Kemin (Belgium)

High tibial osteotomy (HTO) is a reliable treatment for medial gonarthrosis in painful varus knees, relieving pain by redistributing load to the lateral compartment. Traditionally, lateral compartment osteoarthritis (OA) has been considered a contraindication. However, the recent ESSKA consensus suggests that mild lateral OA may not be an absolute contraindication, although supporting evidence remains limited. This retrospective study investigates the safety and efficacy of HTO in patients with mild-to-moderate asymptomatic lateral OA, hypothesising that HTO provides significant pain relief and functional improvement. A single-centre retrospective observational study was conducted on 132 patients who underwent HTO between 2017 and 2020 at AZ Herentals, Belgium. Inclusion criteria were completion of a 2-year postoperative questionnaire and preoperative magnetic resonance imaging (MRI) or single-photon emission computed tomography (SPECT-CT) within 1 year before surgery. The 'Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form' and 'Numeric Pain Rating Scale' were used. Lateral OA severity was assessed using radiographs, MRI and SPECT-CT. Outcomes were compared across different grades of lateral OA. A total of 132 patients (95 men, 38 women; mean age 56 ± 8.7 years) were included. Patients with mild or moderate lateral OA signs on MRI showed significant improvement in pain and function up to 2 years. This was consistent with SPECT-CT and radiographic findings. No significant differences were observed between patients with different degrees of lateral OA. Linear regression revealed that larger osteophytes on MRI predicted more pain (β = 40.2, p = 0.0037) and worse function (β = 23.2, p = 0.049), while lower SPECT uptake predicted less pain (β = -16.9, p = 0.031). At 2 years post-HTO, pain and function did not differ significantly between patients with or without mild-to-moderate lateral gonarthrosis. Thus, mild asymptomatic lateral gonarthrosis should not be considered a contraindication for HTO. Longer-term studies are needed to confirm these findings. Level III, retrospective comparative study.

Abstract Late gestation marks the prominent period for fetal muscle development in-utero, pre-dispositioning offspring muscle development, and carcass value. Adequate glucose metabolism facilitates muscle fibers formation, although it can be compromised by maternal energy imbalances. Nutritional strategies such as supplementation of organic chromium propionate, in late gestation, aim to enhance insulin sensitivity and glucose metabolism, potentially improving maternal energy balance to promote efficient glucose uptake for fetal muscle development. However, this relationship between chromium and glucose in this stage of gestation is yet to be fully understood. This study aimed to evaluate the effects of maternal chromium propionate supplementation and the impacts on the growth and muscle metabolism in the offspring. One hundred late-gestation Angus-cross beef cows were randomly assigned to two treatments until parturition: control (CON, n = 50), receiving a basal diet, and chromium propionate (CRP, n = 50), receiving the same diet supplemented with 10 g/head/day of KemTRACE® Chromium 0.04% (Kemin Industries, Inc., Des Moines, IA). Cow performance was monitored from 56 days prepartum to parturition, and calf metabolic parameters were assessed at birth. From 2-10 days of age, skeletal muscle samples were collected from calves to assess gene expression and protein abundance related to adipogenesis and glucose metabolism. Maternal CRP-supplementation had no impact (P > 0.05) on calf birth weight, weaning weight, or average daily gain from birth to weaning. A treatment by calf sex interaction was observed for the number of muscle fibers, where CRP-supplemented male calves exhibited a greater number (P = 0.01) of muscle fibers compared to CON male calves. However, no significant differences were observed for muscle fiber size (P = 0.53) or muscle fiber type (P > 0.05) between dietary treatments or calf sex. Calves from CRP-supplemented dams showed increased skeletal muscle mRNA expression of adipogenic markers PPARγ (P < 0.01), ZFP423 (P < 0.01), and DLK1 (P = 0.02). Similarly, they exhibited enhanced mRNA expression of IRS1 (P = 0.01) and GLUT4 (P = 0.04) and tended to increase the IRS1 activity (P = 0.08). In summary, these findings suggest maternal supplementation with chromium propionate at late gestation affects the skeletal muscle development of the offspring likely enhancing the early intramuscular adipogenesis and glucose uptake capacity, increasing their potential for intramuscular fat deposition.

Abstract Black mulberry extract (BME) is rich in phenolics; however, their health benefits are restricted by their instability and poor absorption in the small intestine. Liposomal BME-loaded pullulan/pectin nanofibers were developed to enhance the in vitro bioaccessibility of BME. The liposomes with BME (0.8%, w/v), were produced by the thin-film hydration and ultrasonication method with a size of 76.41 ± 1.23 nm and encapsulated 79.40 ± 0.99%.of the BME. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) images showed that the uniform distribution of liposomes within the defect-free fiber structure. Liposomal BME loading elevated the mucoadhesiveness of the nanofibers compared to free BME loading. Liposomal BME-loaded nanofiber demonstrated a nearly two-fold increase in the bioaccessibility of anthocyanins. The cellular release of all four different anthocyanins by Caco-2 cells was significantly higher (3.92%–10.50%) in liposomal BME-loaded nanofiber. Therefore, liposomal nanofibers show great potential as a method for delivering phenolics, specifically anthocyanins.

ObjectivesTo investigate if patients with early rheumatoid arthritis responding insufficiently to initial methotrexate (MTX) and bridging glucocorticoids (GCs) could benefit from early but temporary etanercept introduction as a second remission-induction attempt.MethodsCareRA2020 (NCT03649061) was a 2-year, open-label, multicentre, pragmatic randomised controlled trial. Treatment-naïve patients started MTX and GC bridging (COBRA-Slim: CS). Within a time window from week (W) 8 until W32, early insufficient responders (28-joint Disease Activity Score – C-reactive Protein (DAS28-CRP) >3.2 between W8 and W32 or ≥2.6 at W32) were randomised to a Standard-CS strategy (adding leflunomide first) or Bio-induction-CS strategy (adding etanercept for 24 weeks). Additional treatment adaptations followed the treat-to-target principle. Longitudinal disease activity (DAS28-CRP) over 104 weeks (primary outcome), achievement of DAS28-CRP <2.6 28 weeks after randomisation, and biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) use at W104 were compared between randomisation groups.ResultsFollowing CS treatment, 142 patients were early responders; 55 early insufficient responders received Standard-CS and 55 Bio-induction-CS. Superiority of Bio-induction-CS over Standard-CS could not be demonstrated (ß=−0.204, (95% CI –0.486 to 0.078), p=0.157) for the primary outcome. More patients on Bio-induction-CS achieved DAS28-CRP <2.6 at 28 weeks after randomisation (59% (95% CI 44% to 72%) vs 44% (95% CI 31% to 59%) in Standard-CS) and they were treated less frequently with b/tsDMARDs at W104 (19/55, 35%) compared with Standard-CS (29/55, 53%).ConclusionHalf of the patients responded well to initial COBRA-Slim induction therapy. In early insufficient responders, adding etanercept for 6 months did not improve disease control over 104 weeks versus adding leflunomide first. However, temporary introduction of etanercept resulted in improved disease control early after randomisation and less patients on b/tsDMARDs at W104.Trial registration numberNCT03649061.CTR pilot approval BelgiumS59474, EudraCT number: 2017-004054-41.

Summary Purpose Novel technologies standardising the testing process of immediate hypersensitivities have been developed and validated in recent years. Meanwhile, challenges with regard to availability of testing agents and shortage of trained personnel have increased. Novel technologies could fight these challenges, but their distribution is at present not known. The current survey, conducted by the German Society for Allergology (AeDA), aimed to assess current practices of allergy diagnostics in Germany. Methods Members of AeDA were invited to complete an online questionnaire to obtain information on their perspectives on allergy testing and diagnostics. Results A total of 150 allergologists from different disciplines treating patients with allergy completed the questionnaire. This survey revealed that twice as many skin prick tests (SPT; 21.2 tests/week) compared to serum specific immunoglobulin E tests (IgE; 10.4 tests/week) are being performed. Nasal allergen provocation tests are being performed in 56.0% of hospitals and physicians’ offices. An individual standard allergen panel for SPT is applied in 78.0% of testing cases. Methods used to perform a read out of SPT are variable with measurement of the longest wheal diameter being used most frequently (68.0%), followed by a qualitative evaluation (46.6%) or the longest wheal diameter including pseudopods (34.4%). In all, 66% of allergologists indicated that a device that automating the SPT process would be valuable for clinical practice. Conclusion Skin prick tests and serum IgE tests are still the cornerstones in the diagnostic work-up of immediate-type allergies. Variability in the execution of skin prick tests exists between different hospitals and physicians’ offices in Germany. Inconsistent availability of testing reagents was considered most problematic for maintaining allergy diagnostics in Germany. A majority of allergologists are open to evaluating tools that may contribute to standardize skin prick tests.

This study aimed to investigate the efficacy of Bacillus-based probiotics supplemented at two different levels to modulate the productive performance, egg quality, tibia traits, and specific cecal bacteria counts of Hy-Line Brown layers from 25 to 37 weeks of age. A total of 216 twenty-five-week-old hens were randomly distributed into 3 experimental diets with 12 replicates of 6 birds per cage. Diets included basal diet supplemented with 0 (CON), 3×108 (PRO1), or 3×109 (PRO2) colony-forming unit (CFU) of the test probiotic containing Bacillus subtilis PB6, Bacillus subtilis FXA, and Bacillus licheniformis G3 per kilogram of feed. Improved egg weights and mass at 29 weeks; and feed intake at 31 weeks (p<0.10) were noticed with the probiotic-supplemented PRO1 and PRO2 diets. Considering egg quality, the shell thickness, Haugh units, and yolk color were improved; but yolk cholesterol was lowered (p<0.05) with PRO1 and PRO2 diets at 29 weeks. At both 33 and 37 weeks, the egg-breaking strength, shell color and thickness, albumen height, Haugh units, and yolk color were improved; but yolk cholesterol was similarly lowered (p<0.05) with the PRO1 and PRO2 diets. Improved tibia Ca, ash, weights, and density; and raised cecal counts of Bifidobacteria and Lactobacilli (p<0.05) were noticed with PRO1 and PRO2 diets. Improved tibia P but reduced Clostridia counts (p<0.10) were also observed with the PRO1 and PRO2 diets. Probiotic supplementation of Bacillus subtilis PB6, Bacillus subtilis FXA, and Bacillus licheniformis G3 at 3×108 CFU/kg of feed is adequate to significantly improve egg quality, lower yolk cholesterol, enhance several tibia traits, and raise the populations of beneficial cecal bacteria. Modest improvements in several productive parameters and tibia P but reduced Clostridia were also observed; and could warrant further investigation of probiotic effects beyond the current test period.

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Acknowledgements The authors would like to acknowledge the help of Ben Goethuys for the computerized data collection as well as the support of drs. Katarzyna Korwin-Kochanowska, Ruben Schreurs, Robbert Buck and Bram Byloos and block nurses at Ziekenhuis Oost-Limburg, Genk, Belgium. We would also like to thank Darren Jacobs for his assistance