levels of PrEP adherence suggests it is a viable adherence support tool that should be further evaluated in definitive trial among YMSM who need basic support, or as part of a more comprehensive adherence support package for those who need greater assistance. Trial registration Clinical Trials # NCT04509076 (registered August 10, 2020). [ABSTRACT FROM AUTHOR]

Objective: Home healthcare services play a crucial role in reducing health expenditure, providing tailored care, and improving the quality of healthcare, particularly for managing chronic diseases. Methods: This retrospective cross-sectional study analyzed the blood test and laboratory results of 1,461 patients who were evaluated by the home health services unit in Ankara between May 1, 2020, and July 31, 2020. The patients' ages, genders, and laboratory data were collected, and statistical analyses were performed using SPSS software. A p-value of <0.05 was considered statistically significant. Results: The study included 1,461 patients, of whom 64.06% were female and 35.94% were male. Significant age differences were observed among the patients (p<0.001). Home visits were conducted for medical examinations and laboratory tests, and the results showed age-related variations in several parameters, such as albumin, alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase, creatine-kinase, gamma-glutamyl transferase (GGT), calcium (Ca), free triiodothyronine, free thyroxine, total protein, triglycerides, prothrombin time, activated partial thromboplastin time, urea, uric acid, creatinine, and potassium. Gender differences were also observed, with varying levels of amylase, activated partial thromboplastin time, ALT, total bilirubin, direct bilirubin, GGT, C-reactive protein, albumin, phosphorus, high-density lipoprotein cholesterol, Ca, and unsaturated iron binding capacity. Conclusion: Considering age-related laboratory test results is crucial in home healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is often associated with metabolic disorders. Statin drugs are potent inhibitors of cholesterol biosynthesis. Objective: The aim of this study was to evaluate the effect of atorvastatin on the concentrations of methylglyoxal (MGO), glyoxalase 1 (GLO-1), and aldo–keto reductase family 1 member B10 (AKR1B10) in patients with T2DM and prediabetes. Methods: This study was conducted on 80 subjects with and without T2DM and prediabetics divided into 5 groups: patients with T2DM receiving statins (group A, n = 17), patients with T2DM not receiving statins (group B, n = 17), patients with prediabetes receiving statins (group C, n = 12), patients with prediabetes not receiving statins (group D, n = 17), and healthy controls without T2DM (control group, n = 17). Patients with T2DM and prediabetes received atorvastatin 20 mg/day for 3 months. The measurement of MGO and AKR1B10 was performed with a non-competitive sandwich-type enzyme-linked immunosorbent assay (ELISA) at 450 nm. The measurement of GLO-1 was performed by an enzymatic method at 240 nm. Results: The serum level of MGO was significantly higher in patients with T2DM and prediabetes than that of healthy controls (p = 0.001). In patients with T2DM, statins decreased the serum level of MGO, but in patients with prediabetes, statins increased the serum level of MGO (p = 0.001). The level of GLO-1 activity was significantly higher in healthy controls than that of patients with T2DM and prediabetes (p = 0.001). Furthermore, the level of GLO-1 activity was significantly higher in patients with T2DM and prediabetes receiving statins than that of patients with T2DM and prediabetes not receiving statins (p = 0.002). The serum level of AKR1B10 was significantly higher in groups C and D than that of the other groups (p = 0.001). Conclusion: Atorvastatin can improve the level of GLO-1 activity and thereby prevent diabetic complications. [ABSTRACT FROM AUTHOR]

Background: Sepsis, a complex condition characterized by dysregulated immune response and organ dysfunction, is a leading cause of mortality in ICU patients. Current diagnostic and prognostic approaches primarily rely on non-specific biomarkers and illness severity scores, despite early endothelial activation being a key feature of sepsis. This study aimed to evaluate the levels of soluble thrombomodulin and soluble endoglin in seriously ill surgical septic patients and explore their association with organ dysfunction and disease severity. Methodology: A case control study was conducted from March 2022 to November 2022, involving seriously ill septic surgical patients. Baseline clinical and laboratory data were collected within 24 h of admission to the Surgical Intensive Care Unit. This included information such as age, sex, hemodynamic parameters, blood chemistry, SOFA score, qSOFA score, and APACHE-II score. A proforma was filled out to record these details. The outcome of each patient was noted at the time of discharge. Results: The study found significantly elevated levels of soluble thrombomodulin and soluble endoglin in seriously ill surgical septic patients. The RTqPCR analysis revealed a positive correlation between soluble thrombomodulin and soluble endoglin levels with the qSOFA score, as well as, there was a positive association between RTqPCR soluble thrombomodulin and the SOFA score. These findings indicate a correlation between these biomarkers and organ dysfunction and disease severity. Conclusion: The study concludes that elevated levels of soluble thrombomodulin and soluble endoglin can serve as endothelial biomarkers for early diagnosis and prognostication in seriously ill surgical septic patients. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to assess differentially expressed blood proteins between patients with active RA and patients in remission after MTX treatment, with the aim of identifying a biomarker of MTX resistance (MTXR). Methods Two populations of RA patients treated with a stable dose of s.c. MTX for at least 3 months were constituted according to the DAS28: remission (DAS28 < 2.6; n  = 24) and active disease (DAS28 > 3.2; n  = 32). The two groups of RA patients were homogeneous regarding their epidemiological characteristics, except for the duration of treatment, which was longer in the remission group. After collection of a blood sample, plasma protein digestion was performed, followed by untargeted proteomics analysis. Then, a targeted analysis was performed to confirm the results of the untargeted approach. Results Untargeted proteomics analysis revealed eight plasma proteins that were differentially expressed between the two groups of patients. Among them, triosephosphate isomerase (TPI-1) and glucose-6-phosphate isomerase (GPI), which are main actors in glycolysis, were found down-regulated in the active group. This result was confirmed for TPI-1 in the targeted proteomics analysis. Conclusion A first step was achieved in the search for biomarkers of MTXR, with the identification of two actors in glycolysis (TPI-1 and GPI). The next step will be to confirm these results in a larger cohort, including samples from treatment-naive patients, to assess the predictive potential of these protein markers. [ABSTRACT FROM AUTHOR]

Objectives: In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these sudden hemostasis abnormalities and to evaluate the performances of point of care coagulation testing. Methods: In this prospective and descriptive study, we included 33 consecutive patients undergoing elective cardiac surgery for 1 month. Heparin-induced anticoagulation and calculation of the protamine dose were tested by the Hemostasis Management System Plus device (Medtronic, Minneapolis, MN, USA). Fifteen minutes after the end of the protamine infusion, activated clotting time (ACT), activated partial thromboplastin time and anti Xa activity were measured. In case of unusual clinical bleeding, a Quantra analysis (Stago, HemoSonics LLC, Charlottesville, VA) was added. Results: Residual antiXa activity >0.2 IU/mL after neutralization was present in 44% of patients. Our investigation concluded incomplete heparin reversal. There was no association between cellular reinfusate and the presence of heparin. The unusual rate of hemostasis abnormalities was explained by a less efficient protamine reversal of heparin. ACT and Clot Time Ratio (CTR, Quantra system) correlated with AntiXa with Spearman's coefficients of 0.85 (p <.0001) and 0.95 (p =.0012), respectively. About ACT, a threshold of 150 seconds had a sensitivity of 85% [58–97] and a specificity of 85% [58–97%] for detection of AntiXa>0.2. For CTR, a threshold of 1.4 had a sensitivity of 67% [30–94] and a specificity of 100% [18–100]. Conclusion: The use of point of care coagulation testing is effective in detecting incomplete reversal of heparin. [ABSTRACT FROM AUTHOR]

BACKGROUND: Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance OBJECTIVES: This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort. METHODS: Participants were recruited into CARES when they were 7–9 y old, and reenrolled at 13–18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height–weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine. RESULTS: CARES participants who completed the adolescent postural balance assessment (푛 = 123) were 98% White and 54% female and had a mean age of 16 y (range: 13–18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males DISCUSSION: This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Psychosocial consequences of false-positive results following newborn bloodspot screening have been identified as a potential risk to this highly successful public health initiative. A scoping review was undertaken in October 2023 underpinned by the Arksey and O'Malley framework. Twenty-four papers were included in the review, many of which focused on cystic fibrosis. The results indicated that impact of false-positive results is variable; some studies suggest false-positive results have the potential to result in negative sequelae including increased stress and changes in parental perceptions of their child, while others suggest these impacts are transient and, in some instances, may even lead to positive outcomes. Further evidence is needed to ensure the representation of other conditions included in newborn bloodspot screening and to support strategies to overcome potential negative sequela. [ABSTRACT FROM AUTHOR]

Dementia is a major public health issue and a heavy economic burden. It is urgently necessary to understand the underlying biological processes and to identify biomarkers predicting risk of dementia in the preclinical stage for prevention and treatment. By using the data of the 367,093 white British individuals from UK Biobank, we investigated the relationship between 56 laboratory measures and 5-year dementia incidence using logistic regression. Adjusted odds ratios for dementia incidence with values below or above the 95 % confidence interval (<2.5th or > 97.5th percentile) on each of clinical laboratory tests were computed. We observed that markers of endocrine dysregulation: elevated hemoglobin A1C (AOR = 2.01 [1.35, 2.88]) was associated with increased dementia incidence. Indicators of liver dysfunction: elevated gamma glutamyltransferase (AOR = 2.28 [1.49, 3.32]), and albumin (AOR = 2.01 [1.15, 3.25]), indicators of renal impairment: high urea (AOR = 1.69 [1.15, 2.40]), and cystatin C (AOR = 1.89 [1.30, 2.67]), and some immune markers, like elevated neutrophill count, low lymphocyte count, and indicators of anemia were also observed to be associated with increased dementia incidence. Both low and high concentrations of insulin-like growth factor 1 were found to be risk factors for dementia. This is an observational study. Several systemic biomarkers were associated with dementia incidence. These results implicate a contributory role of diverse biological processes to dementia onset, and enrich our understanding of potential dementia prevention strategy. • We examined associations of serum lab tests with dementia incidence longitudinally. • Endocrine, liver, renal dysfunction, immunity, and anemia markers are linked to dementia. • Our findings suggest diverse biological processes contribute to dementia onset. [ABSTRACT FROM AUTHOR]

In Southern and Eastern Africa, initiation of daily oral pre-exposure prophylaxis (PrEP) for HIV prevention has been high among adolescent girls and young women (AGYW) offered PrEP. However, persistence and prevention-effective use of PrEP among this critical group continues to be a challenge. We conducted a qualitative sub-study of AGYW from the Community PrEP Study in Eastern Cape Province, South Africa who had high rates of pick up for monthly PrEP refills over two years, but differing levels of PrEP adherence based on tenofovir-diphosphate (TFV-DP) measurements in dried blood spots (DBS). Contrasting 22 AGYW with low versus high levels of TFV-DP in DBS, we qualitatively explored factors which influenced PrEP persistence vs. non-persistence, unique patterns of PrEP use (e.g., discarding or stockpiling), and participant recommendations for improving AGYW prevention-effective use of PrEP in the future. Results showed that PrEP misconceptions and mistrust among participants' social networks negatively influenced adherence. In comparison, supportive families and/or partners and personal trust that PrEP works positively influenced adherence. Those with low adherence described being motivated to come to the site for other study benefits (e.g., reimbursement money, snacks, sanitary pads) and discarding PrEP to avoid stigma associated with being seen with pills. Future PrEP implementation strategies should focus on involving families and partners in PrEP support for AGYW and minimizing PrEP stigma at a community level. Trial registration NCT03977181. Retrospectively registered on June 6, 2019. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study was to evaluate the therapeutic effects of carbon quantum dots (CQDs) in immunomodulation on non‐obese diabetic (NOD) mice, as the model for Sjögren's syndrome (SS). Methods: Carbon quantum dots were generated from Setaria viridis via a hydrothermal process. Their toxic effects were tested by cell viability and blood chemistry analysis, meanwhile therapeutic effects were investigated in NOD mice in the aspects of saliva flow, histology, and immune cell distribution. Results: Carbon quantum dots, with rich surface chemistry and unique optical properties, showed non‐cytotoxicity in vitro or no damage in vivo. Intravenously applied CQDs alleviated inflammation in the submandibular glands in NOD mice after 6‐week treatments. The inflammatory area index and focus score were significantly decreased in CQD‐treated mice. Besides, the levels of anti‐SSA and anti‐SSB were decreased in the presence of CQDs. The stimulated saliva flow rates and weight of submandibular glands were significantly increased in CQD‐treated mice by reducing the apoptosis of cells. The CD3+ and CD4+ T cells distributed around the ducts of submandibular glands were significantly decreased, while the percentage of Foxp3+ cells was higher in CQD‐treated mice than that in the control group. Conclusions: Our findings suggest that CQDs may ameliorate the dysregulated immune processes in NOD mice. [ABSTRACT FROM AUTHOR]

Although the field of oncology pharmacotherapy has progressed rapidly with the introduction of novel targeted therapies, there are many unintended side effects that require knowledge of laboratory monitoring for appropriate management. The purpose of this article is to summarize the importance of appropriately interpreting laboratory test results, understanding the implications of blood chemistries, and using resources available for monitoring the parameters of novel oncologic therapies. AT A GLANCE * Novel targeted drugs used in cancer treatment can have off-target effects that may affect many organ systems, depending on the drug. * Off-target effects create less predictable side effect profiles compared with cytotoxic chemotherapy. * Nurses can manage treatment side effects through monitoring of laboratory results. [ABSTRACT FROM AUTHOR]

Introduction: The clinical laboratory testing process has three phases, and one of the most common errors that adversely affect the accuracy of laboratory test results occurs in the pre-analytical phase. Different brands of blood collection tubes used in laboratories can adversely affect the accuracy of the parameters. This study aims to compare the clot activator gel biochemistry tubes for selected clinical parameters. Methods: Fifty healthy volunteers aged between 18-70 years were included who didn't have any chronic or inflammatory disease, any clinical or pathological disease, and didn't use any medication. The biochemical parameters such as serum albumin, creatinine (crea), urea, triglyceride (TG), calcium (Ca), sodium (Na), potassium (K), and chloride (Cl) levels; aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) activity were measured by an autoanalyzer. Student's t-test and Bland-Altman plot methods were used for statistical data analysis by SPSS software. Results: There was no statistical difference between the two different tube brands in terms of all evaluated clinical parameters that could affect the accuracy of the test results. Discussion and Conclusion: When the BD® brand tube is taken as a reference, it is thought that AYSET® tubes give the same or close values, and the clinical use of AYSET® brand tubes will not cause an error in laboratory tests. [ABSTRACT FROM AUTHOR]

Background: As patient-reported outcome measures (PROMs) become available to clinicians for routine clinical decision-making, many wonder how to define a meaningful change in a patient's PROM score. Some PROMs have a specific threshold that indicates meaningful change, but since those numbers are based on population averages, they do not necessarily apply to the varying experiences of each individual patient. Rather than viewing this as a weakness of PROMs, it is worth considering how clinicians use other existing measures in clinical decision-making—and whether PROMs can be used similarly. Body: An informal survey of 43 clinicians reported using measures such as weight, blood pressure, and blood chemistry to inform clinical decision-making. Although clinicians were very consistent with what constituted a meaningful change for some measures (e.g., ECOG performance status), other measures had considerable variability (e.g., weight), often informed by their specialization (for example, differing thresholds for meaningful weight change for adult primary care, pediatrics, and oncology). For interpreting change in measures, they relied on clinical experience (44%), published literature (38%), and established guidelines (35%). In open-response comments, many clarified that the results of any measure had to be taken in the context of each individual patient before making treatment decisions. In short, clinicians already apply individualized clinical judgment when interpreting score changes in existing clinical measures. As clinicians gain familiarity with PROMs, PROMs will likely be utilized in the same way. Conclusion: Like other clinical measures from weight to blood chemistry, change in a PROM score is but one piece of a patient's clinical story. Rather than relying on a hard-and-fast number for defining clinically meaningful change in a PROM score, providers should—and many already do—consider the full scope of a patient's experience as they make treatment decisions. [ABSTRACT FROM AUTHOR]

Objective To investigate the liver and renal function, blood lipids, and blood glucose at 3 months after blood donation in long-term blood donors aged 45-65 years, as well as the possibility of continuing to donate blood after exceeding the age for blood donation. Methods The long-term blood donors who donated blood at our station from September to December 2016 were selected, and according to the age, they were divided into group A (45-49 years of age), group B (50-54 years of age), group C (55-59 years of age), and group D (60-65 years of age). Liver and renal function, blood glucose, and blood lipid levels were measured at 3 months after the most recent blood donation and were compared between groups. Results There was a significant difference in the serum level of low-density lipoprotein cholesterol (LDL-C) at 3 months after blood donation between groups A/B/C and group D (t=2.45-4.61,P0.05). Conclusion The long-term blood donors, aged 45-59 years, tend to have stable liver and renal function, blood lipids, and blood glucose at 3 months after blood donation, and long-term blood donation does not affect the above indicators. The blood donors aged 60-65 years have a higher level of LDL-C after blood donation, with other indicators remaining stable, and therefore, they may be considered as potential blood donors.

Background The clinical application of flash glucose monitoring system (FGM) is becoming increasingly widespread, which can be continuously monitored for 14 days and does not require fingertip blood correction during wearing, providing a basis for clinical treatment. Therefore, the accuracy of FGM is particularly important. Objective To investigate the effect of human body composition and serum biochemical indicators on the accuracy of FGM sensor. Methods Patients with type 2 diabetes mellitus (T2DM) hospitalized in the Department of Endocrinology of the Second Affiliated Hospital of Zhengzhou University in 2022 were selected as the study objects, and their general data was collected through the electronic medical record system. The blood glucose was detected by FGM and compared with intravenous blood glucose, the physical analysis data of patients was collected. Fasting venous blood was collected to analyze hematological parameters. The clinical accuracy of FGM was evaluated by Clarke error grid analysis. The included patients were divided into the accurate group (MARD20%, n=34) according to the matched mean absolute relative difference of blood glucose (MARD). Binary Logistic regression analysis was used to analyze the influencing factors of FGM accuracy. Results A total of 694 pairs of blood glucose data were collected. Clarke error grid analysis was performed on the blood glucose values of FGM scans using venous blood glucose as the reference value. The results showed that 82.9% fell in zone A, 16.9% fell in zone B, 99.8% fell in zone A+B, and 0.2% fell in zone D, with an average MARD of 12.7%. MARD and muscle mass in the inaccurate group were higher than those in the accurate group (P

Purpose: This study evaluated the effects of 12 weeks of karate training on cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. Method: Seventy adolescents were randomized into 2 groups: control received nutritional and psychological interventions once a week for 12 weeks, and treatment received nutritional and psychological interventions once a week, plus 3 karate sessions per week, for 12 weeks. The main outcome measure was improvement in cardiometabolic parameters, oxidative stress, and inflammation. Results: After the intervention period, the treatment group showed a reduction in resting heart rate (77.86 [10.89]), high-density lipoprotein cholesterol (40.86 [8.31]), and triglycerides (75.18 [32.29]) and an increase in low-density lipoprotein cholesterol (95.64 [42.53]) in relation to pretraining. Regarding oxidative stress markers, there was a reduction in protein carbonylation (0.07 [0.06]) and nitric oxide (1.39 [1.11]) and an increase in superoxide dismutase (0.68 [0.31]) and glutathione (0.11 [0.08]) compared with pretraining. With respect to inflammation, adiponectin increased (14.54 [5.36]) after the intervention when compared with preintervention. Conclusion: The study concluded that the intervention may improve cardiometabolic parameters, oxidative stress, and inflammation in adolescents with overweight and obesity. Long-term effects need to be evaluated. [ABSTRACT FROM AUTHOR]

The role of complement in human autoimmune, inflammatory, and infectious diseases is reviewed, focusing on clinical applicability. A typical case is presented in which serum testing for C3 and C4 is performed to help assess a syndrome with a broad differential diagnosis. The review includes a discussion of complement deficiency states, consumption of complement by diseases characterized by immune‐complex formation and deposition, usefulness and interpretation of laboratory tests for complement, and development of drugs targeting specific components of the complement pathway for a growing number of indications. [ABSTRACT FROM AUTHOR]

Aim: To assess the relationship of cardiovascular risk factors (CRFs) with carotid intima media thickness (IMT) in adolescents with a parental history of premature coronary artery disease (PCAD). Methods: This cross-sectional study included 50 healthy adolescents, aged 14–18 years, both sexes, with a parental history of PCAD, that were compared to 50 controls without this history. Questionnaires regarding information of CRFs were applied. Blood chemistry analyses, included lipid profile, lipoprotein (a), low density lipoprotein (LDL) susceptibility to oxidation, and inflammatory cytokine levels. The IMT was evaluated by ultrasound. Results: The mean age of all participants was 15.9 years. Anthropometric measurements, blood pressure, and lipid profile were similar in both groups. However, the parental history of PCAD group exhibited lower high density lipoprotein cholesterol concentrations, shorter LDL particle oxidation time, and higher lipoprotein (a) levels compared to the control group. IMT was significantly higher in adolescents with a parental history of PCAD compared to controls, (0.53 ± 0.04 mm vs 0.47 ± 0.02 mm, p = 0.001). Among adolescents with a parental history of PCAD, those with ≥ 3 CRFs had significantly higher IMT values (0.56 mm) than those with < 3 CRFs (0.52 mm) and controls (0.48 mm). Multivariable analyses identified that systolic blood pressure and parental history of PCAD explained 26.8% and 16.1% of the variation in IMT. Furthermore, body mass index, LDL-C, ApoB-100, triglycerides and lipoprotein (a) interact with blood pressure levels to explain the IMT values. Conclusion: Adolescents with a parental history of PCAD had higher IMT values than the control group, primary explained by systolic blood pressure and the parental inheritance. Adolescents with parental history of PCAD and ≥ 3 CRFs exhibited the highest IMT values. Notably, lipids and systolic blood pressure jointly contribute to explain IMT in these adolescents. [ABSTRACT FROM AUTHOR]

This article provides a step-by-step guide for nurses to interpret arterial blood gas (ABG) results, focusing on five key components: SaO2, PaO2, pH, PaCO2, and HCO3-. It explains how to assess a patient's oxygenation status, compensation levels, and determine if there is an acid-base disturbance and if that disturbance is respiratory or metabolic. [ABSTRACT FROM AUTHOR]

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The management of severe burns remains a complex challenge. Adenosine, lidocaine, and magnesium (ALM) resuscitation therapy has been shown to protect against hemorrhagic shock and traumatic injury. The aim of the present study was to investigate the early protective effects of small-volume ALM fluid resuscitation in a rat model of 30% total body surface area (TBSA) thermal injury. Male Sprague–Dawley rats (320–340 g; n = 25) were randomly assigned to: 1) Sham (surgical instrumentation and saline infusion, without burn, n = 5), 2) Saline resuscitation group (n = 10), or 3) ALM resuscitation group (n = 10). Treatments were initiated 15-min after burn trauma, including 0.7 mL/kg 3% NaCl ± ALM bolus and 0.25–0.5 mL/kg/h 0.9% NaCl ± ALM drip, with animals monitored to 8.25-hr post-burn. Hemodynamics, cardiac function, blood chemistry, hematology, endothelial injury markers and histopathology were assessed. Survival was 100% for Shams and 90% for both ALM and Saline groups. Shams underwent significant physiological, immune and hematological changes over time as a result of surgical traums. ALM significantly reduced malondialdehyde levels in the lungs compared to Saline (P =.023), and showed minimal alveolar destruction and inflammatory cell infiltration (P <.001). ALM also improved cardiac function and oxygen delivery (21%, P =.418 vs Saline), reduced gut injury (P <.001 vs Saline), and increased plasma adiponectin (P <.001 vs baseline). Circulating levels of the acute phase protein alpha 1-acid glycoprotein (AGP) increased 1.6-times (P <.001), which may have impacted ALM's therapeutic efficacy. We conclude that small-volume ALM therapy significantly reduced lung oxidative stress and preserved alveolar integrity following severe burn trauma. Further studies are required to assess higher ALM doses with longer monitoring periods. [ABSTRACT FROM AUTHOR]

Early work reentry among postpartum mothers may negatively impact mothers' mental and physical health and adversely impact telomere length. Understanding the challenges mothers face upon work reentry postpartum may aid in developing policies and programs that support mothers and their families' well-being and help them achieve a better work-life balance. Objective: Transitioning to motherhood can create work family conflicts affecting mothers' health. Although employment is generally associated with longer telomeres, this may diminish during the early years of child-rearing. This study aimed to assess the impact of work reentry on telomere length (TL) among first-time mothers. Methods: In this 1-year prospective study, a total of 103 first-time postpartum mothers participated from two medical institutions in Northern Israel; they completed validated questionnaires, reported their current working status, and provided dried blood spots measuring TL. Results: We found that working status significantly predicted change in TL and was negatively correlated with change in TL over time (β = −0.245; 95% confidence interval, −0.169, −0.018; P = 0.016). Conclusions: Identifying ideal timing of work reentry is recommended for first-time postpartum mother's optimal health and TL. [ABSTRACT FROM AUTHOR]

Ocular flutter (OF) is a rare oculomotor syndrome. The most common etiologies are paraneoplastic, postinfectious and toxic-metabolic. However post-vaccinal etiology was rarely reported in OF. Here, we reported a post-vaccinal clinical syndrome characterized by OF-myoclonus and ataxia associated with oligoclonal bands (OCBs). A 60-year-old male who presented with dizziness, unsteady gait, involuntary movements, involuntary conjugate eye oscillations and extremity jerks that started 3 days after the second dose of mRNA BNT162b2 Covid-19 vaccine. Routine biochemical and serological analysis were within normal limits. No pathological finding was detected in brain MRI. Paraneoplastic and autoimmune encephalitis tests were unremarkable in cerebrospinal fluid (CSF). Oligoclonal band s were positive in CSF. This is the first description of the relationship between vaccines against SARS-CoV-2 and the clinical syndrome of OF, Myoclonus and Ataxia (OFMAS). Humoral immune mechanisms seem to play an important role in OFMAS. Presence of OCBs in CSF may also be associated with this condition. [ABSTRACT FROM AUTHOR]

Bilateral emphysematous pyelonephritis (EPN) is a rare complication in uncontrolled diabetes mellitus patients and linked to a high patient mortality rate [1]. We present a case of a 62-year-old female patient with bilateral EPN who also developed a concurrent lung abscess. She came with high-grade fever, lethargy, and left flank pain. She had left lumbar tenderness and right-sided chest crepitations. Upon hospitalization, the patient developed septic shock. However, severity of her clinical presentation does not correlate with chest X-ray of right sided pneumonic changes and cavitation of the lungs on admission. Abdominopelvic computed tomography (CT) imaging revealed extensive left EPN (Huang-Tseng CT classification: class 4), early right EPN (Huang-Tseng CT classification: class 2), and right middle lobe lung abscess, which was treated with intravenous antibiotics, drainage, and optimal glycaemic management. This was followed by the resolution of sepsis and improvement in clinical status. [ABSTRACT FROM AUTHOR]

The aim is to evaluate the effect of viral inactivation methods on the quality and quantity of compounds in dried blood spots (DBS). Three effective and common inactivation methods were selected via the literature search, including: heating at 56 °C for 30 min, irradiation with UVC for 30 min, and surface wetting with 70 % ethanol. The concentration and clinical predicting significance of hormones, amino acids, and acylcarnitines from DBS were assessed, and the quality and quantity of extracted deoxyribonucleic acid (DNA) from DBS were evaluated. Compared to control, we found that there was no significant difference on hormones concentration in the DBS treated by heating at 56 °C for 30 min (thyroid stimulating hormone p=0.36, 17-hydroxyprogesterone p=0.52). And heating at 56 °C for 30 min had a minimal changed coefficient of variation on the concentration of amino acids and acylcarnitines. All three inactivation methods slightly changed the yield of DNA extraction, but did not affect the quality of the DNA. Importantly, the three inactivation methods wouldn't change the clinical predicting significance of above-compounds mostly, especially heating at 56 °C for 30 min. Considering the minimal effect on the quality and quantity of various compounds, the contaminated DBS could be pretreated by the three inactivation methods, as temporary emergency inactivation methods, especially heating at 56 °C for 30 min. [ABSTRACT FROM AUTHOR]

Although immunoassays are the most widely used protein measurement method, aptamer-based methods such as the SomaScan platform can quantify up to 7000 proteins per biosample, creating new opportunities for unbiased discovery. However, there is limited research comparing the consistency of biomarker-disease associations between immunoassay and aptamer-based platforms. In a substudy of the TRIBE-AKI cohort, preoperative and postoperative plasma samples from 294 patients with previous immunoassay measurements were analyzed using the SomaScan platform. Inter-platform Spearman correlations (rs) and biomarker-AKI associations were compared across 30 preoperative and 34 postoperative immunoassay-aptamer pairs. Possible factors contributing to inter-platform differences were examined including target protein characteristics, immunoassay, and SomaScan coefficients of variation, other assay characteristics, and sample storage time. The median rs was 0.54 (interquartile range [IQR] 0.34-0.83) in postoperative samples and 0.41 (IQR 0.21-0.69) in preoperative samples. We observed a trend of greater rs in biomarkers with greater concentrations; the Spearman correlation between the concentration of protein and the inter-platform correlation was 0.64 in preoperative pairs and 0.53 in postoperative pairs. Of proteins measured by immunoassays, we observed significant biomarker-AKI associations for 13 proteins preop and 24 postop; of all corresponding aptamers, 8 proteins preop and 12 postop. All proteins significantly associated with AKI as measured by SomaScan were also significantly associated with AKI as measured by immunoassay. All biomarker-AKI odds ratios were significantly different (P < 0.05) between platforms in 14% of aptamer-immunoassay pairs, none of which had high (rs > 0.50) inter-platform correlations. Although similar biomarker-disease associations were observed overall, biomarkers with high physiological concentrations tended to have the highest-confidence inter-platform operability in correlations and biomarker-disease associations. Aptamer assays provide excellent precision and an unprecedented coverage and promise for disease associations but interpretation of results should keep in mind a broad range of correlations with immunoassays.

Background: Gout is the most common inflammatory arthritis and closely related to metabolic syndrome, leading to excruciating pain and the decline in quality of patients' life. However, the pathogenesis of gout is still unclear, and novel biomarkers are demanded for the early prediction and diagnosis of gout. Objective: This study aimed at profiling the dysregulated metabolic pathways in asymptomatic hyperuricemia (AHU) and gout and elucidating the associations between AHU, gout and metabolomics, which may aid in performing gout screening. Methods: A total of 300 participants, including 114 healthy controls, 92 patients with AHU, and 94 patients with gout, were analyzed by using a combination of dried blood spot (DBS) sampling and mass spectrometry (MS) technology. Multiple algorithms were applied to characterize altered metabolic profiles in AHU and gout. The mainly altered metabolites were identified by random forest analysis. Results: There were significant differences in AHU and gout compared with control group. The altered metabolites were involved in oxidation of fatty acids, carnitine synthesis, urea cycle, and amino acid metabolism in AHU and gout. Random forest classification of 16 metabolites yielded 3 important features to distinguish gout from AHU. Conclusions: Distinct metabolomic signatures were observed in AHU and gout. The selected metabolites may have the potential to improve the early detection of gout. [ABSTRACT FROM AUTHOR]

Context Atherosclerosis is a systemic pro-inflammatory and pro-oxidative disease, accounting for approximately a third of deaths globally. It has been proposed that omega-3s, through their antioxidant and anti-inflammatory properties, mitigate atherosclerotic disease progression. However, due to the systemic pro-inflammatory and pro-oxidative state of atherosclerosis, it is proposed that patients with atherosclerotic disease may have higher omega-3 requirements than the average requirement, due to increased nutrient utilization in anti-inflammatory and anti-oxidant processes. Objective The aim of this review was to determine what dose and duration of omega-3 supplementation is required to reach a therapeutic blood level of omega-3s (eicosapentaenoic acid ≥150 µg/mL or omega-3 index ≥8%) in people with chronic atherosclerotic disease. Data Sources This systematic review comprehensively searched MEDLINE, Emcare, Scopus, and CINAHL using key search terms for atherosclerotic disease, omega-3, supplementation, and blood levels of omega-3s. Data Extraction Two reviewers independently screened 529 randomized controlled trials (RCTs) supplementing omega-3s in patients with chronic atherosclerotic disease. Data Analysis In total, 25 journal articles from 17 original RCTs were included and assessed quantitatively. Supplementation at 1.8 g to 3.4 g per day for a 3-month–6-month duration, and at 4.4 g and above for as little as 1 month–6 months were identified as the most effective dosage ranges for increasing blood levels of omega-3s to therapeutic levels in people with atherosclerotic disease. Conclusions Consideration should be given to routine omega-3 supplementation and to increasing the omega-3 dietary recommendations and upper limits of daily intake to improve clinical outcomes and reduce the risk of cardiac mortality in this population. [ABSTRACT FROM AUTHOR]

Objective The acid/molybdate assay performed on the Beckman Coulter AU5821 could be subject to paraprotein interference, which potentially results in spurious hyperphosphatemia. We attempted to find a reliable solution to eliminate paraprotein interference in laboratory test results and discuss the causes of paraprotein interference. Methods We observed 50 multiple myeloma patients with serum paraproteins. We used the trichloroacetic acid (TCA) deproteinizing method to confirm that paraproteins indeed interfered with phosphate detection in the serum acid/molybdate assay. Furthermore, we used the dry chemical method (Vitros 5.1 FS, Johnson) and deionized water (H2O), normal saline (NS), and healthy human serum as alternative diluents. We assessed the clinical acceptability of the 4 methods by evaluating a bias percentage (bias%) lower than 10% under the premise of TCA treatment as a serum phosphate reference method. Results In total, comparing the results of the TCA treatment on the Beckman Coulter AU5821, 3/50 (6%) multiple myeloma patients exhibited phosphate pseudo-elevation (bias% >10%). Additionally, we found pseudo-hypophosphate only in immunoglobulin (Ig)G-kappa paraprotein samples, and all were above 50 g/L. The bias% between TCA and dry chemical method for the 3 patients was below 10%. The maximum acceptable dilutions for patient 22 were 8-fold H2O, 4-fold H2O , and 2-fold serum; those for patient 45 were 16-fold H2O, 16-fold H2O, and 2-fold serum. However, the bias% of patient 40 was beyond the acceptable range in all 3 dilution groups. Conclusion High concentrations of IgG kappa–type paraproteins are more likely to interfere with serum phosphorous detection. Both the TCA and dry chemical method can effectively eliminate paraprotein interference. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of Zhenqi Buxue Oral Liquid (ZQ), progesterone capsules, and their combination in treating oligomenorrhea and hypomenorrhea with qi-blood and Kidney (Shen) essence deficiency. Methods: This was a prospective, randomized, multi-center controlled trial between June 2022 to December 2022. Ninety-six oligomenorrhea and hypomenorrhea patients with qi-blood and Shen essence deficiency were randomly assigned to receive ZQ (ZQ group, 29 cases), progesterone capsules (PG group, 32 cases), or the combined Chinese and Western medicine (COM group, 31 cases) at a ratio of 1:1:1. Patients in the ZQ or PG group took daily 10 mL twice a day of ZQ or 200 mg once a day of progesterone capsules for 10 consecutive days on day 15 of the menstrual cycle respectively, and patients in the COM group received the same ZQ combined with progesterone capsules. The treatment course lasted for 3 months and follow-up was performed at 1 and 3 months after the end of treatment. Primary endpoint was the menstrual Traditional Chinese Medicine Syndrome Scale (TCMSS) scores. Secondary endpoints included pictorial blood loss assessment chart (PBAC) scores, clinical efficacy rate, 36-item Short Form Health Survey (SF-36) scores, sex hormones and thickness of endometrium. Adverse events (AEs) were recorded. Results: TCMSS scores after 1- and 3-month treatment in all groups were significantly lower than those at baseline (P<0.05). Only TCMSS scores after 3-month treatment in the ZQ and COM groups continuously decreased compared with those after 1-month treatment in the same group (P<0.01). TCMSS scores after 3-month treatment in the ZQ and COM groups were significantly lower than those in the PG group (P<0.05, P<0.01). Compared with baseline, PBAC scores in the ZQ and COM groups after 3 months of treatment were also significantly higher (both P<0.01). The total effective rates of TCM syndrome of 3-month treatment were significantly improved in all groups compared with that after 1 month of treatment (P<0.05). The total effective rate of the COM group was the highest in the 3rd month of treatment and significantly higher than that of PG group alone (P<0.05). Compared with baseline, only the SF-36 scores of COM group were significantly improved after 3 months of treatment (P<0.05). No serious adverse reactions were observed after treatment. Conclusions: The combination of ZQ and PG, or ZQ only had better effects on reducing TCMSS scores compared with PG, and COM showed the higher total effective rate compared with monotherapy. Besides, COM could effectively improve menstrual blood loss and quality of life. ZQ combined with PG may be an effective and safe option for oligomenorrhea and hypomenorrhea patients with qi-blood and Shen essence deficiency. [ABSTRACT FROM AUTHOR]

Background: This single-center retrospective cohort study aimed to describe the findings and validity of Bilateral inferior petrosal sinus sampling (BIPSS) in the differential diagnosis of patients with ACTH-dependent Cushing's syndrome (CS). Methods: Eleven patients underwent BIPSS due to equivocal biochemical tests and imaging results. Blood samples were taken from the right inferior petrosal sinus (IPS), left IPS, and a peripheral vein before and after stimulation with desmopressin (DDAVP). ACTH and prolactin levels were measured. The diagnosis was based on the ACTH ratio between the IPS and the peripheral vein. Also, lateralization of pituitary adenoma in patients with Cushing's disease (CD) was predicted. No significant complications were observed with BIPSS. Results: Based on the pathology report, eight patients had CD, and three had ectopic ACTH syndrome (EAS). Unstimulated BIPSS resulted in a sensitivity of 87.5%, specificity of 100%, PPV of 100%, NPV of 75%, and accuracy of 91%. Stimulated BIPSS resulted in a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. However, pituitary magnetic resonance imaging (MRI) had a lower diagnostic accuracy (sensitivity:62.5%, specificity:33%, PPV:71%, NPV:25%, accuracy:54%). BIPSS accurately demonstrated pituitary adenoma lateralization in 75% of patients with CD. Conclusions: This study suggests that BIPSS may be a reliable and low-complication technique in evaluating patients with ACTH-dependent CS who had inconclusive imaging and biochemical test results. The diagnostic accuracy is improved by DDAVP stimulation. Pituitary adenoma lateralization can be predicted with the aid of BIPSS. [ABSTRACT FROM AUTHOR]

Objective. To investigate the targets and mechanisms of valsartan in the treatment of chronic renal failure based on network pharmacology and animal experiment validation. Methods. The objectives of using valsartan were predicted with the PubChem and SwissTargetPrediction databases. Relevant targets of chronic renal failure have been searched in various disease databases, with the common purposes of drugs and diseases extracted. Network analysis was carried out with the STRING database to construct a protein-protein interaction (PPI) network, as Cytoscape 3.9.1 software was used to analyze network topology of the key targets and establish the "valsartan-core target gene" network. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on core targets to explore their possible molecular mechanisms. The chronic renal failure mouse model was established by the plat method. Hematoxylin-eosin (H&E) and Masson staining observed morphological changes in renal problems of each group, as levels of serum Cre, BUN, T-SOD, and MDA in each group were detected by kit; real-time PCR was used to detect the relative expression of mRNA of TNF-αIL-1β, IL-6, and IL-10 in renal disease of mice in each group, with WB detect CALM, PKCα, and CaMKIV protein expression levels in renal disease from each group. Results. The network pharmacology approach identified 10 key targets for treatment of chronic renal failure with valsartan, including EGFR, PTGS2, PPARG, and ERBB2. KEGG enrichment analysis predicted that the drug exerted neuroactive ligand-receptor interaction, the calcium signaling pathway, the HIF-1 signaling pathway, the proteoglycans in cancer, PD-L1 expression, and the PD-1 checkpoint pathway in cancer. Results from animal experiments were compared to those of the model group, as renal function was significantly improved in the valsartan-dose group. The serum levels of Cre, BUN, and MDA and relative mRNA expression of TNF-α, IL-1β, and IL-6 decreased significantly, while serum T-SOD levels, relative mRNA expression of IL-10, and the protein expression level of CALM, PKCα, and CaMKIV increased significantly (P < 0.05 and P < 0.001). Conclusion. Valsartan yields certain renal protection, which may improve chronic renal failure in mice through the calcium signaling pathway. [ABSTRACT FROM AUTHOR]

Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P <.05), waist-to-hip ratio (WHR) (OR = 1.258; P <.05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P <.01), diastolic blood pressure (DBP) (OR = 1.304; P <.01), and HRR values (OR = 0.892; P <.05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia and sleep disorders are related to a decrease in physical and mental health and quality of life. The purpose of this study was to investigate the effect of sleep deprivation on blood sugar, cortisol and insulin levels in athletes compared to non-athletes. Methods: In this semi-experimental study, 14 healthy men participated in two groups of athletes (7 people) and non-athletes (7 people). One night of sleeplessness (8 hours) was applied to the subjects of both groups. According to the objectives of the research, blood samples were taken from all the subjects in two stages. The data were analyzed using the dependent t test for intragroup comparison and independent t test for inter-group comparison at a significance level of 5%. In conducting the research, the principles of the Declaration of Helsinki, the general guidelines for ethics in research with human subjects and the regulations governing it were observed and the code of ethics was issued by the ethics committee of Lorestan University. Results: Insomnia did not lead to a significant difference between the blood sugar and insulin levels of athletes and non-athletes when faced with a (p ≤ 0.05). Also, insomnia did not cause a significant difference in the amount of cortisol between two groups of athletes and nonathletes (p ≤ 0.05). Conclusions: It seems that changes in blood sugar, cortisol and insulin are related to the duration of insomnia and are not affected in short-term and intermittent insomnia. [ABSTRACT FROM AUTHOR]

Background Direct puncture of the superior ophthalmic vein (SOV) is an alternative approach to traversing the inferior petrosal sinus for embolization of carotid cavernous fistulas (CCFs). Objective To analyze direct SOV puncture for the treatment of CCFs and review the literature. Methods All patients at a single center, treated for a CCF with direct SOV cannulation between January 1, 2000, and December 31, 2020, were retrospectively analyzed. An additional review of the literature for all case series for direct puncture of the SOV for treatment of CCF was performed. Results During the 21- year study period, direct cannulation of the SOV for treatment of a CCF was attempted for 19 patients, with the procedure aborted for one patient because of an inability to navigate the wire into the distal aspect of the cavernous sinus. In 18 patients with direct SOV CCF treatment, 1 experienced a minor complication with an asymptomatic postoperative hemorrhage. Angiographic cure and improvement of symptoms were achieved in 17 patients with a mean (SD) follow- up of 6 (5.2) months. In the review of the literature, an additional 45 patients were reported to have direct cannulation of the SOV for CCF treatment, with angiographic cure in 43 (96%) and decreased objective visual acuity in 1 (2%). Conclusion Direct SOV cannulation to treat CCFs is safe and effective. Although it is typically used after other endovascular approaches have failed, SOV access for CCF treatment may be warranted as a first- line treatment for select patients. [ABSTRACT FROM AUTHOR]

Tenofovir diphosphate (TFV-DP) concentrations in dried blood spots (DBS) predict viral breakthrough, but their use remains understudied in real-world clinic settings. This pilot study examined acceptability, feasibility, and initial adherence outcomes of providing adherence feedback using TFV-DP concentrations on patient- and provider-levels in Cape Town, South Africa. We enrolled 60 persons with HIV (PWH) receiving tenofovir-containing ART attending a primary health clinic. They were randomized 1:1 to an intervention receiving TFV-DP concentration feedback by research staff vs. no feedback at monthly visits for 4 months. Acceptability among medical providers and level of clinical follow-up of TFV-DP results was examined. Patient acceptability was assessed descriptively. Mean electronic adherence (EA), as measured by WisePill device, and TFV-DP in DBS were compared between the two arms. All participants in the intervention group (100%) reported finding TFV-DP feedback helpful and 86% reported changing adherence behaviors. Medical providers indicated high acceptability of incorporating TFV-DP concentration feedback into the clinic, yet among 29 results < 1000 fmol/punch, only 2 were reviewed with no follow-up actions performed. In the intervention arm, mean TFV-DP concentrations were significantly higher (t = 2.5, p <.01) during follow-up and EA in upper quartile (96–100%) was greater compared to controls (x2 = 7.8, p ≤.05). This study found high acceptability among patients for receiving adherence feedback based on TFV-DP concentrations. TFV-DP and EA data demonstrated greater adherence in the intervention group. Providers indicated high acceptability of incorporating TFV-DP feedback into the clinic, but few providers reviewed results, which could impact clinic-level feasibility. [ABSTRACT FROM AUTHOR]

Background: Suboptimal antiretroviral (ART) adherence can lead to virologic failure with consequent HIV-1 resistance. Tenofovir diphosphate (TFV-DP) in dried blood spots (DBS) is a powerful biomarker of cumulative adherence, predictive of future viremia. It has been associated with resistance in Persons With HIV (PWH) in South Africa and the US. We explored the relationship of TFV-DP concentrations with antiretroviral drug resistance at the time of treatment failure in SA. Methods: Adult PWH from health clinics in Cape Town, South Africa on efavirenz-based first-line ART containing tenofovir disoproxil fumarate (TDF) with an undetectable (< 50 copies/mL) HIV-1 viral load (VL) were prospectively enrolled in an observational cohort for 12 months. Monthly study visits included blood collection for HIV-1 VL and DBS for TFV-DP. The first confirmed viral breakthrough (VB) > 400 copies/mL triggered HIV-1 genotyping at the subsequent visit. An electronic adherence (EA) device monitored ART adherence in real-time, estimated as a percent for the 30-days prior to VB. Wilcoxon rank sum test was used to compare median [IQR] TFV-DP by genotype outcome. Results: Of 250 individuals, (n = 195, 78% women), 21 experienced VB, with a median of 5 [4;7] months on study, and a median EA of 33.3 [13.3;53.3]%. Demographic characteristics between those with and without VB were similar. Median VL at VB was 4.0 [3.2;4.5] log copies/mL. TFV-DP concentrations trended down towards the VB visit. Median TFV-DP concentrations were significantly higher in those HIV-1 genotype did not amplify due to being virally suppressed at the subsequent visit (n = 10; 380 [227–661] fmol/punch, p = 0.035; EA 45 [24.9; 59.2]%); than in those who were successfully genotyped with evidence of drug resistance (n = 5, 241 [150–247] fmol/punch, EA 20 [6.7;36.7]%) and in individuals who did not have resistance (n = 3, 39.9 [16.6; 93.9] fmol/punch; EA 33.3 [16–38]%). Three genotype collections were not done. Only non-nucleoside reverse transcriptase inhibitor-associated mutations were identified on resistance testing. (K103N, E138K, Y118H). Conclusion: TFV-DP in DBS showed a step-wise inverse relationship with VB and drug resistance, with evidence of low cumulative ART adherence in PWH who developed antiretroviral resistance. Monitoring TFV-DP concentrations could be a valuable tool for predicting future VB and future resistance. [ABSTRACT FROM AUTHOR]