Single-Center Multidisciplinary Experience with Type A Dissections with Malperfusion.

Traumatic brain injury (TBI) is a known risk factor for poorer later-life outcomes and earlier mortality, but its association with psychological health is less well-characterized. We tested for associations between TBI and depression, each ascertained multiple ways, and in opposing directions (depression predicting TBI; TBI predicting depression). Using UK Biobank data (N=502,356) we investigated bi-directional associations between TBI (ICD-10 coded broad- or narrow-band TBI) and depression (self-report and/or incident ICD-10 coded). We tested this in each direction: baseline historic TBI predicting the incidence of subsequent depression and, separately, baseline depression predicting the incidence of a first subsequent TBI. All analyses were adjusted for age at UK Biobank baseline assessment, sex, educational attainment, deprivation, smoking history, alcohol intake, physical and neurological health conditions. In participants with history of TBI (versus not), there was increased risk of subsequent incident depression, compared with participants with no documented TBI history (e.g. narrow-band TBI fully-adjusted hazard ratio [HR]=2.18 risk of depression; 95% confidence interval [CI]=1.87 to 2.55; P<0.001). In the other direction there was evidence that people with history of lifetime depression had significantly increased risk of subsequent incident TBI (e.g. HR=1.76 of narrow-band TBI, 95% CI=1.61 to 1.94, P<0.001). We show significant associations between TBI and depression: depression was a risk factor for subsequent TBI in previously undiagnosed participants, but also vice-versa. Psychological support should be considered post-TBI, however clinical management should consider premorbid psychological health as a possible contributing factor.

Sulfur mustard-induced pulmonary injury: current mechanisms and intervention strategies.

Prediction of early mortality in acute pancreatitis using arterial base excess: an international multicenter cohort study.

Cryptotanshinone suppresses ESCC metastasis by inhibiting macrophage polarization: A mechanistic study elucidating the rationale for cisplatin combination.

Retinal imaging and supervised learning predict hospitalizations and kidney and heart-lung damage in sickle cell disease.

Secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome (sHLH/MAS) is a rare but highly fatal complication after allogeneic hematopoietic cell transplantation (allo-HCT), frequently diagnosed under conditions of clinical uncertainty. We aimed to characterize post-transplant sHLH/MAS and to identify clinically accessible factors associated with early mortality. We retrospectively analyzed adult patients who developed sHLH/MAS after allo-HCT between 2018 and 2025. Inclusion required an HScore ≥ 169. Overall survival within 60 days from sHLH/MAS onset was the primary endpoint. Clinical and laboratory variables were evaluated using Cox proportional-hazards models, and patients were stratified according to the number of adverse prognostic factors identified. Seventy-two patients met inclusion criteria. Median time from allo-HCT to sHLH/MAS onset was 22 days. Sixty-day overall survival was poor. In univariable and multivariable analyses, vasopressor-dependent sepsis (HR 7.77, p < 0.001) and ferritin > 15 000 μg/L (HR 3.48, p = 0.002) were independently associated with early mortality. Stratification based on these two factors separated patients into low-, intermediate-, and high-risk groups with 60-day survival of 92%, 52%, and 9%, respectively (p < 0.001). Post-transplant sHLH/MAS is associated with extremely high early mortality. Vasopressor-dependent sepsis and extreme hyperferritinemia identify patients at particularly high risk. These findings require confirmation in independent cohorts.

Associations between non-methane volatile organic compounds and cause-specific mortality across 14 major categories.

WWOX in brain development and disease: Molecular mechanisms and therapeutic opportunities.

Late-onset TK2 deficiency in adults: Long-term clinical outcomes of deoxynucleoside therapy.

A simple oral STZ/alloxan-induced diabetic zebrafish model for chronic wound healing and therapeutic assessment.

Mucopolysaccharidosis type III (MPS III, Sanfilippo syndrome) is a group of rare, hereditary, autosomal recessive, lysosomal storage disorders characterized by neurocognitive decline and early mortality. Pronounced visual impairment is frequent and retinal disease is more common in MPS III than in other MPS subtypes. The aim of this study was to characterize the retinal phenotype in MPS III and to provide insights into the disease course. Retrospective monocenter case series. In this study, 27 patients with genetically confirmed MPS III (n = 16 MPS IIIA; n = 9 MPS IIIB; n = 2 MPS IIIC) were included. The disease phenotype was classified as rapid or slowly progressive. All patients underwent spectral-domain optical coherence tomography (OCT) imaging to analyze central retinal thickness, peripapillary retinal nerve fiber layer thickness (RNFL), and configuration of retinal layers. Depending on neurocognitive status and compliance, best-corrected visual acuity (BCVA), slitlamp microscopy, and fundoscopy were performed. The median age at the ophthalmological examination was 6.5 years (range, 1-16 years). Slitlamp examination findings were usually unremarkable. BCVA was assessable in 6 of 27 patients and was within the normal age-adjusted range. Parafoveal degeneration of the outer retinal layers was observed in 59% of patients, whereas foveal thickening of the external limiting membrane was noted in 67%. One MPS IIIA patient showed severe foveal atrophy, and another presented with foveal intraretinal fluid accumulation. Quantitative retinal thickness analysis of all patients showed median values at the lower end of the reference spectrum in the inner perifoveal ring and below the normal range in the outer perifoveal ring, with no distinct pattern that distinguishes the subtypes or phenotypes. RNFL thickness was unremarkable in all patients. This study reveals a pattern of parafoveal degeneration of outer retinal layers in patients with all 3 MPS III subtypes, of whom MPS IIIA patients, known to have a more rapidly progressive neurocognitive disease, show the most severe retinal involvement. We provide natural history data that may contribute to planning and conducting future clinical trials, and we recommend further systematic ophthalmological examinations of MPS III patients to evaluate ocular involvement.

Wide resection margin fails to demonstrate improved survival outcomes in early-stage hepatocellular carcinoma following anatomical resection: A propensity score-matched analysis from two tertiary centers.

Femoral neck fractures in the elderly are a major public health issue. Hemiarthroplasty is widely used for displaced fractures; however, the optimal fixation method, cemented versus uncemented, remains controversial. In Japan, despite a high prevalence of osteoporosis, cemented hemiarthroplasty is underutilized. To date, no large-scale Japanese study has directly compared early outcomes between cemented and uncemented fixation. We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database from December 2011 to March 2023. Patients aged more than 65 years who underwent hemiarthroplasty for femoral neck fractures were identified. A one-to-three propensity score matching was applied using age, sex, body mass index, and Charlson Comorbidity Index. After matching, 26,591 cemented and 79,773 uncemented cases were analyzed. Multivariate logistic regressions were used to assess early postoperative complications and in-hospital mortality. Cement use significantly reduced the risk of infection (odds ratio [OR] 0.747, 95% confidence interval [CI] 0.637 to 0.877, P < 0.01), periprosthetic fracture (OR 0.668, 95% CI 0.539 to 0.829, P < 0.01), and deep vein thrombosis (OR 0.683, 95% CI 0.628 to 0.743, P < 0.01). Conversely, it was associated with increased risk of transfusion (OR 1.463, 95% CI 1.418 to 1.510, P < 0.01) and cerebrovascular events (OR 1.222, 95% CI 1.061 to 1.407, P < 0.01). There were significant differences found in in-hospital mortality (OR 1.128, 95% CI 0.985 to 1.291, P = 0.082). Cemented hemiarthroplasty significantly lowered early mechanical and thrombotic complications without increasing in-hospital mortality. Although transfusion and cerebrovascular risks were slightly elevated, cemented fixation appears to be a safe and effective option in Japan's aging population when appropriate perioperative management is implemented.

Early hemoglobin levels and mortality in non-transfused TBI patients: A linear, inverse association.

Turtles and tortoises are highly threatened yet understudied, particularly regarding reproductive traits and early life stages. In long-lived species, reliance on adult census data can mask reproductive failure for decades before population declines become apparent. This knowledge gap is evident in the Aldabra giant tortoises (Aldabrachelys gigantea), despite its widespread use in conservation translocations and ecosystem restoration. We present preliminary data on fertilisation success, early embryo survival and hatching success, across one natural and five translocated populations in the Seychelles. Of 317 eggs from 24 clutches, only 16% successfully hatched. Most failed eggs (97%) were undeveloped. Using recently developed microscopic methods to assess egg fertility, we provide the first population-level comparisons of fertilisation and hatching outcomes for this species. Although sample sizes are limited, our results indicate low and variable hatching success, driven primarily by embryo mortality. Complete clutch failure was common (67%), and embryo mortality was prevalent even among clutches that had some degree of hatching success. Hatching rates were markedly reduced in translocated populations (0%-26%) compared to a natural Aldabra Atoll population (46%) and all fell below historical estimates from ~50 years ago (60%-80%). We also found a negative association between hatching success and a Human Modification Index, although interpretation of this result should be cautious considering the small sample size. These findings provide the first reproductive success data for translocated Aldabra giant tortoise populations and the first for the species in the last five decades. We argue that incorporating productivity metrics into monitoring frameworks is essential to improve vulnerability predictions and inform effective conservation management.

Assessing the Interactive Effect of Age and Pulmonary Pressure on Early and Mid-Term Mortality After Bilateral Sequential Lung Transplant

Predictive value of early blood glucose trajectory for poor prognosis in ARDS patients.

Management of Inferior Mesenteric Artery Aneurysms Based on a Comprehensive Review of all Reported Cases in the Last 50 Years.

Evaluating maternal mortality, risk factors, and emergency c-section timing in polytrauma pregnant patients.