Articoli di riviste sul tema "341.4/8"

Background. Until now, the issue of the correlation between the cytokine balance and the progression of structural changes in the gastric mucosa remain completely uncertain. At the same time, the determination of the role of cytokine ba­lance as a component of gastric carcinogenesis will make it possible to substantiate new approaches to managing patients with atrophic gastritis. The purpose was to assess the level of pro- and anti-inflammatory cytokines, vascular endothelial growth factor (VEGF) at the stages of progression of structural changes in the gastric mucosa of patients with atrophic gastritis. Materials and methods. The study included 79 individuals with atrophic gastritis who underwent narrow band imaging endoscopic examination. The patients were divided into groups taking into account the revealed structural changes in the gastric mucosa: group I — 7 people with gastric mucosal atrophy without intestinal metaplasia (IM); group II — 16 individuals with gastric mucosal atrophy with IM limited by the antrum; group III — 45 people with diffuse IM against the background of gastric mucosal atrophy; group IV — 10 individuals with gastric mucosal dysplasia. In all patients, we assessed the level of interleukins (IL-8, IL-10, IL-18), tumor necrosis factor alpha (TNF-α), VEGF. Results. In patients of group IV, the concentration of IL-8 in the blood serum was 18.6 (11.3; 23.9) pg/ml that was significantly higher than in group I (by 5.0 times, p < 0.05), group II (by 3.6 times, p < 0.05) and group III (by 3.4 times, p < 0.05). According to the results of the Kruskal-Wallis test, the probability of a difference in the IL-8 level between the groups was 0.0260. The level of VEGF in the blood serum of patients with gastric mucosal dysplasia was significantly increased compared to that in people with gastric mucosal atrophy without IM (by 1.8 times, p < 0.05) and those with gastric mucosal atrophy with IM (by 1.7 times, p < 0.05). Changes in the cytokine balance towards proinflammatory cytokines were most pronounced in patients of groups III and IV; according to the results of the Kruskal-Wallis test, the probability of a difference in the IL-8/IL-10 ratio between the groups was 0.0207. Conclusions. With the progression of structural changes in the gastric mucosa of patients with atrophic gastritis, an increase in the level of proinflammatory cytokines (IL-8, IL-18 and TNF-α) in the blood serum does not induce the secretion of anti-inflammatory cytokines (IL-10). According to the results of the ROC analysis, the diagnostic criteria for the formation of the risk group for detecting dysplastic changes in the gastric mucosa are VEGF level of more than 341.4 mU/ml (sensitivity — 90.0 %, specificity — 77.2 %) and the level of IL-8 above 14.4 pg/ml (sensitivity — 80.0 %, specificity — 78.3 %).

ABSTRACT BACKGROUND Apples are rich in bioactive polyphenols and fiber. Evidence suggests that consumption of apples or their bioactive components is associated with beneficial effects on lipid metabolism and other markers of cardiovascular disease (CVD). However, adequately powered randomized controlled trials are necessary to confirm these data and explore the mechanisms. OBJECTIVE We aimed to determine the effects of apple consumption on circulating lipids, vascular function, and other CVD risk markers. METHODS The trial was a randomized, controlled, crossover, intervention study. Healthy mildly hypercholesterolemic volunteers (23 women, 17 men), with a mean ± SD BMI 25.3 ± 3.7 kg/m2 and age 51 ± 11 y, consumed 2 apples/d [Renetta Canada, rich in proanthocyanidins (PAs)] or a sugar- and energy-matched apple control beverage (CB) for 8 wk each, separated by a 4-wk washout period. Fasted blood was collected before and after each treatment. Serum lipids, glucose, insulin, bile acids, and endothelial and inflammation biomarkers were measured, in addition to microvascular reactivity, using laser Doppler imaging with iontophoresis, and arterial stiffness, using pulse wave analysis. RESULTS Whole apple (WA) consumption decreased serum total (WA: 5.89 mmol/L; CB: 6.11 mmol/L; P = 0.006) and LDL cholesterol (WA: 3.72 mmol/L; CB: 3.86 mmol/L; P = 0.031), triacylglycerol (WA: 1.17 mmol/L; CB: 1.30 mmol/L; P = 0.021), and intercellular cell adhesion molecule-1 (WA: 153.9 ng/mL; CB: 159.4 ng/mL; P = 0.028), and increased serum uric acid (WA: 341.4 μmol/L; CB: 330 μmol/L; P = 0.020) compared with the CB. The response to endothelium-dependent microvascular vasodilation was greater after the apples [WA: 853 perfusion units (PU), CB: 760 PU; P = 0.037] than after the CB. Apples had no effect on blood pressure or other CVD markers. Conclusions These data support beneficial hypocholesterolemic and vascular effects of the daily consumption of PA-rich apples by mildly hypercholesterolemic individuals. This trial was registered at clinicaltrials.gov as NCT01988389.

The risk of maturation failure in arteriovenous fistula (AVF) remains high. Curcumin poses antioxidant effects may enhance AVF maturation. This study evaluates the antioxidant effect of Curcumin on AVF maturation among type 2 diabetic patients (T2DM) with end-stage renal disease (ESRD). This was a single-blinded, randomized controlled trial conducted in three tertiary hospitals in Jakarta, Indonesia. Patients underwent the first hemodialysis. A total of 67 patients divided into groups of Curcumin, acetylsalicylic acid, and placebo. After 4 weeks, TAC level among the curcumin group was significantly higher compared to acetylsalicylic acid, and placebo groups 794.2(457.4±1473.7) µM vs. 519.2(247.7 ± 1027.7) µM and 794.2(457.4± 1473.7) µM vs. 542.5(281.91± 1054.64) µM, respectively (p<0.05). Also, TAC after 8 weeks was significantly higher among curcumin group compared to acetylsalicylic acid, and placebo groups (820.5(380.7± 1643.7) µM vs. 509.7(341.0± 981.91) µM and 820.5(380.7± 1643.7) µM vs. 497.7(324.7± 979.2) µM, respectively (p<0.001). The TAC level patients with mature AVF were also higher. A 2000 mg/day of curcumin increases antioxidant capacity after 4 and 8 weeks following AVF surgery among ESRD with T2DM.

The purpose of this study was to evaluate the nutritional adequacy and suitability of rice polish and mustard oil cake as protein sources in the diet of Nile Tilapia (Oreochromis niloticus). To assess the growth performance and feed utilization of Nile Tilapia, three diets containing rice polish (0, 8, and 16%) and mustard oil cake (8, 16, and 24%) were formulated and fed to the fish over a period of 60 days. According to the findings, the growth performance tended to decline as the levels of rice polish and mustard oil cake increased. The control diet (30% Fish meal) resulted in the highest weight gain (373.79±49.78%), whereas the diet (20% Fish meal) resulted in the least weight gain (341.24±27.23%). The specific growth rate (SGR) followed the same pattern, and there were no statistically significant differences in SGR between diets (p>0.05). At the end of this trial, the feed intake (FI) of the various diets ranged between 32.37 g and 37.78 g per fish. Although feed conversion ratio (FCR) and protein efficiency ratio (PER) were not significantly different among diets (p>0.05), feed intake decreased as the incorporation of rice polish increased.

Cardiotomy suction enhances inflammation and fibrinolysis during cardiopulmonary bypass (CPB). Aprotinin has been shown to reduce the generalized inflammatory insults associated with CPB. The purpose of this study was to evaluate the effect of Aprotinin administration through cardiotomy suction on the inflammatory and fibrinolytic responses during CPB. A pig model of CPB was utilized including 8 animals divided into control and treatment groups. In the treatment group, Aprotinin was infused into the cardiotomy suction (3000 KIU/min), while the same volume of saline was infused in the control group. D-dimer, platelet count, and IL-8 level were analyzed from systemic and cardiotomy suction. It was found that Aprotinin significantly suppressed the increase in D-dimer levels in the systemic (476.3 ± 341.2 vs. 1218.8 ± 281.3 ng/ml, p < 0.05) and the cardiotomy suction (565.0 ± 192.5 vs. 1875.0 ± 125.0 ng/ml, p < 0.05). Platelet count fell in both groups during CPB, although the reduction was greater in the control (13.1 ± 5.1 vs. 37.9 ± 13.8 %, p < 0.05). In addition, IL-8 level in the suction solution was significantly lower in the Aprotinin group (56.5 ± 18.0 vs. 136.3 ± 14.8 pg/ml, p < 0.05). In conclusion, this study suggested that Aprotinin treatment of the cardiotomy solution might be an effective way of reducing fibrinolysis, platelet reduction, and inflammation associated with CPB.

Background. Extubation failure contributes to poor outcome of mechanically ventilated children, yet the prevalence and risk factors have been poorly studied in South African (SA) children. Objective. To determine the prevalence, risk factors and outcomes of extubation failure in an SA paediatric intensive care unit (PICU). Methods. This was a prospective, observational study of all mechanically ventilated children admitted to a tertiary PICU in Cape Town, SA. Extubation failure was defined as requiring re-intubation within 48 hours of planned extubation. Results. There were 219 episodes of mechanical ventilation in 204 children (median (interquartile range (IQR)) age 8 (1.6 - 44.4) months). Twenty-one of 184 (11.4%) planned extubations (95% confidence interval (CI) 7.2% - 16.9%) failed. Emergency cardiac admissions (adjusted odds ratio (aOR) 7.58 (95% CI 1.90 - 30.29), dysmorphology (aOR 4.90; 95% CI 1.49 - 16.14), prematurity (aOR 4.39; 95% CI 1.24 - 15.57), and ventilation≥48 hours (aOR 6.42 (95% CI 1.57 - 26.22) were associated with extubation failure. Children who failed extubation had longer durations of ventilation (231 hours (146.0 - 341.0) v. 53 hours (21.7 - 123.0);p<0.0001); longer duration of PICU (15 (9 - 20) days v. 5 (2 - 9) days;p<0.0001) and hospital length of stay (32 (21 - 53) days v. 15 (8 - 27) days;p=0.009); and higher 30-day mortality (28.6% v. 6.7%;p=0.001) than successfully extubated children. Conclusions. Extubation failure was associated with significant morbidity and mortality in our setting. Risk factors for extubation failure identified in our context were similar to those reported in other settings.

In septic condition, the skin normal flora Staphylococcal spp. may trigger local and sistemic skin infection. In this study antibacterial activity of cocoa ethanolic extract (CEE) against Staphylococcus aureus and Staphylococcus epidermidis infections was observed in vitro and in vivo. Ethanolic extract from unfermented cocoa beans was prepared as solution in the in vitro testing, while for in vivo testing the extract was prepared as cream. Agar well diffusion assay showed that CEE ranging from 7.8 mg/mL to 1000 mg/mL demonstrated inhibitory activity against growth of either S. aureus and S. epidermidis. Inhibitory activity of CEE was in concentration dependent manner, and was less potential than either cephalexin 4 x 10 -3 mg/mL or cefotaxime 8 x 10 -3 mg/mL. Linear regression of CEE concentration plotted against inhibition zone values ha dpredicted the minimum inhibitory concentrations (MIC) of CEE towards S. aureus and S. epidermidis were at 341.9 mg/mL and 359.7 mg/mL, respectively. Topical application of cream containing CEE at several concentrations (2%, 4%, and 8%) demonstrated healing properties towards incision wound infected with S. aureus and S. epidermidis cultures in rabbit-skin model. CEE cream promoted wound contraction and higher recovery rate than of base cream (negative control) but lower than mupirocin 2% cream. In S. aureus and S. epidermidis infected wound models, CEE cream 8% improved wound recovery to 72.7% and 86.1% from original rates of 23.5% and 34.7% (base cream application). Catechin and procyanidis are suggested playing roles in alleviation of wound inflammation and stimulation of extracellular matrix accumulation, thus accelerate the wound healing process. This study proposes utilization of cocoa bean as source of active ingredient for skin care products.

Abstract A field experiment was conducted for the autumn season in 2022 in an agricultural land in the province of Raranjia (Hamzawiyah), 10 km south of Babylon Governorate, the center of Hilla, in soil with sandy clay mixed texture to improve the growth efficiency of the Maize plants (Zea mays L.) Fajr 1 cultivar under water stress conditions by the effect of irrigation durations and the addition of different amounts of potassium sulfate. The experiment was designed in randomized complete block design (R.C.B.D) with three replicates. in a split - plots arrangement, as the irrigation periods included four levels, namely irrigation every (6, 8, 10 and 12) days as a main factor, while potassium sulfate included four levels (0, 150, 200 and 250) kg.h-1. The results achieved the duration of irrigation every 8 days significant superiority in the average on the highest, leaf area, leaves content of chlorophyll and the dry matter of plant, which amounted to 177.8 cm, 519.3 cm 2, 47.9 SPAD and 428.5 g, while the duration of irrigation every 12 days was significantly reduced in reducing some vegetative growth characteristics, as the average yield of dry matter reached 341.9 g and the level of potassium sulfate added significantly affected the increase in vegetative of growth indicators such as plant height, leaf area, dry weight and leaf content of chlorophyll, and the potassium level of 250 kg.h-1 achieved the highest values among other potassium levels for the same traits, reaching 180.3 cm, 522.9 cm2, 432.1 g and 47.9 SPAD respectively, while the interaction between the two factors had a significant impact on most of the studied traits and gave interference Irrigation periods 8 days and potassium addition 250 kg.ha -1.

Development and validation of new simple, sensitive, accurate and precise spectrophotometric method involving ratio derivative and dual-wavelength method, was done as per ICH Q2 (R1) for simultaneous estimation of Sofosbuvir (SOFO) and daclatasvir dihydrochloride (DACLA) in a combined dosage form. The overlapping in the spectra of both drugs was the reason for the selection of both methods. The absorbance difference (ΔA) value between 235.8 nm and 270.6 nm was selected for the quantitative determination of SOFO, where DACLA gives equal absorbance at the selected wavelength in the dual-wavelength method (Method A). The determination of DACLA is done quantitatively by measuring the difference in absorbance value at 249 nm and 268.6 nm where SOFO gives equal absorbance at a selected wavelength. Ratio spectra method (Method B) was based on dividing the spectra of a mixture with standard spectra of one of the analytes, and the first derivative spectra was recorded with Δλ = 8 nm and scaling factor 1. The amount of SOFO and DACLA was estimated in the binary mixtures by computing the first derivative signal at 247.0 nm and 341.0 nm, respectively. The calibration curve was linear in the concentration range of 10–90 μg/mL for SOFO and 4–20 μg/mL for DACLA for both the methods. The methods were successfully applied for the simultaneous determination of these drugs in combined dosage form with acceptable recoveries.

AbstractEight new intermetallic rare earth-ruthenium-magnesium compounds have been synthesized from the elements in sealed niobium ampoules using different annealing sequences in muffle furnaces. The compounds have been characterized by powder and single crystal X-ray diffraction. Sm9.2Ru6Mg17.8 (a=939.6(2), c=1779(1) pm), Gd11Ru6Mg16 (a=951.9(2), c=1756.8(8) pm), and Tb10.5Ru6Mg16.5 (a=942.5(1), c=1758.3(4) pm) crystallize with the tetragonal Nd9.34Ru6Mg17.66 type structure, space group I4/mmm. This structure exhibits a complex condensation pattern of square-prisms and square-antiprisms around the magnesium and ruthenium atoms, respectively. Y2RuMg2 (a=344.0(1), c=2019(1) pm) and Tb2RuMg2 (a=341.43(6), c=2054.2(7) pm) adopt the Er2RuMg2 structure and Tm3Ru2Mg (a=337.72(9), c=1129.8(4) pm) is isotypic with Sc3Ru2Mg. Tm3Ru2Mg2 (a=337.35(9), c=2671(1) pm) and Lu3Ru2Mg2 (a=335.83(5), c=2652.2(5) pm) are the first ternary ordered variants of the Ti3Cu4 type, space group I4/mmm. These five compounds belong to a large family of intermetallics which are completely ordered superstructures of the bcc subcell. The group-subgroup scheme for Lu3Ru2Mg2 is presented. The common structural motif of all three structure types are ruthenium-centered rare earth cubes reminicent of the CsCl type. Magnetic susceptibility measurements of Y2RuMg2 and Lu3Ru2Mg2 samples revealed Pauli paramagnetism of the conduction electrons.

Poor supervision, impaired exercise adherence, and low compliance with exercise regimens result in inconsistent effects regarding exercise interventions. A supervised-walk training regimen (9 km/week) may have a positive effect on functional recovery in female total knee arthroplasty (TKA). This study aimed to evaluate the effect of a supervised walking regimen on lower limb muscle strength, functional fitness, and patient-reported outcomes in female TKA. Twenty-eight female TKA were allocated into a control (CON) (n = 14) or walk training (WT) (n = 14) group. WT on treadmills was initiated 12 weeks after TKA. All patients were examined for lower muscle strength (including extension and flexion of hip and knee), physical function (including a 6-min walk test, 8-foot up-and-go test, and 30-s chair stand test), and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Knee flexor (WT: CON; 64.4 ± 4.1 nm/kg: 43.7±3.3 nm/kg; p = 0.001; effect size: 5.62) and extensor strengths (WT: CON; 73.1 ± 7.5 nm/kg: 48.2 ± 2.4 nm/kg; p = 0.001; effect size: 4.47) statistically increased in the WT group compared to the CON group. The 6-min walk test (from 341.3 ± 20.5 m to 405.5 ± 30.7 m; p = 0.001; effect size: 2.46) and 8-foot up-and-go test (from 9.5 ± 0.7 s to 8.3 ± 0.7 s; p = 0.002; effect size: 1.71) tests also showed significant improvements in the WT group in the follow-up compared to the baseline. An increase in quality of life score according to the KOOS questionnaire (WT: CON; 91.0 ± 2.8: 68.1 ± 5.8; p = 0.001; effect size: 5.02) was noted in the WT group compared to the CON group in the follow-up. WT facilitated improvements in knee muscle strength and functional outcomes in TKA patients.

Diabetic macular oedema is still a significant cause of vision drop in the diabetic patient with no definitive regime for treatment. This study was on the result of effects of intravitreal injection of (2mg) triamcinolone on central macular thickness measured by OCT, visual acuity and intraocular pressure in pseudophakic eyes with diabetic macular oedema as a primary treatment line followed in six months. This study is a prospective, interventional case study series. It was on patients who received intravitreal injection of Triamcinolone in a single dose of ( 2 mg/0. 05 ml). Central macular thickness by OCT, visual acuity, and intraocular pressure was measured pre-injection and 1,3,6 months after injection. This study was performed in Iraq, Baghdad, Ibn Al-Haitham Teaching Eye Hospital from October 2014 to July 2015. Results showed 25 eyes received intravitreal injection of Triamcinolone Acetoniod with pre-injection central macular thickness 597.9+98.02 µm, visual acuity 1.096+0.61 Log MAR and intraocular pressure of 16.5+ 2.53 mmHg. After six months of follow up on central macular thickness 341.6+163.1 µm, visual acuity was 0.63 + 0.40 Log MAR and IOP was 18. 04+ 5. 63mmHg. This study suggests that intravitreal injection of Triamcinolone in a dose 2mg / 0. 05ml improves both anatomical and visual outcome in 21 eyes (84%) out of 25 pseudophakic eyes with diabetic macular oedema during first six months after injection and an increase in intraocular pressure in 2 eyes (8%). The intraocular pressure was despite the use of anti-glaucoma medications during this period.

Abstract Background and study aims Oropharyngeal dysphagia (OPD) is prevalent in patients with Parkinson’s disease (PD). Upper esophageal sphincter (UES) dysfunction is an important pathophysiological factor for OPD in PD. The cricopharyngeus (CP) is the main component of UES. We assessed the preliminary efficacy of cricopharyngeal peroral endoscopic myotomy (C-POEM) as a treatment for dysphagia due to UES dysfunction in PD. Patients and methods Consecutive dysphagic PD patients with UES dysfunction underwent C-POEM. Swallow metrics derived using high-resolution pharyngeal impedance manometry (HRPIM) including raised UES integrated relaxation pressure (IRP), raised hypopharyngeal intrabolus pressure (IBP), reduced UES opening caliber and relaxation time defined UES dysfunction. Sydney Swallow Questionnaire (SSQ) and Swallowing Quality of Life Questionnaire (SWAL-QOL) at before and 1 month after C-POEM measured symptomatic improvement in swallow function. HRPIM was repeated at 1-month follow-up. Results C-POEM was performed without complications in all (n = 8) patients. At 1 month, there was an improvement in both the mean SSQ (from 621.5 to 341.8, mean difference –277.3, 95 %CI [–497.8, –56.7], P = 0.02) and SWAL-QOL (from 54.9 to 68.3, mean difference 9.1, 95 %CI [0.7, 17.5], P = 0.037) scores. Repeat HRPIM confirmed a decrease in both the mean UES IRP (13.7 mm Hg to 3.6 mm Hg, mean difference –10.1 mm Hg, 95 %CI [–16.3, –3.9], P = 0.007) and the mean hypopharyngeal IBP (23.5 mm Hg to 10.4 mm Hg, mean difference –11.3 mm Hg, 95 %CI [–17.2, –5.4], P = 0.003). Conclusions In dysphagic PD patients with UES dysfunction, C-POEM is feasible and enhances UES relaxation and reduces sphincteric resistance to flow during the swallow, thereby improving dysphagia symptoms.

Abstract INTRODUCTION The Vigilant ObservatIon of GlIadeL WAfer ImplaNT (VIGILANT) registry (NCT02684838) was initiated to evaluate the use of BCNU wafers for treatment of CNS malignancies in contemporary practice and in the new era of molecular analysis. METHODS The VIGILANT registry is an observational study. Each patient receives usual care from treating physicians in routine quarterly visits, with no registry-specific visits required. The VIGILANT registry will enroll up to 500 patients at 35 US sites. Patients must be ≥18 years of age with no medical conditions increasing risk through participation. Patient follow-up will last 3 years. RESULTS The interim analysis is ongoing, with the following preliminary data. Of the 143 patients enrolled to date (mean age 59.8 ± 13.41 years, 60.1% male, 82.5% white), BCNU wafers have been implanted for newly diagnosed glioblastoma (GBM) in 49 (34.3%); for recurrent GBM in 48 (33.6%); for brain metastases in 28 (19.6%); for anaplastic oligodendroglioma in 4 (2.8%); and for other CNS tumors in 14 (9.8%). For patients with recurrent GBM, the median time from prior to current CNS tumor diagnosis was 341.5 days (IQR 88, 890). The majority of recurrent GBM patients had previously undergone systematic chemotherapy (87.5%) and radiation therapy (70.8%); only 8 (16.7%) had previously received BCNU wafers and only 4 (8.3%) had previously undergone alternating electric-field therapy. Of patients with brain metastases, 15 (51.7%) had previously undergone stereotactic radiosurgery. Of GBM patients with baseline biomarker assessments, MGMT promoter status was methylated in 52.1% (37/71), and IDH1 mutation status was positive in 15.9% (11/69). Median survival and contemporary practice patterns will be available at the time of presentation. CONCLUSIONS In the VIGILANT registry to date, BCNU wafers have been implanted most often and with equal frequency for treatment of newly diagnosed and recurrent GBM. Preliminary safety and efficacy data are pending.

The bottom trawl survey (430 stations) was conducted over the shelf and continental slope in the Russian sector of the Japan Sea (total depth range 10–750 m) on April 1 — July 8, 2015. In total, 211 taxa of invertebrates were recorded in the trawl catches. Most of them belonged to sea stars (36), shrimps (32), gastropods (27), bivalves (23), crabs and craboids (11), polychaetes (11), coral polyps (10), and sponges (10). The total biomass of macrozoobenthos in the surveyed area was assessed as 1572.5 . 103 t (136.6 . 103 t in Peter the Great Bay, 341.5 . 103 t at southern Primorye, 686.0 . 103 t at northern Primorye, and 408.4 . 103 t at western Sakhalin) that was higher than the mean long-term level. The total stock of commercial invertebrates was assessed as 630.0 . 103 t. Its highest portion (265.2 . 103 t or 42.1 %) was concentrated in the western Tatar Strait. The average biomass of macrozoobenthos was 13.5 ± 1.1 g/m2 , including 6.3 ± 0.5 g/m2 of commercial species. The most abundant groups were basket stars (372.2 . 103 t), crabs (231.6 . 103 t), shrimp (226.9 . 103 t), sponges (182.9 . 103 t), sea lilies (167.5 . 103 t), sea stars (77.2 . 103 t), sea urchins (59.0 . 103 t), craboids (48.7 . 103 t), and bivalves (49.5 . 103 t). Vertical distribution of both total and commercial benthos was distinguished by peaks on the upper shelf (10–50 m) and upper slope (300–400 m). Over the surveyed northern Japan Sea waters, 18 biocoenotic complexes of trawl macrozoobenthos were identified. The largest area was occupied by the complex of immobile sestonophagous sea lily Heliometra glacialis (131 stations in the depth range of 104–692 m with average biomass 5.5 g/m2 ), other wide-spread complexes were those of polyphagous snow crab Chionoecetes opilio (71 stations, 27–552 m, 4.4 g/m2 ), mobile sestonophagous basket star Gorgonocephalus eucnemis (40 stations, 58–372 m, 6.6 g/m2 ), and polyphagous fawn sea urchin Strongylocentrotus pallidus (40 stations, 17–351 m, 4.7 g/m2 ).

Abstract Lenalidomide (Len), an immunomodulatory drug, has significant clinical activity in patients with relapsed and refractory multiple myeloma (MM), and it is usually administered at a dose of 25 mg daily. For Len to exert its therapeutic effects with minimum adverse effects, it is important to determine the most suitable dosage on the basis of the physiques and body surface area (BSA) of patients. We investigated the relationship between pharmacokinetic variability of this drug and its toxicity and therapeutic efficacy. The institutional review boards and ethics committees at both participating centers approved the study protocol and all patients provided written informed consent. Thirteen Japanese patients with relapsed and refractory MM were enrolled in this study. They were treated with Len at 10-25 mg for 21 days every 4 weeks. The dose of Len administered to patients with renal dysfunction was reduced according to consensus statements on the optimal use of Len. Dexamethasone at 8-40 mg weekly was added to each drug cycle. Peripheral blood was collected three hours after Len administration in the first cycle and the plasma concentration of Len was evaluated using high performance liquid chromatography. Response and progression were assessed according to the International Myeloma Working Group criteria and the severity of adverse events was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. The median values of age (years) and estimated creatinine clearance (eCLcr, mL/min) of the 13 enrolled patients (male to female ratio=5:8) were 69 and 66.3, respectively. The number of patients in stages I, II, and III or the unknown stage of the International Staging System were 8, 1, 2, and 2, respectively. The number of the patients who achieved the best responses during three cycles of treatment were one (7.7%) in complete response, four (30.8%) in partial response, and eight (61.5%) in stable disease. The percentage of hematological adverse events (Grade 3/4) was 38.5% and no non-hematological events (Grade 3/4) were observed. The Len concentration ranged from 172.5 ng/mL to 555.6 ng/mL with a median concentration of 341.8 ng/mL. eCLcr values did not correlate with Len concentrations, but significantly correlated with C/D ratios (p <0.005, Figure 1). We next evaluated the correlation between Len concentration and the severity of adverse events. The percentage of patients with any Grade 1/2 adverse event and the percentage of those with Grade 3/4 adverse events were 61.5% (8/13) and 38.5% (5/13), respectively. A Receiver Operating Characteristic curve analysis of Len concentrations was used to determine an optimal cutoff value with the Youden index. The percentage of severely of any Grade 3/4 adverse event for patients with ≥ 320 ng/mL Len was 62.5% (5/8), and that of patients with <320 ng/mL was zero (0/5). The Fisher's exact test demonstrated that the severity of adverse effects significantly correlated with the Len concentration (Table 1, p <0.05). However, there was no correlation between Len concentrations and best responses. These findings indicate that it is possible to avoid severe adverse events without reducing therapeutic efficacy by monitoring Len concentrations. In conclusion, this pilot study suggests that it is important to determine the Len dosage on the basis of its plasma concentration. This issue should be clarified further in a large-scale study. Disclosures Kado: Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Kitazawa:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Fuchida:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Okano:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Hatsuse:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Murakami:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Ueda:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Kokufu:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment. Shimazaki:Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center: Employment.

This study was conducted to evaluate the efficacy of Saccharomyces cerevesiae as a growth promoting agent in tomato. Soaking the seeds in yeast suspension at 5 g/L for 12h increased germination percentage, root length, root fresh and dry weight, plant height, foliage fresh and dry weight, attained 88.5% ; 8.1 cm ; 84.3 mg ; 7.03 mg ; 10.75 cm ; 839 mg and 37.75 mg compared with 80% ; 5.33 cm ; 39 mg ; 4.8 mg ; 7.35 cm ; 608 mg and 25.5 mg in seedlings grown from non treated seeds respectively. Similar results were obtained with seedling from seeds soaked in S. cerevesiae filtrate for 12 hrs. with values of 77.5% ; 6.875 cm ; 91.5 mg ; 7.5 mg ; 9.5 cm ; 777 mg and 40.35 mg compared to 66% ; 5.8 cm ; 57.7 mg ; 5.03 mg ; 5.9 cm ; 493 mg and 27.28 mg in control (non treated seeds) for the same above criteria respectively. Watering the soil together with spraying the foliar parts with S. cerevesiae suspension at 5 and 8 g/L were found to be more effective than watering and spraying the plants separately in plant growth stimulation under plastic house conditions. The leaf contents of chlorophyll attained to 60.4 and 61.17 SPAD unit compared with 50.37 SPAD units in control respectively and leaf area reached to 3124 and 3119 cm2 / plant compared with 1904 cm2 / plant in control for the two concentrations respectively. The treatment induced also an increasing in plant high ; fresh and dry weights which attained 222 cm ; 223.3 cm ; 1485.7 g ; 1489 g ; 340.7 g ; 341.7 compared to 186 cm ; 1169.3 g ; 286 g in control for the two concentrations respectively. Similar increasing in root length , root fresh and dry weight and yields which attained 30.33 cm ; 30.7 cm ; 61 g ; 61.33 g ; 14.33 g ; 14.33 g ; 6.9 kg / plant and 6.95 kg / plant compared to 24.13 cm ; 46 g ; 10 g and 4.22 kg / plant in control , were found. The stimulations of plant growth criteria was found in concomitance with increase of N ; P and K in treated plant leaves which reached 2.293 ; 2.3 ; 0.4007 ; 0.402 ; 0.5506 and 0.5723% compared to 1.458 ; 0.2283 and 0.1226% in control for the two concentrations respectively . In addition increasing in total solid soluble material (TSS), 5.2 and 5.2023% compared to 3.867% in control treatment were observed.

Background: Russian state policy for health protection, rehabilitation, and health improvement requires studying regional mortality rates, including those related to COVID-19.Objective: To assess differences in COVID-19-related mortality between the regions of the same federal district.Materials and methods: Mortality data are sourced from death records in the Unified State Register of Civil Status Acts. The data were analyzed using unweighted arithmetic means, specific indicators, and standard deviation (the mean ± standard deviation). To eliminate the distortion by an age factor in mortality rates comparison, we replaced the age structure of the individual region’s population with that of Russia through indirect standardization of mortality rates. We used K-means clustering to group the regions by COVID-19-related mortality rates.Results: In 2021 Russia had 2,446,922 deaths, i.e. 648,615 (36.1%) and 163,645 (7.2%) cases more compared to 2019 and 2020, respectively. Of the total number, 17.3% of cases (424,252) had COVID-19 as a primary cause of death: nearly three times more than in 2020 (144,691 COVID-19-related deaths). Based on the average sizes of all individual age groups related to the respective region, nonstandardized and standardized COVID-19-related mortality rates were 265.30 ± 103.16 and 279.28 ± 91.07 per 100,000 persons in 2021, respectively. The cluster analysis showed that the largest number of regions (28 regions in 8 federal districts) comprised the third cluster with an average mortality rate of 276.26 ± 15.16 per 100,000 persons. The first cluster with an average mortality rate of 406.43 ± 29.26 per 100,000 persons included 12 regions in 7 federal districts. The second сluster included 21 regions (341.49 ± 18.16 per 100,000 persons) in 6 federal districts, the fourth cluster – 17 regions (196.73 ± 25.05 per 100,000 persons) in 6 districts, and the fifth cluster – 7 regions (87.22 ± 12.42 per 100,000 persons) in 5 districts.Conclusions: There is no common explanation for the COVID-19-related mortality differences not only between the regions of the same country but also between countries. This lack of understanding gets worse because one should also separate the pandemic’s health factors from social, psychological, and economic ones. The government should play a more important role in healthcare management, reform payment systems, and eliminate private financial intermediaries used to pay for medical services.Restrictions: The Unified State Register of Civil Status Acts data, which consisted of preliminary death certificates, may differ from the data of the Federal State Statistics Service, which became available to researchers later in 2022.

ImportancePatients with lower extremity peripheral artery disease (PAD) have reduced lower extremity perfusion, impaired lower extremity skeletal muscle function, and poor walking performance. Telmisartan (an angiotensin receptor blocker) has properties that reverse these abnormalities.ObjectiveTo determine whether telmisartan improves 6-minute walk distance, compared with placebo, in patients with lower extremity PAD at 6-month follow-up.Design, Setting, and ParticipantsDouble-blind, randomized clinical trial conducted at 2 US sites and involving 114 participants. Enrollment occurred between December 28, 2015, and November 9, 2021. Final follow-up occurred on May 6, 2022.InterventionsThe trial randomized patients using a 2 × 2 factorial design to compare the effects of telmisartan plus supervised exercise vs telmisartan alone and supervised exercise alone and to compare telmisartan alone vs placebo. Participants with PAD were randomized to 1 of 4 groups: telmisartan plus exercise (n = 30), telmisartan plus attention control (n = 29), placebo plus exercise (n = 28), or placebo plus attention control (n = 27) for 6 months. The originally planned sample size was 240 participants. Due to slower than anticipated enrollment, the primary comparison was changed to the 2 combined telmisartan groups vs the 2 combined placebo groups and the target sample size was changed to 112 participants.Main Outcomes and MeasuresThe primary outcome was the 6-month change in 6-minute walk distance (minimum clinically important difference, 8-20 m). The secondary outcomes were maximal treadmill walking distance; Walking Impairment Questionnaire scores for distance, speed, and stair climbing; and the 36-Item Short-Form Health Survey physical functioning score. The results were adjusted for study site, baseline 6-minute walk distance, randomization to exercise vs attention control, sex, and history of heart failure at baseline.ResultsOf the 114 randomized patients (mean age, 67.3 [SD, 9.9] years; 46 were women [40.4%]; and 81 were Black individuals [71.1%]), 105 (92%) completed 6-month follow-up. At 6-month follow-up, telmisartan did not significantly improve 6-minute walk distance (from a mean of 341.6 m to 343.0 m; within-group change: 1.32 m) compared with placebo (from a mean of 352.3 m to 364.8 m; within-group change: 12.5 m) and the adjusted between-group difference was −16.8 m (95% CI, −35.9 m to 2.2 m; P = .08). Compared with placebo, telmisartan did not significantly improve any of the 5 secondary outcomes. The most common serious adverse event was hospitalization for PAD (ie, lower extremity revascularization, amputation, or gangrene). Three participants (5.1%) in the telmisartan group and 2 participants (3.6%) in the placebo group were hospitalized for PAD.Conclusions and RelevanceAmong patients with PAD, telmisartan did not improve 6-minute walk distance at 6-month follow-up compared with placebo. These results do not support telmisartan for improving walking performance in patients with PAD.Trial RegistrationClinicalTrials.gov Identifier: NCT02593110

Abstract BACKGROUND There are few FDA-approved therapies for pediatric patients with inflammatory bowel disease (IBD). Clinical remission rates plateau at 60%, even with the currently available biologic therapies. Nutraceuticals are novel alternative treatments that can be used as adjunct treatments. AIM In this case series of 8 patients, we aim to present the clinical and radiological response to a novel nutraceutical agent, CurQD, composed of QingDai (Indigo Naturalis) and Curcumin. METHODS Patients included required a baseline pre-treatment clinical assessment and at least a single follow-up examination. Clinical status was evaluated based on the Physician General Assessment (PGA, determined independently from the clinical scoring systems) and the pediatric Crohn’s disease activity index (PCDAI) or the pediatric ulcerative colitis activity index (PUCAI), as appropriate. Baseline biomarkers (Hgb, ESR, CRP, albumin, and calprotectin(FC)) were collected pre and post-treatment when available. When available, intestinal ultrasound (IUS) features were also noted. On the IUS, bowel wall thickness (BWT, in mm) and color Doppler signaling (measured by the modified Limberg score graded 0,1,2, or 3 based on severity) were collected. The longitudinal changes were demonstrated on the most inflamed segment. Considering the small sample size, only descriptive statistics were applied. RESULTS Primary therapies received included anti-TNFα for 3 patients, ustekinumab in 3 patients, 1 on vedolizumab, and mesalamine in 1. Baseline assessment was done at a median time of 1.8 weeks (IQR 0.9-3.6 weeks) before starting the supplement, and the follow-up was 3.9 weeks (IQR 2.8-5.4 weeks) after starting the supplement. Two patients were in clinical remission at baseline but had active disease based on Doppler activity on IUS, 3 patients had mild active disease, and 3 patients had either moderate or severe disease activity. At follow-up, all patients but one were in clinical remission. (Table 1) Median baseline FC decreased from 1047.4 ug/g (IQR 532.4-1107) to 27.1 (IQR 27.5-341.3). Five patients had complete IUS information. When isolating the most inflamed segment on IUS, all patients demonstrated a response to treatment, noted by a decrease in BWT and/or a decrease in Doppler signaling. (Figure 1) No patient had a baseline therapy change after their follow-up. One patient reported abdominal bloating after starting CurQD and discontinued the product after five weeks. CONCLUSION CurQD is a promising nutraceutical that may assist in breaking the therapeutic ceiling of biological therapies in IBD. Based on this small experience, a larger randomized controlled trial in children would be needed to assess the safety and efficacy of this product in this vulnerable patient group. Furthermore, IUS is a practical tool for evaluating response to therapy in a pragmatic clinical setting. Table 1 Change in clinical disease scores in patients receiving CurQD Figure 1 Description of changes in a) bowel wall thickness (BWT) and b) color Doppler signaling (measured by the modified Limberg score) in patients treated with CurQD.

Abstract Background: Pediatric venous thromboembolism (VTE) is a rare but serious medical condition resulting in significant morbidity, mortality and healthcare costs. In the recent decade, the rate of general pediatric VTE has dramatically increased across all age ranges, from neonates to adolescents. This increase is likely multi-factorial, including more aggressive management of critically ill patients, improved survival of children with chronic disease and the increased use of central venous catheters (CVCs). Cystic fibrosis (CF) is a chronic, inflammatory disease process often managed with courses of intravenous antibiotics administered through CVCs, both peripherally inserted central catheters (PICC) and implantable venous ports. There are limited data documenting an increased risk of VTE in CF patients with ports. However, there are no published data on PICC line-associated VTE or overall VTE incidence specifically in the pediatric CF population. Methods: A retrospective cohort study was conducted in CF patients, ages 0 to 21 years, followed at the CF Care Center at Children's Hospital Colorado between 2003 and 2016, who were enrolled in the national CF Foundation Patient Registry. VTE cases were identified by informatics, including anticoagulation administration, documentation of VTE in radiographic reports and nursing flowsheets, and use of VTE ICD-9 and ICD-10 codes. All identified cases were confirmed by manual chart review and data including personal and family history of VTE, use of prophylaxis and VTE type, diagnosis date, diagnostic modality and line-association were entered into a secured REDCap longitudinal database. Data including CF mutation, CF co-morbidities, microbiology history, pulmonary function testing, disease modifying medications, thrombophilia testing and central line specifications and duration were collected for every admission on all study participants to allow for future risk factor analysis. Results: The cohort consisted of 488 participants with a total of 2,590 admissions (mean 5.34 per participant, range 1-56). Two hundred and forty-nine individuals were male (51%) and the majority were Caucasian (463, 95.3%) with a normal BMI (average 19.7, range 14.8-25.4). A total of 1,157 CVCs were placed over the study period including 981 PICCs (84.8%), 93 ports (8%) and 83 unspecified (7.2%). Thirty-one VTEs were diagnosed in 23 participants (4.3%) on 29 admissions (1.12%). Twelve of the 23 participants with VTE were male (52%) and the average age of those with VTE was 15.3 years (range 4-21). Twenty-two of the VTEs were deep vein thromboses, including 4 pulmonary emboli, and 9 were in superficial veins. The average day of VTE diagnosis was hospital day 4.9 (range 0-14). At the time of diagnosis, 11 had ports, 15 had PICCs and 5 had no CVC. The majority of VTEs were associated with the CVC (19, 61.3%) and of those CVC-associated VTEs, the majority were seen with PICCs (14, 73.7%). On average, PICC-associated VTE occurred on line day 5.2 (range 2-14) and port-associated VTE occurred on line day 897.5 (range 37-1496). Of the 23 participants with VTE, 14 were tested for Factor V Leiden mutation and 2 were heterozygous. Similarly, for the prothrombin mutation, 13 were tested and two were heterozygous. While the majority of participants had minimal to no thrombophilia evaluation, notably, an elevated factor VIII was associated with 11 of 12 VTE diagnoses (91.7%, average 215.47, range 61-341.3). Conclusion: In this large pediatric cohort of patients with CF, there was an increased number of VTE when compared to previously published general pediatric populations. Consistent with known risk factors, the average participant with VTE was in their teenage years and had a CVC, although 16% occurred without a line in place. Gender and obesity did not appear to contribute dramatically as the male/female distribution was roughly equal and the average BMI was within normal range. If a CVC was placed, the vast majority of CF patients received PICCs. PICCs also made up the majority of CVC-associated VTE with the average thrombosis occurring on day 5 following line placement. Few participants with VTE had complete thrombophilia evaluations but of those that did, factor VIII was elevated in all but one individual. Disclosures Wang: HEMA Biologics: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees; Baxalta: Membership on an entity's Board of Directors or advisory committees; LFB: Membership on an entity's Board of Directors or advisory committees; Biogen: Membership on an entity's Board of Directors or advisory committees; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees.

ABSTRACT Finger millet (Eleusine coracana (L) commonly known as ragi is an important crop used for food, forage and industrial products. Finger millet has a wide ecological and geographical adaptability and resilience to various agro-climatic adversities hence, it is highly suited to drought condition and marginal land and requires low external input in cultivation.. Farmers participatory field demonstrations of ragi variety Arjun and Bhairabi were conducted at two villages ie Pedawada of Malkangiri block and MPV -1 of Kalimela block of Malkangiri district, comprising 40 farmers in cluster approach in Kharif 2018 and 2019 , by Krishi Vigyan Kendra, Malkangiri , in South Eastern Ghat Zone of Odisha . Conducting front line demonstrations on farmer’s field help to identify the constraints and potential of the finger millet in the specific area as well as it helps in improving the economic and social status of the farmers. Observation on growth and yield parameters were taken and economic analysis was done. The final seed yield was recorded at the time of harvest and the gross return in (Rs ha -1) was calculated based on prevailing market prices. The results from the demonstration conclusively proved that finger millet variety Arjun (OEB-526) recorded the higher yield ( 18.8 q ha-1) , followed by Bhairabi ( 15.3 q ha-1) and farmer’s traditional variety Nali Mandia ( Dasaraberi) recorded an average yield of (8.6 q ha-1 ) . HYV Finger millet variety Arjun with proper nutrient management and plant protection measures gave 118 % higher over farmer’s practices. The technological and extension gap was 1.9 q ha-1 and 12.07 q ha-1 respectively. Similarly, technological index was 8.2 percent. The benefit cost ratio was 2.4 and 1.9 in case of Arjun and Bhairabi respectively and in case of farmer’s variety Nali Mandia it was 1.4. Hence the existing local finger millet variety can be replaced by HYV Arjun ans Bhairabi , since it fits good to the existing rainfed farming situation for higher productivity. By conducting front line demonstrations on millet on large scale in farmer’s field, yield potential of finger millet can be enhanced largely which will increase in the income level of farmers and improve the livelihood condition of the farming community. Introduction Among small millets, finger millet (Elusine coracana L,) locally known as Ragi/Mandia is the most important crop grown in tribal districts of Odisha and it is the staple food of the tribals. It was originated about 5000 years ago in east Africa (possibly Ethiopia) and was introduced into India, 3000 years ago (Upadhyaya et al., 2006) and it is highly suited to drought condition and marginal land and requires low external input in cultivation. Millet is a collective term referring to a number of small seeded annual grasses that are cultivated as grain crops, primarily on marginal lands in dry areas in temperate, subtropical and tropical regions (Baker, 1996). Nutritionally finger millet is superior to major cereal crops and rich source of micronutrients such as calcium, phosphorous, magnesium and iron. And it has several health benefits. Finger millet grains contain higher amount of proteins, oils and minerals than the grains of rice, maize or sorghum (Reed et al., 1976). Vadivoo and Joseph (1998) mentioned finger millet grains contain 13.24% moisture, 7.6% protein, 74.36% carbohydrate, 74.36% carbon, 1.52% dietary fiber, 2.35% minerals, 1.35% fat and energy 341.6 cal/100g. (Joshi and Katoch, 1990; Ravindran, 1991). It is a rich source of micronutrients such as calcium, phosphorus, magnesium and iron. Cysteine, tyrosine, tryptophan and methionine are the right spectrum of amino acids found in finger millet protein (Rachie, 1975). The increase in global temperature leads to climate changes that directly affect crop production and increase people's hunger and malnutrition around the world.. With regard to protein (6-8%) and fat (1-2%) it is comparable to rice and with respect to mineral and micronutrient contents it is superior to rice and wheat (Babu et al., 1987). It is also known for several health benefits such as anti-diabetic, anti-tumerogenic, atherosclerogenic effects, antioxidant, which are mainly attributed due to its polyphenol and dietary fiber contents. Being indigenous minor millet it is used in the preparation of various foods both in natural and malted forms. Grains of this millet are converted into flours for preparation of products like porridge, puddings, pancakes, biscuits, roti, bread, noodles, and other snacks. Besides this, it is also used as a nourishing food for infants when malted and is regarded as wholesome food for diabetic's patients. Diversification of food production must be encouraged both at national and household level in tandem with increasing yields. Growing of traditional food crops suitable for the area is one of the possible potential successful approaches for improving household food security. Malkangiri is one of the seven districts where a flagship programme called “Special Programme for Promotion of Millets in Tribal Areas of Odisha (hereafter, Odisha Millets Mission, (OMM)” has been launched by Department of Agriculture and Farmers Empowerment, Odisha in order to revive millets in rainfed farming systems and household consumption. It was started in kharif 2017 in four blocks of the district, namely Chitrakonda, Korkunda, Mathili and Khairiput. The Government of Odisha launched Odisha Millets Mission (OMM) also known as the Special Programme for Promotion of Millets in Tribal Areas of Odisha in 2017 to revive millets in farms and on plates. The aim was to tackle malnutrition by introducing millets in the public distribution system (PDS) and other state nutrition schemes. The focus is on reviving millets in farms and putting it on plates.” Millet, a nutritious and climate-resilient crop, has traditionally been cultivated and consumed by tribal communities in the rainfed regions of southern Odisha. Technology gap, i.e. poor knowledge about newly released crop production and protection technologies and their management practices in the farmers’ fields is a major constraint in Ragi production. So far, no systematic approach was implemented to study the technological gap existing in various components of Ragi cultivation. Awareness of scientific production technology like HYV of ragi, seed treatment with fungicide, use of insecticide and bio-fertilizers, is lacking in Malkangiri district which were a key reason for low productivity. The production potential could be increased by adopting recommended scientific and sustainable management production practices with improved high yielding varieties and timely use of other critical inputs. Objective The field experiment was undertaken to study the performance of three finger millet varieties Local Mandia (Nali Mandia), Bhairabi and Arjun in rainfed upland situation in kharif season. The present investigation was undertaken to evaluate the field performance of newly released finger millet varieties Arjun and Bhairabi under rainfed condition. The demonstrations were carried out in Malkangiri district covering two villages like Pedawada and MPV-6 to find out the existing technological and extension gap along with technology index with an objective to popularize the ragi varieties having higher yield potential. Material and methods The study was carried out in operational area of Krishi Vigyan Kendra (KVK), Malkangiri during Kharif season in the year 2018 and 2019. The study was under taken in Malkangiri and Kalimela blocks of Malkangiri district of Odisha and the blocks were selected purposefully as Finger millet is the major cereals crop grown in large area in Kharif season. The demonstrations were conducted in two different adopted villages Pedawada and MPV-6 in cluster approach. The Front Line Demonstration (FLD) is an applied approach to accelerate the dissemination of proven technologies at farmer’s fields in a participatory mode with an objective to explore the maximum available resources of crop production and also to bridge the productivity gaps by enhancing the production in national basket.The necessary steps for selection of site and farmers and layout of demonstrations etc were followed as suggested by Choudhary (1999). Forty numbers front line demonstrations on HYV Ragi were conducted in two clusters comprising 40 numbers of farmers. All the participating farmers were trained on various aspects of Ragi production technologies and recommended agronomic practices and certified seeds of Ragi variety Arjun and Bhairabi were used for demonstration. The soil of demonstration site was slightly acidic in reaction (pH-5.0 to 5.25) with sandy loam in texture and EC was 0.134 (dS m −1). The available nitrogen, phosphorus and potassium was between 214 .00, 22 .00, 142 .00 (Kg ha−1) respectively with 0.48 (%) Organic Carbon. The crop was sown in under rainfed condition in the first to second week of July. The crop was raised with recommended agronomic practices and harvested within 4th week of November up to 2nd week of December. Krishi Vigyan Kendra ( KVK), Malkangiri conducted front line demonstration with HYV varieties like Bhiarabi and Arjun and farmer’ local var Dasaraberi as check Finger millet Variety Arjun (OEB-526) is having Maturity duration 110 days and average yield 20.7q/ha with moderate resistance to leaf, neck and finger blast and brown seed and Bhairabi is a HYV of Ragi with Maturity duration 110 days and average yield 17.6 q/ha. Moderate resistance to leaf, neck blast and brown seeded and protein content 81%. Local variety Dsaraberi or Nali Mandia is having 105 days duration and drought tolerant variety used as farmers variety as local check . The technologies demonstrated were as follows: Popularization of high yielding Ragi variety, Seed treatment with Trichoderma viride @ 4g kg-1 seed , Line sowing with, soil test based fertilizer application along with need based plant protection measures. The field was ploughed two times and planking was done after each plugging, Need based plant protection measures were taken; along with soil test based fertilizer application was done with fertilizer dose 40:30:60 kg. N: P2O5: K2O kg ha -1. In case of local checks existing practices being used by farmers were followed. The observations were recorded for various parameters of the crop. The farmers’ practices were maintained in case of local checks. The field observations were taken from demonstration plot and farmer’s plot as well. Parameters like Plant height, number of fingers per plant, length of finger , no of fingers per year, 1000 seed weight and seed yield were recorded at maturity stage and the gross returns (Rs ha -1 ) were calculated on the basis of prevailing market price of the produce. The extension gap, technology gap, technology index along with B: C ratio was calculated and the data were statistically analyzed applying the statistical techniques. Statistical tools such as percentage, mean score, Standard deviation, co-efficient of variation, Fisher‘s “F” test, were employed for analysis of data. The farmer’s practices (FP) plots were maintained as local check for comparison study. The data obtained from intervention practices (IP) and famers practices (FP) were analyzed for extension gap, technological gap, technological index and benefit cost ratio study as per (Samui et al., 2000) as given below. Technology gap = Pi (Potential yield) - Di (Demonstration yield) Extension gap = Di (Demonstration Yield) - Fi (Farmers yield) Technology index = X 100 Result and Discussion The results obtained from the present investigation are summarized below. The Table 1 depicts the major differences observed between demonstration package and farmer’s practices in ragi production in the study area. The major differences were observed between demonstration package and farmer’s practices were regarding recommended varieties, seed treatment, soil test based fertilizer application, keeping optimum plant population by thinning, weed management and plant protection measures. The data of Table 1 shows that under the demonstrated plot only recommended high yielding variety, proper weeding and optimum plant population maintaining by thinning and the farmers used herbicides and the farmers timely performed all the other package and practices. It was also observed that farmers were unaware about balanced fertilizer application, seed treatment, and use of fertilizers application and maintenance of plant population for enhancing the yield. Majority of the farmers in the study area were unaware about use of weed management practices. The findings are in corroborated with the findings of (Katar et al., 2011) From the Table 2 it was revealed that in the district Malkangiri the productivity of finger millet was 6.38 (q ha-1) as compare to state average productivity 8.67 (q ha-1), but there exists a gap between potential yield and farmers yield, which can be minimized by adoption High yielding varieties with improved management practices. The productivity of finger millet was very low in the district as the crop is mostly grown along the hillsides on sloppy land on light textured soil. It was also coupled with negligence in adoption of improved varieties no input like fertilizers use and no plant protection measures and improper method and time of sowing. However, there is a wide gap between the Potential and the actual production realized by the farmers due to partial adoption of recommended package of practices by the growers. Several constraints contributed to yield fluctuation on Ragi production, including: unreliable rainfall; lack of high yielding variety ,disease tolerant varieties; pests and diseases incidence; low producer prices; poor agronomic practices; and lack of institutional support (Bucheyeki et al., 2008; Okoko et al., 1998). One of the central problems of ragi production and processing in this district is due to an uncertain production environment owing to rain fed cultivation, the low resource base of smallholder farmers and processors, and no scope for post harvest management and value addition facilities and poor marketing facility. The results clearly indicated from the Table 3 that the positive effects of FLDs over the existing practices. HYV Ragi Arjun recorded higher yield 18.8(q ha-1) followed by Bhairabi 15.53 (q ha-1) which was 21 % more and the yield performance of these two HYV varieties was higher than the farmer’s variety. This is due to higher of panicle length, more number of tillers and more number of fingers per panicle in HYV of ragi as compared to local variety. The results are in conformity with the findings of (Tomar et al. , 2003). The results clearly indicated the positive effects of FLDs over the existing practices towards enhancing the productivity. It is revealed form table 4 that, as the calculated ‘F’ value at α=0.05 level was found to be larger than table value, indicating significant difference in yield between farmer’s variety and recommended varieties. There was significant difference between average yield of ragi under Farmers practice (FP) and Recommended practice (RP) in variety Arjun under this demonstration. It was concluded that the yield of these HYV ragi varieties was significantly higher as compared to farmer’s variety. The economics and B:C ratio of farmers practice and Demonstration practice has been presented in Table 6. From the table it was revealed that Benefit: Cost ratio (B:C) was recorded to be higher under demonstrations against control treatments during all the years of experimentation. The cost of cultivation in HYV variety was higher due to more labour cost involved in transplanting and also it included cost of fertilizers and plant protection chemicals and also net returns was higher as compared to farmer’s practice. The B: C ratio was found to be 2.4 in case of variety Arjun as compared to 1.9 in case of variety Bhairabi. The results on economic analysis indicated that HYV ragi Arjun and Bhairabi performed better than local variety Ragi. The HYV variety Arjun recorded higher gross return upto Rs 54,332 and followed by Bhairabi Rs 44,289 per ha which was significantly higher than farmers practice and it was due to higher productivity of varieties under demonstration. Conclusion The results revealed that in Malkangiri district finger millet variety Arjun rerecorded highest yield followed by Variety Bhirabi with proper package and practices under rainfed upland condition. From the above study it was concluded that use of finger millet varieties like Arjun or Bhairabi with scientific methods and technological practices of can reduce the technological gap and enhance the productivity in the district. Yield improvement in Finger Millet in the demonstration was due to use of HYV seed and scientific management practices adopted by the farmers. Yield of Finger Millet can be increased to a great extent by conducting effective front line demonstrations in larger area with proven technologies. Finger millet is one of future smart food crop of India and can be grown in the drought condition. This crop is rich in nutrient for food insecurity and within few years because of increase in population of world and depletion of area of production.. The principal reasons of lower productivity of finger millet in the district Malkangiri were lack of knowledge among the farmers about cultivation of HYV finger millet varieties and improper fertilization, late season sowing and severe weed infestation in crop at critical stages. From the above findings, it can be concluded that use of scientific methods of Finger millet cultivation can reduce the technology gap to a considerable extent thus leading to increased productivity of millets in the district. Moreover, extension agencies in the district need to provide proper technical support to the farmers through different educational and extension methods to reduce the extension gap for better production. Acknowledgments The OUAT Bhubaneswar and ICAR-ATRI Kolkata, is acknowledged for financial support to the research program. Conflicts of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References: Babu, B. V.; Ramana, T.; Radhakrishna, T.M. Chemical composition and protein in hybrid varieties of finger millet. Indian J. Agric. Sci. 1987, 57(7), 520-522. Biplab, M.; Samajdar, T. Yield gap analysis of rapeseed-mustard through Front Line Demonstration. Agricultural Extension Review. 2010, 16-17. Bucheyeki, T. L.; Shenkalwa, E. M.; Mapunda, T. X.; Matata, L.W. On-farm evaluation of promising groundnut varieties for adaptation and adoption in Tanzania. 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Finger Millet: A “Certain” Crop for an “Uncertain” Future and a Solution to Food Insecurity and Hidden Hunger under Stressful Environments. Frontiers on Plant Sci. 2017, 8, 643 Joshi, H. C.; Katoch, K. K. Nutritive value of millets: A comparison with cereals and pseudocereals. Himalayan Res. Dev. 1990, 9, 26-28. Kande, M.; Dhami, N B.; Subedi, N.; Shrestha, J. Arjun. Field evaluation and nutritional benefits of finger millet (Eleusine coracana (L.) Gaertn.) 2019. Katare, S.; Pandey, S.K.; Mustafa, M. Yield gap analysis of Rapeseed-mustard through front line demonstration. Agriculture update. 2011, 6(2), 5-7. Lupien, J.R. Sorghum and millets in human nutrition. FAO, ICRISAT. At: ao.org. 1990, 86. Mohanty, B. Odisha Millet Mission: The successes and the challenges. 2020. 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USDA, USA. 1976. Samui, S K.; Maitra, S.; Roy, D K.; Mandal, A. K.; Saha, D. Evaluation of front line demonstration on groundnut. Journal of Indian Society of Coastal Agricultural Research. 2000, 18(2), 180-183. Singh, J.; Kaur, R..; Singh, P. Economics and Yield gap analysis of Front Line Demonstrations regarding Scientific practices of Indian Mustard in district Amritsar. Indian Journal of Economics and Development. 2016, 12(1a), 515. Singh, P.; Raghuvanshi. R. S. Finger millet for food and nutritional security. African Journal of Food Science. 2012, 6(4), 77-84. Srivastava, P.P.; Das, H.; Prasad, S. Effect of roasting process variables on hardness of Bengal gram, maize and soybean. Food Sci. Technol. 1994, 31(1), 62-65. Tomar, L. S.; Sharma, B. P.; Joshi, K. Impact of front line demonstration of soybean in transfer of improved technology. Journal of Extension Research. 2003, 22(1), 139. Upadhyaya, H.D.; Gowdaand C.L.L.; Reddy, V.G. Morphological diversity in finger millet germplasm introduced from Southern and Eastern. African Journal of SAT Agriculture Research. 2007, 3(1). ejournal.icrisat.org. Vadivoo, A.S.; Joseph, R. Genetic variability and diversity for protein and calcium contents in finger millet (Elusine coracona (L.) Gaertn) in relation to grain color. Plant Foods for Human Nutrition Dordrecht. 1998, 52, 353-364. Department of Botany, Avinashilingam Institute for Home Science and Higher Education for Women, Deemed University, Coimbatore, TN, 641 043, India.

Menopause and aging are associated with increased blood pressure. High fructose may modify the development of the pathologies associated with these conditions. The objective was to investigate the effects of exercise training (ET) in aged, oophorectomy mimic of menopause fructose-fed rats. Female Wistar rats (24 months old) were ovariectomized, fed with fructose (100g/L) in drinking water and divided in 5 groups (n=8/group): control (C), ovariectomized (O), ovariectomized trained (OT, n= 8), ovariectomized fructose (OF, n= 8) and ovariectomized fructose trained (OFT, n= 8). The ET was performed on a treadmill (1 h/day; 5 days/wk for 8 wk). The metabolic results showed that ET decreased adipose tissue in both trained groups (OT: 4.3±0.5, OFT: 5.3±0.7), compared with sedentary rats (C: 6.2± 0.6, O: 9.6±1.3, OF: 10.1±0.6, g). The same findings were observed for insulin resistance (OT: 4.6±0.2, OFT: 5.5±0.6 vs C: 3.2± 0.6, O: 3.2±0.3, OF: 4.0±0.5, mg/dl/min). ET increased physical capacity (OT: 20±0.9, OFT: 17.5±0.9 vs C: 11.5± 0.5, O: 10±0.5, OF: 10.3±0.5 Min/h). The hemodynamic results showed that ET attenuated the increase in MBP (C: 109.4± 1.9, OT: 103±1.1, OFT: 107±1.1 vs O: 119.1±1.9, OF: 119.1±2.7, mmHg) and HR (C: 341.4± 8, OT: 302±1, OFT: 306.4±8 vs O: 398.17±19, OF: 378.9±17 Bpm). The sympathetic tonus was decreased in C, OT and OTF (C: 63.6± 4, OT: 62.2±3, OFT: 51.2± 7 beats/ min) when compared with O and OF (O: 102.6±12, OF: 91.9±7 beats/min) while vagal tonus was increased just in OT (OT: 44.8±5) vs (C: 24.9± 6, OFT: 22±3, O: 13±6, OF: 9±2 beats/min). The OT and OTF groups showed an increased bradycardic response to BP changes (C: -1.50±0.06 OT: -1.74±0.12, OFT: -1.77±0.15 vs O: -0.93±0.07, OF: -1.21±0.12 bpm/mmHg). ET increased the Standard deviation of the pulse interval (C: 6.7±1.1 OT: 11.6±0.8, OFT: 13.0±1.5 vs O: 7.05±0.6, OF: 9.57±0.7 ms) and decreased VARR PAS (C: 6.7±1.09 OT: 23.6±0.8, OFT: 30.7±2.6 vs O: 56.4±8.1, OF: 40.5±3.7 mmHg2) as well as representative sympathetic modulation (LF PAS) (C: 6.7±1.1 OT: 3.6±0.5, OFT: 3.7±0.4 vs O: 9.8±1.2, OF: 8.3±0.8 mmHg. In conclusion, ET effectively improved metabolic and cardiovascular parameters altered by aged or excessive fructose consumption in rats submitted to ovarian hormone deprivation.

Abstract Study question Do patients with adenomyosis have an impaired inflammatory state of the endometrium that could affect implantation and pregnancy? Summary answer Adenomyosis patients show increased proinflammatory cytokines expression and deregulated decidualization markers expression in eutopic endometrium which could lead to altered endometrial receptivity and impaired implantation. What is known already Adenomyosis is an estrogen-dependent chronic inflammatory condition, characterized by the presence of endometrial glands and stroma within the myometrium. Adenomyosis patients present altered decidualization and defective embryo-endometrium communication, resulting in implantation failure, miscarriage, and other fertility-related disorders. Although the underlying mechanisms of this infertility remain unknown, it is known that a favorable immune and inflammatory uterine environment is necessary for developmental pregnancy. It has been proposed that a uterine hyperinflammatory state could be involved in adenomyosis-related infertility. For this reason, we aim to evaluate the inflammatory and endometrial receptivity status during implantation in eutopic endometrium from adenomyosis patients. Study design, size, duration Sixteen endometrial samples were collected from infertile patients with and without adenomyosis undergoing hormonal replacement therapy before in vitro fertilization (IVF) at IVIRMA Valencia between January to December 2022. Participants/materials, setting, methods Eutopic endometrial samples were obtained at secretory phase (LH + 7) from patients diagnosed with adenomyosis (n = 8) by ultrasound or hysteroscopy and patients without gynecological diseases (control, n = 8). Total RNA extraction was performed to later determine the gene expression of the decidualization-related genes Prolactin (PRL), SPP1 and PAEP by qRT-PCR. In addition, proteins were extracted from eutopic endometrium using a lysis buffer and the relative expression levels of human cytokines were measured by Human Cytokine Array (Raybiotech). Main results and the role of chance Gene expression evaluation in endometrium from adenomyosis patients compared to control showed a significant downregulation of the key marker of decidualization PRL (fold change [fc] = 0.56, p = 0.0047) and a significant upregulation of SPP1 (fc = 1.75, p = 0.009) and PAEP (fc = 1.56, p = 0.0192), both involved in endometrial receptivity and in immune regulation. Regarding cytokines expression, array results showed upregulation of different interleukins (IL) involved in the mediation of the immune and inflammatory response previously described in adenomyosis. Specifically, IL1ß (12±19.63 vs. 1.37±2.77, p = 0.009) that regulates several inflammatory responses, including cell proliferation, differentiation, and apoptosis; and IL6 (584.7±121.8 vs. 488.4±57.44, p = 0.06) that acts on the inflammation and maturation of B cells, contributing to the development of autoimmune diseases. Similarly, cytokines related to the promotion of inflammation and cellular proliferation in endometriosis, IL17a (173.6±44.75 vs. 102.10±71.85, p = 0.04) and TNFβ (430.9±139.6 vs. 315.3±37.09, p = 0.04), were also upregulated in adenomyosis compared to control. There were also other cytokines upregulated with diverse functions like an anti-inflammation response, growth factors or immune modulation: IL5 (308.1±88.77 vs. 202.6±45.72, p = 0.01), IL2 (341.4±60.38 vs. 270.8±35.13, p = 0.014), TGFα (215.3±27.04 vs. 117.8±36.67, p = 0.002), IL31 (77.74±40.57 vs. 14±15.96, p = 0.0012), IL7 (739.1±147.1 vs. 511.8±103.7, p = 0.003) and IL15 (301.9±95.73 vs. 209.8±50.62, p = 0.03). Limitations, reasons for caution Our findings are limited by the relatively small sample size and inherent biological variability of human samples. Wider implications of the findings Adenomyosis patients showed impaired decidualization and a hyperinflammatory endometrial environment that could be affecting the endometrial receptivity and consequently, the embryo implantation. These findings open insight to further investigations to study the mechanism by which exaggerated inflammation affects fertility in the context of adenomyosis to define new management approaches. Trial registration number Not applicable

AbstractBackgroundHuman leukocyte antigen (HLA) allele frequencies have a known association with the pathogenesis of various autoimmune diseases.MethodsWe recruited 31 Indian patients of acquired dermal macular hyperpigmentation (ADMH) and 60 unrelated, age‐and‐gender‐matched healthy controls. After history and clinical examination, 5 ml of blood in EDTA vials was collected. These samples were subjected to DNA extraction and the expression of HLA A, B, C, DR, DQ‐A, and DQ‐B was studied.ResultsThere was a predominance of females with a gender ratio of 23 : 8 and the most common phototype was Fitzpatrick type IV (83.9%). There was a significant association of HLA A*03:01 (OR: 5.8, CI: 1.7–17.0, P = 0.005), HLA B*07:02 (OR: 5.3, CI: 1.9–14.6, P = 0.003), HLA C*07:02 (OR: 4.3, CI: 1.8–9.6, P = 0.001), HLA DRB1*10:01 (OR: 7.6, CI: 1.7–38.00, P = 0.022), and HLA DRB1*15:02 (OR: 31.0, CI: 4.4–341.8, P < 0.001) with patients compared to controls, whereas HLA DQB*03:01 was less associated with patients compared to controls (OR: 0.2, CI: 0.0–0.6, P = 0.009).ConclusionPatients with ADMH are more likely to have the HLA A*03:01, HLA B 07*02, HLA C*07:02, HLA DRB1*10:01, HLA DRB1*15:02 and less likely to have the HLA DQB*03:01 allele. Larger cohort studies may thus be conducted studying these specific alleles.

Objective To evaluate the safety, efficiency, short term stability, and sensory results of photorefractive keratectomy (PRK) in anisometropic in non-compliant children with correction. Methods Twelve eyes of 12 children with an age range: 6–17 years and anisometropic amblyopia who underwent PRK under general anesthesia to correct the dioptric difference between the eyes were included in this study. A complete ophthalmic assessment including refractive status, uncorrected and corrected distance visual acuity (UDVA & CDVA), and binocular vision status using the Worth 4-dot test and stereopsis were performed before and 1, 3, 6, and 12 months after PRK. Results The mean preoperative CDVA was 0.34 ± 0.24 LogMAR which showed a statistically significant improvement at 12 months (0.20 ± 0.19, p = 0.024) after surgery compared to the preoperative assessment. (p = 0.003) The mean preoperative UDVA was 0.63 ± 0.24 LogMAR that increased to 0.44 ± 0.24, 0.32 ± 0.16, 0.25 ± 0.19, and 0.25 ± 0.19 LogMAR at 1, 3, 6, and 12 months after PRK, respectively. One to three lines improvement in UDVA and CDVA was seen in 10 (83.4%) and 8 eyes (66.7%); while one line UDVA and CDVA loss was seen in one (8.3%) and one (8.3%) eye and unchanged UDVA and CDVA was seen in 1 (8.3%) and 3 eyes (25%), respectively. The mean preoperative stereoacuity was 341.9 ± 245.7 s of arc, which significantly improved to 166.6 ± 87.5 s of arc 12 months after PRK. (p = 0.012) Conclusion PRK was an effective surgical alternative to improve visual acuity and stereopsis in anisometropic children who did not cooperate with conventional methods of amblyopia therapy.

Introduction: Glioblastoma Multiforme (GBM) is the most frequent malignant brain tumor, with an aggressive course and a short life expectancy despite standard treatment (chemotherapy and radiotherapy). The possibility of the development of Thrombotic Events (VTE) with this type of cancer is frequent. We designed this study to determine the risk of presenting VTE and hemorrhagic events in patients affected by GBM. Methods: Observational retrospective study of patients with GBM diagnosis at the General University Hospital of Ciudad Real between 2012 and 2015. The demographic characteristics of patients were studied, predictive models were compared, and a survival analysis was performed. Results: 77 patients were studied, 42 (55.3%)/34 (44.7%), men and women respectively, with an average age of 66.42 years. 13 (16.9%) presented VTE; of which 10 (61.54%) in the form of Deep Venous Thrombosis (DVT), 3 (23.08%) Pulmonary Embolism (PE) and 2 (15.38%) mixed events. The quality of life according to the performance status ECOG scale at the moment of diagnosis was 1 in 42 (15.38%) patients, and at the time of VTE, 5 (41.7%) had a value of 2, and 4 (33.3.3 %) registered 3. In the group that developed VTE according to the predictive model of risk for thrombosis in Khorana 5 (38.5%) had low risk and 8 (61.5%) intermediate; on the ASCO 2013 modified scale 5 (38.5%) had an Intermediate risk and 8 (61.5%) high. With a median, 1 year follow-up, 64 (84.2%) patients died, with an average time after the diagnosis of 279.09 days (216.6-341.6) (SE 31,8). 2 (2.6%) of the patients presented a greater haemorrhagic event and 7 (7.9%) cerebral haemorrhage, of which 4 (44.4%) had prophylactic Low Molecular Weight Heparins (LMWHs). In the survival analysis of Kaplan Meyer, patients who received prophylactic treatment with LMWHs had a higher survival rate with an average of 298.5 days compared to 239.3 of those who did not (p >0.05). There were no significant variables in the multivariate analysis for thrombotic or haemorrhagic events. Conclusion and Discussion: The demographic and clinical characteristics of our patients were similar to those reported in other international publications. The predictive scale of Khorana was not validated in our study, in contrast, the modified ASCO 2013 scale was closer to our results. The creation of a precise predictive model would help to delineate the benefit of prophylactic anticoagulation in high-risk patients. Long-term prophylaxis with LMWHs has demonstrated a reduction of thrombotic events without significantly increasing the fatal haemorrhagic episodes, also demonstrating greater long-term survival, independent of thrombotic events. Randomized prospective studies are needed to demonstrate its benefits.

Introduction: Glioblastoma multiforme (GBM) is the most frequent malignant brain tumor, with an aggressive course and a short life expectancy despite standard treatment (chemotherapy and radiotherapy). The possibility of the development of thrombotic events (VTE) with this type of cancer is frequent. Objective: To determine the risk of presenting VTE and haemorrhagic events in patients affected by GBM. Methods: Observational retrospective study of patients with GBM diagnosis at the General University Hospital of Ciudad Real between 2012 and 2015. The demographic characteristics of patients were studied, predictive models were compared, and a survival analysis was performed. Results: 77 patients were studied, 42 (55.3%) / 34 (44.7%), men and women respectively, with an average age of 66.42 years. 13 (16.9%) presented VTE; of which 10 (61.54%) in the form of deep venous thrombosis (DVT), 3 (23.08%) pulmonary embolism (PE) and 2 (15.38%) mixed events. The quality of life according to the performance status ECOG scale at the moment of diagnosis was 1 in 42 (15.38%) patients, and at the time of VTE, 5 (41.7%) had a value of 2, and 4 (33.3.3 %) registered 3. In the group that developed VTE according to the predictive model of risk for thrombosis in Khorana 5 (38.5%) had low risk and 8 (61.5%) intermediate; on the ASCO 2013 modified scale 5 (38.5%) had an Intermediate risk and 8 (61.5%) high. With a median, 1 year follow-up, 64 (84.2%) patients died, with an average time after the diagnosis of 279.09 days (216.6-341.6) (SE 31,8). 2 (2.6%) of the patients presented a greater haemorrhagic event and 7 (7.9%) cerebral haemorrhage, of which 4 (44.4%) had prophylactic Low molecular weight heparins (LMWHs). In the survival analysis of Kaplan Meyer, patients who received prophylactic treatment with LMWHs had a higher survival rate with an average of 298.5 days compared to 239.3 of those who did not (p> 0.05). There were no significant variables in the multivariate analysis for thrombotic or haemorrhagic events. Conclusion and Discussion: The demographic and clinical characteristics of our patients were similar to those reported in other international publications. The predictive scale of Khorana was not validated in our study, in contrast, the modified ASCO 2013 scale was closer to our results. The creation of a precise predictive model would help to delineate the benefit of prophylactic anticoagulation in high-risk patients. Long-term prophylaxis with LMWHs has demonstrated a reduction of thrombotic events without significantly increasing the fatal haemorrhagic episodes, also demonstrating greater long-term survival, independent of thrombotic events. Randomized prospective studies are needed to demonstrate its benefits.

Abstract Background A recent review of 86 patients with short or long-coupled premature ventricular complex (SLC-PVC) initiating idiopathic ventricular fibrillation (IVF) found high success rate in arrhythmia control with quinidine (QND) (83%) or radiofrequency ablation (RFA) (70.8%). Purpose To compare the efficacy of QND vs. RFA therapy in a large patient cohort with SLC-IVF. Methods THESIS included 287 patients with SLC-IVF screened from 58 centers and 1 multicenter group in 22 countries across 4 continents. The study cohort included 146 (50.9%) males, aged 39+14 years at the time of IVF documentation. Therapy groups were defined according to the first therapy given. Therapy success was defined as no VF recurrence. Results Patients presented after aborted cardiac arrest, ICD shocks, syncope, aborted cardiac arrest + arrhythmic storm, arrhythmic storm, palpitations, seizures or were asymptomatic in 121 (42%), 51(18%), 42(14.6%), 27 (9.4%), 23 (8%), 8 (2.8%), 6 (2.1%) and 9 (3.1%), respectively. Fifty-three patients (18.5%) had a prior history of syncope. Eleven (3.8%) patients required ECMO support. Mean shortest and longest coupling interval which triggered VF in the same patient were 304.9+82ms and 341.2+94.1ms, respectively. VF initiation with "long" coupled PVC (coupling interval &gt;350ms) was observed in 41 (18.1%) patients, and VF initiation with both short and long coupled PVC was documented in 30 (13.2%) others. RFA was performed in 112 patients and QND was given to 68 patients. Patients were followed during a mean follow-up of 84.8+64.5 months. Therapy success was achieved in the RFA or QND group in 69 (62.2%) and 49 (71%) patients, respectively (p=0.29). The RV Purkinje was the main targeted ablation site in 46 (47.4%) patients. Treatment success varied according to the site of origin (SOO) of the PVC which triggered VF. Therapy success was higher with QND when PVC SOO based on ECG, was the RV inflow tract (81.3% vs. 57.7%, p=0.048) or when the SOO was not available (67.9% vs 36.4%, p=0.064), and when the coupling interval/QT ratio was &lt;1 (75.5% vs. 57.5%, p=0.03), Figures 1,2. A higher success rate with ablation compared with QND was seen with LV- SOO compared with RV-SOO (82.1% vs 60.3%, p=0.019). Similarly, successful ablation was achieved in 83.3% (n=24) vs. 55.9% (n=68) patients with LV and RV-SOO respectively; p=0.004. One patient expired of sudden cardiac death due to misdiagnosis, while wearing a subcutaneous -ICD, without any drug or ablation therapy. Conclusions SLC-IVF strikes males and females equally. SLC-PVCs triggering the arrhythmia mainly arise from the RV Purkinje system. QND and RFA have similar efficacy in arrhythmia control. Quinidine has a higher treatment success rate in patients with PVC-SOO in the RV inflow area and in those with coupling interval/QT&lt;1.Figure 1Treatment success by SOOFigure 2Treatment success by CI/QT

Abstract Patients with Eisenmenger’s syndrome (ES) have better survival than other patients with pulmonary arterial hypertension (PAH) probably due to the preservation of right ventricular (RV) function. As in PAH patients RV remodeling and function depend not only on pulmonary artery (PA) pressure but also on the intrinsic properties of PA wall, there is also a possible role of PA stiffness (PAS) as outcome predictor in this setting. Purpose. To study the prognostic role of PAS parameters assessed by 2D transthoracic echocardiography in patients with ES compared to other patients with pulmonary hypertension (PH) receiving specific vasodilator therapy. Methods. Sixty-eight PH patients were enrolled: 27 ES patients and 41 non-ES patients, including patients with other types of PAH (12 idiopathic PAH, 5 operated congenital heart disease, 10 connective tissue disease, 7 other forms of PAH) or chronic thromboembolic PH (7 patients) receiving oral vasodilator therapy. Clinical data, B-type natriuretic peptide (BNP), RV function and PAS parameters were assessed: pulmonary capacitance (PC), PC indexed to body surface area (PC/BSA), pulsatility, elastic modulus (EP), beta-index. PH patients were followed-up for 2.9 years (4 months-6.8 years). Results. Pulmonary vascular resistance (PVR) assessed by right heart catheterization was similar in both groups (11.9 ± 8.0 vs 11.0 ± 6.4 Wood units, p = 0.68). ES patients had lower BNP levels (lnBNP 3.63 ± 1.31 vs 5.31 ± 1.33, p &lt; 0.001) and better RV function than non-ES patients: RV-free wall S wave, RV-S (12.2 ± 2.3 vs 10.2 ± 2.0 cm/s, p &lt; 0.001), RV fractional area change, RV-FAC (40 ± 7 vs 32 ± 9%, p &lt; 0.001), RV global longitudinal strain (RV-GLS) on 3 segments (-20.2 ± 4.4 vs -14.8 ± 6.0%, p = 0.001) or 6 segments (-16.2 ± 4.2 vs -13.1 ± 4.9%, p = 0.011). In ES patients PAS parameters were less impaired than in non-ES group (PC 1.68 ± 0.86 vs 1.18 ± 0.66 ml/mmHg, p = 0.014; PC/BSA 1.05 ± 0.53 vs 0.68 ± 0.37 ml/mmHg m2, p = 0.003; pulsatility 18.8 ± 8.4 vs 13.8 ± 6.4%, p = 0.007, EP 390.7 ± 198.6 vs 578.8 ± 341.6 mmHg, p = 0.007; beta index 6.09 ± 2.85 vs 10.77 ± 6.21, p &lt; 0.001). During follow-up, 12 cardiac deaths occurred: 1 in ES group and 11 in non-ES group (p = 0.021). In non-ES group, predictors of cardiac death were parameters of RV function and PAS: BNP levels (lnBNP 6.20 ± 1.10 in deceased patients vs 4.97 ± 1.27 in survivors, p = 0.007), RV-S (9.1 ± 2.0 vs 10.6 ± 1.9 cm/s, p = 0.038), RV-FAC (25 ± 8 vs 35 ± 7%, p = 0.001), RV-GLS on 3 segments (-11.1 ± 4.4 vs -16.2 ± 6.0%, p = 0.015) or 6 segments (-9.0 ± 3.7 vs -14.6 ± 4.4%, p = 0.001), PC (0.86 ± 0.29 vs 1.32 ± 0.72 ml/mmHg, p = 0.01; PC/BSA (0.51 ± 0.17 vs 0.76 ± 0.41 ml/mmHg m,2 p = 0.013). Conclusion: Patients with ES have better RV function and less impaired PAS compared to patients with other types of PH and similar PVR. Moreover, besides RV function, PAS parameters emerged as predictors of cardiac death in non-ES patients that had worse prognosis than ES patients. The impact of these findings on clinical outcomes in ES patients remains to be further studied.