Nocturnal blood pressure (BP) is a better predictor of health outcomes than office or daytime BP. However, the clinical significance of nocturnal hypertension in patients of very advanced age remains unexplored. We aimed to assess the association between nocturnal hypertension and composite cardiovascular outcomes in this population. This was a prospective observational study including Japanese elderly outpatients aged ≥80 years. All patients underwent 24-hour ambulatory BP monitoring at baseline. Nocturnal hypertension was defined as nocturnal systolic BP ≥120 mm Hg and diastolic BP≥70 mm Hg. Daytime hypertension was defined as daytime systolic BP ≥135 mm Hg and diastolic BP ≥85 mm Hg. The association between those BP phenotypes and composite cardiovascular outcomes (including fatal and nonfatal cardiovascular disease and all-cause mortality) was examined using Cox regression analysis. A total of 485 patients were followed for a median of 3.9 years (1734 person-years), during which 72 (14.8%) composite cardiovascular outcomes occurred. The median age (interquartile range) was 82 (81-85) years; 44.7% were male; and 89.3% took antihypertensive medications. Nocturnal hypertension and daytime hypertension were present in 54.2% and 33.6% of patients, respectively. Relative to nocturnal normotension (nocturnal systolic BP <120 mm Hg and diastolic BP <70 mm Hg), nocturnal hypertension was associated with an increased risk of composite cardiovascular outcomes, even after adjustment for daytime BP values (adjusted hazard ratio, 2.15 [95% CI, 1.18-3.93]). Daytime hypertension showed no such association. Screening for nocturnal hypertension identifies a high-risk group for composite cardiovascular outcomes among patients of very advanced age.

ABSTRACT Since its initial discovery in Swedish pigs in 2009, porcine bocavirus (PBoV) has been detected across Asia, Europe, Africa, and North America. However, the pathogenic potential of PBoV has remained uncertain due to the lack of suitable cell culture systems for viral propagation. In this study, we report the first successful isolation of a Chinese PBoV strain (BK19) from diarrheic piglets in Hunan Province using trypsin-supplemented LLC-PK1 cells. The isolate was characterized through immunofluorescence assay, electron microscopy, plaque formation, and growth kinetics. Whole genome sequencing revealed 43.4-95.7% nucleotide identity with known PBoV strains, with phylogenetic analysis classifying BK19 within the G3 genogroup. Experimental infection of 5-8, 17-19, and 31-33 days old piglets demonstrated age-dependent pathogenicity, with all groups developing characteristic clinical signs including fever, respiratory distress, and diarrhea lasting 3-4 days. Viral shedding peaked in rectal swabs at 4 days post-infection (dpi), with persistent detection through 14 dpi in 5-8 and 17-19 days old groups. Postmortem examination revealed broad tissue tropism in 5-8 and 17-19 days old piglets and age-dependent pathological lesions in intestinal, pulmonary, lymphoid and renal tissues. Immunohistochemical analyses confirmed viral antigen presence in these tissues in 5–8 days old piglets, which correlated with enhanced proliferation of infected cells. These findings provide definitive evidence that PBoV is a primary pathogen in swine, with particular clinical significance for young piglets. This study establishes crucial tools for further research into PBoV biology and control strategies.

altered taste perception, appetite loss, and dietary non-compliance are common complications in hemodialysis patients (HD) that contribute to protein-energy wasting (PEW) and poor nutritional status. this study investigated the relationships between altered taste perception (altTP), appetite status, and nutritional parameters in HD patients, particularly in relation to PEW, based on the Malnutrition Inflammation Score (MIS). a total of 70 HD patients were included. PEW was classified using MIS. Taste perception was evaluated subjectively, appetite was measured using the Appetite and Diet Assessment Tool (ADAT), and fluid/dietary compliance was assessed with the Dialysis Diet and Fluid Non-adherence Questionnaire (DDFQ). Anthropometric data, dietary intake, and biochemical markers were recorded. according to MIS, 31.4 % of patients were classified as PEW. Patients reporting altered taste, especially those perceiving a metallic taste, had significantly higher MIS scores and dietary sodium intake, while showing lower dry weight and total iron-binding capacity (TIBC) (p < 0.05). A significant positive correlation was found between zinc and albumin levels (r = 0.422, p = 0.001). Logistic regression analysis showed that, changes in appetite and non-adherence to diet were positively associated with MIS, while MUAC, serum albumin, TIBC, and daily energy intake were negatively associated. the findings underscore the clinical importance of altered taste, particularly metallic taste, and appetite loss as indicators of nutritional risk in HD patients. These sensory changes are strongly associated with key markers of PEW, suggesting the need for early identification and nutritional intervention in this population.

Purpose Routine oncological whole-body 18F-1-fluoro-2-deoxyglucose (FDG) PET/CT in the majority of institutions is performed from the base of the skull to the mid-thigh. However, at our institution, the brain is included. The aim of this study was to identify the prevalence of unsuspected intracranial findings in patients undergoing oncological 18F-FDG PET/CT examinations with inclusion of the brain in the field of view. Methods A total of 3,523 patients who underwent oncological limited whole-body 18F-FDG PET/CT scans between February 2019 and December 2021 were retrospectively reviewed. The study variables included the patient's age, sex, type of malignancy, disease stage, and clinical presentation and the presence of clinically unsuspected intracranial findings. The intracranial findings were correlated with brain MRI findings in a subset of patients. Clinical significance, defined by a change in disease stage and/or patient management informed by the identification of unsuspected intracranial findings, was assessed. Results In total, 132/3,523 (3.7%) oncological whole-body 18F-FDG PET/CT scans had unsuspected intracranial findings, of which clinically significant unsuspected intracranial findings were found in 62 cases (1.4%). The most common intracranial findings were metastasis, followed by subclinical vascular findings. Moreover, 22/62 cases underwent follow-up brain MRI, and the sensitivity and specificity of the 18F-FDG PET/CT scans were 94.7% and 66.7%, respectively. Data on post-PET/CT management were available for 32/132 patients. A change in management was observed in 25/32 (78%) cases. Conclusion The inclusion of the brain in the field of view in oncological whole-body 18F-FDG PET/CT may lead to the early detection of unsuspected intracranial metastases and changes in patient management. This is especially true for breast and lung cancers, which have a greater propensity to metastasize to the brain.

Diffuse pleural mesothelioma (PM) is a rare malignant neoplasm with an extremely poor prognosis. Prognostic assessment remains challenging, highlighting the urgent need for reliable biomarkers to guide precise and effective therapy. Programmed death ligand 1 (PD-L1) has been suggested as a predictive biomarker for PM, but existing data are limited and controversial. Although advances have been made in understanding cancer-associated fibroblasts (CAFs) within the PM tumor microenvironment, their clinical and prognostic significance remains poorly elucidated. A retrospective analysis of 51 pathologically diagnosed PM was performed. We evaluated clinicopathological factors (including tumoral PD-L1, stromal α-SMA, and Ki-67 percentage by immunohistochemistry) and analyzed their correlation with overall survival (OS) using Kaplan-Meier and multivariate Cox regression. A total of 12 potential prognostic factors were evaluated in the univariate analysis, and 6 factors were found to be significantly associated with a poor prognosis in PM patients. Multivariate analysis identified histological classification, TNM stage, and PD-L1 expression as independent prognostic factors in PM patients. Stromal α-SMA positivity, a marker of poor prognosis, was significantly correlated with male, non-epithelioid subtype, and a high Ki-67 index. Moreover, α-SMA positivity tended to show an increased likelihood of PD-L1 expression (p = 0.065). The expression of tumor PD-L1 could serve as an adverse prognostic factor for PM patients. Its potential association with tumor stromal α-SMA expression warrants further investigation, particularly in the context of unmet needs in tumor immunotherapy.

Portugal has one of the highest incidence rates of tuberculosis (TB) in Western Europe and, historically, multidrug-resistant (MDR) cases have been strongly associated with Mycobacterium tuberculosis strains pertaining to the endemic Q1 and Lisboa3 clades. Notwithstanding, the contribution of drug resistance-associated allelic configurations in these clades to differing levels of drug resistance and their relationship with drug efficacy has yet to be uncovered. A representative sample of the drug-resistant M. tuberculosis population in Portugal, comprised of 40 clinical strains were subjected to whole genome sequencing for characterization of allelic combinations of drug resistance-associated mutations and their minimum inhibitory concentrations for 12 anti-TB drugs was determined. Pharmacokinetic (PK) models were generated to ascertain the maximum concentration to which each drug remains efficacious. Drug resistance levels were determined and compared between different allelic configurations. Double inhA and embA/B mutation genotypes contributed with increased isoniazid and ethambutol resistance levels compared with single mutation configurations, respectively. Significant differences in drug resistance levels were observed between phylogenetic groups for rifamycin, streptomycin and ethionamide, largely explained by the presence/absence of unique high-level resistance-associated genotypes. The PK models for isoniazid and moxifloxacin suggest an increase in dosage to be ineffective against strains harboring high-level resistance-conferring double inhA mutations and gyrA/B mutations. Cycloserine and para-aminosalicylic acid are the only drugs predicted to remain efficacious against the majority of tested strains, while the effectiveness of newer drugs like bedaquiline, pretomanid and delamanid have yet to be uncovered. Proper diagnosis of drug resistance-associated mutations provides invaluable insights into the treatment of TB, as different allelic configurations lead to differing drug resistance levels, often rendering drugs ineffective.

The clinical significance of house dust mites (HDMs) as sources of allergens for medical diagnostics, allergen-specific immunotherapy, and allergology research is dependent on accurate morphological and molecular data analysis for species identification and characterization. Here, we report the species identification and allergenicity of a tropical HDM, Suidasia pontifica (Sp), via morphological-molecular characterization tandem and IgE ELISA, respectively. Electron microscopy of monocultures of HDM samples collected from Laguna, Philippines, revealed different traits related to chaetotaxy, cuticle pattern, and body anatomy. Genus-specific characters such as the length of the scapular setae, cuticle patterns, vertical setae, ω1 setae, along with species-specific traits such as short dorsal setae, long h3 setae, average c1 to c1 verrucae count, presence of sclerotized bursa copulatrix (female), and c3 setae size, suggest that the sample identity is Sp. In addition, PCR amplification from the HDM monoculture genomic DNA and bidirectional sequencing of the 18S and COI gene markers were performed. Sequences were subjected to sequence assembly, consensus acquisition, sequence alignment, and phylogenetic inference. The COI gene showed an exact match and phylogenetic attachment of the sample assembly to Sp, confirming the species-level identification, corroborated with morphological data. Furthermore, 18S gene character analysis was able to prove phylogenetic demarcation of the Sp 18S gene from the sister species S. nesbitti and other allergenic sarcoptiform species. Our molecular phylogenetic analysis, which is strongly supported by electron microscopy data, indicates the identity of our monocultures as Sp. Interestingly, the Sp allergenicity profile of allergic patients and controls (n = 200) suggests 47% IgE-binding reactivity, confirming its allergenicity and clinical importance among atopic patients. This study emphasizes the resolving power of the morphological-molecular phylogenetic approach and IgE-reactivity to objectively verify Sp species identity and allergenicity for downstream immunological studies.

Endometrial carcinoma (UCEC) exhibits a rising incidence in China, imposing a substantial burden on both women and society. Identifying biomarkers for UCEC is critical for precise diagnosis and treatment. RNA-seq data for UCEC and normal endometrial tissues were sourced from the GEO and TCGA databases. The Limma package was used to analyze differentially expressed genes (DEGs) from GEO datasets, while weighted gene co-expression network analysis (WGCNA) was employed to identify gene modules associated with UCEC. Machine learning algorithms (GBM, KNN, LASSO, SVM, NNET, RF, DT, GLM) were subsequently applied for further gene screening. Key biomarkers were identified by analyzing overall survival (OS) and progression-free survival (PFS) using TCGA-UCEC data on the Xiantao Academic online analysis platform.Functional enrichment analysis, clinical significance assessment, COX regression analysis, prognostic nomogram construction, single-gene logistic regression analysis, potential mechanism exploration, and immune characterization were all conducted via the Xiantao Academic online analysis platform. Drug sensitivity profiling was performed using the CPADS database, followed by molecular docking validation. In vitro functional assays included the EdU assay for evaluating cell proliferation and the Transwell assay for assessing cell invasion. Kaplan-Meier survival analysis showed that both overall survival (OS) and progression-free survival (PFS) were significantly shorter in the high-MAL-expression group than in the low-expression group, suggesting a close association between high MAL expression and poor prognosis. Further multivariate Cox regression analysis, which included clinical stage and tumor grade, revealed that the independent predictive value of MAL for OS was attenuated, indicating that its prognostic significance may be partially confounded by traditional clinicopathological factors. MAL may serve as a potential biomarker in UCEC patients, with its high expression promoting tumor progression, correlating negatively with prognosis, and modulating immune characteristics. In vitro experiments demonstrated that elevated MAL expression promoted the proliferation and invasion of ECC-1 cells, while MAL knockdown suppressed these phenotypes. This study found that high MAL expression is significantly correlated with poor prognosis in endometrial cancer patients, which is consistent with its functional role in promoting tumor cell proliferation and invasion. However, after adjusting for clinical factors such as stage and grade, the independent prognostic effect of MAL on overall survival was not prominent, suggesting that it may more likely reflect the extent of tumor progression and adverse clinical features, rather than serving as a sole determinant of prognosis. Therefore, MAL can be regarded as a molecular marker closely associated with disease progression and survival outcomes, and it holds potential for providing auxiliary value in risk stratification and personalized management when combined with clinical parameters.

Objective. Cephalometric alandmark localization is of great clinical significance in diagnosing and treating patients with dental-maxillofacial deformities. Domain shifts across clinical centers significantly hinder model generalizability, causing existing methods to struggle with accurate and robust anatomical landmark localization due to insufficient alignment of high-level semantic features across domains. We aim to improve the cross-domain generalizability of cephalometric landmark detection by aligning semantic features and enhancing output resolution under an unsupervised domain adaptation (UDA) setting.Approach. In this paper, we propose bi-Level alignment with super-resolution head, an effective framework for precise and robust anatomical landmark detection under UDA. Specifically, we employ adaptive instance normalization to generate target-style images while preserving original anatomical spatial structure at the input level. At the output level, a Mean-Teacher framework leverages high-quality pseudo-labels from the teacher model to guide the student model's learning. Additionally, a lightweight super-resolution head enables the generation of high-resolution heatmaps from the multi-scale feature maps and the low-resolution heatmaps, reducing quantization errors with low computational cost.Results. The proposed method achieved a mean localization error of 1.64 mm, a successful detection rate of 72.68% within the clinically acceptable threshold of 2 mm, and an average classification accuracy of 81.81% for anatomical types.Significance. Extensive experiments on public cephalometric datasets demonstrate superiority over state-of-the-art UDA methods, highlighting its potential for clinical applications in cephalometric analysis and orthodontic surgery planning.

Background: Sepsis is a life-threatening condition that complicates major diseases like myeloid leukemia. Both conditions can lead to morbidity and mortality. Despite its clinical significance, trends in sepsis among myeloid leukemia patients remain understudied. Methods: Nationwide mortality records were obtained from the CDC-WONDER database for U.S. adults aged ≥25 with myeloid leukemia (ICD-10 code C92) and sepsis (ICD-10 codes A40, A41) from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables. Joinpoint analysis was utilized to evaluate annual percent changes (APCs). Results: From 1999 to 2023, a total of 35,075 deaths were recorded. The overall AAMR showed a modest but statistically significant increase (0.62) per 100,000 (AAPC 0.31; 95% CI 0.09 to 0.53; p = 0.007). Males experienced higher AAMRs (AAPC: 0.17, 95% CI: -0.05 to 0.40; p = 0.113) than females (0.82 vs.0.48) (AAPC: 0.33, 95% CI: -0.01 to 0.67; p = 0.056). Time trends within each sex were not statistically significant. The highest overall AAMR was recorded among NH Blacks (0.68), followed by NH Whites (0.64). Regional AAMRs were similar; the Northeast showed the largest decline, while the West increased modestly. The overall AAMR was slightly higher in metropolitan areas (0.64) compared to non-metropolitan areas (0.60). Older adults aged ≥ 65 years consistently exhibited the highest CMRs (1.86). Most deaths occurred in inpatient medical facilities (88.80%). Conclusion: Trends in sepsis mortality among myeloid leukemia patients increased modestly. Higher trends observed in urban areas and NH Blacks. Declines were observed in the Northeast region.

The pediatric neurosurgical literature supports the placement of a ventricular access device (VAD) in the premature infant with posthemorrhagic ventricular dilatation as a temporizing measure prior to definitive diversionary shunting. However, there is an absence of data identifying the clinical utility and significance of VADs left in situ at the time of permanent shunt placement. The potential risks of leaving an initial VAD at the time of definitive contralateral cerebral spinal fluid (CSF) diversion and the benefits of a concomitant VAD in these patients with regard to potential life-saving or temporizing aspirations are not well documented. Retrospective cohort review of premature infants (< 37weeks gestational age) treated for PHH at a tertiary pediatric neurosurgery center from January 2005 to December 2021. Patients were grouped by whether a previously placed VAD was retained during permanent shunt insertion. number and outcome of VAD taps, shunt revisions, shunt infections. Statistical comparison between the two groups; p < 0.05 considered significant. Seventy-two premature patients (gestational age < 37weeks) were identified. This cohort included 40 (55.55%) patients with both a VAD and shunt and 32 (44.44%) patients with a shunt only (12 with VAD removed at shunt insertion; 20 with no VAD insertion). Of the 40 patients with a shunt and VAD in situ, 17/40 (42.5%) had their VADs tapped at the time of shunt failure, resulting in 29 total VAD taps. There were 23 emergent VAD taps, of which 17/23 (73.91%) were successful. Leaving the VAD in situ did not result in increased rates of total shunt infections or revisions (p = 0.215; p = 0.129). Based on this analysis, VADs placed for initial management of post-hemorrhagic IVH may serve an important role in children with subsequent proximal shunt malfunctions, potentially lifesaving. A high percentage of shunted patients with VADs benefited without increased risk of shunt revisions or infections. The decision for a VAD to remain in situ at the time of permanent shunt placement in these patients should be strongly considered.

ABSTRACTObjectivesUstekinumab (UST), an anti‐interleukin‐12/23 p40 monoclonal antibody, has emerged as an effective therapeutic option for patients with moderate to severe ulcerative colitis (UC). However, early predictors of long‐term treatment response remain unclear. This study aimed to assess whether 6‐month endoscopic improvement (EI) predicts sustained clinical remission (CR) in patients with UC treated with UST.MethodsThis was a retrospective observational study performed at Kyorin University Hospital. Patients with active UC (Lichtiger Index ≥ 5) who began UST between June 2020 and July 2023 were included. CR was assessed using the LI at weeks 4, 8, 16, and 24. EI at week 24 and sustained CR at week 56 were evaluated.ResultsFifty‐seven patients were enrolled, and the CR rate at week 24 was 57.9%. CR at week 4 was significantly associated with CR at week 24 (p = 0.004). Thirty‐one patients underwent colonoscopy at week 24. EI was achieved in 11 patients (35.5%), and patients with EI versus without EI at week 24 showed significantly higher rates of sustained CR at week 56 (90.0% sensitivity, 100.0% specificity; p = 0.005). The UST continuation rate was also significantly higher in the EI group compared with non‐EI patients (p = 0.04).ConclusionsEI 6 months after UST initiation was associated with sustained CR at week 56. This finding highlights the importance of early endoscopic assessment in optimizing long‐term outcomes in UST‐treated UC.

Stenotrophomonas maltophilia is increasingly recognized as a major cause of healthcare-associated infections in intensive care units. It presents serious risks for immunocompromised patients and can cause severe lung infections in individuals with cystic fibrosis. Recent studies have documented a rising occurrence of S. maltophilia infections among hospitalized COVID-19 patients. However, understanding of these infections in this setting remains limited or inconsistent, with only one review specifically examining S. maltophilia infections in COVID-19 patients. This review critically evaluates all relevant studies from the literature, along with a case series, to explore the clinical significance of S. maltophilia infections in patients with COVID-19. In particular, the review discusses the prevalence, risk factors, phenotypic traits, clinical consequences, and treatment options for S. maltophilia infections in this clinical context.

Clinical significance and impact on the cell behaviors of miR-758-5p/MMP-2 axis in ovarian cancer cells.

Fibrosis, a consequence of dysregulated wound healing underlying chronic diseases such as metabolic dysfunction-associated steatohepatitis (MASH), inflammatory bowel disease (IBD), chronic kidney disease (CKD), idiopathic pulmonary fibrosis (PF) and systemic sclerosis (SSc), accounts for nearly 45% of deaths in developed countries. Fibrosis is driven by persistent epithelial injury and aberrant communication among epithelial, mesenchymal, and immune cells, leading to fibroblast activation, myofibroblast accumulation, and excessive extracellular matrix (ECM) deposition. Despite its clinical significance, antifibrotic therapy remains largely limited to pirfenidone and nintedanib for PF and resmetirom for MASH. The continued failure of many candidates in clinical development highlights the persistent unmet need for more effective antifibrotic approaches. FFA1 (GPR40) and FFA4 (GPR120) are free-fatty acid receptors (FFAR) that sense medium- and long-chain fatty acids, primarily coupling to Gαq/11 and β-arrestin signalling pathways to regulate diverse physiological processes. Although these FFAR have been extensively investigated in the context of metabolic disorders, emerging evidence indicates that FFA1 and FFA4 also play critical roles in the pathophysiology of fibrosis across multiple organs. This review highlights the roles of FFA1 and FFA4 in mitigating fibrosis, either directly or indirectly, across various organs, including the liver, kidney, lung, heart, and peritoneum, as well as in disorders associated with fibrosis-related injuries.

Non-coding RNA plays an important role in the occurrence and development of Parkinson's disease (PD). This study only explores the diagnostic value of miR-431-5p in PD and its role in the development of PD.A total of 92 patients with PD were selected as the PD group, and 100 healthy individuals undergoing physical examinations were selected as the control group. The levels of serum miR-431-5p were detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of serum miR-431-5p for PD. Multivariate Logistic regression was utilized to analyze the risk factors of PD with cognitive impairment. The in vitro PD cell model was constructed by inducing SH-SY5Y cells with MPP+, and the effects of miR-431-5p on the proliferation, apoptosis, inflammation, oxidative stress and autophagy of the cell model were explored. Luciferase reporter gene was used to evaluate the interaction between miR-431-5p and its downstream target genes.The expression of miR-431-5p in PD is decreased, and its expression in PD with cognitive impairment is lower than that in PD without cognitive impairment. The diagnostic value of miR-431-5p combined with α-Syn for PD is better than that of a single indicator. Logistics regression analysis demonstrated that total unified Parkinson's disease rating scale (UPDRS) and miR-431-5p were the risk factors for the occurrence of PD with cognitive impairment. In vitro studies have shown that MPP+ induces the inhibition of proliferation and the promotion of apoptosis, autophagy, inflammation and oxidative stress. However, the above effects can be offset by the addition of miR-431-5p mimics. SOX9 is a direct target gene of miR-431-5p, which is upregulated in PD.miR-431-5p is down-regulated in PD and has clinical significance for the early diagnosis of PD. miR-431-5p may play a role in the progression of PD by targeting SOX9.

Preterm birth occurs in approximately 10% of all pregnancies, and is not only the leading cause of neonatal mortality but also a major contributor to short- and long-term morbidities due to immaturity. Preterm birth has also been linked to an increased risk of maternal cardiovascular and cerebrovascular diseases, making it a critical concern in both perinatal medicine and women's lifelong health. Effective treatment requires interventions during threatened preterm labor, and several tocolytic agents have been developed and used in clinical practice. However, no pharmacological agent has been shown to prolong gestation and improve neonatal outcomes. Nifedipine, a calcium channel blocker, is widely used as a first-line tocolytic agent because of its oral administration route and relatively favorable safety profile compared with other drugs. Evidence from randomized controlled trials, meta-analyses, and Cochrane reviews suggests that nifedipine can delay delivery for a short period; however, robust evidence demonstrating sustained prolongation of pregnancy or improved neonatal survival is still lacking. Moreover, data on maternal hemodynamic changes and fetal effects are limited, highlighting the need for optimal dosing strategies and monitoring protocols. In this study, we discuss the clinical significance and limitations of nifedipine in the management of threatened preterm labor and outlined future directions. Future studies should involve large and homogeneous populations, continuous assessment of maternal hemodynamics, and application of novel biomarkers to support individualized therapy. Accumulation of such evidence is expected to optimize the management of threatened preterm labor and ultimately improve outcomes for mothers and infants.

Vascular variations may be found incidentally during radiological imaging and may not cause any symptoms throughout life. This study was carried out to determine the incidence and clinical significance of normal, variable and abnormal branching patterns of thoracic vascular structures in the general adult population using computed tomography (CT) images. Thorax CT images of 1510 patients (716 males and 794 females) aged between 18 and 95 years were reviewed for this purpose. One hundred and eighty-four (12.2%) patients had bovine arch variation in which the brachiocephalic trunk and the left common carotid artery originated from a common source. In 57 (3.8%) of the examined cases, the left vertebral artery was observed to directly originate from the aortic arch. Additionally, in 14 (0.9%) patients, the right subclavian artery was found to arise directly from the aortic arch. The accessory hemiazygos vein drained into the left brachiocephalic vein in 329 (21.8%) patients, and the right internal thoracic vein opened into the superior vena cava in 29 (1.9%) patients. Azygos vein variation was detected in 18 (1.2%) patients among the examined 1510 patients. Among 1510 patients analysed, double superior vena cava was found in one female patient, and situs inversus totalis was found in two female patients. Knowledge about these variations is important during interventional procedures. CT is a non-invasive imaging modality that offers a comprehensive assessment of these variations.

Staphylococcus coagulans, formerly called Staphylococcus schleiferi subsp. coagulans is the second most common isolate from skin lesions of dogs with superficial bacterial folliculitis (SBF). However, the clinical significance of S. coagulans in pustules of canine SBF remains uncertain. This study aimed to investigate the prevalence and genotypic and phenotypic diversity of S. coagulans isolated from pustules in two dogs with SBF. Two dogs with SBF were included in this study. S. schleiferi/coagulans was isolated as the sole organism from three pustules in case #1, whereas it coexisted with S. pseudintermedius in two of seven pustules in case #2. S. pseudintermedius was the sole organism in the remaining five pustules in case #2. Whole genome sequences revealed that all isolates tested were annotated as S. coagulans. The isolates from the same pustules exhibited identical genotypic and phenotypic profiles, indicating clonal multiplication. S. coagulans isolated from different pustules exhibited similar yet distinct genotypic and phenotypic profiles. S. coagulans with identical genetic and phenotypic profiles can be identified as the sole pathogen or coexist with S. pseudintermedius in the pustules of the same dogs with SBF.

Abstract Aim The aim of this study is to evaluate the effects of Sodium-glucose cotransporter-2 (SGLT2) inhibitors on hemoglobin (Hb) and hematocrit (Hct) levels in patients with heart failure (HF). Methods We systematically searched PubMed, Web of Science, Cochrane Library, and Embase for randomized controlled trials (RCTs) until April 2025. Changes in Hb and Hct were evaluated in HF patients treated with SGLT2 inhibitors compared to control subjects. A random-effects model was applied to calculate mean differences (MDs) with corresponding 95% confidence intervals (CIs). Subgroup analyses were performed across different SGLT2 inhibitors, follow-up durations, and types of control groups. Between-study heterogeneity was quantified using the I² statistic, and meta-regression analyses were performed to explore the influence of baseline clinical characteristics on hematologic responses. Publication bias was evaluated using funnel plots and Egger’s test. Results Seventeen randomized controlled trials (RCTs) with 16,784 participants (mean age 68.65 years, 65.56% male) were included. SGLT2 inhibitors significantly increased Hb (MD = 0.68 g/dL, 95% CI: 0.53; 0.83, I² = 39.7%, p-value &amp;lt; 0.0001) and Hct (MD = 2.15%, 95% CI: 1.73; 2.57, I² = 66.6%, p-value &amp;lt; 0.0001) compared to controls. Subgroup analyses showed consistent benefits across individual SGLT2 inhibitors, duration of follow-up (≥6 months vs &amp;lt;6 months), and comparator type (placebo vs active control). There was no evidence of publication bias. Conclusion SGLT2 inhibitors significantly increase levels of Hb and Hct in patients with HF. Further research is warranted to assess clinical significance in relation to Hb and Hct changes in patients with pre-existing anemia or renal dysfunction.