A Natural Astragalus-Based Nutritional Supplement Lengthens Telomeres in a Middle-Aged Population: A Randomized, Double-Blind, Placebo-Controlled Study.

Telomeres are ribonucleoprotein structures that form a protective buffer at the ends of chromosomes, maintaining genomic integrity during the cell cycle. A decrease in average telomere length is associated with with age and with aging-related diseases such as cancer and cardiovascular disease. In this study, we conducted a randomized, double-blind, placebo-controlled trial over six months to compare the effects of the Astragalus-based supplement versus a placebo on telomere length (TL) in 40 healthy volunteers (mean age 56.1 ± 6.0 years). Twenty subjects received the supplement, and 20 received placebo capsules. All participants completed the study, and no adverse side effects were reported at six months. Subjects taking the Astragalus-based supplement exhibited significantly longer median TL (p = 0.01) and short TL (p = 0.004), along with a lower percentage of short telomeres, over the six-month period, while the placebo group showed no change in TL. This trial confirmed that the supplement significantly lengthens both median and short telomeres by increasing telomerase activity and reducing the percentage of short telomeres (<3 Kbp) in a statistically and possibly clinically significant manner. These results align with a previous open prospective trial, which found no toxicity associated with the supplement's intake. These findings suggest that this Astragalus-based supplement warrants further investigation for its potential benefits in promoting health, extending life expectancy, and supporting healthy aging.

6DoF Object Pose and Focal Length Estimation from Single RGB Images in Uncontrolled Environments.

Accurate 6DoF (degrees of freedom) pose and focal length estimation are important in extended reality (XR) applications, enabling precise object alignment and projection scaling, thereby enhancing user experiences. This study focuses on improving 6DoF pose estimation using single RGB images of unknown camera metadata. Estimating the 6DoF pose and focal length from an uncontrolled RGB image, obtained from the internet, is challenging because it often lacks crucial metadata. Existing methods such as FocalPose and Focalpose++ have made progress in this domain but still face challenges due to the projection scale ambiguity between the translation of an object along the z-axis (tz) and the camera's focal length. To overcome this, we propose a two-stage strategy that decouples the projection scaling ambiguity in the estimation of z-axis translation and focal length. In the first stage, tz is set arbitrarily, and we predict all the other pose parameters and focal length relative to the fixed tz. In the second stage, we predict the true value of tz while scaling the focal length based on the tz update. The proposed two-stage method reduces projection scale ambiguity in RGB images and improves pose estimation accuracy. The iterative update rules constrained to the first stage and tailored loss functions including Huber loss in the second stage enhance the accuracy in both 6DoF pose and focal length estimation. Experimental results using benchmark datasets show significant improvements in terms of median rotation and translation errors, as well as better projection accuracy compared to the existing state-of-the-art methods. In an evaluation across the Pix3D datasets (chair, sofa, table, and bed), the proposed two-stage method improves projection accuracy by approximately 7.19%. Additionally, the incorporation of Huber loss resulted in a significant reduction in translation and focal length errors by 20.27% and 6.65%, respectively, in comparison to the Focalpose++ method.

Spontaneous termination of ventricular tachycardia in the human heart.

INTRODUCTION: Understanding the spatiotemporal location of the spontaneous termination of ventricular tachycardia (VT) may provide new insights for ablation. To test the hypothesis that spontaneous VT termination most frequently occurs at the VT exit due to source-sink mismatch and to characterize electrophysiological properties of the sites termination during VT and with extra-stimulus technique. METHODS: Retrospective analysis of intraoperative mapping studies of nine patients with ischemic cardiopathy or repaired tetralogy of Fallot. Simultaneous endocardial and epicardial mapping was performed in both ventricles using a custom mapping array during VT. Electrogram (EGM) characteristics before and at the moment of termination were analyzed including: cycle length oscillations, EGM heterogeneity and a variation in the systolic/diastolic path. The decrements to extra stimulus were analysed for termination sites and other diastolic sites. RESULTS: Nine VTs in seven patients demonstrated spontaneous VT termination. Seven VTs (77.8%) spontaneously terminated in the final third of the systolic interval, one (11.1%) in early diastole and one (11.1%) in mid diastole. Cycle length oscillations (prolongation, shortening, and no change) were seen in equal frequency. Four VTs (44.4%) showed alternans in the local EGM at the site of termination and this was more prevalent than alternans at other sites in the diastolic pathway (p < .001). Only one-third of VTs showed a change in activation pattern before termination. There was no difference based on etiology. During substrate characterization with extra-stimulus pacing, sites of spontaneous termination showed greater decrement than other sites of the VT circuit during pacing (43.5 ± 14.5 ms vs. 31.2 ± 31.2 ms; p = .003). CONCLUSION: The entrance zone rather than the exit is the commonest site for the spontaneous termination of VT in the human heart. These sites tend to demonstrate EGM alternans during VT and greater decrement during extrastimulus pacing. These findings may help guide future studies into improving the success of VT ablation.

Latitudinal gradients and sex differences in morphology of the Black Oystercatcher (Haematopus bachmani).

Environment and behavior are widely understood to affect bird morphology, which can lead to differences among subspecies or populations within a wide-ranging species. Several patterns of latitudinal gradients in morphology have been described, though Allen's and Bergmann's rules are the most well-known and have been tested and confirmed across a diversity of taxa and species. These state that individuals at higher latitudes will have larger bodies (Bergmann's Rule) but smaller extremities (Allen's Rule) to conserve heat in colder climates. Migratory behavior also can influence avian morphology, particularly wing shape, where migratory birds tend to have longer, more pointed wings than residents. The Black Oystercatcher (Haematopus bachmani) is a large, partially migratory shorebird species restricted to intertidal habitats and distributed from Alaska to Baja California, spanning about 35° of latitude. A large proportion of Black Oystercatchers that breed in Alaska are migratory, where nearly all individuals breeding in British Columbia through the southern end of their range remain resident through the annual cycle. Their broad latitudinal range and diversity in migratory behavior may drive geographic variation in morphology. Here we evaluate three explanations for geographic variation in morphology of the Black Oystercatcher using data from seven sites across two regions: Alaska and British Columbia. We found evidence consistent with Allen's but not Bergmann's rule; birds in Alaska have shorter bills than those in British Columbia, and these findings held when controlling for body size using wing length. Despite regional differences in migratory behavior, we detected no difference in the wing shape of birds in Alaska and British Columbia. Differences between sexes and among sites suggest that multiple factors drive patterns of morphological variation in the Black Oystercatcher.

Telomere Length, HLA, and Longevity-Results from a Multicenter Study.

Aging is an exceptionally complex process that depends on genetic, environmental, and lifestyle factors. Previous studies within the International HLA and Immunogenetics Workshop (IHIWS) component "Immunogenetics of Ageing" showed that longevity is associated with positive selection of HLA-DRB1*11- and DRB1*16-associated haplotypes, shown to be protective against diseases. Within the 18th IHIWS, we aimed to investigate the relevance of telomere length for successful aging and its association with classical HLAs. In total 957 individuals from Bulgaria, Turkey, Romania, and Poland in two age groups, elderly individuals (age 65-99 years) and ethnically matched young group (age 18-64 years), were investigated. The obtained results confirmed interpopulation differences in the distribution of HLA alleles, documented the lengths of telomeres in analyzed populations, and demonstrated significant associations of telomere length with aging as well as with the presence of some HLA class I or class II alleles. They suggest that telomere length assessment combined with HLA genotyping may help identify immunogenetic profiles associated with longevity. The associations between HLA and telomeres support the theory that HLA genes influence the aging process. However, further research is needed to clarify the biological basis of the observed relationships.

Impact of Insurance on Readmission Rates, Healthcare Expenditures, and Length of Hospital Stay among Patients with Chronic Ambulatory Care Sensitive Conditions in China.

Background: The disparities in healthcare access due to varying insurance coverage significantly impact hospital outcomes, yet what is unclear is the role of insurance in providing care once the patient is in the hospital for a preventable admission, particularly in a weak gatekeeping environment. This study aimed to investigate the association between insurance types and readmission rates, healthcare expenditures, and length of hospital stay among patients with chronic ambulatory care sensitive conditions (ACSCs) in China. Methods: This retrospective observational study utilized hospitalization data collected from the Nanhai District, Foshan City, between 2016 and 2020. Generalized linear models (GLMs) were employed to analyze the relationship between medical insurance types and readmission rates, lengths of hospital stay, total medical expenses, out-of-pocket expenses, and insurance-covered expenses. Results: A total of 185,384 records were included. Among these, the participants covered by urban employee basic medical insurance (UEBMI) with 44,415 records and urban and rural resident basic medical insurance (URRBMI) with 80,752 records generally experienced more favorable outcomes compared to self-pay patients. Specifically, they had lower readmission rates (OR = 0.57, 95% CI: 0.36 to 0.90; OR = 0.59, 95% CI: 0.42 to 0.84) and reduced out-of-pocket expenses (ß = -0.54, 95% CI: -0.94 to -0.14; ß = -0.41, 95% CI: -0.78 to -0.05). However, they also experienced slightly longer lengths of hospital stay (IRR = 1.08, 95% CI: 1.03 to 1.14; IRR = 1.11, 95% CI: 1.04 to 1.18) and higher total medical expenses (ß = 0.26, 95% CI: 0.09 to 0.44; ß = 0.25, 95% CI: 0.10 to 0.40). Conclusions: This study found that different types of health insurance were associated with varying clinical outcomes among patients with chronic ambulatory care sensitive conditions (ACSCs) in China. Since the hospitalization of these patients was initially avoidable, disparities in readmission rates, lengths of hospital stay, and medical expenses among avoidable inpatient cases exacerbated the health gap between different insurance types. Addressing the disparities among different types of insurance can help reduce unplanned hospitalizations and promote health equity.

Effects of Paclobutrazol on Reproductive and Vegetative Traits of Phalaenopsis Join Grace 'TH288-4'.

Phalaenopsis is the most popular potted plant worldwide. However, its typically long stalks often lead to increased shipping costs and risks. This study investigates the effectiveness of varying the concentration, timing, and frequency of paclobutrazol (PP333) applications on shortening the stalk of Phalaenopsis Join Grace 'TH288-4'. Concurrently, it also examines the potential for producing visually appealing and single-flower potted phalaenopsis products by means of truncation. Mature phalaenopsis plants were moved to a cool room in the seventh week to induce flowering. Four experimental groups were established based on different PP333 application schedules: the control (CK) group, with reverse osmosis water application in the second week; the T2 group, with a single application in the second week; the T2T3 group, with applications in both the second and third weeks; and the T7T8 group, with applications in the seventh and eighth weeks. The PP333 concentrations used were 250, 500, 750, and 1000 mg·L-1, applied as foliar sprays. The results showed that the shortest stalks, measured from the base to the first flower, were observed in the T2 group treated with PP333 at 750 mg·L-1 and in the T2T3 group with PP333 at 500, 750, and 1000 mg·L-1. These treatments resulted in stalk lengths of 19.18-22.17 cm, which are 67.2-71.6% shorter than the controls. PP333 application had minimal effect on the stalk diameter, pedicel length, flower width, length, and length/width ratio. However, root diameter was thicker in plants treated with PP333 compared with the control plants. For producing single-flower phalaenopsis, a foliar spray of 750 mg·L-1 PP333 is recommended approximately a month before moving the plants to cooler conditions, followed by truncation, retaining only the first flower. As a result, this study establishes a PP333 treatment protocol for phalaenopsis, offering a strategy to effectively shorten the stalks.

Higher Seed Rates Enlarge the Effects of Wide-Belt Sowing on Root Length Density, Thereby Improving Nitrogen Uptake and Use Efficiencies in Winter Wheat.

The optimized sowing method and appropriate seed rate can improve wheat N use efficiency. However, the interactive effect of the sowing method and seed rate on N use efficiency, particularly N uptake and root length density, are unclear. A field experiment was conducted for two growing seasons in southern Shanxi province, China, using a split-plot design with the sowing method as the main plot (wide-belt sowing, WBS, and conventional narrow-drill sowing, NDS) and seed rate as the sub-plot (100-700 m-2). Our results showed that WBS had a significant and positive effect on N use efficiency (yield per unit of available N from the fertilizer and soil, by 4.7-15.4%), and the relatively higher seed rates (>300 or 400 m-2) enlarged the effects. The N use efficiency increases under WBS were mainly attributed to the increases in N uptake before anthesis, resulting from the promoted nodal roots per plant and per unit area, and root length density in the top layer(s). WBS promoted N translocation and the N harvest index, resulting in equivalent grain protein concentration and processing quality compared to NDS. Thus, adopting higher seed rates (>300 m-2) combined with WBS is recommended for achieving greater N efficiencies while maintaining the grain protein concentration and processing quality of winter wheat.

Machine Learning Prediction Model to Predict Length of Stay of Patients Undergoing Hip or Knee Arthroplasties: Results from a High-Volume Single-Center Multivariate Analysis.

Background: The growth of arthroplasty procedures requires innovative strategies to reduce inpatients' hospital length of stay (LOS). This study aims to develop a machine learning prediction model that may aid in predicting LOS after hip or knee arthroplasties. Methods: A collection of all the clinical notes of patients who underwent elective primary or revision arthroplasty from 1 January 2019 to 31 December 2019 was performed. The hospitalization was classified as "short LOS" if it was less than or equal to 6 days and "long LOS" if it was greater than 7 days. Clinical data from pre-operative laboratory analysis, vital parameters, and demographic characteristics of patients were screened. Final data were used to train a logistic regression model with the aim of predicting short or long LOS. Results: The final dataset was composed of 1517 patients (795 "long LOS", 722 "short LOS", p = 0.3196) with a total of 1541 hospital admissions (729 "long LOS", 812 "short LOS", p < 0.001). The complete model had a prediction efficacy of 78.99% (AUC 0.7899). Conclusions: Machine learning may facilitate day-by-day clinical practice determination of which patients are suitable for a shorter LOS and which for a longer LOS, in which a cautious approach could be recommended.

Comparative Accuracy and Reliability of Three Electronic Apex Locators in Determining the Apical Constriction of Molar Canals: A Micro-CT Evaluation.

Background: Determining the correct apical limit for root canal treatment is essential for its success. This study evaluates the accuracy of three electronic apex locators (EALs) in locating the apical constriction (AC) in molar canals. Methods: Forty extracted human mandibular molars were scanned using micro-CT, and endodontic access cavities were created. Teeth were mounted in alginate, and three EALs-Root ZX-mini, Root ZX-II, and Sirona integrated apex locator-were used to measure the canal working length in dry canals and with EDTA gel. Micro-CT scans were performed with files in place, and the distance from the AC was calculated. Measurements within 0.1-0.5 mm were categorized as 'close'. Those extending beyond towards the major foramen were categorized as 'beyond', otherwise they were classified as 'far'. Data analysis was conducted with a level of significance set at 5%. Results: Most readings for all EALs were in the 'close' category, with significant differences between devices (p < 0.0001). Root ZX-mini and Root ZX-II had 74.4% and 72.5% 'close' readings, respectively, versus 51% for Sirona integrated. Accuracy did not differ significantly between dry and EDTA-treated canals (p = 0.306). All EALs demonstrated excellent operator reliability (ICC 0.996-1.00). Conclusions: All EALs accurately determined AC, unaffected by lubricants. However, Root ZX-mini and Root ZX-II outperformed Sirona integrated. All EALs showed consistent reliability.

Experimental Research of Bond Strength of Lightweight Aggregate Concrete to 15.7 mm Non-Pretensioned Steel Strands.

This paper deals with the issue of the bond of concrete with the new artificial aggregate Certyd to prestressing steel strands. The solution of the problem is of great importance in the development of the use of lightweight aggregate concrete for prestressed concrete elements. Experimental research on the bond stress-slip relationship of concrete to 15.7 mm non-pretensioned steel strand was carried out. The results of bond stress-slip tests for various embedment lengths (40, 80, 120, 240, 330 and 460 mm) for test specimens made of the same lightweight aggregate concrete mixture, in which the transfer of prestressing force took place at different levels of concrete maturity (after 3, 7 and 28 days of concrete maturing), are presented. Based on the obtained results, an analytical model of the bond stress-slip relationship of lightweight aggregate Certyd concrete to 15.7 mm non-pretensioned steel strand was proposed. The tests presented demonstrated that the lightweight aggregate (Certyd) concrete is suitable for the production of pretensioned concrete elements.

Two different visual stimuli that cause axial eye shortening have no additive effect.

Previous studies identified two visual stimuli that can shorten the human eye by thickening the choroid after short-term visual stimulation, potentially inhibiting myopia: (1) watching digitally filtered movies where the red plane has full spatial resolution while green and blue are low-pass filtered according to the human longitudinal chromatic aberration (LCA) function (the "red in focus" filter), and (2) reading text with inverted contrast. This study aimed to determine whether combining these two stimuli would have an additive effect on axial length. Twenty-two emmetropic subjects were recruited to read text (standard and inverted contrast) for 30 min from a large screen, 2 m away, either unfiltered or filtered with the "red in focus" filter. Axial length was measured before and after each reading episode using low-coherence interferometry (Lenstar LS 900, Haag Streit). Reading text with conventional contrast polarity (dark letters on a bright background) resulted in no significant axial length change. Adding the "red in focus" filter did not alter the outcome. Consistent with previous findings, reading inverted contrast text made emmetropic eyes shorter. Surprisingly, when the text was combined with the "red in focus" filter, eyes became longer rather than shorter. A possible explanation for this contradictory result is that, for the text stimulus, the "red in focus" filter removes spatial information in the blue channel needed by the retina to use LCA analysis to thicken the choroid.

Comparison of engineered nanoparticle transport in columns of three different lengths: Transport experiments and multi-observation point modeling.

This study focuses on the effectiveness of commonly-used 15 cm column lengths for investigating nanoparticle transport in porous media. Experimental tests examined the transport and retention behaviors of two types of nanoparticles, graphene oxide (GO) and titanium dioxide (TiO2) nanoparticles, in saturated sand columns of different lengths (15, 30 and 45 cm), while considering key environmental factors like ionic strength (IS, 1-50 mM), flow rate (1-3 mL min-1), and grain size (150-850 µm). In the 15 cm columns, both GO and TiO2 transport decreased with higher IS and lower flow rate; grain size affected GO and TiO2 differently. Smaller grain size increased GO retention in the sand columns through straining, thus weakening GO mobility, whereas increased fluid shear force suppressed the ripening of TiO2, enhancing its migration. Similar environmental effects were noted in longer columns (30 and 45 cm), but fitted transport parameters (Smax and k) and predicted long-term mobility (Lmax) indicated that 15 cm columns might underestimate nanoparticle mobility. Blocking and ripening models based on single and multiple observation points to simulate nanoparticle transport and retention showed that predictions aligned well with experimental data. These results indicate that using combinations of columns of different lengths to achieve multiple observation points improves model prediction accuracy; in single-column experiments, the 45 cm and 30 cm columns respectively better predict the mobility range of GO and TiO2 compared to 15 cm columns.

Prenatal and early life exposure to fine particulate matter and telomere length in early childhood.

BACKGROUND: Telomere length is a biomarker of molecular aging that may be impacted by air pollution exposure starting in utero. We aimed to examine the association between prenatal and early life exposure to fine particulate matter (PM2.5) and leukocyte telomere length (LTL) in children and explore sex differences. METHODS: Analyses included 384 mother-child pairs enrolled in the Programming Research in Obesity, Growth, and Environmental Stressors (PROGRESS) birth cohort in Mexico City. Exposure to PM2.5 was estimated at the residential level using a satellite based spatio-temporally resolved prediction model. Average relative LTL was measured in DNA isolated from blood collected at age 4-6 years using quantitative real-time polymerase chain reaction. Linear regression models were used to examine the association between average PM2.5 across pregnancy, individual trimesters, first postnatal year, and LTL. Models were adjusted for maternal age and education at enrollment, prenatal environmental tobacco smoke exposure, child sex, age, and body mass index z-score at LTL measurement. Effect modification by sex was investigated with interaction terms and stratification. RESULTS: In trimester specific models, we found an association between 2nd trimester PM2.5 and elongated LTL (ß: 4.34, 95%CI [0.42, 8.42], per 5 µg/m3 increase). There was suggestive effect modification by sex on average 2nd trimester PM2.5 with stronger associations seen in females compared to males (ß: 7.12, [95%CI: 0.98, 13.6] and ß: 1.43 [95%CI: -3.46, 6.57]) per 5 µg/m3 increase respectively. CONCLUSION: Second trimester PM2.5 levels were associated with changes in LTL in early childhood. Understanding temporal and sex differences in PM2.5 exposure may provide insights into telomere dynamics over early life.

Alu insertion-mediated dsRNA structure formation with pre-existing Alu elements as a disease-causing mechanism.

We previously identified a homozygous Alu insertion variant (Alu_Ins) in the 3'-untranslated region (3'-UTR) of SPINK1 as the cause of severe infantile isolated exocrine pancreatic insufficiency. Although we established that Alu_Ins leads to the complete loss of SPINK1 mRNA expression, the precise mechanisms remained elusive. Here, we aimed to elucidate these mechanisms through a hypothesis-driven approach. Initially, we speculated that, owing to its particular location, Alu_Ins could independently disrupt mRNA 3' end formation and/or affect other post-transcriptional processes such as nuclear export and translation. However, employing a 3'-UTR luciferase reporter assay, Alu_Ins was found to result in only an ∼50% reduction in luciferase activity compared to wild type, which is insufficient to account for the severe pancreatic deficiency in the Alu_Ins homozygote. We then postulated that double-stranded RNA (dsRNA) structures formed between Alu elements, an upstream mechanism regulating gene expression, might be responsible. Using RepeatMasker, we identified two Alu elements within SPINK1's third intron, both oriented oppositely to Alu_Ins. Through RNAfold predictions and full-length gene expression assays, we investigated orientation-dependent interactions between these Alu repeats. We provide compelling evidence to link the detrimental effect of Alu_Ins to extensive dsRNA structures formed between Alu_Ins and pre-existing intronic Alu sequences, including the restoration of SPINK1 mRNA expression by aligning all three Alu elements in the same orientation. Given the widespread presence of Alu elements in the human genome and the potential for new Alu insertions at almost any locus, our findings have important implications for detecting and interpreting Alu insertions in disease genes.

Impact on Inpatient Length of Stay in Adults with Deep Partial-Thickness Burns: Comparing the Bioengineered Allogeneic Cellularized Construct Expanded-Access Trial with National Burn Repository Data.

Purpose: To investigate the effect of StrataGraft (bioengineered allogeneic cellularized construct [BACC]) treatment on inpatient length of stay (LOS) as an indicator of hospital resource utilization. Patients and Methods: Data from the single-arm StrataCAT trial for adult patients with deep partial-thickness (DPT) burns who received BACC were compared with data from a matched external control arm comprising patients who received autografting for burn treatment from the National Burn Repository (NBR) during the same time period as StrataCAT. A matching, quasi-experimental approach was used to investigate the cause-and-effect relationship between BACC treatment and LOS (days). Matching factors included sex, age, ethnicity, race, burn causes, %TBSA burned (third-degree), %TBSA burned (second- and third-degrees), inhalation injury, diabetes mellitus, and hypertension. Balance was assessed between the cohorts for each confounder by standardized mean differences (SMD). Outcome was reported as average treatment effect on the treated. Results: The BACC and NBR Autograft cohorts included 47 and 2641 patients, respectively. Following matching, the Autograft cohort had 137 patients and was weighted to 47 patients. Patients in the BACC and final (matched) Autograft cohorts were similar in all demographic and clinical covariate categories after matching (ie, the absolute SMD were < 0.1). Treatment with BACC reduced the inpatient LOS by an average of 4.84 days (P = 0.0127) relative to the comparable (matched) Autograft cohort. An ad hoc analysis revealed that mean [SD] LOS for BACC and the weighted Autograft cohorts were 17.68 [12.75] and 22.51 [19.75] days, respectively, and were 1.39 [0.94] and 1.88 [1.31] days per %TBSA burned, respectively. Conclusion: The significantly reduced inpatient LOS observed with BACC compared to Autograft in adults with DPT burns may translate into reduced burden on the healthcare system, reduced costs for inpatient burn treatment, and clinical benefits for patients.

Revealing novel insights into the enhancement of quality in black tea processing through microbial intervention.

Black tea is highly favored by consumers worldwide, with enzymatic reactions being recognized as a pivotal factor influencing tea quality. The role of microorganisms in shaping the composition of black tea has emerged as a focus of research due to their involvement in enzyme catalysis and metabolic processes. In this study, full-length amplicon sequencing combined with qPCR more accurately reflected microbial profile, and Pantoea, Pseudomonas, Paucibacter, and Cladosporium were identified as the main microbial genera. Moreover, by comprehensively analyzing color, aroma, and taste components over time in black tea samples, correlations were established between the dominant genus and various quality factors. Notably, peroxidase activity levels, total soluble sugar content, and tea pigments concentration exhibited significant associations with the dominant genus. Consequently, this microbiological perspective facilitated the exploration of driving factors for improving black tea quality while establishing a theoretical foundation for quality control in industrial production.

Comparing Serum AMH, InhB, Testosterone Levels and Finger Length Ratio (2D/4D) of Male Children with Specific Learning Disorder and Controls.

Introduction: It has been suggested that inhibin B (InhB), Anti-Müllerian hormone (Müllerian-inhibiting substance, AMH) levels, and 2D/4D finger length ratios are related to sex differences in neurodevelopmental disorders. The aim of this study is to investigate the role of InhB, AMH levels, and 2D/4D finger length ratios in male children with specific learning disorder (SLD). Methods: The study included 38 male children diagnosed with SLD and 38 males of similar ages without SLD as the control group. Tests used in the evaluation were the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version, Specific learning disorder clinical observation battery, Wechsler Intelligence Scale for Children-Revised (WISC-R), and Conners' Parent Rating Scale. Revised: Short Form. Serum AMH, InhB, and Testosterone levels were measured using an enzyme-linked immunosorbent assay. Results: Male children diagnosed with SLD demonstrated significantly higher levels of serum InhB compared to controls (t= 2.59 p=0.009); both groups had similar levels of serum testosterone and AMH. The 2D/4D finger ratios in the SLD group were found to be lower than those in the control group (t= 2.92 p= 0.005). Serum InhB levels were positively correlated with WISC-R verbal scores (p= 0.003). Conclusion: Our findings suggest that serum InhB levels and the 2D/4D ratio, which is an indicator of prenatal testosterone exposure, may play a role in the male predominance of SLD.

Increased red cell distribution width predicts mortality in COVID-19 patients admitted to a Dutch intensive care unit.

BACKGROUND: Abnormal red blood cell distribution width (RDW) is associated with poor cardiovascular, respiratory, and coronavirus disease 2019 (COVID-19) outcomes. However, whether RDW provides prognostic insights regarding COVID-19 patients admitted to the intensive care unit (ICU) was unknown. Here, we retrospectively investigated the association of RDW with 30-day and 90- day mortalities, duration of mechanical ventilation, and length of ICU and hospital stay in patients with COVID-19. METHODS: This study included 321 patients with COVID-19 aged >18 years who were admitted to the ICU between March 2020 and July 2022. The outcomes were mortality, duration of mechanical ventilation, and length of stay. RDW >14.5% was assessed in blood samples within 24 hours of admission. RESULTS: The mortality rate was 30.5%. Multivariable Cox regression analysis showed an association between increased RDW and 30-day mortality (hazard ratio [HR], 3.64; 95% CI, 1.54-8.65), 90-day mortality (HR, 3.66; 95% CI, 1.59-8.40), and shorter duration of invasive ventilation (2.7 ventilator-free days, P=0.033). CONCLUSIONS: Increased RDW in COVID-19 patients at ICU admission was associated with increased 30-day and 90-day mortalities, and shorter duration of invasive ventilation. Thus, RDW can be used as a surrogate biomarker for clinical outcomes in COVID-19 patients admitted to the ICU.

Does the length of bypassed bowel during distal gastric bypass affect weight loss?

INTRODUCTION: Weight recurrence (WR) affects > 20% of patients following Roux-en-Y gastric bypass (RYGB). Shortening of the common channel (CC) after RYGB (distal bypass) has been proposed for additional weight loss in patients with WR, but results vary, and concerns for vitamin deficiencies/malnutrition exist. Our aim was to determine whether the percentage of bowel bypassed after distal bypass is associated with the amount of postoperative weight loss. METHODS: Patients undergoing distal bypass between 2018 and 2022 were reviewed. Small bowel limb lengths before and after distal bypass were measured, and the percentage of bypassed bowel was calculated (= bypassed biliopancreatic limb/total small bowel length). Patients were dichotomized into two groups based on the percentage bypassed bowel (≤ 50% vs. > 50%). Weight loss (measured as excess BMI loss; EBIL%), comorbidities resolution, complications, and nutritional deficiencies were reviewed. RESULTS: Thirty female patients underwent distal bypass during the study period. After distal bypass, the Roux was lengthened to 150 cm (75-175 cm) from 75 cm (20-200 cm), and the CC shortened to 150 cm (100-310 cm) from 510 cm (250-1000 cm). These changes resulted in an increase in the size of the bypassed biliopancreatic limb from 40 cm (15-90 cm) to 330 cm (180-765 cm) and a total alimentary limb (TALL; Roux + CC) shortening from 590 cm (400-1075 cm) to 300 cm (250-400 cm). The group with > 50% bowel bypassed had higher EBIL%. Overall EBIL% was 36.9 ± 14.7%, 53.3 ± 25.6%, and 62.1 ± 36.9% at 0.5, 1, and 2 years, respectively. There were minimal vitamin deficiencies. Diabetes resolved in 100% (n = 3/3), HTN in 67% (n = 10/15), and GERD in 73% (n = 11/15). Complication rate was 23%. No reintervention for malnutrition or vitamin deficiencies was required. CONCLUSIONS: Distal bypass effectively leads to considerable weight loss and comorbidity improvement in patients with WR after RYGB, but the amount of weight loss depends on the percentage of bypassed bowel. An exact threshold of bypassed bowel that optimizes weight loss outcomes and simultaneously minimizes the nutritional complications needs to be determined. Meanwhile, close monitoring for vitamin deficiencies is recommended.