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Additive main effects and multiplicative interaction (AMMI) model is most widely used to analyse genotype*environment interactions (GEI) wherein interaction effects of location is masked by year effect. Hence, presently available models are not able to estimate interaction effects of genotype*location (GLI) and genotype*year (GYI) separately. Moreover, genotype ranking differs as number of years of evaluation vary making selection of genotype for target location difficult. In the present study we propose a novel stability model i.e Higher-order-AMMI (HO-AMMI) analysis which is capable of calculating GLI without the confounding effect of GYI and GLYI. GEI of AMMI model and all 2-way interactions of HO-AMMI model follow χ2 distribution, whereas 3-way interaction (GLYI) of HO-AMMI follow noncentral χ2 distribution. With increase in number of years of evaluation contribution of GLI towards total variation increased whereas in AMMI model contribution of GEI towards total variation decreased. Variation explained by multiplicative components is higher in HO-AMMI compared to AMMI model. Genotypes were ranked using GL, GY and GL+GY+GLY interactions of HO-AMMI and GEI of AMMI for stability and yield and compared their ranks with field ranking. Correlation and linear regression analysis have indicated high association of GLI (HO-AMMI) with field ranking with high R2 values. Further, HO-AMMI model was able to remove the confounding effect of GYI and GLYI on GLI for accurate identification of genotype for target location irrespective of number of years of evaluation. Hence, HO-AMMI model can be used under multi-environment trials (MET) for selecting genotypes efficiently.Availability and InformationSource code implemented in R is available from corresponding author.

BackgroundSequential drug treatment with biological agents in ulcerative colitis (UC) is becoming increasingly complex. There are few studies comparing head-to-head outcomes in second-line treatments. The study assesses whether using anti-tumour necrosis factor (anti-TNF)-α therapy following the α4β7 integrin blocker vedolizumab (VDZ) or VDZ after an anti-TNF has more favourable clinical outcomes in UC in a real-world outpatient setting.MethodsPatients with UC who were exposed to first-line anti-TNF (adalimumab or infliximab) or VDZ who subsequently switched to the alternate class between May 2013 and August 2020 were identified by reviewing patient databases at 10 hospitals. Data were collected retrospectively using patient records. Baseline demographics, disease activity indices, biochemical markers, endoscopic Mayo score, colectomy rates, treatment persistence and urgent hospital utilisation composite endpoint (UHUC) rates were examined over a 52-week period.ResultsSecond-line week 52 treatment persistence was higher in the VDZ group (71/81, 89%) versus the anti-TNF group (15/34, 44%; p=0.0001), as were week 52 colectomy-free survival (VDZ: 77/80, 96%, vs anti-TNF: 26/32, 81%; p=0.009), week 52 UHUC survival (VDZ: 68/84, 81%, vs anti-TNF: 20/34, 59%; p=0.002) and week 52 corticosteroid-free clinical remission (CFCR) rates (VDZ: 22/34, 65%, vs anti-TNF: 4/20, 20%; p=0.001).ConclusionCompared with second-line anti TNF usage, the VDZ second-line cohort had significantly higher 52-week treatment persistence, UHUC survival, higher colectomy-free survival rates and higher week 52 CFCR. These data suggest that VDZ is an effective biologic in UC as a second-line therapy after anti-TNF exposure. It highlights the effect of biological order on clinically important outcomes.

Background The gut microbiota has been implicated in the pathogenesis of inflammatory bowel disease (IBD), with Faecalibacterium prausnitizii associated with protection, and certain genera (including Shigella and Escherichia) associated with adverse features. The variability of patient response to medical therapies in IBD is incompletely understood. Given the recognised contribution of the microbiota to treatment efficacy in other conditions, there may be interplay between the gut microbiota, IBD medical therapy and IBD phenotype. Aims To evaluate the bidirectional relationship between IBD medical therapies and the gut microbiota. Methods We conducted a systematic search of MEDLINE and EMBASE. All original studies analysing interactions between the gut microbiota and established IBD medical therapies were included. Results We screened 1296 records; 19 studies were eligible. There was heterogeneity in terms of sample analysis, treatment protocols, and outcome reporting. Increased baseline α-diversity was observed in responders versus non-responders treated with exclusive enteral nutrition (EEN), infliximab, ustekinumab or vedolizumab. Higher baseline Faecalibacterium predicted response to infliximab and ustekinumab. A post-treatment increase in Faecalibacterium prausnitzii was noted in responders to aminosalicylates, anti-TNF medications and ustekinumab; conversely, this species decreased in responders to EEN. Escherichia was a consistent marker of unfavourable drug response, and its presence in the gut mucosa correlated with inflammation in aminosalicylate-treated patients. Conclusions Both gut microbiota diversity and specific taxonomic features (including high abundance of Faecalibacterium) are associated with the efficacy of a range of IBD therapies. These findings hold promise for a potential role for the gut microbiota in explaining the heterogeneity of patient response to IBD treatments.

The frequency of total knee arthroplasty (TKA) is increasing, particularly in younger and more active patients. In these patients, there may be greater functional demands, with an expectation to return to sporting activities (RTS) following TKA. There is a paucity of data on the time to RTS following TKA and the aim of this meta-analysis is to determine the time to RTS following TKA. Using the PRISMA guidelines, an electronic search of PUBMED, MEDLINE, EMBASE, and the Cochrane Library for trails was performed on TKA and RTS in English language, published since the inception of the database to 31st October 2020. Data evaluating the time to RTS and functional outcomes were recorded by two authors independently that were included in the analysis. Pooled analysis using random effect model on overall proportions at the different time intervals and at the end of the follow-up was carried out for all studies. In total, 1,611 studies were retrieved from literature search. Of these, nine studies met the inclusion criteria with 1,307 patients. Two studies with 148 patients demonstrated an overall pooled proportion of 18.7% (95% CI 8.2–32.3%) of patients RTS at 3 month post-TKA; Three studies reported RTS rate at 6 months 70.% (95% CI 48–88.4). Two studies with 123 patients demonstrated an overall pooled proportion of 84.0% (95% CI 77.1–89.9%) patients RTS at 12 months. 986 patients returned to sport from total of 1307, with an overall adjusted proportion return to sport of 87.9 (95% CI 80.5–93.8%) at the end of follow-up; mean 14 months (range 3–36 months). Patients undergoing TKA were found to successfully RTS, pooled proportion analysis showed an increasing rate of RTS with time, at a mean of 14 months following TKA, where 87.9% of patients had returned to sports. The findings of this study will enable more informed discussions and rehabilitation planning between patients and clinicians on RTS following TKA.

Introduction: Total Hip Arthroplasty (THA) is being increasingly undertaken in younger and more active patients, with many of these patients wanting to return to sport (RTS) after surgery. However, the percentage of patients RTS and time at which they are able to get back to sport following surgery remains unknown. The objective of this meta-analysis was to determine the time patients RTS after THA. Methods: A search was performed on PUBMED, MEDLINE, EMBASE, and the Cochrane Library for trials on THA and RTS, in the English language, published from the inception of the database to October 2020. All clinical trials reporting on to RTS following THA were included. Data relating to patient demographics, methodological quality, RTS, clinical outcomes and complications were recorded. The PRISMA guidelines were used to undertake this study. Results: The initial literature search identified 1720 studies. Of these, 11 studies with 2297 patients matched the inclusion criteria. 3 studies with 154 patients demonstrated an overall pooled proportion of 40.0% (95% CI, 32.5–47.9%) of patients RTS between 2 and 3 months after surgery. 4 studies with 242 patients demonstrated an overall pooled proportion of 76.9% (95% CI, 71.5–82.0) of patients RTS by 6 months after surgery. Pooled proportion analysis from 7 trials with 560 patients demonstrated 93.9% (95% CI, 82.7–99.5%) of patients RTS between 6 and 12 months after surgery. Conclusions: Pooled proportion analysis showed increasingly more patients were able to RTS after THA over the first 1 year after surgery. There remains marked inter and intra-study variations in time for RTS but the pooled analysis shows that over 90% of patients were able to RTS at 6–12 months after THA. These finding will enable more informed discussions between patients and healthcare professionals about time for RTS following THA.

Twenty different groundnut genotypes were evaluated in a randomized block design with three replications during kharif 2012 to study the variability parameters, heritability, genetic advance, correlation coefficient and path analysis for ten characters. Analysis of variance revealed highly significant differences among genotypes for all the traits except stability of soil plant analytical development (SPAD) and Chlorophyll Meter Reading 45 days after sowing indicating that adequate variability was found in the genotypes studied for most of the characters. The characters like 100 kernel weight, SPAD Chlorophyll Meter Reading 75 days after sowing, specific leaf area 75 days after sowing and rust resistance had high heritability with high genetic advance as per cent of mean and medium genotypic coefficient of variation indicating greater role of additive gene effects on these traits. While pod yield had moderate genotypic coefficient of variation and heritability along with high genetic advance as per cent of mean revealed that this character is also governed by additive gene effects and selection would be effective even in the early generation. Days to maturity, shelling outturn and specific leaf area 45 days after sowing had moderate heritability accompanied with low genotypic coefficient of variation and genetic advance indicating these traits are governed by non-additive gene effects. Selection may be practiced in later generations for improving these traits. The results on genotypic correlation coefficients revealed that pod yield had significant highly positive correlationwith days to maturity, 100-kernel weight, and SPAD Chlorophyll Meter Reading 45 days after sowing while it was negative and significant for days to flower initiation and rust disease. SPAD Chlorophyll Meter Reading 45 days after sowing and SPAD Chlorophyll Meter Reading 75 days after sowing had highly significant negative correlation with specific leaf area 45 days after sowing and specific leaf area 75 days after sowing. Specific leaf area 45 days after sowing had highly significant negative correlation with rust. Therefore, SPAD Chlorophyll Meter Reading value could be used to identify genotypes with low specific leaf area and rust resistance. Path analysis indicated that 100-kernel weight had high positive direct effect with highly significant positive correlation with pod yield. Hence, this character may be effective for selection of high pod yield.

Interventions incorporating both educational and recreational activities can bring in positive changes to participants whatever may be their age group not to mention elderly. Realising the opportunities available and support from family and community as well as participating in various social activities can keep the elderly busy and active. A feeling of inner peace and gratitude for being wanted by the dear and near will be induced instead of solitude and or isolation and negligence. Regaining freedom and independence through community activities and a life free from diseases will boost their confidence and bring in successful ageing. The present study was a pre-test post-test control group design. After assessing the quality of life (QOL) of elderly, they were divided into two groups. The experimental group (n=204) received a set of classes and instruction on how to fight the debilitating conditions by getting organized themselves. The QOL of the control group (n=203)was assessed at the beginning of the study. The control group received all necessary sessions after assessing the QOL. The study proves to be successful and cost effective if undertaken by the community. Stepping up of the community in the affairs of their elderly will be twofold. Elderly will be benefitted and the young and adults in community can learn valuable lessons from this experienced group and plan for improve their own life to minimize frictions and for successful ageing. The tool used was Older People Quality of Life 35 developed by Bowling A. Key words: health promotion, quality of life, elderly, Kerala

Faecal or biopsy samples are frequently used to analyse the gut microbiota, but issues remain with the provision and collection of such samples. Rectal swabs are widely-utilised in clinical practice and previous data demonstrate their potential role in microbiota analyses; however, studies to date have been heterogenous, and there is a particular lack of data concerning the utility of swabs for the analysis of the microbiota’s functionality and metabolome. We compared paired stool and rectal swab samples from healthy individuals to investigate whether rectal swabs are a reliable proxy for faecal sampling. There were no significant differences in alpha and beta diversity measures between swab and faecal samples, and inter-subject variability was preserved. Additionally, no significant differences were demonstrated in abundance of major annotated phyla. Inferred gut functionality using Tax4Fun2 showed excellent correlation between the two sampling techniques (Pearson’s coefficient r = 0.9217, P 1H NMR) spectroscopy enabled the detection of 20 metabolites with good correlation between rectal swab and faecal samples for butyrate, succinate and 5-aminovalerate relative abundances, though more variable degrees of association for other identified metabolites. These data support the utility of rectal swabs in both compositional and functional analyses of the gut microbiota.

Background: Patients undergoing unicompartmental knee arthroplasty (UKA) often want to return to sport (RTS) after surgery. However, the time taken to RTS and proportion of patients who RTS after UKA remain unknown. Purpose: To determine the time to RTS and proportion of patients who RTS after UKA. Study Design: Systematic review; Level of evidence, 4. Methods: A search was performed using PubMed, Medline, Embase, SPORTDiscus and the Cochrane Library databases for clinical trials reporting on RTS after UKA published between database inception and September 2021. In addition, a manual search was performed of relevant sports medicine and orthopaedic journals, and bibliographies were reviewed for eligible trials. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to undertake this study. Results: This meta-analysis included 11 studies (749 patients) that reported on RTS after UKA. The proportion of patients returning to sports increased over time: 6 studies (432 patients) demonstrated an overall pooled proportion of 48.1% (95% CI, 36.3%-60.2%) of patients who returned to sport at 3 months after surgery, while 7 studies (443 patients) demonstrated an overall pooled proportion of 76.5% (95% CI, 63.9%-87.1%) of patients who returned to sport at 6 months after surgery. Overall, 92.7% (95% CI, 85.8%-97.4%) of 749 patients were able to RTS at 4 years after surgery. Overall excellent patient-reported functional outcomes scores and low risk of complications with RTS after UKA were reported. Conclusion: The authors found that 48.1% of patients were able to RTS at 3 months after surgery and 76.5% were able to RTS at 6 months after UKA. Pooled proportion analysis showed that >90% of patients undergoing UKA were able to RTS at 48 months after surgery. The majority of patients who were able to RTS after UKA did so at a lower level of intensity than their preoperative level. RTS after UKA was associated with good patient-reported functional outcomes scores and a low risk of complications.

Short-chain carboxylic acids (SCCAs) produced by gut microbial fermentation may reflect gastrointestinal health. Their concentrations in serum and urine are indicative of specific metabolic pathway activity; therefore, accurate quantitation of SCCAs in different biofluids is desirable. However, it is often challenging to quantitate SCCAs since matrix effects, induced by the presence of a vast variety of other compounds other than SCCAs in complex biofluids, can suppress or enhance signals. Materials used for sample preparation may introduce further analytical challenges. This study reports for the first time a LC-MS/MS-based method to quantitate ten SCCAs (lactate, acetate, 2-hydroxybutyrate, propionate, isobutyrate, butyrate, 2-methylbutyrate, isovalerate, valerate and hexanoate) and evaluates the matrix effects in five human biofluids: serum, urine, stool, and contents from the duodenum and intestinal stoma bags. The optimized method, using 3-Nitrophenylhydrazone as a derivatization agent and a Charge Surface Hybrid reverse phase column, showed clear separation for all SCCAs at a concentration range of 0.1-100 µM, in a 10.5 min run without carry-over effects. The validation of the method showed a good linearity (R2 0.99), repeatability (CV ≤ 15%) assessed by intra- and inter-day monitoring. The lowest limit of detection (LLOD) was 25 nM and lowest limit of quantitation (LLOQ) was 50 nM for nine SCCA except acetate at 0.5 and 1 µM, respectively. Quantitative accuracy in all biofluids for most compounds was ±15%. In summary, this methodology has the advantages over other techniques for its simple and fast sample preparation and a high level of selectivity, repeatability and robustness for SCCA quantification. It also reduced interferences from the matrix or sample containers, making it ideal for use in high-throughput analyses of biofluid samples from large-scale studies.