Plasma Folate, Vitamin B6 and B12 in Their Relationship to the Presence of Probiotic Strain Bifidobacterium animalis subsp. Lactis HNO19 (DR10TM) Among Indonesian Pregnant Women in Their Third Semester

Introduction Vitamin B12 plays a role during pregnancy in maintaining folate metabolism. Together with folate and vitamin B6, B12 is involved as a coenzyme in DNA synthesis and various methylation reactions in developing embryos. This study aims to compare plasma folate, vitamin B6 and B12 blood levels with respect to the presence of probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10TM) among pregnant women in Indonesia. Methods: This study is part of a larger study entitled “Effects of Bifidobacterium animalis subsp. lactis HNO19 (DR10TM), inulin, and micronutrient fortified milk on fecal DR10TM, immune markers, and maternal micronutrients among Indonesian pregnant women.” Further analyses were performed using independent-t test or Mann Whitney test, GLM-repeated measures and chi-square test, to compare folate, vitamin B6 and B12 intake and blood concentration during pregnancy with presence (n=22) and absence (n=55) subjects of fecal DR10TM at third trimester. Results: At the first trimesters there was no difference in plasma vitamin B6 and vitamin B12 levels between the two groups, based on the presence or absence of fecal DR10TM. However, at the second and third trimester, vitamin B6 blood concentration (p=0.034 and p=0.001) and vitamin B12 blood concentrations at the third trimester (p=0.035) were significantly higher in the fecal DR10TM positive group, while having a similar vitamin B6 and B12 intake. Conclusion: Consumption of pre- and probiotics during the periconceptional period may be a useful strategy for improving maternal vitamin B’s vitamins, especially vitamin B6 and B12 status and therefore provide benefits for the offspring’s quality of life

Stochastic Population Forecasting Based on Combinations of Expert Evaluations Within the Bayesian Paradigm

The paper suggests a procedure to derive stochastic population forecasts adopting an expert-based approach. As in a previous work by Billari et al. (2012), experts are required to provide evaluations, in the form of conditional and unconditional scenarios, on summary indicators of the demographic components determining the population evolution, i.e. fertility, mortality and migration. Here two main purposes are pursued. First, the demographic components are allowed to have some kind of dependence. Second, as a result of the existence of a body of shared information, possible correlations among experts are taken into account. In both cases, the dependence structure is not imposed by the researcher but it is indirectly derived through the scenarios elicited from the experts. To address these issues, the method is based on a mixture model, within the so-called Supra-Bayesian approach according to which expert evaluations are treated as data. The derived posterior distribution for the demographic indicators of interest is used as forecasting distribution and a Markov Chain Monte Carlo algorithm is designed to approximate this posterior. The paper provides the questionnaire which was designed by the authors to collect expert opinions. Finally, an application to the forecast of the Italian Population from 2010 up to 2065 is proposed

Scanning electrochemical microscopy (SECM) studies of catalytic EC′ processes : theory and experiment for feedback, generation/collection and imaging measurements

This paper describes the use of scanning electrochemical microscopy (SECM) in the tip generation/substrate collection (TG/SC), or feedback, mode and substrate generation/tip collection (SG/TC) mode to measure homogeneous kinetics in the catalytic EC' process. Theoretical analyses of both configurations have been developed numerically to allow the optimal conditions for sensitive kinetic measurements to be determined. This is shown to involve collection efficiency measurements as a function of tip-substrate electrode distance in the case of TG/SC measurements and tip (collector current) images in a plane normal to the substrate electrode for the SG/TC mode. An important consideration for the SECM configuration (particularly for TG/SC and feedback measurements) is that the electroinactive co-reactant may be depleted more significantly than with other electrode geometries, because of cycling of the redox couple in the tip/substrate electrode gap, while the co-reactant can only enter this gap by hindered diffusion. The approaches described are examined through studies of the oxidation of amidopyrine by electrogenerated Fe(CN)(6)(3-) in 0.5 mol dm(-3) aqueous KOH solution. A second-order rate constant of 390 +/- 80 dm(3) mol(-1) s(-1) is obtained from TG/SC measurements, consistent with SG/TC quantitative imaging measurements. The consistency of the kinetic measurements confirms the validity of the approaches described. The kinetic constant is lower than expected based on previous ultramicroelectrode (UME) studies, and this is attributed to the fact that background currents for the direct heterogeneous oxidation of amidopyrine are more significant with conventional UME measurements, which will tend to enhance the current measured and may therefore lead to an overestimation of kinetic constants. The TG/SC approach, on the other hand, provides a means of making dual-electrode collection efficiency measurements with diffusional feedback of the redox couple, leading to superior voltammetric responses and enabling more accurate kinetic determination

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research