Lithium ascorbate (LiAsc) is a non-toxic lithium salt (LD50>5000 mg/kg) with normothymic and neuroprotective properties. Chemoreactomic modeling of LiAsc predicted possible hepatoprotective effects which were tested here on a rat model of a non-alcoholic fatty liver disease (NAFLD) with multiorgan pathology caused by combined intake of excess saturated fats (palm oil), carbohydrates (fructose) and inorganic iron salt (ferrous sulfate). Dynamics of biochemical parameters (biomarkers of liver function, kidneys, hematopoiesis, inflammation, thrombus formation, etc.) and histological evidence of hemosiderosis in the model upon reproduction of the model are described. Experimental confirmations of the hepatoprotective effects of LiAsc were obtained. Comparison of the effects of LiAsc with the effects of myoinositol (a substance with known hepatoprotective properties) shown a number of differences in pharmacological action. Both LiAsc and MI lowered ferritin, transferrin saturation, serum iron, AST, ALT, serum creatinine, leukocytes (LiAsc to a greater extent) and normalized lowered serum protein and glomerular filtration rate. However, only LiAsc lowered heightened reticulocytes (absolute and fraction) and platelets towards the corresponding reference intervals, normalized levels of vitamin B12 in blood and lowered the number of Kupffer cells in liver that were overloaded with iron (contained Prussian blue in morphometric studies). In a clinical perspective, hepatoprotective properties of a neuroprotector and it’s potential to reduce hemosiderosis might be useful for treating patients with hepatic encephalopathy.

Cardiovascular disease (CVD) is a major global health concern. The number of people with CVD is expected to rise due to aging populations and increasing risk factors such as obesity and diabetes. Identifying new molecular markers is crucial for early diagnosis and treatment. Among these, plasma levels of some miRNAs specifically expressed in cardiac and skeletal muscle known as myomiRs, has gained attention for their roles in cardiovascular health. This study analyzed the plasma levels of myomiR-133a, -133b, and -206 in the pathogenesis of cardiovascular diseases. Exploiting of a case-control study design with patients recruited from several nursing homes form Calabria (Southern Italy) characterized by different types of CVD compared to non-CVD controls, we found downregulation of miR-133a in heart failure and miR-133b in stroke, along with the overall decreased expression of miR-133b and miR-206 in CVD patients. In silico functional characterization of their targets and signaling pathways revealed their involvement in critical cardiovascular processes. Although further research is necessary to fully elucidate their mechanisms and clinical utility, the results here reported support the idea that myomiRs could serve not only as biomarkers but also as therapeutic targets, offering new avenues for managing and potentially preventing CVD progression.

Background: Exclusive enteral nutrition (EEN) is the recommended first-line induction therapy for pediatric patients with active luminal Crohn’s disease (CD). The primary aim of this retrospective study was to ascertain the efficacy of EEN used as induction therapy for children with newly di-agnosed CD resident in the South Island of NZ over a ten-year period (2010 – 2021). Secondary aims were to assess the clinical impact of EEN therapy on anthropometry, biochemistry, the pro-gression to medical therapies over three time periods, and to identify positive predictors of re-sponse to EEN therapy. Methods: This retrospective clinical case review collected data from children diagnosed with CD at Christchurch Hospital, Christchurch, New Zealand, and prescribed EEN as induction therapy between the years January 1st, 2010 – December 31st, 2021. Descriptive statistics, Spearman’s correlation coefficient, multivariate logistic regression test and standard t-tests were used for analyses. Results: Data were collected for total of 161 children, 128 (80%) children were offered EEN as induction therapy and were included in this analysis. One hundred and twenty-one (94.5%) children successfully completed an eight-week course of EEN, and a de-crease in PCDAI scores ≥ 15 points from baseline to the end of week 8 of EEN treatment was seen in 119 (98.3%). L1 and L4 disease location were positive predictors of response (p

This study aimed to determine the incidence of post-chikungunya chronic rheumatism (pCHIK-CR) its impact on quality of life (QoL) and chronic fatigue in adult seven years after the 2014-2015 CHIKV outbreak in Piedecuesta, Colombia. We evaluated 78 adults (median age: 30 years, IQR: 21.0; women 60.3%) with confirmed CHIKV infection. In 2022, participants underwent a GALS examination and completed surveys on disability, stiffness, health status, and fatigue. A rheumatologist evaluated patients who reported arthralgia, morning stiffness, and abnormal GALS examination. Chronic fatigue was defined as fatigue persisting for over six months. Seven years after infection, 14.1% of participants were classified as pCHIK-CR cases, 41.0% as having non-inflammatory pain likely degenerative (NIP-LD), and 44.9% without rheumatic disease (Wo-RM). Patients with pCHIK-CR and NIP-LD exhibited significantly worse QoL compared to Wo-RM cases. Chronic fatigue prevalence increased from 8.6% in Wo-RM patients to 25.0% in NIP-LD and 54.6% in pCHIK-CR cases. This study implemented a comprehensive clinical as-sessment to objectively estimate and characterize the incidence of chronic rheumatological disease attributed to CHIKV infection. One in seven cases with CHIKV infection develops pCHIK-CR, which impacts both QoL and chronic fatigue. This study contributes to understanding the burden of these arboviruses in the medium term.

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide, including in Croatia. Since most patients have multiple disorders and diseases caused largely by the same risk factors, and as it is essential to approach each patient as a person with all disorders, today we are talking about a new paradigm - cardio-renal-metabolic (CKM) syndrome and cardio-renal-metabolic health, which necessarily includes brain health. Elevated systolic blood pressure, LDL cholesterol, smoking, obesity, diabetes, impaired renal function or chronic kidney disease, which all stem from insufficient physical activity, unhealthy diet with excessive intake of table salt, and air pollution, are the leading causes of overall morbidity and mortality from CKM diseases, especially mortality from CVD. Experts from various fields key to CKM health have written this document with the aim of integrating it as part of the national plan for the prevention of chronic non-communicable diseases with a focus on CVD, which should become mandatory and be based on the existing guidelines of professional societies.

Commercial Brazilian wheat flour was subjected to extrusion, oven, and microwave treatments. The solubility, monomeric and polymeric proteins, and glutenin and gliadin profiles of gluten were analyzed. In addition, in vitro digestibility and response against potential celiac disease immune-stimulatory epitopes were investigated. All treatments resulted in low solubility of the polymeric and monomeric proteins. The amounts of insoluble proteins increased from 5.6 % in control flour to approximately 10 % for all treatments, whereas soluble proteins decreased from 6.5 % to less than 0.5 % post treatment. In addition, treatments affected glutenin and gliadin pro-files. The amount of α/β- gliadin extracted decreased after all treatments, while that of γ-gliadin was unaffected. Finally, alteration of the gluten structure and complexity was not sufficient to render a product safe for consumption for individuals with celiac disease; the number of poten-tial celiac disease immune-stimulatory epitopes remained high.

Aim: This study aims to analyze the collaborative structure of Intestinal Behçet’s Disease (IBD) research by examining co-authorship networks in publications indexed in the Web of Science (WoS) Core Collection from 2000 to 2023. The goal is to identify key researchers, institutions, and collaboration patterns that have shaped the field over the past two decades. Method: This study utilized network analysis techniques to evaluate 484 publications related to IBD research indexed in the WoS Core Collection between 2000 and 2023. The analysis was conducted using Python (Version 3.10.5) in the PyCharm development environment (Software Version 2022.1.3). The co-authorship networks were assessed using macro-level indicators such as network density (the ratio of actual to possible connections), clustering coefficient (degree of node clustering), number of components (distinct connected subgroups), and average path length (average distance between nodes). Micro-level indicators including degree centrality (importance based on the number of connections), closeness centrality (proximity to other nodes), and betweenness centrality (frequency of a node on the shortest paths between others) were also analyzed.Result: From 2000 to 2009, the co-authorship network was highly fragmented with a low network density of 0.0114 and 84 distinct components, indicating limited collaboration. Key contributors during this period included Kim, Won Ho, and Cheon, Jae Hee (South Korea), who played central roles in connecting disparate research clusters. In the following decade (2010-2019), network density decreased slightly to 0.0086, and the number of components increased to 113, reflecting continued fragmentation despite growing research output. However, from 2020 to 2023, network density increased to 0.0171, and the number of components decreased to 73, indicating a trend towards greater integration and collaboration. Notable researchers in this period included Emmi, Giacomo (Italy), and Hatemi, Gulen (Turkey), who emerged as central figures, highlighting a shift in research leadership from Asia to Europe..Conclusion: The co-authorship network analysis of IBD research reveals an evolving collaborative landscape with increasing network density and decreasing fragmentation over time, particularly in the most recent period. From 2000 to 2019, Japanese and Korean researchers were prominent contributors, highlighting the significance of Asia in the global research arena. However, since 2020, researchers from Italy and Turkey have gained significant international prominence, suggesting a shift in the research focus from Asia to Europe. This transition may be attributed to changes in the incidence rates of IBD, where rapid increases were observed in Asian countries like Japan, Korea, and China until 2020, followed by stabilization or decline, while incidence rates have been increasing in European countries such as Italy and Turkey. These findings underscore the importance of expanding international collaborations to enhance the understanding of IBD. Fostering global partnerships could further advance the field, promoting more integrated and innovative research efforts, and addressing the shifting dynamics of IBD prevalence across regions.

Introduction. The management of anemia in chronic kidney disease (CKD-An) presents significant challenges for nephrologists due to variable responsiveness to erythropoietin-stimulating agents (ESA), hemoglobin (Hb) cycling, and multiple clinical factors affecting erythropoiesis. The Anemia Control Model (ACM) is a decision support system designed to personalize anemia treatment, which has shown improvements in achieving Hb targets, reducing ESA doses, and maintaining Hb stability. This study aimed at evaluating the association between ACM-guided anemia management with hospitalizations and survival in a large cohort of hemodialysis patients. Methods. This mul-ti-center, retrospective cohort study evaluated adult hemodialysis patients within the European Fresenius Medical Care NephroCare network from 2014 to 2019. Patients treated according to ACM recommendations were compared to those from centers without ACM. Data on demographics, comorbidities, and dialysis treatment were used to compute a propensity score estimating the like-lihood of receiving ACM-guided care. The primary endpoint was hospitalizations during follow-up; the secondary endpoint was survival. A 1:1 propensity score-matched design was used to minimize confounding bias. Results. A total of 20,209 eligible patients were considered (reference group: 17,101; ACM adherent group: 3,108). Before matching, the mean age was 65.3±14.5 years, with 59.2% men. Propensity score matching resulted in two groups of 1,950 patients each. Matched ACM adherent and non-ACM patients showed negligible differences in baseline characteristics. Hospi-talization rates were lower in the ACM group both before matching (71.3 vs. 82.6 per 100 per-son-years, p<0.001) and after matching (74.3 vs. 86.7 per 100 person-years, p<0.001). During fol-low-up, 385 patients died, showing no significant survival benefit for ACM-guided care (hazard ratio = 0.93; p=0.51). Conclusions: ACM-guided anemia management was associated with a sig-nificant reduction in hospitalization risk among hemodialysis patients. These results further support the utility of ACM as a decision support tool enhancing anemia management in clinical practice.

Background/Objectives: This study aimed to evaluate compliance and accuracy in comparison with traditional PD diaries for tracking motor symptoms using a new smartphone application (My Parkinson’s) and paper diary strategies. Parkinson's disease (PD) is a neurodegenerative disorder with progressive motor symptoms. Treatment becomes more challenging as PD progresses, motor complications in the form of wearing-off phenomenon and levodopa-induced dyskinesia develop. Traditional paper diaries and clinical scales used to evaluate patients may be inadequate in assessing whether the patient is “on” or “off,” resulting in less-than-ideal treatment changes. Methods: A randomized crossover design was utilized to examine 22 advanced PD patients who underwent symptomatic assessment with both diaries during two separate 24-hour periods seven days apart. The compliance and accuracy of data were assessed by comparing diary entries with the clinical examination notes and WhatsApp queries. Latterly, patients' diary preferences were also evaluated.; Results: The digital diary had significantly better compliance and accuracy than the paper diaries, with substantial/almost perfect levels of agreement (κ = 0·615 to 0·818) between logged symptoms and clinical examination notes. 65% of patients preferred the digital diary for follow-ups, and there was no significant difference in ease of use compared to paper diaries. Conclusions: Digital diaries are helpful in the clinical management of PD patients as they minimize recall bias and reduce data errors in appropriately selected patients. Our study suggests a broader adoption of digital health technologies in PD management. Still, additional research is necessary to improve the tools and assess long-term patient outcomes.

SOCS2, an E3 ubiquitin ligase, regulates the JAK/STAT signaling pathway, essential for cytokine signaling and immune responses. Its dysregulation contributes to cardiovascular diseases (CVDs) by promoting abnormal cell growth, inflammation, and resistance to cell death. This study aimed to elucidate the molecular mechanisms underlying the interactions between Lumbricus-derived proteins and peptides and SOCS2, with a focus on identifying potential therapeutic candidates for CVDs. Utilizing a multifaceted approach, advanced computational methodologies, including 3D structure modeling, protein-protein docking, 100 ns molecular dynamics (MD) simulations, and MM/PBSA calculations, were employed to assess the binding affinities and functional implications of Lumbricus-derived proteins on SOCS2 activity. The findings revealed that certain proteins, such as Lumbricin, Chemoattractive glycoprotein ES20, and Lumbrokinase-7T1, exhibited similar activities to standard antagonists in modulating SOCS2 activity. Furthermore, MM/PBSA calculations were employed to assess the binding free energies of these proteins with SOCS2. Specifically, Lumbricin exhibited an average ΔGbinding of -59.25 kcal/mol, Chemoattractive glycoprotein ES20 showed -55.02 kcal/mol, and Lumbrokinase-7T1 displayed -69.28 kcal/mol. These values suggest strong binding affinities between these proteins and SOCS2, reinforcing their potential therapeutic efficacy in cardiovascular diseases. Further in vitro and animal studies are recommended to validate these findings and explore broader applications of Lumbricus-derived proteins.

Breast cancer remains a significant health concern worldwide, necessitating early detection and treatment. The rapid appearance or a change in the shape of skin lesion on the breast or just of the nipple-areola complex(NAC), especially if it is unilateral needs to be evaluated. Several primary or secondary tumours such as inflammatory skin lesions can affect this body area. Ultrasound, mammography, or magnetic resonance imaging (MRI) are the most used non-invasive diagnostic techniques for breast cancer, but in recent years reflectance confocal microscopy (RCM) and optical coherence tomography have emerged as additional tools to diagnose cases characterized by cutaneous changes.The introduction of new techniques such as reflectance confocal microscopy (RCM), may open new perspectives in the non-invasive diagnosis of mammary paget disease (MPD). RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time. It is non-invasive, painless and repeatable, making it a valuable tool in the early diagnosis and monitoring of skin diseases. We describe an atypical clinical presentation of mammary paget disease early diagnosed by reflectance confocal microscopy evaluation.

Chagas disease, caused by Trypanosoma cruzi, leads to severe complications in 30% of infected individuals, including acute myocarditis and chronic fibrosing cardiomyopathy. Despite the significant burden of the disease, there is currently no licensed vaccine available to prevent it. This study aimed to evaluate the mucosal and systemic immunogenicity as well as the prophylactic efficacy of a mucosal vaccine and its impact on both acute and chronic cardiomyopathy. The results showed that nasal administration of Trans-sialidase (TS) plus c-di-AMP (TS+A). TS+A vaccine elicited NALT expression of IFN-γ, IL-17a, and IL-4 mRNA, and nasal-specific IgA production. Ex vivo challenge with TS also triggered enhanced proliferation of lymphocyte from the NALT, sentinel cervical lymph node and spleen. TS+A immunization increased plasma levels of Th1/Th2/Th17 cytokines and an evident cellular response to judge enhanced delayed-type hypersensitivity responses following TS footpad challenge. After oral infection, TS+A-vaccinated mice showed significantly reduced parasitemia and parasite load in heart, muscle and intestine, while markers of hepatic and muscle damage as well as clinical manifestations of acute infection are strongly diminished. TS+A also attenuated acute myocarditis and heart expression of inflammatory markers. The protection conferred by TS+A extended into the chronic phase, where it resulted in a clear reduction in chronic myocarditis, fibrosis, and functional electrocardiographic abnormalities, associated with decreased expression of the pro-fibrotic TGF-β. These results revealed that it is possible to develop a mucosal vaccine against T. cruzi based on TS and c-di-AMP, capable to reduce the development of Chagas cardiomyopathy, the hallmark of Chagas disease.

Background: The present work aimed to estimate the economic impact of PTSD following COVID-19 in a population of patients affected by systemic autoimmune disease (SAD) using a cost-of-illness approach and accounting for the perspective of society. Methods: Considering data collected from SAD patients enrolled in a specialized outpatient clinic in the Tuscany region, Italy, generalized-linear-models and LASSO logistic regression were used to evaluate the impact of PTSD on costs and its relevance as possible predictors of being a high-cost patient, respectively. Results: Considering 301 SAD patients, 161 (51.2%) of whom diagnosed with PTSD, the overall costs were 3,670 [890;40,529] Euro per patient/year among patients with PTSD and 2,736.7 [283;21,078] Euro per patient/year among those without PTSD (P-value

This analysis investigates health outcomes by cause and income group across European and African countries, highlighting significant disparities tied to economic status. Low and lower-middle-income countries in Africa face a greater burden of disease, particularly in acute lower respiratory infections, diarrheal diseases, bacterial infections, HIV/AIDS, and maternal conditions. This is primarily due to limited access to clean water, sanitation, and healthcare services. In contrast, high-income African countries exhibit better health outcomes. European countries show variations: lower-middle-income nations suffer more fro4m acute respiratory infections and HIV/AIDS, while high-income countries report higher incidences of cancer and bacterial infections. These differences reflect disparities in healthcare quality and social determinants. The study emphasizes the need for targeted policy initiatives to address these disparities by focusing on socioeconomic factors and improving healthcare access and quality across all income groups.

Background: Alzheimer's disease (AD) is the most common cause of dementia and cognitive decline in the elderly. Although the etiology of AD is unknow, the increase of amyloid precursor protein (APP) leads to the toxic aggregation of Aβ plaques. Several factors such as hypertension, diabetes, dyslipidemia, smoking, hormonal changes, and metal exposure could increase the risk of developing AD. In this review, we will examine the role of copper (Cu) in the pathophysiology of AD, as well as the mechanisms involved in neurotoxicity and cognitive decline. Methods: This review was conducted in accordance with PRISMA guidelines. We performed a comprehensive literature analysis of the last ten years on AD and Cu. Only late-onset Alzheimer’s disease was considered; therefore, only studies on elderly people of both sexes were included. Results: A total of seven articles were picked for this review, three studies focused on non-ceruloplasmin bound Copper (non-Cp-Cu) and four on ceruloplasmin bound Copper (Cp-Cu). The results showed higher Cu concentrations in patients compared to healthy controls. Conclusion: Elevated concentrations of Cu may contribute to the progression of AD, potentially interacting with ATP7B mutations, oxidative stress, and amyloid-β plaques. Future research is needed to provide more robust evidence and better characterize the relationships between AD and Cu.

It is generally assumed that spirochetemia does not take place at the early localized stage of Lyme disease. This misassumption is due to the lack of sensitive and specific methods for detection. This paper reports that separation of the platelet-rich plasma immediately after venous blood collection to prevent the spirochetes from invading the lymphocytes in the test tube is crucial in molecular detection of a single Borrelia burgdorferi cell spun down in platelet pellets. In 2023, we tested the venous blood specimens of 145 people residing in Lyme disease-endemic areas in the United States. In 98 of them, who were suspected of having early localized Lyme disease irrespective of the absence or presence of a skin lesion, we found 33 specimens (33.7%) positive for B. burgdorferi, including 17 positive for FlaB gene only, 15 positive for both FlaB gene and 16S rRNA gene, and 1 positive for 16S rRNA gene only. Eight (17.0%) of the 47 asymptomatic resident controls were positive for FlaB PCR only. FlaB is a more sensitive chromosomal target than the 16S rRNA gene for the detection of 1-3 B. burgdorferi cells in 1 mL of platelet-rich plasma due to spirochetes gaining or retaining FlaB paralogs at the early localized stage of Lyme disease.

Results: This case series study included 20 PD participants with STN-DBS, with a mean age of 61.2±10.1 years. There were no differences in equilibrium scores of SOT conditions between 60, 130, and 180 Hz frequencies (p&gt; 0.05), except the SOT6 score (p= 0.003), where 60 Hz showed better equilibrium performance in SOT6, indicating an advantage in postural control when visual and somatosensory cues are disturbed, and vestibular cues are not.

This literature review focusses on diagnostics of Equine Asthma (EA), possible influencing factors on diagnostic techniques and latest developments in diagnosing horses during EA remission or in case of subclinical disease. Routine EA diagnostics include clinical examination of the respiratory system including percussion and auscultation, clinical pathology including white blood cells and arterial blood gas analysis, bronchoscopy to evaluate the amount and viscosity of respiratory secretion, bronchoalveolar lavage and cytology of tracheal aspirates (TA) and bronchoalveolar lavage fluid (BALF). Grading of EA severity and inflammatory subtype is based on BALF cy-tology, while TA cytology helps to rule out previous bacterial infections. Different factors have an impact on the airways regarding structure of the epithelium, cytology and inflammatory markers possibly influencing the diagnosis of EA. Short-term exercise increases the total cell count and inflammatory mediators in BALF of men, asymptomatic horses and other species. Further factors involve cold or chlorinated air, long-term training effects and the co-incidence of further respir-atory disease, in particular exercise-induced pulmonary hemorrhage. As BALF cytology may be unremarkable during EA remission and low-grade disease, exercise and other factors stressing the bronchial epithelium may help to diagnose these patients.

The global landscape of health and disease has undergone significant transformations over the past several decades. While infectious diseases once dominated the morbidity and mortality statistics, non-communicable diseases (NCDs) have emerged as the leading cause of death and disability worldwide. This shift has profound implications for public health systems, healthcare delivery, and global health policies. This introduction aims to explore the main tendencies of disease burden, morbidity, and mortality in the world, with a special emphasis on NCDs and the Implications of Emerging AI Technologies. By examining the current trends and underlying factors, we can better understand the challenges and opportunities for improving global health outcomes.

This review aims to show, by an analysis of the literature on the topic, that hyperinsulinemia associated with insulin resistance is a multiple risk factor for type 2 diabetes, cardiovascular diseases, cellular senescence and cancer, and neurodegenerative diseases. This condition is progressively increasing in developed and developing countries, and its prevalence has now exceeded 50% of the general population. Since it is asymptomatic or poorly symptomatic, it can last for many years before manifesting itself in the form of type 2 diabetes mellitus, cardiovascular disease, neoplasm, cognitive impairment or dementia, therefore determining enormous social and health care costs. For these reasons, we strongly believe that a screening plan for this pathology should be implemented, in order to identify affected subjects and promptly start them on preventive treatment.

The problem can be stated as over 3 billion choices to improve 14 disease states with 9 optimization goals (some of the optimization goals are diametrically opposed) to improve dyspnea, shortness of breath, fatigability, exercise intolerance, edema, swelling, fluid retention, and arrhythmias. The goal is to increase Left Ventricular Outflow Integral, reduce mitral regurgitation, increase longitudinal conduction velocities and restore synchrony of the septum to the ventricle that needs it the most. A method to accomplish this task for the spectrum of cardiac disease is presented.

GRP78/BiP, a stress-induced protein and autoantigen in rheumatoid arthritis (RA), exhibits different expressions in various biological fluids and tissues, namely serum, synovial fluid (SF), and synovium, all of which are pertinent to the disease activity and progression of RA; however, there is a scarcity of data linking both intracellular and extracellular GRP78/Bip to the disease activity and progression of RA within the realm of rheumatology. This study was undertaken to investigate the differential expression of intracellular and extracellular GRP78/Bip in serum, SF, and synovium, and to determine their association with disease activity and progression in patients with RA. Patients with RA, osteoarthritis (OA), and traumatic meniscal injury (TMI) without radiographic OA were consecutively recruited for the study at our hospital. Among the patients with RA, six different subgroups were established based on their disease activity and progression. Disease activity was measured using the DAS28 criterion, while disease progression was evaluated using the Steinbrocker classification grade. This study conducted a comprehensive analysis of the differential expressions of GRP78/Bip in multiple sample types, including serum, SF, and synovium, with the specific emphasis on their associations with disease activity and progression in RA. The expression levels of GRP78/Bip, TNF-α, and IL-10 were significantly elevated in serum, SF, and synovium of patients with RA when compared to both the CON and iCON groups(P

Abstract: Background: The acute hemodynamic response to isometric exercise in hypertensive patients ischemic heart disease (IHD) has been poorly investigated. The aim of this study was to assess acute changes on left ventricular myocardial work (MW) during isometric bilateral knee extension in patients with IHD. Methods. Twenty stable hypertensive patients with IHD and ten healthy, age-matched controls (HC) were enrolled. All subjects performed an isometric knee extension exercise, at 30% of their maximal voluntary contraction. The effort was maintained for three minutes or until exhaustion. At baseline, at peak exercise and after 10 minutes of recovery, echocardiography evaluation was perforned, blood pressure (BP) and heart rate (HR) were measurement. Results. The exercise was well tolerated by all subjects. At peak exercise: systolic BP in the IHD was significantly higher than HC (37.6± 7.2 vs 8.4±2.3 mmHg; p = 0.002). HC group had a greater increase in HR than IHD (19.7±6.2 vs 8.4±2.2 bpm; p = 0.009). E/E’ ratio increased in IHD and was unchanged in control. Global work index increased significantly in IHD compared to HC (+15% vs +3%; p 0.026). Global constructive work increased significantly in IHD compared to HC (+29.8% vs +7.4 respectively, p 0.031). Global waste work increased by 92.3% in IHD and was unchanged in HC. Global work efficiency decreased in IHD (-18%) while was unchanged in HC (between-groups p 0.019). Stroke volume decreased in IHD. and was unchanged in HC. Cardiac output was unchanged in IHD while it increased in HC. Conclusion: In patients with hypertension and underlying IHD, an acute isometric load caused a great increase in systolic BP and LV filling pressure. It follows a mostly ineffective increase of MW that fails to maintain stroke volume.

Search for the new non-invasive methods of investigating the functioning of human internal organs is an urgent task. One of these methods for assessing the functioning of the human res-piratory system is electromagnetic sensing, based on a significant difference in the dielectric permittivity of muscle tissue and air. During breathing, when the lungs are filled with air, the dielectric permittivity of the lungs decreases, which leads to a change in the level of the elec-tromagnetic signal passing through the body. Results of experiments on recording changes in the level of electromagnetic radiation passing through the human body, performed on an experimental device consisting of eight transmitting and receiving antennas located on opposite sides of the chest have been presented in the article. The possibility of visualizing the measured “pulmonograms” in the form of dynamic two-dimensional images showing the process of filling various parts of the lungs with air has been demonstrated.

Transactive response DNA-binding protein of 43 kDa (TDP-43) is a major component of pathological inclusions in various neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD). The detection of TDP-43 in biofluids is crucial for the development of diagnostic and prognostic indicators of disease and therapeutic development for TDP-43 related proteinopathies. Despite its potential as a biomarker for numerous neurological disorders, the lack of a sensitive and reproducible TDP-43 assay hinders progress in TDP-43-based therapy development, underscoring the need for an effective and standardized method for accurate quantification. In this study, we developed and validated a sensitive immunoassay for the detection of TDP-43 in human biofluids using the Meso Scale Discovery (MSD) platform. We used this immunoassay to quantify TDP-43 levels in the plasma and serum of healthy controls and ALS patients. Our results indicate a reduction of total TDP-43 in the blood of ALS patients compared to healthy controls.

Background/Objectives: Periodontitis (P), a chronic inflammatory condition that affects the supportive tissues around the teeth, is 3 to 4 times more prevalent in individuals with diabetes mellitus (DM), with a direct correlation between its severity and the levels of glycosylated haemoglobin (HbA1c). This study aimed to evaluate the periodontal clinical parameters following non-surgical periodontal treatment (NSPT) in patients with and without type 2 DM and P. Methods: Forty patients with P were divided into two groups: Group DM/P and Group P. All patients were assessed at baseline, and 90 and 180 days after receiving NSPT. The parameters evaluated included HbA1c levels, plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BoP). Statistical analysis was performed with a significance level set at α = 5%. Results: There were significant differences in HbA1c levels between the DM/P and P groups at baseline, 90, and 180 days, as expected. Importantly, HbA1c levels did not change after NSPT. Group P showed a significant reduction in both PI and BoP values at 90 and 180 days (p &lt; 0.05). In contrast, group DM/P demonstrated a significant increase in the percentage of sites with PPD ≥ 5mm at 180 days (p &lt; 0.05). Additionally, group P exhibited an increase in sites with PPD ≤ 4mm and a decrease in sites with PPD ≥ 5mm at both 90 and 180 days (p &lt; 0.05). Conclusions: Our findings suggest that DM may compromise the effectiveness of NSPT, potentially hindering favorable outcomes during the follow-up period.

Objectives: To develop a risk prediction model for the identification of features involved in the prediction of erectile dysfunction (ED) at 12 months following COVID-19 recovery. Methods: We performed an observational prospective multicentre study. Participants were classified according to their history of COVID-19: I) Patients with a past history of COVID-19; and II) Patients without a previous microbiological diagnosis of COVID-19. A total of 361 patients (Past history of COVID-19, n=166; No past history of COVID-19, n=195) were assessed from January 2022 to March 2023. Patients with a past history of COVID-19 were assessed at 12 months following COVID-19 recovery. The primary outcome measure was ED, assessed through the 5-item International Index of Erectile Function (IIEF-5). Data concerning epidemiologic variables, comorbidities and active treatment were also collected. We performed a binary logistic regression to develop a risk predictive model. Among the models developed, we selected the one with the higher Area Under the Curve (AUC). Results: The median age was 55 years in both groups. The ED prevalence was 55.9% in patients with past history of COVID-19 and 44.1% in those with no past history of COVID-19. The best predictive model developed for ED comprised 40 variables and had an AUC of 0.8. Conclusions: We developed a regression model for the prediction of ED 12 months after COVID-19 recovery. The application of our predictive tool in a community setting could eventually prevent the adverse effects of ED on cardiovascular health, and the associated unfavourable economic impact.

Introduction: Inflammation is a significant contributor to cardiovascular disease (CVD) in people with HIV (PWH), who face twice the risk of CVD compared to the general population. The presence of co-existing rheumatic disease (RD) may further exacerbate inflammation and increase the incidence of CVD events in this population. Methods: We conducted a retrospective study using electronic health record (EHR) data from the Veterans Affairs Medical Center in Atlanta, covering the period from 2000 to 2019. The study included 3,930 veterans with HIV, and assessed the impact of rheumatic disease therapies (RDT) on CVD outcomes. The primary outcome was the first occurrence of a CVD event. Results: Rheumatic disease was significantly associated with an increased risk of CVD events (OR = 2.67; p < 0.001). Additionally, exposure to multiple RDTs (aHR = 2.121, p = 0.047), NSAIDs (aHR = 1.694, p = 0.003), glucocorticoids (aHR = 2.332, p < 0.0001), and hypouricemic agents and colchicine (aHR = 3.445, p < 0.0001) were all significantly associated with increased CVD events. Conclusion: The co-existence of HIV infection and rheumatic disease, along with the use of RDTs, may amplify the risk of CVD events in PWH. These findings underscore the need for further investigation into the relationship between RD, RDTs, and CVD risk in larger, controlled studies, given the potential implications for treatment decisions in this patient population.

This case report demonstrates the rare but potentially serious complication of pulmonary vein stenosis (PVS) diagnosed several years after radiofrequency ablation for atrial fibrillation. Pulmonary vein stenosis can remain asymptomatic until significant occlusion occurs, after which it can present with a variety of symptoms, mimicking numerous cardiovascular and pulmonary pathologies. Early diagnosis and treatment rely on consistent follow-up using appropriate diagnostic imaging modalities, which are paramount in preventing severe complications.

Background: Systemic-to pulmonary collaterals (SPC) are common in congenital heart disease (CHD). Particularly in single ventricle anatomy and Fontan circulation, SPC can both complicate the postoperative course and lead to clinical deterioration in the long term. Treatment of SPC is controversial. The aim of our study was (1) to analyze retrospectively patients who underwent SPC embolization using Concerto™ Helix nylon-fibred microcoils (CHM) and (2) to describe the interventional technique. Methods: In this a single-center retrospective observational cohort study, we analyzed clinical and imaging data of all patients who underwent transcatheter embolization of SPC using CHM from January 2016 to December 2023. Results: In 38 consecutive patients (65.8 % male, median age 41 months, range 2 – 490), a total number of 141 CHM had been implanted into 64 SPC in 49 procedures. The majority were arterial SPC (n = 59/64) originating from the thoracic aorta or its branches; 5/64 were veno-venous SPC. Primary closure succeeded in all procedures. The CHM diameters ranged from 3 to 8 mm, with 5 mm being the most commonly used diameter. The mean coil / SPC ratio was 2.6 (range 1.3 – 5.3). CHM implantation was performed via 4 French sheaths. Both detachment and stable positioning was simple and safe. Neither non-target embolization nor coil migration occurred. One complication occurred with a minor vascular injury without clinical relevance. Conclusion: CHM are easy to use and appropriate for SPC embolization in all age groups, including infants, with a low complication rate. The coils are particularly suitable for closure of collaterals with small diameter or tortuous course.

Background: Neurocognitive disorders (NCDs) have a variable decline in cognitive function, while loneliness was associated with cognitive impairment and increased dementia risk. In the present study, we examined the associations of loneliness with functional and cognitive status in patients with minor (mild cognitive impairment) and major NCDs (dementia). Methods: We diagnosed mild NCD (n=42) and major NCD (n=164) through DSM-5 criteria on 206 participants aged>65 years using the UCLA 3-Item Loneliness Scale (UCLA-3) to evaluate loneliness, the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales to measure functional status, and Mini-Mental State Examination (MMSE) to assess cognitive functions. Results: In a multivariate regression model, the effect of loneliness on cognitive functions was negative in major (=-1.05-p<.0001) and minor NCD (=-0.06-p<.01). In the fully-adjusted multivariate regression model (sex-age-education-multimorbidity-depressive symptoms-antidementia drug treatment), the effect of loneliness remained negative for major NCD and became positive for minor NCD (=0.09-p<.001). The effect of loneliness on IADL (=-0.26-p<.0001) and ADL (=-0.24-p<.001) showed a negative effect for major NCD across the different models, while for minor NCD, the effect was positive (IADL:=0.26-p<.0001-ADL:=0.05-p=0.01). Minor NCD displayed different levels of MMSE (=6.68-p<.001), but not ADL or IADL, compared to major NCD for the same levels of loneliness. MANOVA pill’s test suggested a statistically significant and different interactive effect of loneliness on functional and cognitive variables between minor and major NCDs. Conclusions: We confirmed the relationships between loneliness and cognitive and functional status in major NCD, observing a novel trend in minor NCD.

Cardiovascular (CV) morbidity and mortality are markedly increased in non-dialysis patients with chronic kidney disease (CKD). Thus, the precise management of CV risk factors involved in CKD is crucial to improving outcomes. Serum phosphate (Pi) and FGF-23 levels have been linked with a higher risk of CV events in CKD. However, the exact thresholds of Pi and FGF-23, at which the risk of adverse events increases, remain unknown. We evaluated the expression of intact FGF-23 (iFGF-23) and Pi in a non-dialysis CKD patient population (n=82; 42M:40F; median age 61 years) and investigated their association with CV and renal outcomes, in a 5-year follow-up period. At baseline, the median estimated glomerular filtration rate (eGFR), iFGF-23, and Pi were 45 ml/min/1.73m² (IQ 26.6-73.1), 69.9 µg/ml (IQ 33-117) and 3.4 mg/dL (IQ 3.3-3.9), respectively. Univariate analysis showed a strong association of both iFGF-23 and Pi with age, Charlson Comorbidity Index, hypertension, and diabetes. In addition, iFGF-23 and Pi were both associated with the composite outcome (major CV and cerebrovascular events – MACCEs, hospitalizations, and all-cause mortality) during follow-up. Moreover, Pi was independently associated with all-cause mortality during follow-up. The segmentation of the population in terciles, according to Pi (<3mg/dL; 3-3.6 mg/dL; ≥3.7 mg/dL) within reference serum levels, showed a distribution of the fatality of 0%, 20% and 80% (p =0.034), respectively. Our results reinforce the association of both iFGF-23 and Pi with composite CV outcomes in non-dialysis CKD patients and further suggest that Pi, within current reference levels, may behave as an independent risk factor for mortality in this population. It is suggested that a reassessment of Pi reference levels for early therapeutic intervention in this population may be justified.

Background: Cardiovascular risk in prediabetic patients is substantial yet it is often underestimated in everyday clinical practice. Objectives: This study examines the future cardiovascular risk in prediabetic patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We conducted a retrospective analysis of 725 STEMI patients at a tertiary center in Austria between 2018 and 2020, categorized into groups of non-diabetic, prediabetic, and diabetic patients. Baseline characteristics, cardiovascular risk factors, and long-term survival outcomes were compared using Kaplan-Meier survival analysis along with other statistical tests. Results: Of the 725 patients, 407 (56.1%) were non-diabetic, 184 (25.4%) prediabetic, and 134 (18.5%) diabetic. Prediabetic patients exhibited significant additional cardiovascular risk factors, such as arterial hypertension (67.4%) and dyslipidemia (78.3%), with prevalence rates between those of non-diabetic and diabetic patients. Kaplan-Meier analysis revealed that at three-year follow-up, prediabetic patients faced a survival disadvantage with a significant decrease in survival rates compared to non-diabetic patients (log-rank p = 0.016); their survival outcomes approached those of diabetic patients (p = 0.125). Conclusions: Our findings underscore the critical need for early identification and aggressive management of prediabetes in cardiovascular care of patients after acute STEMI. In current clinical practice, prediabetic patients are often underdiagnosed and undertreated, putting them at disproportionate risk. Integrating rigorous cardiovascular risk management strategies for prediabetic individuals, including lifestyle interventions and potentially pharmacological treatments, could prevent the progression to diabetes and mitigate associated cardiovascular risks. This paradigm shift in treating prediabetes as seriously as diabetes may significantly improve long-term survival outcomes for this vulnerable population.

There have been exciting advances in our knowledge of primary glomerular diseases and nephrotic syndromes in recent years. Beyond the histological pattern from renal biopsy, more precise phenotyping of the diseases and the use of modern nephrogenetic helps to improve treatment decisions and sometimes also to avoid unnecessary exposure to potentially toxic immunosuppression. New Biomarkers led to easier and more accurate diagnoses and more targeted therapeutic decisions. The treatment landscape is getting wider with a pipeline of promising new therapeutic agents with more sophisticated approaches. This review focuses on all aspects of entities that are associated with nephrotic syndromes with updated information on recent advances in each field. This includes podocytopathies (Focal Segmental Glomerulosclerosis and Minimal-Change Disease), Membranous Nephropathy, Membranoproliferative Glomerulonephritis, IgA-Nephropathy, Fibrillary Glomerulonephritis, Amyloidosis and monoclonal gammopathy of renal significance in the context of the nephrotic syndrome, but also renal involvement in systemic diseases, diabetic nephropathy, and drugs that are associated with nephrotic syndromes.

Infection-related cardiovascular diseases (CVDs) represent a significant health challenge, necessitating novel therapeutic strategies targeting key receptors involved in inflammation and infection. Antimicrobial peptides (AMPs) offer a promising approach, potentially disrupting pathogenic processes. This study aimed to investigate the efficacy of AMPs as therapeutic agents by examining their interactions with critical CVD-related receptors. A comprehensive computational approach was utilized to assess the interactions between AMPs and receptors associated with CVDs. Molecular docking studies were conducted to evaluate AMP binding to target receptors: ACE2, CRP, MMP9, NLRP3, and TLR4. The top-performing AMPs were further analyzed through 100 ns molecular dynamics (MD) simulations, and their binding affinities were quantified using MM/PBSA calculations. The analysis revealed that Tachystatin, Pleurocidin, and Subtilisin A exhibit strong binding affinities to key CVD-related receptors, including ACE2, CRP, and MMP9. These AMPs demonstrated the potential for disrupting receptor-peptide interactions critical to infection and inflammation. MD simulations confirmed the stability of AMP-receptor complexes, with MM/PBSA calculations showing significant binding energies. Future directions include conducting in vitro and in vivo studies to validate the therapeutic efficacy and safety of these AMPs in clinical settings.

Nonlinear single unit activity (SUA) characteristics are the useful measures to reveal the information processing and transfer features associated with Parkinson’s disease (PD) in the basal ganglia. Most of the state-of-the-art approaches to compute such parameters in continuous and discrete forms are strongly dependent on SUA recording length, noise level and input parameters. Due to the specificity of SUA data collection (mainly short recordings with relatively low signal-to-noise ratio) new techniques to evaluate neuronal nonlinear properties are needed. We have developed an encoding technique based on a mean interspike interval (ISI) value to calculate spike train discrete nonlinear features. The approach to compute mutual information (MI) of isolated neurons with its unstructured activity was also proposed. The proposed technique of SUA nonlinear features evaluation slightly depends on spike train length, has low correlations with other SUA characteristics (firing rate, coefficient of ISI variance and asymmetry index). The derived entropy measure in the subthalamic nucleus has significant positive correlation with PD severity. The proposed approach provides nonlinear features that are slightly dependent on investigated sample size and independent on input parameters. Also, the developed mean ISI based measures reflect the more complex nature of oscillatory activity in the basal ganglia, than it was thought previously. Moreover, MI, unlike entropy, takes into account the position of the spike train elements, which allows us to investigate the amount of information retained after the occurrence of temporary failures. The developed approach may be useful in describing nonlinear features of basal ganglia activity contributing to PD pathophysiology probably associated with impaired information transfer in movement disorders.

Purpose of review: In this review, we discuss the importance of digital health equity and how social determinants of health (and intersectionality with race, ethnicity, and gender) affect cardiovascular health-related outcomes in digital health trials. We propose strategies to improve digital health equity as we move to a digitally-connected world for healthcare applications and beyond.Recent findings: Digital health has immense promise to improve population health by reaching individuals in their homes, at their preferred times. However, initial data demonstrate decreased patient engagement and worse cardiovascular outcomes for racial and ethnic minorities, leading to unequal uptake of digital health technologies. In addition, while women generally have higher uptake of technology, they are less likely to be referred by clinicians for digital health interventions. We highlight several exemplar trials and analyze their methodology for replication in future digital health research.Summary: The promise of digital health equity has not been reached due to exclusionary practices. Specific focus must be placed on societal/governmental policies that enable digital inclusion, particularly of racial and ethnic minority populations and women, to ensure that the expansion of digital health technologies does not exacerbate existing health disparities.

This review explores the transformative role of artificial intelligence (AI) in the entire winemaking process, from viticulture to bottling, with a particular focus on enhancing food safety and traceability. It discusses AI’s applications in optimizing grape cultivation, fermentation, bottling, and quality control, while emphasizing its critical role in managing microbiological risks such as mycotoxins. The review aims to show how AI technologies not only refine operational efficiencies but also raise safety standards and ensure traceability from vineyard to consumer. Challenges in AI implementation and future directions for integrating more advanced AI solutions into the winemaking industry will also be discussed, providing a comprehensive overview of AI's potential to revolutionize traditional practices.

Poland suffered an epidemic of louse-borne typhus from 1916-1923, with 400,000 cases and more than 130,000 deaths. The causative factors were depressed economic conditions and a refugee crisis that engulfed Poland after World War I. The recognition of the epidemic in 1919 stimulated the creation of the League of Red Cross Societies (LRCS). However, the LCRS had limited resources and the Poles requested help from other governments and the League of Nations (LoN). The United States sent the American-Polish Relief Expedition to conduct delousing. However, the Polish-Soviet War of 1920 disrupted typhus control and exacerbated the refugee situation. The LoN belatedly organized an underfunded Epidemic Commission. The LCRS sent a research team that did ground-breaking work on the pathology of typhus. Into 1921, the epidemic continued, driven by refugees from typhus-stricken Russia. By 1924, typhus cases were finally approaching pre-World War I levels. Multiple factors lead to the amelioration of the epidemic. The repatriation of prisoners of war and displaced civilians had concluded by 1923. Also, there had been a steady influx of sanitary, food, economic, and medical aid from various organizations into Poland since 1919. Administratively, within Poland, the anti-typhus campaign was also conducted more effectively by the Extraordinary Epidemic Commissariat.

Background/Objectives: The primary life-threatening complication in Spinal-bulbar muscular atrophy (SBMA) is ventilatory failure, which results from the weakening of the bulbar and respiratory muscles. However, systematic studies assessing respiratory function over the long-term have not been performed. The present study analyzes the longitudinal patterns of respiratory function tests over a follow-up of 11 years, aiming to identify any potential, sustained decline during this time. Furthermore, we explored possible correlations between respiratory function tests and clinical and biochemical serum indices. Methods: We collected data from 9 genetically confirmed SBMA patients and conducted spirometric measurements twice a year for eleven years. The spirometric data included maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and forced vital capacity (FVC)]. Additionally, we measured serum biochemical indices and SBMA functional rating scale (SBMAFRS) for clinical analysis. Results: All three respiratory function tests showed a descending trend. A major decrease was observed for MEP (52%) and MIP (42%), while this was minor for FVC (25%). SBMAFRS score correlated with the three pulmonary function tests. MIP and MEP correlated with creatine phosphokinase and creatinine levels, and FVC correlated with serum level of transaminases. Conclusions: This longitudinal study shows a progressive decline of spirometric data throughout life in patients with SBMA. Spirometric measures relative to maximal strength of the respiratory muscles (MIP and MEP) may have a better predictive value for pulmonary and muscular decline than FVC.

Background and Purpose: Moyamoya disease is a rare cerebrovascular disorder characterized by stenosis of the carotid arteries and the formation of collateral vessels at the base of the brain. While advances have been made in understanding its genetics, diagnostic criteria, and treatment strategies, further research is needed. The purpose of this literature review is to synthesize current knowledge on Moyamoya disease and identify areas for future study. Materials and Methods: A literature search of databases including PubMed, Embase, and Web of Science was conducted. Search terms included "Moyamoya disease" and related terms. Only English articles were reviewed, with no date restrictions. Relevant data was extracted and synthesized. Results: Key findings indicate that genetic factors such as RNF213 variants play an important role in disease susceptibility. Imaging modalities such as MRI and CT angiography are crucial for diagnosis. Surgical revascularization shows superior outcomes compared to medical management for ischemic and hemorrhagic presentations. However, optimal treatment for asymptomatic cases remains unclear. Neurocognitive and psychiatric sequelae can negatively impact quality of life. Promising research directions include investigating ethnic differences, developing biomarkers, and exploring novel therapeutics targeting molecular pathways. Conclusions: In summary, comprehension of Moyamoya disease has significantly progressed but gaps remain regarding treatment of certain populations and underlying mechanisms. Further research addressing these areas can aid in developing personalized care approaches and new interventions to improve patient outcomes

The human brain is highly dependent on oxygen, utilizing approximately 20% of the body’s oxygen at rest. Oxygen deprivation to the brain can lead to loss of consciousness within seconds and death within minutes. Recent studies have identified regions of the brain with spontaneous episodic hypoxia, referred to as "hypoxic pockets." Hypoxia can also result from impaired blood flow due to conditions such as heart disease, blood clots, stroke, or hemorrhage, as well as from reduced oxygen intake or excessive oxygen consumption caused by factors like low ambient oxygen, pulmonary diseases, infections, inflammation, and cancer. Severe hypoxia in the brain can manifest symptoms similar to Parkinson’s disease (PD), including cerebral edema, mood disturbances, and cognitive impairments. Additionally, the development of PD appears to be closely associated with hypoxia and hypoxic pathways. This review seeks to investigate the molecular interactions between hypoxia and PD, emphasizing the pathological role of hypoxic pathways in PD and exploring their potential as therapeutic targets.

Background/Objectives: interpretation of evidence on de-escalation of triple therapy with with-drawal of inhaled corticosteroids (ICS) to dual bronchodilator therapy with a long-acting musca-rinic antagonist (LAMA) and a long-acting beta-agonist (LABA) in patients with chronic obstruc-tive pulmonary disease (COPD) is conflicting. We evaluated the efficacy and safety of ICS discon-tinuation from LABA-LAMA-ICS triple therapy compared to its continuation. Methods: we searched PubMed, Embase, Scopus, Web Of Science, clinicaltrial.gov and CENTRAL for RCTs and observational studies from inception to March 22, 2024, investigating the effect of triple therapy de-escalation with withdrawal of ICS to dual therapy on the risk of COPD exacerbation, pneumonia and lung function. This study was registered with PROSPERO, CRD42024527942. Results: 3335 studies were screened; three RCTs and three real-world non-interventional studies were ultimately identified as eligible. Analysis of the time to the first moderate or severe exacerbation showed a pooled HR of 0.96 (95% CI, 0.80 to 1.15; I²=77%) for ICS withdrawal compared with triple therapy continuation. Analysis according eosinophil levels showed that COPD subjects with ≥300 eosino-phils/µL had a significant increase in the incidence of moderate or severe exacerbations when de-escalated from ICS/LABA/LAMA to LABA/LAMA (pooled HR: 1.35, 95% CI 1.00-1.82; I2: 56%). The ICS withdrawal in favour of LABA/LAMA did not significantly affect the risk of mortality and pneumonia. Conclusions: the main findings of this meta-analysis are consistent with current recommendations and suggest that the use of eosinophil counts may be of help in guiding maintenance therapy. However, methodological heterogeneity between the included studies is evident.

Aim: This study aims to analyze the evolution of co-author networks in Gastroesophageal Reflux Disease (GERD) research from 2000 to 2023, using data from the Web of Science (WoS) Core Collection. The objective is to provide a structural overview of researcher collaborations in this specialized field, highlighting key contributors and the impact of international cooperation. Method: I conducted a co-author network analysis on 19,463 GERD -related articles indexed in the WoS Core Collection between 2000 and 2023. Using Python (Version 3.10.5) within the PyCharm development environment (Software Version 2022.1.3), I assessed macro-level indicators including network density, clustering coefficient, number of components, and average distance. Micro-level indicators such as degree centrality, closeness centrality, and betweenness centrality were also evaluated to understand the roles of individual researchers in the network.Result: The GERD co-authorship network exhibited a sparse structure with low network density, indicating limited realized collaborations compared to potential connections. The clustering coefficient was consistently high across the analyzed periods, suggesting that researchers frequently formed tight-knit groups. The network was fragmented into numerous components, with significant disconnection between groups. Degree centrality highlighted key researchers such as Dent, J., and Shaheen, N.J., who had extensive collaborative reach. In contrast, closeness and betweenness centrality identified strategic intermediaries like Bredenoord, A.J. and Kahrilas, P.J., who facilitated connections across otherwise isolated segments of the network.Conclusion: The co-authorship network analysis revealed a persistently fragmented landscape in GERD research, with considerable room for enhancing collaboration among researchers. Identifying key contributors and understanding their roles within the network can guide future efforts to foster more integrated and comprehensive research collaborations. This study underscores the importance of strategic networking and partnership development in advancing GERD research and optimizing the field's collaborative potential.

The purpose of this paper is to evaluate the possible application of a therapeutic carnivore diet regimen in the treatment of chronic inflammatory bowel disease (IBD). Based on current research and anecdotal reports, we hypothesized that the diet might potentially exhibit both anti-inflammatory and microbiome-modulating properties salutary to the IBD patient population. Our hypothesis demands comprehensive clinical validation. Therefore, in this paper, we review theories on ketogenic and carnivore diets, discussing their immunomodulatory effects and propose an experimental study to test the feasibility, safety, and clinical efficacy of the carnivore diet for IBD treatment.

Background and aims: In recent years, a possible connection between HLA-Cw6 and a distinctive cardiometabolic (CM) profile in patients with psoriatic disease (PsD) has been proposed, although there is still little support for this. Our aim was to further investigate this possible association by studying a large population of PsD patients. Methods: For this study, three different cohorts of patients with PsD were analyzed: two with a majority of cutaneous psoriasis, pooled n: 600, and a third with only psoriatic arthritis -PsA- cases, n: 340. Potential relationships between HLA-Cw6 and the different CM risk factors (hypertension, diabetes, obesity, dyslipidemia) were analyzed using univariate and multivariate regression models, while the final net effect was assessed using fixed- or random-effects meta-analyses, as appropriate. Results: In the PsA cohort, no association was detected between HLA-Cw6 carriership and any of the CM comorbidity factors. In psoriasis cohorts, after correcting for age, sex, disease duration and arthritis, HLA-Cw6 carriers reduced diabetes risk (OR 0.49, 95%CI: 0.26-0.91, p = 0.026). This latter effect was confirmed by a fixed-effects meta-analysis of the included cohorts (pooled OR: 0.50, 95%CI: 0.27-0.90). Conclusion: This work demonstrates a potential protective effect of the HLA-Cw6 allele on the risk of diabetes in PsD. Our findings together with those of others seem to confirm the existence of a novel HLA-Cw6-linked cardiometabolic endotype in this disease.

Parkinson's disease (PD) is the second most common neurodegenerative disorder, entailing several motor-related symptoms that contribute to a reduced quality of life in affected subjects. Recent advances in wearable technologies and computing resources have shown great potential for the assessment of PD-related symptoms. However, the potential applications (e.g., early diagnosis, prognosis and monitoring) and key features of digital biomarkers for motor symptoms of PD (DB-MS-PD) have not been comprehensively studied. This study aims to provide a state-of-the-art review of current digital biomarker definitions for PD, focusing on the use of wearable devices. This review systematically examines research articles from 2012 to 2024, focusing on key features and recent technologies in PD research. A total of 22 studies were included and thoroughly analyzed. Results indicate that DB-MS-PD can accurately distinguish patients with PD (PwPD) from healthy controls (HC), assess disease severity or treatment response, and detect motor symptoms. Large sample sizes, proper validation, non-invasive devices, and ecological monitoring make DB-MS-PD promising for improving PD management. Challenges include sample and method heterogeneity and lack of public datasets. Future studies can leverage evidence of the current literature to provide more effective and ready-to-use digital tools for monitoring PD.

Background: Atrial fibrillation (AF) is increasingly recognized in pediatric patients, presenting unique challenges in management due to its association with various underlying heart conditions. This study aimed to evaluate the prevalence, management strategies, and outcomes of AF in this population. Methods: A retrospective analysis was conducted at a tertiary pediatric cardiology center, including patients aged ≤18 years diagnosed with AF between January 2015 and December 2023. The study focused on demographic details, clinical presentations, treatments, and outcomes. Descriptive statistics were employed to assess treatment efficacy, recurrence rates, and complications. Results: The study included 36 pediatric patients (median age: 15 years, IQR: 13-17; 58% male). Of these, 52.8% had acquired heart disease, 16.7% had congenital heart anomalies, and 16.7% presented with lone AF. The initial management strategies involved electrical cardioversion in 53.3% of patients and pharmacological conversion with amiodarone in 46.7%. Rhythm control therapy was administered to over 80% of the cohort, and 63.9% were placed on oral anticoagulation, predominantly for rheumatic and congenital heart diseases. The overall success rate of rhythm control was 96.2%, with an AF recurrence rate of 3.8%. Ischemic stroke was the most common complication, occurring in three patients, all with underlying rheumatic heart disease. Conclusion: AF in pediatric patients is predominantly associated with rheumatic and congenital heart diseases, though a significant proportion of patients present with lone AF. Despite effective rhythm control in most cases, neurological complications, particularly ischemic strokes in patients with underlying heart disease, remain a critical concern. These findings underscore the need for more comprehensive studies to better understand the etiology, risk factors, and optimal management strategies for pediatric AF.

The microvessel neurovascular unit with its brain endothelial cell (BEC) and blood-brain barrier remodeling is important in the development of impaired cognition in sporadic or late-onset Alzheimer’s disease (LOAD) and vascular dementia or vascular cognitive impairment and dementia including cerebral amyloid angiopathy in neurodegeneration. LOAD is considered to be the number one cause of dementia globally; however, when one considers the role of mixed dementia (MD) (the combination of both the amyloid cascade hypothesis and the vascular hypothesis of LOAD), it becomes apparent that MD is the number one cause. The microvessel BECs are the first cells in the brain to be exposed to the peripheral neurotoxins of the systemic circulation and are therefore the brain cells at the highest risk for early and chronic injury. Therefore, it is not surprising that microvessel BECs are the first cells to undergo injury and the response to injury wound healing mechanism and remodeling that is excessive and recurrent in the aging process plus other age-related diseases such as cerebro-cardiovascular disease, hypertension, type 2 diabetes mellitus, Parkinson’s disease, plus others. This narrative review explores the intricate relationship between microvessel remodeling, cerebral small vessel disease (SVD), and neurodegeneration as occurs in LOAD. Further, it discusses the current understanding of how microvessel dysfunction, disruption, and pathology contribute to the pathogenesis of LOAD and thus, highlights potential avenues for therapeutic interventions.

Late-onset Alzheimer’s disease (LOAD) is a dementia category disease that starts after the age of 65. Progressive problems in thinking, behaviour, learning etc. are its characteristics. Due to its progressive nature, early diagnosis is crucial. A complex pathway mechanism with different risk factors is involved in LOAD progression. A comprehensive study is done on factors causing LOAD, biomarkers used for diagnosis in clinical and preclinical stage of the disease, ML (Machine Learning) techniques to identify disease stage. We reviewed research papers on clinical and preclinical diagnosis of LOAD using ML techniques from biomarker data: MRI, PET image, MMSE, Genome / Gene expression, DNA / RNA binding sites with protein, Epigenetic expression /DNA, methylation, Speech and text. We have listed improvement scope after finding the gaps and scope of using Generative AI and SMOTE (Synthetic Minority Oversampling Technique) for data augmentation. At the end, we have elaborated current use of DL (Deep Learning) and CNN (‘Convolution Neural Network’) in Alzheimer’s disease (AD) diagnosis.

Background/Objectives: Cardiovascular diseases are one of the leading causes of morbidity and mortality worldwide. Health-related quality of life is crucial to assess the impact of cardiovascular diseases and to guide therapeutic strategies. The Short Form 36 Health Survey and the RAND 36-Item Health Survey questionnaires are common tools for measuring health-related quality of life in patients with cardiovascular disease, but their reliability may vary according to the population studied. The aim of this study is to compare the reliability of the SF-36 and the RAND-36 in a population with cardiac pathology, addressing the question of which of these instruments offers a more consistent and useful measurement in this specific group. Methods: Cross-sectional observational study carried out at the University Hospital of Burgos (Spain). 413 patients with cardiovascular pathology referred to the Cardiac Rehabilitation Unit were included. Patients with incomplete data or who did not participate in the program were excluded. Internal consistency (Cronbach’s alpha), item-total correlation and reliability and a half-half analysis were performed. Results: Both questionnaires showed similar and adequate reliability for patients with cardiovascular pathology. Internal consistency, as measured by Cronbach’s alpha, was above 0.80 for most dimensions, supporting its robustness. Significant inter-item and inter-dimension correlations were found in both scales, except in some specific cases in the dimension ‘Physical Functioning’. The half-half analysis confirmed the good reliability of both scales. Conclusions: Both the SF-36 and the RAND-36 are highly reliable tools for assessing health-related quality of life in patients with cardiovascular disease. The results may have significant implications for clinical practice, helping in the selection of health-related quality of life monitoring instruments and in the evaluation of the efficacy of therapeutic interventions.

Artificial intelligence (A.I.) is the key to process big amounts of data to useful information for operators. In the present study the suitability of a 24/7 A.I. sound based coughing monitoring system for early detection of respiratory distress caused by porcine respiratory disease complex (PRDC) associated pathogens was assessed in the nursery of a conventional pig farm. Screening for PRDC associated pathogens was conducted by PCR examination of oral fluids (OFs) and bioaerosol samples (AS). A significant correlation between A.I. and human gained health data was observed in both batches. An increase in coughing episodes, either measured by A.I. or human, was significantly correlated with decreasing Ct-values of swIAV. The Odds to detect nucleic acids of PRRSV or Actinobacillus (A.) pleuropneumonia was significantly higher for OFs compared to AS. Moreover, PCR examinations of OFs revealed significantly lower Ct-values for swIAV and A. pleuropneumonia compared to AS. The quantity of swIAV RNA in OFs and AS was significantly associated with the A.I. calculated respiratory health score and thus, with clinical disease. Due to its reliable data A.I. based health monitoring is beneficial for early recognition of respiratory distress and thus can assist farmer’s daily work.

INTRODUCTION: This study focusses on diagnosis of stages of AD (Alzheimer’s disease) including MCI (Mild Cognitive Impairment) from two data modalities - gene expression and clinical data of ADNI (Alzheimer’s Disease Neuroimaging Initiative ) participants using multiclassification. The gene expression dataset is highly imbalanced and of HDLSS (high-dimensional and low-sample-size) characteristics. This is the only study where multiclassification based AD stage diagnosis is done to identify multiple stages of Alzheimer. We are able to achieve the best multiclassification result in both the modalities and identify new genetic biomarkers. METHODS: Combination of XGBoost and SFBS (“Sequential Floating Backward Selection”) methods is used to select features. We are able to select the most effective 95 gene probsets out of 49,386. For clinical study data, 8 most effective biomarkers could be selected using SFBS. For both genomic and clinical data, DL (‘Deep Learning’) classifier is used to identify stages - CN (Cognitive Normal), MCI (Mild Cognitive Impairment), AD (Alzheimer’s Disease / Dementia). Because of high data imbalance in genomic data, border line oversampling is used for model training and original data for validation. RESULT & DISCUSSION: With clinical data, we achieved ‘ROC AUC’ scores 0.97, 0.95, 0.94 for CN, MCI, Dementia stage respectively . We achieve ‘ROC AUC’ scores 0.75, 0.74, 0.70 for CN, MCI, Dementia stage respectively and 0.67 for both micro average F1 scores and micro weighted F1 score. This is the best result so far for AD stage diagnosis from gene expression profile data through multiclassification with ADNI data. Results reflect that our multiclassification model can efficiently handle the imbalanced data of HDLSS nature to identify samples of minority class. MAPK14, ZNF835, MID1, HLA-DQA1, TEP1 are some of the new genes found to be associated with AD risk. DRAXIN, HSPA12B, USP47 etc. are found to be AD preventive or suppressor.

The defining characteristic of Alzheimer's disease (AD) is the aberrant deposition of pathogenic proteins, particularly a massive build-up of amyloid-β peptides, specifically in the brain. Amy-loid-β aggregation is neurotoxic and ultimately results in dysfunction of the nervous system. The present investigation aims to predict potential amyloid-β fibrils disaggregating molecules from plant sources through molecular modeling techniques, this appears to be a very promising and appealing treatment philosophy. Here, 500 flavonoids from various plants were considered, ini-tially undergoing ADME studies to screen molecules that could cross the blood-brain barrier. Later, potential Amyloid-β-disaggregating molecules were identified by molecular docking and dynamics (MD) simulation studies. Five molecules, prenylmethoxy flavonol (-7.3 kcal×mol-1), isopentenyl flavonol (-7.3 kcal×mol-1), 7,3'-Dihydroxyflavone (-7.2 kcal×mol-1), 7-Hydroxy-5-methyl-4'-methoxyflavone (-7.2 kcal×mol-1), 8-hydroxy-7-methoxyflavone (-7 kcal×mol-1) showed higher binding affinity score against Alzheimer's Aβ (1-42) fibrils, these are very close to the standard drug (Donepezil) (-7.90 kcal×mol-1). Further, the MD simulation studies established the intermolecular interaction and stability of the five selected ligands-Amyloid-β oligomer protein complexes. These results suggest that the chosen five flavonoid molecules could be used as possible agents to disaggregate amyloid-β fibrils; however, more in vitro and in vivo investigations are required to verify the therapeutic effectiveness.

The landscape of clinical management for metastatic melanoma (MM) and other solid tumors has been modernized by the advent of immune checkpoint inhibitors (ICI), including programmed cell death-1 (PD-1), programmed cell death-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen 4 (CTLA-4) inhibitors. While these agents demonstrate efficacy in suppressing tumor growth, they also lead to immune-related adverse events (irAEs), resulting in exacerbation of autoimmune diseases such as Rheumatoid arthritis (RA), Ulcerative colitis (UC), and Crohn’s disease (CD). The immune checkpoint inhibitors offer promising advancements in the treatment of melanoma and other cancers, but they also present significant challenges related to irAEs and autoimmune diseases. Ongoing research is crucial to better understand these challenges and develop strategies for mitigating adverse effects while maximizing therapeutic benefits. In this manuscript, we addressed this challenge using network-based approaches by constructing and analyzing molecular and signaling networks associated with tumor-immune cross-talk.. Our analysis revealed that IL6 is the key regulator responsible for irAEs during ICI therapies. Furthermore, we conducted an integrative network and molecular-level analysis, including virtual screening, of drug libraries, such as the Collection of Open Natural Products (COCONUT) and the Zinc15 FDA-approved library, to identify potential IL-6 inhibitors.. Subsequently, the compound amprenavir was identified as the best molecule that may disrupt essential interactions between IL6 and IL6R responsible for initiating signaling cascades underlying irAEs in ICI therapies.

Heat index (HI) is a biometeorological indicator that combines temperature and relative humidity. This study aimed to investigate the relationship between heat index and daily counts of diarrhoea hospitalisation in Dhaka, Bangladesh. Data on daily diarrhoea hospitalisations and meteorological variables from 1981–2010 were collected. We categorised heat index of >94.3°F, >100.7°F and >105°F as high, very high and extremely high heat index, respectively. We applied time-series adjusted generalised linear model (GLM) with negative binomial distribution to investigate the effects of heat index and extreme heat index on hospitalisations for diarrhoea. Effects were assessed for all ages, <5 children and by gender. A unit higher HI, and high, very high and extremely high HI were associated with 0.8%, 8%, 7% and 9% increase in diarrhoea hospitalisation in all ages, respectively. The effects varied slightly by gender and were most pronounced in <5 children with a rise of 1°F in high, very high and extremely high HI associated with a 14.1% (95% CI: 11.3% – 17.0%), 18.3% (95% CI: 13.4% – 23.5%) and 18.1% (95% CI: 8.4% – 28.6%) increase of diarrhoea, respectively. This suggest that heat index may serve as an alternative indicator for measuring the combined effects temperature and humidity on diarrhoea.

This work focused on Diplectanum aequans, a gill parasite of European seabass Dicentrarchus labrax. The analyses allowed us to detect factors regulating parasite distributions on Corsican fish farms and to highlight the ecological structure of D. aequans communities on gills of fish. The study of parasite distribution showed that bigger fish appear more parasitized and that the infection dynamics of D. aequans can be explained by several factors such as biotic factors or farm environment conditions. The study of gill repartition of D. aequans showed that parasites tend to have a homogeneous distribution with no statistically significant difference in infection between the two sides of fish. However, the distribution of the number of parasites on gill arches varied according to the total number of parasites. The results differ depending on infection degree and host weight. When parasites are numerous, the individuals are distributed on the gill arches according to an anterior-posterior gradient, while with low rates of infection, the parasites are randomly distributed on the four arches. The spatial distribution of D. aequans appears to be determined by the differential action of water flow through the gill arches and the sizes of anterior arches. We also proposed a tool to reduce sampling effort and allow optimal exploitation for fish farmers.

Background/Objectives: Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular disease (CVD). Carotid intima-media thickness (C-IMT) is a non-invasive marker of atherosclerosis. Low omega-3 polyunsaturated fatty acids (PUFA) intake and vitamin D deficiency are potential cardiometabolic risk factors in patients with CKD. The aim of this study was to evaluate dietary intake and status of omega-3 PUFA and vitamin D in pre-dialysis and hemodialysis patients and to examine the link of dietary α-linolenic acid (ALA) and fish consumption with blood pressure and C-IMT in CKD patients. Methods: All 77 selected patients (36 pre-dialysis, 41 on hemodialysis) underwent standardized clinical, nutritional, and laboratory assessments. Repeated 24-hour recalls were performed to assess dietary intake. The fatty acid profile was determined by gas-liquid chromatography. Results: Inadequate vitamin D intake and vitamin D status were found in 95% of patients. PUFAs profiles did not differ between hemodialysis and pre-dialysis participants. Dietary intake of ALA was negatively correlated with systolic blood pressure (SBP) (p=0.007), C-IMT (p=0.002), serum CRP (p=0.044), iPTH (p=0.01) and 25(OH)D3 (p=0.006). ALA intake of more than 0.23 g/daily was associated with lower SBP (p=0.001), serum 25(OH)D3 (p=0.004), and C-IMT (p=0.002). Conclusions: This study contributes to a better understanding of the relationship between dietary ALA intake and C-IMT in CKD. The results of this study could emphasize the significant role of the high prevalence of vitamin D deficiency and inadequate omega-3 PUFA intake and status considering CVD health in CKD patients.

Immersive virtual reality has the potential to motivate and challenge patients that need and want to relearn movements in the process of (neuro-)rehabilitation. The aims of this study were to evaluate the feasibility and users’ acceptance of an innovative immersive virtual reality system (head-mounted display) used in combination with robot assisted gait training in subjects suffering from neurological diseases. Fifteen participants tested a single session of immersive virtual reality by means of head-mounted display during a Lokomat gait session. Training parameters and safety indicators were collected and the acceptance was investigated among the participants and the therapists. The results suggest that the immersive virtual reality system is feasible with respect to safety and tolerance. Furthermore, the very positive overall acceptance of the system suggests that it has potential to be included in a robot assisted gait training session by means of Lokomat. Taken together, this study demonstrates the feasibility and acceptance of an innovative immersive virtual reality system in combination with a robot assisted gait training in subjects suffering from stroke and spinal cord injury, as well as their therapists.

Background The increasing number of elderly individuals in South Korea, now entering a super-aging era, underscores the growing importance of understanding their specific oral health needs. This study investigated changes in oral health conditions, salivary parameters, halitosis, systemic diseases, and medication usage with aging. Methods This study was retrospectively conducted using the medical records of patients who presented with complaints of xerostomia or halitosis between August 2020 and May 2023. A total of 274 patients (66 males, 208 females, mean age 59.39 ± 16.10 years) were included in this study. Results Aging was found to be significantly associated with the presence of sticky saliva, poor oral hygiene, tongue coating, and halitosis (all p < 0.05). Correlation analyses further revealed significant associations between aging and several conditions, including hypertension (r = 0.495, p < 0.001), diabetes mellitus (r = 0.255, p < 0.001), amlodipine usage (r = 0.249, p = 0.001), osteoporosis (r = 0.195, p = 0.001), cardiovascular disease (r = 0.150, p = 0.013), and the presence of tongue coating (r = 0.205, p = 0.001). Conversely, none of the salivary parameters demonstrated a significant relationship with aging. Furthermore, halitosis did not exhibit significant differences across age groups (all p > 0.05), with the exception of methyl mercaptan levels, which were notably higher among patients in their 20s (p = 0.049). Conclusions The findings of this study can help clinicians develop targeted strategies to address specific oral health challenges associated with aging in elderly patients.

Background. National surveys reported on variable prevalence of chronic kidney disease (CKD) due to differences in characteristics of population, design, equations used to estimate glomerular filtration rate (eGFR) and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence and cardio-kidney-metabolic risk factors in Croatia which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of albumin-to-creatinine ratio (ACR) and eGFR (CKD EPI equation). Comorbidities, anthropometric and social factors related to the prevalence of CKD were analyzed, and CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥ G3A A2, and CKD defined only as eGFR < 60 ml/min/1.73 m2 were estimated at 17.1%, 9.8% and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p 30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD of 9.5%. Unaware were older with lower income, less educated, having more frequently diabetes, hypertension (less frequently controlled) and milder renal impairment. Conclusion. In Croatia, the estimated prevalence of CKD is high, being more frequently presented in men than in women. CKD patients have unfavorable CV risk profile. The awareness of CKD is very low reflecting poor health literacy in general population but also in health care workers.

Background: Diagnostic accuracy of Parkinson’s disease (PD), a synucleinopathy, based on diagnostic criteria is suboptimal. A biomarker for synucleinopathies is pivotal both from a clinical and from a research aspect. CSF a-synuclein has been extensively studied over the past two decades as a candidate biomarker of synucleinopathies. Herein we present data on studies focusing on total, phosphorylated and oligomeric CSF a-synuclein in PD. Methods: Pubmed, Scopus and Web of Science were searched for studies with &gt;10 PD patients and control subjects, with data (mean, SD) on total, phosphorylated or oligomeric a-synuclein. Cohen’s d, as a measure of effect size, was calculated for all a-synuclein forms. Subgroup analysis and meta-regression were performed in an effort to explain between-study heterogeneity. Results: Thirty studies on total, six studies on oligomeric and one study on phosphorylated a-synuclein were included. Total a-synuclein was decreased and oligomeric a-synuclein increased in PD patients vs. controls. Effect size was medium for total and high for oligomeric a-synuclein. A-syn forms provided suboptimal combined sensitivity/specificity for the differentiation of PD from controls. There was significant between-study heterogeneity. PD cohort characteristics (sex, age, disease duration, UPDRS, H&amp;Y) and study characteristics (study design, healthy vs. neurological controls, control for CSF blood contamination, method of a-syn measurement) could not account for between-study heterogeneity. Publication bias was limited. Conclusions: CSF a-synuclein levels lack sufficient accuracy to be used as biomarkers for PD. Standardization of (pre)analytical variables may improve the discriminatory power of a-synuclein forms in the future.

Fractional flow reserve (FFR) is regarded as the gold standard for assessing the functional significance of coronary artery lesions, yet it remains underutilized in clinical practice. Our objective was to investigate whether FFR results have the potential to alter treatment decisions for coronary lesions compared to visual assessments of angiographic images made by three operators at a high-volume interventional center. In this retrospective study, we aimed to reassess the angiographic images of 63 patients presenting with chronic coronary syndrome (n=39, 61.9%) and acute coronary syndrome (n=24, 38.1%) who underwent FFR. Three experienced interventional cardiologists (with >300 PCI procedures per year) reevaluated, blinded to FFR results, 105 ambiguous lesions in 63 patients to determine angiographic significance and treatment strategy. The observers reached a concordant agreement (≥2 operators made the same decision) to perform PCI in 60 (57.1%) of the lesions based on angiographic evaluation. Interestingly, 9 (15%) of these lesions were functionally non-significant (FFR &gt;0.80). The observers agreed to defer PCI in 45 (42.9%) of the lesions; however, 4 (8.9%) of these were functionally significant (FFR ≤0.80) and required PCI. Thus, inter-observer concordance in visual-guided therapeutic decision-making is variable and not always confirmed by the functional significance of coronary lesions.

Fungal trunk disease (FTD) poses a significant threat to hazelnut (Corylus avellana L.) production worldwide. In Chile, the fungus Diplodia mutila, from the Botryosphaeriaceae family, has been frequently identified causing this disease in the Maule and Ñuble Regions. However, control measures for D. mutila remain limited. This research aimed to evaluate the effectiveness of chemical and biological fungicides against D. mutila under in vitro, controlled pot experiment, and field conditions. An in vitro screening of 30 fungicides was conducted. The effectiveness was assessed by measuring the length of vascular lesions in hazelnut branches inoculated with D. mutila mycelium disks under controlled and field conditions. Field trials were conducted in a hazelnut orchard in Ñiquén, Ñuble Region, Chile. Results showed that three biological and five chemical fungicides were selected in vitro with &gt; 31% inhibition after 14 days. In pot experiments, all fungicides reduced necrotic lesions on branches by 32 to 61%. In field experiments, the most effective systemic fungicides were fluopyram/tebuconazole, fluxapyroxad/pyraclostrobin, and tebuconazole, while the effectiveness of antagonists Pseudomonas protegens ChC7 and Bacillus subtilis QST713 varied with seasonal temperatures. Effective conventional and biological fungicides against D. mutila could be integrated into disease management programs to protect hazelnut wounds from infections.

Glutamate transporter-1 (GLT-1) dynamics are implicated in excitotoxicity and Alzheimer's disease (AD) progression. Early stages of AD are often marked by hyperactivity and increased epileptiform activity preceding cognitive decline. Previously, we identified a direct interaction between GLT-1 and Presenilin 1 (PS1) in the brain, highlighting GLT-1 as a promising target in AD research. This study reports the significance of this interaction and uncovers a novel role of GLT-1 in modulating amyloid-beta (Aβ) production. Overexpression of GLT-1 in cells reduces the levels of Aβ40 and Aβ42 by decreasing γ-secretase activity pertinent to APP processing and induces a more "open" PS1 conformation, resulting in decreased Aβ42/40 ratio. Inhibition of the GLT-1/PS1 interaction using cell-permeable peptides produced an opposing effect on Aβ, highlighting the pivotal role of this interaction in regulating Aβ levels. These findings emphasize the potential of targeting GLT-1/PS1 interaction as a novel therapeutic strategy for AD.

Objective: SARS-CoV-2 remains the third most common cause of death in North America. We studied methotrexate and tumor necrosis factor inhibitor (TNFi) effects on neutralization responses post-COVID vaccination, in immune-mediated inflammatory disease(IMID). Methods: Prospective data and sera on adults with inflammatory bowel disease (IBD), rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA) and systemic lupus (SLE) were collected at 6 academic centres in Alberta, Manitoba, Ontario, and Quebec between 2022-2023. Sera from two time points were evaluated for each subject. Neutralization studies were divided between 5 laboratories, and each lab’s results analyzed separately using multivariate generalized logit models (ordinal outcomes: absent, low, medium, and high neutralization). Odds ratios (ORs) for methotrexate and TNFi effects were adjusted for demographics, IMID, other biologics and immunosuppressives, prednisone, COVID vaccinations (number/type), and infections in the 6 months prior to sample. Adjusted ORs for methotrexate and TNFi were then pooled in random-effects meta-analyses (separately for ancestral, and Omicron BA1 and BA5 strains). Results: Of 479 individuals (958 samples), 292 (61%) were IBD, 141 (29.4%) RA, and the remainder PsA, SpA and SLE. Mean age was 57 (62.2 % female). For both individual labs and the meta-analyses, adjusted ORs suggested independent negative effects of TNFi and methotrexate on neutralization. The meta-analysis adjusted ORs for TNFi were 0.56 (95% confidence interval, CI 0.39, 0.81) for the ancestral strain and 0.56 (95% CI 0.39, 0.81) for BA5. The meta-analysis adjusted OR for methotrexate was 0.39 (95% CI 0.19, 0.76) for BA1. Conclusions: SARS-CoV-2 neutralization in vaccinated IMID was diminished independently by TNFi and methotrexate. As SARS-CoV-2 circulation continues, ongoing vigilance regarding optimized vaccination is required.

Celiac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten, affecting approximately 1% of the global population and two million Americans. An increasing number of studies have identified a link between celiac disease and adverse maternal and fetal outcomes during pregnancy and after birth. Additionally, both celiac disease and pregnancy are associated with an increased risk for nutrient deficiencies, specifically vitamin B12 and folate. Deficiencies in these key nutrients are linked with several negative maternal and fetal health outcomes including preeclampsia, gestational diabetes, spontaneous abortion/miscarriage, preterm birth, NTDs, Intrauterine Growth Restriction, and low gestational age and birthweight. This review examines the current literature related to the folate trap and vitamin B12 deficiency in patients with celiac disease and pregnant women independently, and to provide rationale for future research to explore the correlation between the folate to B12 ratio in pregnant woman with celiac disease.

Pigeon Newcastle disease, caused by pigeon paramyxovirus type 1 (PPMV-1), is a significant infectious disease in pigeons that can result in substantial mortality and poses a severe threat to the pigeon industry. Rapid and accurate onsite diagnosis of pigeon disease is crucial for timely diagnosis and the implementation of effective prevention and control measures. In this study, we established a rapid detection method for PPMV-1 based on recombinase-aided amplification (RAA) and CRISPR/Cas12a. The RAA primers target the conserved regions of the L gene for preamplification in clinical nucleic acid samples, followed by CRISPR/Cas12a detection of the target gene. Visualization could be achieved by combination with a lateral flow dipstick (LFD). This method demonstrated high specificity, showing no cross-reactivity with non-PPMV-1 samples. The sensitivity of the method assessed by fluorescence analysis reached 100 copy/µL, and when it was combined with an LFD, the sensitivity was 103 copies/µL. The constructed RAA-CRISPR/Cas12a-LFD visual detection method was applied to clinical sample testing and was found to enable rapid and accurate detection of swab samples and tissue specimens. Its sensitivity was consistent with the current gold standard, quantitative real-time PCR results. The RAA-CRISPR/Cas12a-LFD detection method we developed provides a novel approach for the rapid, simple, precise, and specific onsite diagnosis of pigeon Newcastle disease.

Correct diagnosis and early treatment of respiratory diseases can significantly improve the health status of patients, reduce healthcare expences, and enhance quality of life. Therefore, there has been extensive interest in developing automatic respiratory disease detection systems. Most of these methods have recently been using machine and deep learning algorithms. The success of machine learning methods depends heavily on the selection of proper features to be used in the classifier. Although metaheuristic-based feature selection methods have been successful in addressing difficulties presented by high-dimensional medical data in various biomedical classification tasks, there is not much research on the utilization of metaheuristic methods in respiratory disease classification. This paper aims to conduct a detailed and comparative analysis of six widely used metaheuristic optimization methods using eight different transfer functions in respiratory disease classification. For this purpose, two different classification cases were examined: binary and multi-class. The findings demonstrate that metaheuristic algorithms using correct transfer functions could effectively reduce data dimensionality while enhancing classification accuracy.

Bioimpedance analysis (BIA) is a validated non-invasive technique already proven to be useful for the diagnosis, prognosis, and management of body fluids in subjects with heart failure (HF) and chronic kidney disease (CKD). Although BIA has been widely employed for research purposes, its clinical application is still not fully widespread. The aim of this review is to provide a comprehensive overview of the state of art of BIA utilization by analysing the clinical benefits, limitations, and the potential future developments in this clinically unexplored field.

Background: Inflammatory Bowel disease (IBD) is one of the worldwide health issues with increasing incidence. Recent data point out that those patients can have a defective immune system, rendering response to vaccinations suboptimal. Since 1990, Hepatitis B Virus (HBV) vaccination has been introduced among the compulsory childhood vaccinations in Oman. Given the questionable immunogenicity of vaccinations in IBD patients, we designed this study to quantify the immune response to scheduled HBV vaccine in IBD patients and compare it with that in a matching control cohort of healthy blood donors at Sultan Qaboos University Hospital (SQUH). Methods: This is a retrospective case-control study that was conducted between the 1st of July 2023 and the 31st of May 2024 at SQUH. Using the hospital information System (HIS), a total of 252 participants were enrolled in our study and divided into two groups. Group (1) included 126 IBD patients and group (2) included 126 healthy controls. Baseline demographics, medical comorbidities and viral serologies before and after vaccination were collected. The primary outcome of the study was to compare the long term immune response to HBV vaccine between the two groups. The secondary outcomes included identifying possible risk factors for suboptimal vaccine response. Results: One hundred and twenty-six participants were included in each group. Durable protective immune response to HBV vaccine was attained in 29 patients (23%) of the IBD group compared to 109 participants (86.5%) of the control group. There was a statistically significant association (p = 0.0156) between prednisolone treatment and low immune response to HBV vaccine. Moreover, esomeprazole usage exhibited a statistically significant association (p < 0.0001) with suboptimal response to HBV vaccine. Meanwhile, there was no statistically significant correlation between low immunogenicity to HBV vaccine and age, sex, type of IBD, comorbidities, and BMI. Conclusions: IBD patients are less immunogenic to HBV vaccination compared to healthy controls. Factors like esomeprazole and/or corticosteroid therapy might be associated with poor immune response. These findings highlight the importance of reassessing the immunogenicity of HBV vaccination and probably other protective vaccinations in all IBD patients as part of their standard of care.

Lung macrophage cells play a critical role in various lung disease, and their state can change depending on the progression of the disease by inducing either an inflammatory or anti-inflammatory state. In this review, we investigate the potential therapeutic effects of treatment with antioxidant nanoparticles in airway disease focusing on porcine reproductive and respiratory virus (PRRSV), considering Reactive Oxygen Species (ROS) as one of the factors that regulate M1 and M2 macrophages in the inflammatory and anti-inflammatory states, respectively. In addition, we examine the status of protein structure research on CD163 (one of the markers of anti-inflammatory M2 macrophages) in human and veterinary lung diseases and suggest directions for future applicable research areas.

In veterinary medicine, the significance of High-Density Lipoprotein (HDL) measurements is not well-documented than it is in humans. The HDL level can be measured in dogs, and through referring to the normal range, it is possible to find out what this means for various endocrine diseases and hyperlipidemia diseases. Aim of this study is to measure the HDL levels in dogs with various conditions and to evaluate whether the Total Cholesterol (TC), HDL ratio is effective as a prognostic indicator in various hyperlipidemia and endocrine diseases. Through prospective clinical trial, sixteen client-owned dogs and cats visiting a local private practice were divided into three groups; five dogs without hyperlipidemia or metabolic disease (Group 1); eight animals with Cushing's, hypothyroidism, and gallbladder sludge (Group 2) and three diabetics, urinary disorders, and healthy cats (Group 3). In two dogs, the TC/HDL values were between 2 and 3; in two dogs, the values were between 3 and 4; in two dogs, the values were between 4 and 5. In three dogs, the TC/HDL values were between 5 and 6 and in three dogs, the ratio values were between 6 and 7. The other value was higher than 8. Except two dogs which showed lower value than 3, all dogs had concurrent endocrine disease including Cushing’s disease, hypothyroidism, gall bladder mucocele, hyperlipidemia. There was a difference in each group in terms of the TC/HDL value compared to the group with underlying disease. This means that TC/HDL values can be an excellent indicator of endocrine disease in dogs as well. In cats, although this is a very small sample, a high TC/HDL value of 9 points are shown in the cat which had diabetes mellitus. However, for more statistically significant results, a larger sample group for further investigation is needed.

Advances in molecular biology, polymerase chain reaction (PCR), and next-generation sequencing (NGS) have transformed the concept of minimal residual disease (MRD) from a philosophical idea into a measurable reality. Acute promyelocytic leukemia (APL) led the way in this transformation, initially using PCR to detect MRD in patients in remission, and more recently, aiming to eliminate it entirely with modern treatment strategies. Along the way, we have gained valuable insights that, when applied to other forms of acute leukemia, hold the potential to significantly improve outcomes in these challenging diseases. In this review, we explore the current use of MRD in the management of acute leukemia and delve into the biological processes that contribute to MRD persistence, including its overlap with leukemia stem cells and the role of the bone marrow microenvironment.

In vivo proton (1H) magnetic resonance spectroscopy (MRS) is a powerful noninvasive method which can measure Alzheimer’s disease (AD) related neuropathological alterations at the molecular level. AD biomarkers include amyloid-beta (Aβ) plaques and hyperphosphorylated tau neurofibrillary tangles. These biomarkers can be detected via postmortem analysis, but also in living individuals through positron emission tomography (PET) or biofluid biomarkers of Aβ and tau. This review offers an overview of biochemical abnormalities detected by 1H MRS within the biologically defined AD spectrum. It includes a summary of earlier studies that explored the association of 1H MRS metabolites with biofluid, PET, and postmortem AD biomarkers, and examined how apolipoprotein e4 allele carrier status influences brain biochemistry. Studying these associations is crucial for understanding how AD pathology affects brain homeostasis throughout the AD continuum and may eventually facilitate to develop potential novel therapeutic approaches.

Objectives: This study aimed to compare the similarities and differences between the Kawasaki disease (KD) during the SARS-CoV-2 pandemic and multisystem inflammatory syndrome in children (MIS-C). Methods: The medical records of patients diagnosed with KD and MIS-C at a single center between July 2020 and November 2021 were retrospectively reviewed. Results: The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. Compared with the KD patients, MIS-C patients were older (p<0.001), had longer hospital stays (p=0.023), elevated neutrophil count (p<0.001), C-reactive protein (p<0.001), procalcitonin (p<0.001), interleukin-6 (p<0.014), ferritin (p<0.001), fibrinogen (p<0.001), troponin I (p=0.001), NT-proBNP (p<0.001), and, D-dimer levels (p<0.001). They had more hypotension (p=0.024), decreased left ventricular function (p=0.023), and a greater need for corticosteroids (p<0.001), enoxaparin (p=0.045), and therapeutic plasma exchange (p<0.001). Patients with KD displayed a higher frequency of rash (p<0.001), oral mucosal changes (p<0.001), conjunctival injection (p<0.001), extremity changes (p<0.001), and cervical lymphadenopathy (p<0.001). They had a longer duration of fever (p<0.001), elevated white blood cell count (p<0.001), platelet count (p<0.001), and alanine aminotransferase level (p<0.001). The two groups were similar in terms of hemoglobin levels, erythrocyte sedimentation rate, albumin levels, or the frequency of coronary dilation/aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment. Conclusions: Older patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas a longer duration of fever and classical clinical features of KD favor KD.

Objectives: In recent years, ear endoscopy has gradually become an important tool in ear surgery. This study further explored its application in ear surgery, to establish a surgical approach for semicircular canal obstruction (SOC) via the ear canal to control vertigo in Meniere's disease. Methods: With the approval of the ethics committee, recruitment started in June 2019. ​Four patients with Meniere's disease who had been treated conservatively for more than six months received SCO via an external ear canal approach under otoendoscopy and were followed for two years after surgery to assess the safety and efficacy of the procedure. Results The control of vertigo after the operation was satisfactory (100%), and the frequency and degree of vertigo were significantly improved. Tinnitus improved in 1 case (25%) and did not progress in the other 3 cases. Hearing loss did not progress in all patients. Postoperative walking instability occurred in 1 patient (25%), and there were no obvious complications. All patients reported significant improvements in their quality of life. Conclusions: SCO via the external auditory canal approach is safe, effective, easy to accept, and an alternative to conservative treatment of Meniere's disease with no actual hearing for more than 6 months.

Serotonin (5-hydroxytryptamine: 5-HT), a neurotransmitter that regulates mood in the brain and signaling in the gut, has receptors throughout the body that serve various functions. Selective serotonin reuptake inhibitors (SSRIs) are used to treat depression, but their efficacy is uncertain. Depression is often associated with early gastrointestinal symptoms. Gut disorders such as functional dyspepsia (FD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are linked to elevated serotonin levels. In this review, we would like to discuss the approach of using serotonin as a biomarker for gut-brain and body-wide organ communication may lead to the development of preventive and innovative treatments for gut-brain disorders, offering improved visibility and therapeutic monitoring. It could also be used to gauge stress intensity for self-care and mental health improvement.

Field surveys were conducted in October 2022 and March 2023 (60 fields each year) to determine the prevalence, incidence and severity of cassava mosaic disease (CMD) and cassava brown streak disease (CBSD), whitefly numbers and incidence of cassava green mite (CGM) in six counties of western Kenya. A total of 29 varieties were recorded out of which 13 (45%) were improved. The improved varieties were present in 62% of the 120 fields sampled with the most predominant MM96/4271 found in 36% of the fields. There was more CMD infection in 2022 with a prevalence of 68%, incidence of 26.4% and severity score of 2.7, while in 2023 these parameters were 60%, 10.1% and 3.0 respectively. CMD incidence attributed to planting infected cuttings was 20.1% in 2022 but dropped to 4.3% in 2023 while for whitefly-borne infection incidence remained 4.4% for both years. CMD incidence was significantly lower (5.9%) for improved varieties than it was for local varieties (35.9%) in contrast to CBSD incidence which did not differ significantly between improved (2.3%) and local varieties (9.7%). However, the improved variety MM96/4271 was among the varieties most affected by CBSD, with an incidence of 6.3%. Overall, CBSD in 2022 had a prevalence of 20%, incidence of 6.4% and severity of 2.7, while in 2023 these parameters were 12%, 4.1% and 2.7 re-spectively. Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) were both detected. Most infections were single CBSV infections (82.9%), followed by single UCBSV (34.3%) and coinfection with both viruses (16.7%). Whiteflies were more abundant in 2023, in which 28% of the fields had super-abundant populations of >100/plant, compared to 5% in 2022. Molecular characterization based on mtCOI sequencing identified the whiteflies as Bemisia tabaci. KASP SNP genotyping designated 92.8% of the specimens as SSA-ECA for 2022 while it was 94.4% for 2023, compared to 72% for an earlier sample collection in western Kenya in 2017. CGM prev-alence was 95% with a severity of 2.7 in both years, but incidence was lower in 2022 (65.4%) compared to 2023 (79.9%). This study demonstrates that the majority of farmers are cultivating improved varieties, although cassava viruses, whiteflies and cassava green mites are still a threat. There is a need to develop and deploy integrated management strategies against these pests which will include components of resistant varieties, clean seed and control of whiteflies and CGM.

Introduction: Immune checkpoint inhibitors (ICI) are used to treat various malignancies. They block the inhibitory signals of tumor cells and enhance the inflammatory cascade which results in tumor killing. However, this can lead to unchecked inflammation throughout the body, leading to various adverse effects. A rare gastrointestinal adverse effect of ICI therapy is the development of immune-mediated celiac disease. This entity has a similar clinical presentation to the more common ICI-induced enterocolitis. Our study aims to determine the clinical characteristics and optimal treatment strategies for this rare ICI toxicity, and differentiate it from ICI-induced enterocolitis. Methods and Material: We conducted a retrospective analysis of eight cases of ICI-induced celiac disease and 24 cases of ICI-induced enterocolitis from the literature. Data on patient demographics, clinical history, therapeutic interventions and outcomes were collected. Comparative analysis was performed to identify the key differences between the two groups. Results: Patients with ICI-induced celiac disease were more likely to have a pre-existing autoimmune condition and HLA-DQ2 positivity. Significant differences in clinical manifestations, histological findings, and treatment outcomes were observed. Notably, weight loss, nutritional deficiencies and electrolyte abnormalities were more commonly associated with ICI-CD. On pathology, duodenal villous blunting was noted more commonly with ICI-induced celiac disease. Initiating a gluten-free diet led to rapid improvement in patients with ICI-induced celiac disease, while immunosuppressive therapy did not have an impact. Conclusion: ICI-induced celiac disease is a rare and underrecognized gastrointestinal adverse effect of ICI therapy, often misdiagnosed as ICI-induced enterocolitis. Early recognition and treatment with a gluten-free diet can lead to rapid symptom resolution, sparing patients from unnecessary systemic immunosuppression and discontinuation of antineoplastic immunotherapy.

The Minamata Disease in Japan was one of the most notorious public nuisance cases in the 1960s and 70s, but is still ongoing “unfinished business” in terms of victims’ protection even after several decades of struggles. The world standard of epidemiological causation has still been applied in limited cases. However, it has been pointed out in the international report that, in recent years, mercury contamination has decreased in countries in the Global North, except the Canadian Indigenous peoples’ case, at the same time that it has increased in the Global South. In the Amazon, many Indigenous peoples, most prominently, the Munduruku people in Para state and the Yanomami people in Roraima state, suffer from the Brazilian Minamata Disease due to mercury contamination differently as a typical case of global environmental injustice issues. This paper discusses the comparative difference of the Minamata Disease between inside and outside Japan: In Japan, accumulated mercury contamination in Shiranui Bay of Kyushu due to the poisonous waste release by a big corporation named Chisso Co. was serious, while in the Amazon, contamination due to gold mining by ASGM has been much broader and more diffused. Thus, civil law damages litigation has historically worked despite some challenges in Japan, while it’s practically impossible to stop numerous small scale gold mining by judicial approach in the Amazon. Instead, the administrative regulation under the Lula administration contrasted to the Bolsonaro administration might be especially important, although it’s still limited, considering the global demand for gold and related continuous gold mining activities. Minamata Disease symptoms among the Indigenous peoples along the Amazon are generally minor compared to the Japanese case, but they should also be considered the case from the liberal standard that criticizes the traditional stringent standard such as the Hunter=Russell criteria. However, facing the worsening situation of mercury contamination, the challenges in the Global South are serious: The effective measures for their global health are limited except for dietary education to avoid poisonous carnivorous fishes as opposed to herbivorous fishes. International assistance for providing clean water is also imminent agenda.

Extracting entities from large volumes of chicken epidemic texts is crucial for knowledge sharing, integration, and application. However, Named Entity Recognition (NER) encounters significant challenges in this domain, particularly due to the prevalence of nested entities and domain-specific named entities, coupled with a scarcity of labeled data. To address these challenges, we compiled a corpus from 50 books on chicken diseases, covering 28 different disease types. Utilizing this corpus, we developed a nested NER model, MFGFF-BiLSTM-EGP. This model integrates the Multiple Fine-Grained Feature Fusion (MFGFF) module with a BiLSTM neural network and employs an Efficient Global Pointer (EGP) for predicts the entity location encoding. In MFGFF module we designed three encoders, character encoder, word encoder and sentence encoder, this design effectively captures fine-grained features and improves the recognition accuracy of nested entities. Experimental results show that the model performs robustly, with F1 scores of 91.98%, 73.32%, and 82.54% on the CDNER, CMeEE V2, and CLUENER datasets, respectively, outperforming other commonly used NER models. Specifically, on the CDNER dataset, the model achieved an F1 score of 79.68% for nested entity recognition. This research not only advances the development of knowledge graph and intelligent question-answering system for chicken diseases but also provides a viable solution for extracting disease information that can be applied to other livestock species.

It is documented that maternal diseases or treatments influence a newborn’s clinical status at birth; autoimmune diseases with circulating antibodies are often clinically expressed transiently in newborns due to the crossover of the specific IgG through the placenta during pregnancy. The offspring can inherit maternal genetic anomalies, but clinical expression usually becomes patent later in life. If prenatal medical history is not available or if signs or symptoms of a mother’s disease are revealed for the first time during pregnancy or postpartum, their effects on the newborn may be misattributed. In this article, we present three cases of pregnant women, without any known pathology before or during pregnancy, who gave birth to very sick preterm newborns that required admission to the Neonatal Intensive Care Unit (NICU). The neonates’ complications were considered initially as consequences of prematurity or infection, but later investigations revealed transient autoimmune disease in two of the cases (myasthenia gravis and hyperthyroidism) and a severe form of thrombophilia in the third case. In all cases, mothers were asymptomatic and unaware of their subclinical disease. Preemies’ diagnosis has contributed to the identification of their mothers’ pathology and adequate treatment was prescribed with favourable short- and long-term outcomes. In one of the cases (myasthenia gravis) both mother and child had associated infectious diseases in the perinatal period that complicated the clinical picture and created problems of diagnosis. This article intends to emphasize the paramount importance of prenatal care, for both mother and newborn. Repeated medical visits and investigations throughout the pregnancy are a good opportunity to detect subclinical diseases or predispositions. As newborns usually develop non-specific signs, one should have experience and pay attention to differentiate among etiologies. Our paper takes a reversed approach to the usual medical diagnosis pathway: from infant to mother instead of mother towards the infant, proving that inter-speciality collaboration can work bi-directionally.

We developed a protein to rapidly and accurately diagnose Chagas disease, a life-threatening illness identified by the WHO as a critical worldwide public health risk. Complicating the current health situation are serological test limitations that contribute to most infected persons being unaware of their condition and therefore untreated. To improve diagnostic testing, we developed an immunological mimic of the etiological agent, Trypanosoma cruzi, by combining ten pathogen specific epitopes within the beta-barrel protein structure of Thermal Green Protein. The resulting multi-epitope protein, DxCruziV3, displayed high specificity and sensitivity as the antibody capture reagent in an ELISA platform with an analytical sensitivity that exceeds WHO recommendations. Within an immunochromatographic platform, DxCruziV3 showed excellent performance for the point of application diagnosis in a region endemic for multiple diseases, the municipality of Barcelos in the state of Amazonas, Brazil. In total, 167 individuals were rapidly tested using whole blood from a finger stick. As recommended by the Brazilian Ministry of Health, venous blood samples were laboratory tested by conventional assays for comparison. Test results suggest utilizing DxCruziV3 in different assay platforms can confidently diagnosis chronic infections by T. cruzi. Rapid and more accurate results will benefit everyone but will have the most noticeable impact in resource-limited rural areas where the disease is endemic.

Background: The new therapeutic modality incorporating countermeasure against the most plausible environmental factor in inflammatory bowel disease, i.e., a plant-based diet, showed far better outcomes than current standards in inflammatory bowel disease. Infliximab is widely used for induction and subsequent scheduled maintenance therapy in patients with inflammatory bowel disease. However, the efficacy of infliximab diminishes over time. Objectives: To investigate the durability of scheduled infliximab maintenance therapy incorporating plant-based diet in inflammatory bowel disease. Methods: This was a prospective single-group trial at tertiary hospitals. Infliximab maintenance therapy was indicated in patients with severe or unresponsive to conventional therapy. Infliximab (5 mg/kg body weight) was infused every 8 weeks on an inpatient basis, and plant-based diet, a lacto-ovo-vegetarian diet, was served three or four times during hospitalization. Durability was assessed using the Kaplan-Meier method. Results: Twenty-four patients (16 with Crohn’s disease, eight with ulcerative colitis) were included: median age 27.5 years old, disease duration 53.5 months, and concomitant use of immunosuppressant 21%. Intensification of infliximab was employed in 46% of patients. There was no significant difference in durability rates between Crohn’s disease and ulcerative colitis. Durability rates were 87% at both 5 and 10 years. Plant-based diet score in the median follow-up period of 9.3 years, which indicates adherence to the plant-based diet, was significantly higher than the baseline score. Conclusions: Infliximab maintenance therapy incorporating plant-based diet yielded a high durability rate of 87% at 5 years in patients with Inflammatory bowel disease.

The current study investigated the neuroprotective effects of rutin hydrate (RH) in an Alzheimer’s disease (AD)-like learning and memory impairments rat model. Since AD is an age-related degenerative brain disorder characterized by a progressive worsening in cognitive function and memory, RH may be a potential drug for the treatment of AD-like memory loss, and this work is aimed to evaluate whether RH has neuroprotective effects in memory deficits induced by scopolamine (SCO). In our study, RH demonstrated beneficial effects as a neuroprotector in the brain and improved learning, memory, and synaptic plasticity in a rat. Rats were administered RH (100 mg/kg) and SCO (1.5mg/kg), and performed behavioral tests such as Morris water navigation test, Y-maze test, and passive avoidance test to evaluate the ability of learning and memory. In accordance with these findings, RH behaviorally attenuated SCO-induced shortening of step-through latency in the PA test, increased the percent of alternation in the Y-maze, and increased the time spent in the target zone in the MWN. Moreover, the neuroprotective effect of RH on learning and memory was investigated through the long-term potential on organotypic hippocampal slice cultures. RH increased the total activity of field excitatory postsynaptic potential (fEPSP) following theta burst stimulation and attenuated SCO-induced blockade of fEPSP. This approach could potentially be used as a therapeutic strategy for the restoration of learning and memory function and the prevention of the progression of AD. SCO treatment decreased the levels of BDNF/TrkB/ERK/CREB/Bcl2 and increased the Bax protein level in rat hippocampus. RH ameliorated the expression of these proteins by attenuating SCO-induced up or downregulation in the hippocampus. Based on these findings, the results highlight the molecular and cellular mechanisms through which RH is proposed to exert its neuroprotective effects in the prevention and treatment of learning and memory deficit disorders.

Background. Respiratory distress syndrome (RDS) is the primary cause of respiratory failure in preterm infants, but it also affects 5-7% of term infants. Dysfunctions in pulmonary surfactant metabolism, resulting from mutations of the lung surfactant genes, are rare diseases, ranging from fatal neonatal RDS to interstitial lung disease, associated with increased morbidity and mortality. This study aims to clarify the clinical significance of ABCA3 variants found in a specific family case, as existing data in the literature is inconsistent. Material and methods: A family case report was conducted; targeted panel genetic testing identified a variant of the SFTPB gene and two variants of ABCA3 genes. Comprehensive research involving a systematic review of PubMed, Google Scholar databases, and genome browsers was used to clarify the pathogenicity of the two ABCA3 variants found in the index patient. Advanced prediction tools were employed to assess the pathogenicity of the two ABCA3 variants, ensuring the validity and reliability of our findings. Results: The index case exhibited fatal neonatal RDS. Genetic testing revealed the presence of the SFTPB p.Val267Ile variant, not previously reported, a benign variant based on family genetic testing and history. Additionally, two ABCA3 gene variants were identified: c.697C&gt;T, not yet reported, and c.838C&gt;T. These variants were found to affect ABCA3 protein function and were likely associated with neonatal RDS. Prediction tools and data from nine other cases in the literature supported this conclusion. Conclusions: Based on in silico predictors, analysis of the presented family, and cases described in the literature, it is reasonable to consider reclassifying the two ABCA3 variants identified in the index case as pathogenic/pathogenic. Reclassification will improve genetic counseling accuracy and facilitate correct diagnosis.

This study evaluated changes over time in skeletal muscle atrophy, expressions of skeletal muscle anabolic and catabolic genes, and mitochondrial activity by skeletal muscle type in an adenine-induced chronic kidney disease (CKD) model. A CKD model was successfully established by feeding male Wistar rats a 0.75% adenine diet for 4 weeks starting at 8 weeks of age. Control and CKD groups were sacrificed at 12 and 20 weeks of age. Back muscles were analyzed histologically, and succinate dehydrogenase (SDH) staining was performed to evaluate mitochondrial activity. Gene expressions of myogenic determination gene number 1 and myogenin as indicators of muscle anabolism, atrogin-1 and muscle RING-finger protein-1 (MuRF1) as indicators of muscle catabolism, and peroxisome proliferator-activated receptor-γ coactivator-1-α as a marker of mitochondrial biogenesis were assessed. Type I and type II muscle cross-sectional areas (CSAs) were decreased at 12 weeks, but type I muscle CSA recovered at 20 weeks. SDH staining was lower in CKD than control rats at 12 weeks, but no significant difference was observed at 20 weeks. Increased expressions of myogenin, atrogin-1, and MuRF-1 were observed only at 12 weeks, but no differences were observed at 20 weeks. The adenine-induced CKD rat model appears to show changes in muscle atrophy over time.

Histamine (HA), a biogenic monoamine, exerts its pleiotropic effects through four H1R–H4R histamine receptors, which are also expressed in brain tissue. Together with the projections of HA-producing neurons located within the tuberomammillary nucleus (TMN), which innervate most areas of the brain, they constitute the histaminergic system. Thus, while remaining a mediator of the inflammatory reaction and immune system function, HA also acts as a neurotransmitter and a modulator of other neurotransmitter systems in the central nervous system (CNS). Although the detailed causes are still not fully understood, neuroinflammation seems to play a crucial role in the etiopathogenesis of both neurodevelopmental and neurodegenerative (neuropsychiatric) diseases, such as autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), Alzheimer's disease (AD) and Parkinson's disease (PD). Given the increasing prevalence/diagnosis of these disorders and their socioeconomic impact, the need to develop effective forms of therapy has focused researchers' attention on the brain's histaminergic activity and other related signaling pathways. This review presents the current state of knowledge concerning the involvement of HA and the histaminergic system within the CNS in the development of neurodevelopmental and neurodegenerative disorders.

The blood-brain barrier (BBB) acts as a structural and functional barrier for brain homeostasis. This review highlights the pathological contribution of BBB dysfunction to neuroimmunological diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), autoimmune encephalitis (AE) and paraneoplastic neurological syndrome (PNS). The transmigration of massive lymphocytes across the BBB caused by the activation of cell adhesion molecules is involved in the early phase of MS, and dysfunction of the cortical BBB is associated with the atrophy of gray matter in the late phase of MS. In the onset of NMOSD, increased permeability of the BBB causes the entry of circulating AQP4 autoantibodies into the central nervous system (CNS). Recent reports have shown the importance of glucose-regulated protein (GRP) autoantibodies as BBB-reactive autoantibodies in NMOSD, inducing antibody-mediated BBB dysfunction. BBB breakdown has also been observed in MOGAD, NPSLE, and AE with anti-NMDAR antibodies. Our recent report demonstrated the presence of GRP78 autoantibodies in patients with MOGAD and the molecular mechanism responsible for GRP78 autoantibody-mediated BBB impairment. Disruption of the BBB may explain the symptoms in the brain and cerebellum in the development of PNS, as it induces the entry of pathogenic autoantibodies or lymphocytes into the CNS by autoimmunity against tumors in the periphery. GRP78 autoantibodies were detected in paraneoplastic cerebellar degeneration and Lambert-Eaton myasthenic syndrome and were associated with cerebellar ataxia with anti-P/Q type voltage-gated calcium channel antibodies. This review reports that therapies affecting the BBB that are currently available for disease-modifying therapies for neuroimmunological diseases have the potential to prevent BBB damage.

Background/Objectives: RAS is associated with coronary artery disease (CAD), exacerbation of arterial hypertension and progression to heart failure, but remains frequently unrecognised in clinical practice. Methods: We conducted a systematic review and meta-analysis of studies by pooling data of patients undergoing CAG due to suspected or stable CAD that received a bilateral renal artery angiography; Results: A total of 31 studies with 31,689 patients were included (mean age 63.2±8.7 years, 20.9% were female). Overall, 13.4% (95%CI 10.5-16.7%) of patients undergoing coronary angiography had significant RAS, with 6.5% (95% CI 4.5-8.9%) and 3.7% (95%CI 2.5-5.2%) having severe and bilateral RAS. The mean weighted proportion of patients with 3-vessel coronary disease (3VD) was 25.1 (95%CI 19.6-30.9%) while 4.2% (95%CI 2.6-6.2%) had leftmain (LM) coronary disease. Patients with RAS compared to those without RAS were significantly older (mean difference - MD 4.2 years, (95%CI 3.8-4.6). The relative risk of RAS was greater for the female sex (risk ratio, 95%CI; RR 1.3, 1.03-1.57), presence of diabetes (RR 1.2, 1.10-1.36), arterial hypertension (RR 1.3, 1.21-1.46), dyslipidemia (RR 1.1, 1.06-1.14), peripheral artery disease-PAD (RR 2.1, 1.40-3.16), chronic kidney disease-CKD (RR 2.6, 2.04-3.37), 3VD (RR 1.6, 1.30-1.87), and LM disease (RR 1.8, 1.28-2.47). Smoking had a neutral effect on the risk of RAS occurrence (RR 1.0, 0.94-1.06); Conclusions: RAS is common in patients undergoing coronary angiography. CKD, PAD, older age, and severe CAD were among the strongest predictors for the presence of significant RAS.

High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 ml/kg delivered at 5 – 15 Hz equivalent to 300 – 900 breaths per minute. Few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease, therefore oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive impairment and memory loss. Oxidative stress (OS) has emerged as a central element in the pathophysiology of AD, linking various pathological features including amyloid-β (Aβ) plaque formation, tau hyperphosphorylation, and synaptic dysfunction. This review comprehensively examines the role of OS in AD, focusing on the mechanisms of reactive oxygen species (ROS) production, mitochondrial dysfunction, and their impact on neuronal integrity. Additionally, the review highlights recent advances in antioxidant therapy. Elevated ROS levels in the aging brain exacerbate oxidative damage to lipids, proteins, and DNA, contributing to neuronal atrophy and synaptic loss. Mitochondrial dysfunction further amplifies OS, disrupting cellular energy metabolism and promoting neurodegeneration. Despite the strong association between OS and AD, antioxidant therapies have shown inconsistent clinical outcomes. Emerging strategies targeting offer promising avenues for therapeutic intervention. This review highlights the need for a multifaceted approach in understanding and mitigating OS-related damage in AD, aiming to pave the way for more effective treatments and improved patient outcomes.

Rift Valley fever (RVF) is a mosquito-borne zoonotic viral disease that infects both human and animals. This is a descriptive study summarizes investigation and response to RVF outbreak, using surveillance data. A RVF outbreak occurred in Berber locality in northern Sudan. We identified 246 cases of RVF including seven deaths among humans, 119 deaths and 82 abortions among Livestock. Our entomological surveillance confirmed the presence of Anopheles arabiensis, An. stephensi, Aedes aegypti, Ae. vexans, Culex pipiens, Cx. Quinquefasciatus, and Cx. theileri in the area during the outbreak. In a comparison with another outbreak of Rift Valley fever in nearby area while ago, a multisectoral One Health response strategy has resulted in strengthening the health system through re-innovating health facilities and centres and training about 200 healthcare and emergency responders. Additionally, it reduced cases and fatalities among humans by 78% and 63%, respectively, and loss in livestock due to deaths and/or abortions by 82%. The added-value of implementing One Health strategy was saving more lives and resources, while strengthening the health system. We recommend the systematic institutionalization of One Health strategy in the country as a core part of the national prevention and control strategy for zoonotic diseases epidemics and pandemics.

Background The operator's ability in performing carotid stenting (CAS) has improved clinical outcomes. However, more than 3% of patients need to be treated again after CAS. Most of the cases requiring further intervention are affected by hyperplasia. The recommended procedure is the DEBalloon. On the other hand, the literature reports a small number of carotid neoatherosclerosis cases and is recommended to be treated using elective Micronet-covered stent. Discriminating between the two types of in-stent-restenosis ISR (hyperplasia or neoatherosclerosis) is critical for a positive outcome.Case summary We describe a case in which a patient treated with carotid stenting 8 years before, was diagnosed with ISR. Due to the development of neurological symptoms and progressive increases in Peak Systolic Velocity (PSV) eight years following carotid stenting, a DEBalloon was used in a carotid in-stent-restenosis (ISR) standard procedure. About ten minutes after the procedure, the patient developed hemiplegia consistent with the treated carotid territory. The implantation of a MicroNet-covered stent excluded the thrombus and reverted symptoms with a normal MR control at 24 h. Conclusion This case illustrates that when in-stent stenosis evolves years after the stent implantation, neoatherosclerosis should be assessed, and a MicroNet-covered stent should be considered.

Diabetic peripheral neuropathy (DPN) is a prevalent complication of type 2 diabetes that affects a significant proportion of diabetic patients worldwide. Although the pathogenesis of DPN involves axonal atrophy and demyelination, the exact mechanisms remain elusive. Current research has predominantly focused on neuronal damage, overlooking the potential contributions of Schwann cells, which are the predominant glial cells in the peripheral nervous system. Schwann cells play a critical role in neurodevelopment, neurophysiology, and nerve regeneration. This review highlights the emerging understanding of the involvement of Schwann cells in DPN pathogenesis. This review explores the potential role of Schwann cell plasticity as an underlying cellular and molecular mechanism in the development of DPN. Understanding the interplay between Schwann cell plasticity and diabetes could reveal novel strategies for the treatment and management of DPN.

Withania somnifera (WS), also known as ashwagandha, is a popular botanical supplement used to treat various conditions including memory loss, anxiety and depression. Previous studies from our group showed an aqueous extract of WS root (WSAq) enhances cognition and alleviates markers for depression in Drosophila. Here, we sought to confirm these effects in the 5xFAD mouse model of β-amyloid (Aβ) accumulation. Six- to seven-month-old male and female 5xFAD mice were treated with WSAq in their drinking water at 0 mg/mL, 0.5 mg/mL or 2.5 mg/mL for four weeks. In the fourth week of treatment, spatial memory, anxiety and depressive-like symptoms were evaluated. At the conclusion of behavioral testing, brain tissue was harvested, immunohistochemistry was performed, and the cortical expression of antioxidant response genes was evaluated. Both concentrations of WSAq improved spatial memory and reduced depressive and anxiety-related behavior. These improvements were accompanied by a reduction in Aβ plaque burden in the hippocampus and cortex and an attenuation of neuroinflammatory markers. Antioxidant response genes were upregulated in the cortex of WSAq treated mice. Oral WSAq treatment could be beneficial as a therapeutic option in AD for improving disease pathology and behavioral symptoms. Future studies focused on dose optimization of WSAq administration and further assessment of the mechanisms by which WSAq elicits its beneficial effects will help inform the clinical potential of this promising botanical therapy.

Prevalence estimates of Parkinson’s disease (PD) – the fastest growing neurodegenerative disease – are underestimated due to issues surrounding diagnostic accuracy, symptomatic undiagnosed cases, suboptimal prodromal monitoring, and limited screening access. Remotely monitored wearable devices and sensors provide precise, objective, and frequent measures of motor and non-motor symptoms. Here, we used consumer-grade wearable device and sensor data from the WATCH-PD study to develop a PD screening tool aimed at eliminating gaps between patient symptoms and diagnosis. Early-stage PD (n=82) and age-matched comparison (n=50) participants completed a multidomain assessment battery during a one-year longitudinal multicenter study. Using disease- and behavior-relevant feature engineering and multivariate machine learning modeling of early-stage PD status, we developed a highly accurate (92.3%), sensitive (90.0%), and specific (100%) Random Forest classification model (AUC=0.92) that performed well across environmental contexts. These findings provide robust support for further exploring consumer-grade wearable devices and sensors for global population-wide PD screening and surveillance.

Adhesive-invasive E. coli have been suggested to be associated with the development of Crohn's disease (CD). It is assumed that they can provoke the onset of the inflammatory process as a result of the invasion of intestinal epithelial cells, and then, due to survival inside macrophages, stimulate chronic inflammation and the development of granuloma. In previous reports, we have shown that passage of the СD isolate ZvL2 on minimal medium M9 supplemented with sodium propionate (PA) as a carbon source stimulates, and with glucose - inhibits the adherent-invasive properties and the ability to survive in macrophages. This effect was reversible and not observed for the laboratory strain K12 MG1655. We were able to compare the isogenic strain AIEС in two phenotypes - virulent (ZvL2-PA) and non-virulent (ZvL2-GLU). We showed that, unlike ZvL2-GLU, the ZvL2-PA activates the production of ROS and cytokines when interacting with neutrophils. The laboratory strain does not cause a similar effect. Differences in neutrophil NADH-oxidase activation and ζ potential for ZvL2-GLU and ZvL2-PA are associated with changes in the abundance of membrane proteins. Using differential 2D electrophoresis and LC-MS, we identified membrane proteins that may be associated with the activation of the virulence properties of the СD isolate ZvL2.

In the past thirty years, childhood obesity rates have risen significantly worldwide, affecting over 340 million children in affluent nations. This surge is intricately tied to metabolic disorders, notably insulin resistance, type 2 diabetes mellitus (T2DM), and the continually evolving spectrum of metabolic-associated (dysfunction) steatotic liver disease (MASLD). This review underscores the alarming escalation of childhood obesity and delves comprehensively into the evolving and dynamic changes of nomenclature surrounding diverse conditions of hepatic steatosis, from the initial recognition of non-alcoholic fatty liver disease (NAFLD) to the progressive evolution into MASLD. Moreover, it emphasizes the crucial role of pediatric endocrinologists in thoroughly and accurately investigating MASLD onset in children with T2DM where each condition influences and exacerbates the progression of the other. The review critically highlights the inadequacies of current screening strategies and diagnosis, stressing the need for a paradigm shift. A proposed solution involves the integration of hepatic magnetic resonance imaging assessment in the diagnostic arsenal for children showing insufficient glycaemic control and weight loss post-T2DM diagnosis, thereby complementing conventional liver enzyme testing. This holistic approach aims to significantly enhance diagnostic precision, fostering improved outcomes in this vulnerable high-risk pediatric population.