Poor Indicator Research Articles

A District-Level Analysis of Antenatal Care Utilization in Jharkhand using Sopher’s Disparity Index during COVID-19

The coronavirus disease 2019 (COVID 19) pandemic was a litmus test for the health care across the world. In almost each and every corner the impact could be seen particularly in health sector and among vulnerable populations. Women are one of the highly vulnerable populations with poor health indicators and deprived of basic health care services in India. The impact of the COVID 19 would be much higher among them than any other sections of the society because of Lockdown and inadequate and poor health care services for them in India. Therefore, this study was conducted to know spatio-temporal aspects of Maternal Healthcare Services during COVID 19 in districts of Jharkhand through National Family Health Survey (NFHS)-4 and NFHS-5. Sopher’s Disparity was used to study inter-district disparities in maternal health in Jharkhand. The analysis of Sopher's disparity index for antenatal care (ANC) indicators in Jharkhand before and after the COVID-19 pandemic highlights significant inter-district inequalities in maternal healthcare utilization. While districts such as Latehar, Simdega, and Paschimi Singhbhum demonstrated notable progress and equitable access to services, others like Koderma, Dhanbad, and Deoghar faced considerable challenges across multiple ANC indicators, including early registration, completion of four ANC visits, neonatal tetanus protection, and folic acid supplementation. The most important lesson we have learnt during the present pandemic as well as the past pandemics is that investing in preparedness can cost little and could save millions of lives.

Endoscopic papillectomy versus surgical ampullectomy for adenomas and early cancers of the papilla: a retrospective Pancreas2000/European Pancreatic Club analysis

ObjectiveAmpullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study...

Developmental Toxicity of Alkylated PAHs and Substituted Phenanthrenes: Structural Nuances Drive Diverse Toxicity and AHR activation

Polycyclic aromatic hydrocarbons (PAHs) are a diverse class of chemicals that occur in complex mixtures including parent and substituted PAHs. To understand the hazard posed by complex environmental PAH mixtures, we must first understand the structural drivers of activity and mode of action of individual PAHs. Understanding the toxicity of alkylated PAHs is important as they often occur in higher abundance in environmental matrices and can be more biologically active than their parent compounds. 104 alkylated PAHs were screened from 11 different parent compounds with emphasis on substituted phenanthrenes and their structurally dependent toxicity differences. Using a high-throughput early life stage zebrafish assay, embryos were exposed to concentrations between 0.1 to 100 μM and assessed for morphological and behavioral outcomes. The aryl hydrocarbon receptor (AHR) is often implicated in the toxicity of PAHs and the induction of cytochrome P4501A (cyp1a) is an excellent biomarker of Ahr activation. Embryos were evaluated for cyp1a induction using a fluorescence reporter line. Alkyl and polar phenanthrene derivatives were further assessed for spatial cyp1a expression and Ahr dependence of morphological effects. In the alkyl PAH screen 35 (33.7%) elicited a morphological or behavioral response and of those 23 (65%) also induced cyp1a. 31 (29.8%) of the chemicals only induced cyp1a. Toxicity varied substantially in response to substitution location, the amount of ring substitutions and alkyl chain length. Cyp1a induction varied by parent compound group and was a poor indicator of morphological or behavioral outcomes. Polar phenanthrenes were more biologically active than alkylated phenanthrene derivatives and their toxicity was not dependent upon the Ahr2, Ahr1a or Ahr1b when tested individually, despite cyp1a induction by 50% of polar phenanthrenes. Our results demonstrated that induction of cyp1a did not always correlate with PAH toxicity or Ahr dependence and that the type and location of phenanthrene substitution determined potency.

Correlation between Immune Microenvironment and Clinicopathological Characteristics and Prognosis of Primary Large B-cell Lymphoma of Immune-Privileged Sites

ObjectivesTo explore the correlation between tumor-associated macrophages (TAMs), tumor-infiltrating lymphocytes (TILs), and tumor-associated angiogenesis (TAA) in the tumor microenvironment with the clinicopathological characteristics and prognosis of primary large B-cell lymphoma of immune-privileged sites (LBCL-IP).MethodsA total of 46 cases of LBCL-IP from the Department of Pathology, the Third Affiliated Hospital of Xinjiang Medical University, from January 2010 to February 2024, were collected, along with clinical and follow-up data of LBCL-IP patients. Immunohistochemistry and triple immunofluorescence were used to detect related proteins of TAMs, TILs, and TAA, and to analyze the correlation between TAMs, TILs, TAA, and the polarization of TAMs with the clinical and prognostic factors of LBCL-IP patients.ResultsThere are 30 cases (65.2%) showed high expression of CD68 proteins, 32 cases (69.6%) showed high expression of CD163 proteins, 19 cases (41.3%) showed high expression of CD4 proteins, 34 cases (73.9%) showed high expression of CD8 proteins, and 25 cases (54.3%) showed high expression of CD34 proteins. A total of 27 cases (58.7%) showed CD68+CD163+/CD68+CD86+≥1. The chi-square tests showed that high expression of CD163 proteins was positively correlated with elevated LDH and BMG values, and the count of CD68+CD163+/CD68+CD86+≥1 was positively correlated with ECOG scores ≥2, Ann Arbor staging III-IV, and increased BMG value. High expression of CD8 proteins was positively correlated with a Ki-67 proliferation index ≥70%, and high MVD values were positively correlated with Ann Arbor staging III-IV. The Kaplan-Meier estimator analysis showed that LBCL-IP patients with low expression of CD68 proteins, high expression of CD163 proteins, CD68+CD163+/CD68+CD86+≥1, low expression of CD8 proteins, high MVD values, ECOG scores ≥2, Ann Arbor staging III-IV, LDH ≥250U/L, BMG ≥2.2mg/L, and IPI scores ≥2 had shorter survival times. Multivariate Cox regression analysis showed that low expression of CD8 proteins, CD68+CD163+/CD68+CD86+≥1, LDH ≥250U/L, and ECOG scores ≥2 are independent risk factors affecting the survival of LBCL-IP patients.ConclusionM2-polarized TAMs and low infiltration of CD8+ TILs were more strongly correlated with poor clinical pathological indicators and worse prognosis, and MVD values may serve as an aiding means for the diagnosis and prognostic prediction of LBCL-IP disease.

Nutrition and oral health-related quality of life (OHRQoL) in older adults: a systematic review and meta-analysis.

Understanding the interplay between nutrition and oral health-related quality of life (OHRQoL) in older adults is crucial amidst the global aging population. This systematic review and meta-analysis aimed to explore this association, recognizing the growing prevalence of older individuals and the imperative of addressing their health needs for enhanced well-being. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, relevant studies were identified through electronic database searches and manual screening. Included were studies investigating the relationship between nutritional status, assessed via the Geriatric Oral Health Assessment Index (GOHAI), and OHRQoL in individuals aged 60 years and older. Quality assessment adhered to Joanna Briggs Institute (JBI) criteria, and statistical analysis was conducted using Comprehensive Meta-Analysis Software Version 3. Out of 566 initial records, 14 full-text articles were assessed, with 4 studies meeting the inclusion criteria for meta-analysis. A consistent association emerged between lower nutritional assessment scores and poor OHRQoL among the older adults. Significant relationships were identified between poor oral health indicators, as measured by GOHAI, and an elevated risk of malnutrition. Particularly noteworthy was the role of negative self-perception of oral health as a significant predictor of nutritional deficits, emphasizing the importance of OHRQoL instruments in complementing clinical measurements. The findings underscore the predictive capacity of oral health indicators in assessing nutritional well-being in older individuals. Despite previous studies reporting mixed findings, this review contributes to a comprehensive understanding of the association between nutrition and OHRQoL, highlighting the significance of addressing oral health concerns to enhance overall nutritional outcomes in the older adult population. This systematic review and meta-analysis emphasize the significant association between nutrition and OHRQoL among older adults. Highlighting the importance OHRQoL instruments that can complement objective clinical measurements and serve as predictors of malnutrition, particularly among this population. Offering vital insights for stakeholders, policymakers, and public health officials to promote the overall well-being and quality of life of older adults.

Aposematic color polymorphism is a poor indicator of species boundaries in North American Paranthrene (Lepidoptera: Sesiidae) as evidenced by a multi-gene phylogeny.

Color polymorphism among animal species can influence speciation. Factors such as natural and sexual selection, genetic drift and gene flow contribute to the maintenance of color polymorphism within the species or spur speciation. The evolutionary and ecological mechanisms for color polymorphism are taxon specific and only a few species have been studied. A phylogeny provides an evolutionary framework to understanding the association between color polymorphism and species. Paranthrene species are day flying aposematic moths that mimic wasps in both appearance and behavior. The genus has several polymorphic species and some color forms were originally described as species. Paranthrene presents the opportunity to test for an association between color polymorphism and species boundaries. We reconstructed a phylogeny using DNA sequence from COI, EF-1alpha, and Wingless genes from 67 specimens representing all North American Paranthrene species, nine color variants, and two outgroups. Parsimony and Bayesian analyses generally agreed in topology and support values. Paranthrene simulans (Grote, 1881) was polyphyletic, and monophyly of P. pellucida Greenfield and Karandinos, 1979 was not recovered. Paranthrene robiniae Hy. Edwards, 1880 was polyphyletic and genitalic and genetic differences among the three clades supported the recognition of two new pseudocryptic species, Paranthrene oasis Smith, Taft and, Cognato, new species and Paranthrene gilaensis Smith, Taft and, Cognato, new species. Paranthrene color variants did not overwhelming associate with species boundaries. Of the nine color forms we examined, only two were monophyletic, had DNA sequence divergence comparable to other species, and associated with species diagnostic morphology. It is likely that genetic drift and allopatric isolation explains the fixation of color variants with species. The mechanisms maintaining color polymorphisms within Paranthrene species will remain unknown until experimentation concerning the degree of aposematic protection in reference to wasp models is conducted.

Multi-omics analysis deciphers intercellular communication regulating oxidative stress to promote oral squamous cell carcinoma progression

Oral squamous cell carcinoma (OSCC) is a common malignant tumor in the head and neck, associated with high recurrence and poor prognosis. We performed an integrated analysis of single-cell RNA and spatial transcriptomic data from cancerous and normal tissues to create a comprehensive atlas of epithelial cells and cancer-associated fibroblasts (CAFs). Our findings show that AKR1C3+ epithelial cells, located at the tumor’s stromal front, exhibit significant copy number variation and poor prognostic indicators, suggesting a role in tumor invasion. We also identified a distinct group of early-stage CAFs (named OSCC_Normal, characterized by ADH1B+, MFAP4+, and PLA2G2A+) that interact with AKR1C3+ cells, where OSCC_Normal may inhibit the FOXO1 redox switch in these epithelial cells via the IGF1/IGF1R pathway, causing oxidative stress overload. Conversely, AKR1C3+ cells use ITGA6/ITGB4 receptor to counteract the effects of OSCC_Normal, promoting cancer invasion. This study unveils complex interactions within the OSCC tumor microenvironment.

Postoperative mechanical ventilation after corrective Tetralogy of Fallot surgery in infants: Assessment of perioperative factors and radiographic severity scores

Early recovery from surgery for congenital heart disease (CHD) is becoming a trend. Tetralogy of Fallot/pulmonary stenosis (TOF/PS) is the most common cyanotic CHD with excellent long-term outcomes. We examined potential factors associated with early extubation in 249 patients who underwent TOF/PS complete repair in a tertiary pediatric medical center from January 2015 to December 2022. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were acquired from the electronic medical records. Valve sparing repair (VSR) tends to demonstrate earlier recovery profiles than transannular patch repair (TAP) irrelevant of the presence of monocusp valve (P < 0.0001) and the degree of right ventricular outflow pressure drop was significantly correlated with post-operative recovery profile (p = 0.0204). Because of intracardiac shunts and PaO2/FiO2 ratios being poor indicators of lung injury, Brixia scores were also used. Our data suggested that Brixia score could be an excellent alternative to evaluate post-operative lung status.

ERO1A levels are a prognostic indicator in EGFR mutated non small cell lung cancer

We have identified endoplasmic reticulum oxidoreductase 1 alpha (ERO1A) as a poor prognostic indicator in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (EGFRMUT-NSCLC). In addition, comparison of high versus low ERO1A expression among cohorts of EGFRMUT-NSCLC primary samples revealed that ERO1A expression correlated with increased expression of proteins that regulate secretion. Using the CPTAC proteomic data set in lung adenocarcinoma we found that high ERO1A protein expression correlated with both extracellular matrix and matrix modifying enzymes. In this report, we found that ablating ERO1A expression was a determinant of clonogenicity, tumor sphere formation, spheroid growth and growth in vivo, as well as response to Osimertinib. We validated that ERO1A-knockout EGFRMUT-LUAD cell lines demonstrated a reduction in secretion of both laminin gamma 2 (LAMC2) and the collagen modifying enzyme lysyl oxidase-like 2 (LOXL2). Our work supports the role of ERO1A in modulating the tumor microenvironment that is likely to contribute to tumor progression.

The spectrum effect: Convergence of clinical and neuropsychological characteristics in adults referred for autism assessment

Clinical and neuropsychological profiles of adults referred for autism assessment are not thoroughly understood, and information derived from studies comparing autistic adults to neurotypical controls might not be accurate to infer on individuals in a real-world, clinical setting. 263 adults (aged 18–65 years, 70 % males) referred to our clinic with a suspected diagnosis of autism were clinically explored and administered neuropsychological investigations. The suspected diagnosis was either confirmed or rejected. We conducted multivariate and post-hoc univariate analyses of covariance (MANCOVA; ANCOVA), controlling for possible confounders, to evaluate differences between autistic and non-autistic participants and further associations. Effect sizes (partial η²) were calculated for significant results. There were no significant differences in age means and sex ratios. Both groups showed high Autism Questionnaire (AQ) scores, high schizoid, avoidant, and obsessive-compulsive scores, and mild depressive symptoms, without significant difference between groups. The effect sizes of differences ranged from negligible to small for measures of nonsocial cognition, but were large for a measure of social cognition, the emotion recognition 40 (ER40). Autistic and non-autistic participants present converging features across multiple measures. In this diagnostic setting, psychiatric and neuropsychological measures are helpful in identifying individual difficulties and strengths. However, most of them, including the AQ, are poor indicators of autism. Our results mostly aligned with previous research and showed that information derived from comparisons to neurotypical controls cannot be directly transferred to a real-world setting. Detected impairments in emotion recognition were fairly specific to autism, expanding on previous findings.

The relationship between sleep quality and emotional eating during the pandemic in Croatian adults

Abstract Background Social isolation during pandemics has adverse effects on sleep quality which in connection with COVID-19 distress facilitates the development of emotional eating patterns in various populations. This study aimed to evaluate the interconnection between sleep quality and emotional eating in the Croatian adult population during the COVID-19 pandemic. Methods This cross-sectional questionnaire study was conducted from February to June 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data on eating habits, and the Pittsburgh Sleep Quality Index (PSQI), was self-administered to a convenient sample of Croatian adults from central and northwestern Croatia. Results The study sample included 939 subjects with, a median age of 42 years (interquartile range 35-48), 35.4% males, and 64.6% females. At the PSQI 22.6% of subjects presented sleep disturbances. Sleep disturbances were more frequent among females (p &amp;lt; 0.001), and inhabitants of the Croatian capital Zagreb (p = 0.001). Subjects with sleep disturbances detected by PSQI during pandemics consumed a larger amount of food than usual (p &amp;lt; 0.001), consumed snacks more frequently (p &amp;lt; 0.001), and cooked more in their households (p = 0.006). Conclusions Poor sleep quality caused by the COVID-19 pandemic led to emotional eating patterns in the Croatian adult population. Health promotion programs directed toward healthy lifestyle choices need to be implemented to successfully tackle observed poor health indicators in the studied population. Key messages • Following the COVID-19 pandemic the obvious deterioration of sleep quality and eating habits is seen in the Croatian general population. • Comprehensive health promotion programs directed toward healthy lifestyle choices adoption are needed.

HOXA9 and CD163 potentiate pancreatic ductal adenocarcinoma progression

BackgroundThe role of HOXA9 requires investigations in pancreatic ductal adenocarcinoma (PDAC) as HOXA9 inhibitors are being developed. HOXA9 might attract CD163 expressed tumor associated macrophages (TAM) and could affect PDAC prognosis. This work aims to study the expression and relevance of HOXA9 and CD163 in PDAC progression.Materials and methodsSelected 98 PDAC and 98 adjacent non tumor tissues as a control group were immunostained with HOXA9 and CD163 antibodies.ResultsPDAC displayed highly significant higher HOXA9 staining intensity, percent and H score values than control group. HOXA9 staining of PDAC cases showed significant associations with poor prognostic indicators including larger tumor size, higher grade and advanced stage. PDAC showed highly significant differences regarding CD163 macrophage-specific staining intensity, percent and H score values than control group. CD163 showed significant higher expressions with larger tumor size, higher histological grade and advanced stage group. HOXA9 staining in PDAC showed highly significant direct correlations with CD163 positive macrophages. Follow up of PDAC cases revealed that high median H score of HOXA9 and CD163 were significantly associated with worse overall survival. CD163 was an independent prognostic marker of worse survival.ConclusionsIn conclusion, HOXA9 could potentiate PDAC progression by stimulating CD163 expressed TAM attraction in tumors. HOXA9 and CD163 could participate in PDAC therapy. HOXA9 and CD163 could be predictors of worse prognosis and shorter survival in PDAC.

Evaluation of Circulating Tumor DNA and Carcinoembryonic Antigen Levels and Relationship with Clinicopathological Risk Factors and Prognostic Indices in Colorectal Cancer Patients

Objective: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. ctDNA has emerged as a promising biomarker for CRC management, offering real-time insights into tumor burden and genetic mutations. This study investigates the correlation between CEA levels, ctDNA, clinicopathological factors, and treatment outcomes in early and advanced CRC patients. Methods: The study retrospectively analyzed data from CRC patients, including early-stage disease and metastatic disease. ctDNA levels, demographic data, and clinical parameters such as CEA, inflammatory indexes, and tumor characteristics were evaluated to determine correlations with treatment outcomes. Results: The study included 20 patients, with 60% diagnosed at the metastatic stage. The study found no statistically significant correlation between ctDNA levels and disease stage, recurrence, or overall survival. While CEA and ctDNA levels were measured, they did not demonstrate a significant relationship with treatment outcomes. Notably, ctDNA levels were higher in metastatic patients, though this was not statistically significant. Conclusion: Despite its potential, the integration of ctDNA as a routine biomarker in CRC care faces challenges, including variability in measurement techniques and cost-effectiveness. However, ctDNA's ability to guide personalized treatment strategies and monitor disease recurrence holds promise. The study's findings align with previous research, suggesting ctDNA as a poor prognostic indicator, though further research is needed. ctDNA represents a significant advance in CRC management, offering non-invasive, real-time insights into tumor dynamics. Ongoing research is expected to solidify its role in personalized treatment planning, potentially leading to more effective and tailored therapies for CRC patients.

Avoiding complications in medial unicompartmental knee arthroplasty

Medial unicompartmental knee arthroplasty (mUKA) is a highly effective treatment for the management of isolated osteoarthritis in the medial compartment. While favorable long-term survivorship is seen in most series, the long-term rate of revision after mUKAs remains higher than that for total knee arthroplasty. Poor indications and poor surgical technique are often responsible for mUKA failure. Understanding why these complications occur and how to avoid them will optimize clinical outcomes, reduce revision rates, and lead to lower healthcare costs. This review will discuss the five most common causes of mUKA failure including progression of arthritis, aseptic loosening, bearing dislocation, periprosthetic fracture, and polyethylene wear and how to avoid them with proper patient selection and meticulous surgical technique.

Perinephric Extramedullary Disease in Multiple Myeloma.

Extramedullary disease represents an aggressive form of multiple myeloma occurring outside the skeleton and is a poor prognostic indicator. Extramedullary disease most commonly involves the skin, muscle, pleura, lymph nodes, liver, and central nervous system. Infrequently, extramedullary disease can involve the kidneys or perirenal space. We present 3 cases of perirenal involvement of extramedullary disease on 18 F-FDG PET/CT confirmed with tissue sampling as plasma cell infiltration. Within the limitation of physiologic activity in the kidneys due to 18 F-FDG excretion, close consideration is essential when evaluating multiple myeloma patients for genitourinary involvement as it can resemble other malignancies, hemorrhage, or renal injury.

Lymphomas of the submandibular gland: a nationwide cohort study.

This study explores the epidemiology, incidence, and survival outcomes associated with lymphomas of the submandibular gland (SMG) and examines the influence of autoimmune diseases on these parameters. This retrospective nationwide cohort study analysed data from patients diagnosed with SMG lymphomas in Denmark between 2000 and 2020. Information was extracted from medical records, the National Pathology Register, and the Danish Lymphoma Database. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models, focusing on lymphoma subtypes and autoimmune diseases. The cohort consisted of 101 patients with a lymphoma diagnosis and involvement of the SMG. Large B-cell lymphoma (LBCL) was diagnosed in 33 cases (32.7%), follicular lymphoma (FL) in 29 cases (28.7%), extranodal marginal zone lymphoma (EMZL) in 27 cases (26.7%), and 12 cases (11.9%) with other subtypes. EMZL had a significantly longer overall survival (OS) compared to other subtypes, with a median OS of 12.4 years (95% CI 11.2-12.4) vs. 8.4 years (95% CI 6.0-12.2). EMZL and FL showed favourable 5-year OS rates of 95% and 89%, respectively. LBCL had a 5-year OS rate of 65%. Age over 60 significantly negatively impacted OS. Traditional poor prognostic indicators did not significantly affect OS. A notable association between EMZL and autoimmune diseases was observed, particularly with Sjögren's syndrome, indicated by an increased relative risk of 2.67 (CI 95% 0.45-16.01). Lymphomas of the SMG are rare and have ambiguous clinical presentations. This study provides novel epidemiological, clinical, and prognostic information.

7193 Hypocalcemia: Pitfalls, Paradoxes, And Conundrums

Abstract Disclosure: K. Dash: None. P. Eswaran: None. K. Maharajan: None. S. Nangia: None. U. Ayyagari: None. 58 year old female with PV bleed was diagnosed as Carcinoma Cervix and recommended radical radiotherapy with 6 weeks of concurrent chemotherapy with Cisplatin and IV Magnesium premedication. Post 6th cycle of chemo, she presented with nausea, perioral and facial tingling, and lower limb cramps of one day duration. Investigations showed Serum Magnesium 0.4 mg/dl (range 1.6–2.5), Calcium 5.9 mg/dl (8.4-10.2), Potassium 3.3 mg/dl (3.5-5.5). She was treated with IV Calcium gluconate and discharged home post correction with serum Calcium 7.9, Magnesium 1.8, PTH 88.7. She was readmitted twice, 5 and 9 days later, with hypocalcemia, given IV Calcium Gluconate, and discharged post correction of serum calcium levels. She presented to Endocrine OP 2 days later, asymptomatic, serum Calcium 5.9, Magnesium 0.6, K 3.8. She was admitted and replacement commenced with IV Magnesium and Calcium. Over the next day her Calcium and Magnesium levels improved. She was stabilized on oral Calcium and Magnesium replacement and discharged. Calcium replacement was weaned over the next 2 weeks with stable serum Calcium levels on continuing oral Magnesium replacement to date. Cisplatin is a commonly used chemotherapeutic agent. It binds to the N7 reactive center on purine residues and causes DNA damage in cancer cells blocking cell division resulting in apoptotic cell death. This interaction with DNA and the formation of covalent adducts with purine DNA bases is the source of the cytotoxic effect of cisplatin. Therapy is associated with side effects including neuro-, nephro-, hepato-, and cardiotoxicity. Electrolyte disturbances including hypomagnesemia, hypocalcemia, hypokalemia, and hyponatremia are recognized in association with cisplatin therapy. The signs and symptoms of dyselectrolytemias may be nonspecific and a high index of suspicion is required to diagnose. Hypomagnesemia is described in up to 78% of patients on cisplatin due to magnesium wasting attributed to reduced magnesium reabsorption in the distal tubule and/or inadequate intestinal magnesium absorption. Magnesium is primarily an intracellular cation and stored in bone. Serum levels are a poor indicator of total body magnesium and serum concentrations &amp;lt;1.8 mg/dl indicate more severe underlying deficit. Hypocalcemia, possibly due to end organ unresponsiveness to PTH, frequently coexists with hypomagnesimia, and can be resistant to treatment unless hypomagnesimia is corrected. While hypomagnesimia stimulates PTH secretion, very low serum concentrations can induce a paradoxical block. Our case illustrates the importance of recognizing and correcting underlying hypomagnesimia to stabilize serum calcium levels. The normal PTH level, despite low serum Calcium, suggests hypomagnesimia impairing parathyroid gland function. Due to the acute presentation, and ongoing IV correction, we were unable to measure urinary magnesium excretion. Presentation: 6/1/2024

High-turbulence fine particle flotation cell optimization and verification

Microfine mineral particles have a small size, light weight, and low inertia, making it difficult for them to deviate from streamlines and collide with bubbles. Conventional flotation operations consume a large amount of reagents and exhibit poor flotation indicators. This study employs computational fluid dynamics (CFD) simulation and hydrodynamic testing to investigate the flow field within a high-turbulence microfine particle flotation machine equipped with a multilayer impeller–stator configuration, and validates the practical application performance of the microfine particle flotation machine through single-batch flotation experiments. Result shows that the impeller region of the traditional mechanical stirring flotation machine has a turbulent energy dissipation rate of 20 m²/s³, whereas that for the microfine particle flotation machine averages over 120 m²/s³. In the flotation verification, the cumulative recovery rate of the fine particle flotation machine is increased by 28% compared with that of the traditional KYF flotation machine. The flotation rate is also 1.3 times that of the KYF, demonstrating stronger selectivity for fine particle concentrates. It has certain guiding significance for the resource utilization of fine particle minerals.

Gene-variant specific effects of plasma amyloid-β levels in Swedish autosomal dominant Alzheimer disease

BackgroundSeveral blood-based biomarkers offer the opportunity of in vivo detection of brain pathology and neurodegeneration in Alzheimer disease with high specificity and sensitivity, but the performance of amyloid-β (Aβ) measurements remains under evaluation. Autosomal dominant Alzheimer disease (ADAD) with mutations in PSEN1, PSEN2 and APP can be studied as a model for sporadic Alzheimer disease. However, clarifying the genetic effects on the Aβ-levels in different matrices such as cerebrospinal fluid or plasma is crucial for generalizability and utility of data. We aimed to explore plasma Aβ concentrations over the Alzheimer disease continuum in a longitudinal cohort of genetic Alzheimer disease.Methods92 plasma samples were collected from at-risk individuals (n = 47) in a Swedish cohort of ADAD, including 18 mutation carriers (13 APPswe (p.KM670/671NL) MC), 5 PSEN1 (p.H163Y) MC) and 29 non-carriers (NC) as the reference group. Concentrations of Aβ1–38, Aβ1–40 and Aβ1–42 were analyzed in plasma using immunoprecipitation coupled to tandem liquid chromatography mass spectrometry (IP-LC-MS/MS). Cross-sectional and repeated-measures data analyses were investigated family-wise, applying non-parametric tests as well as mixed-effects models.ResultsCross-sectional analysis at baseline showed more than a 3-fold increase in all plasma Aβ peptides in APPswe MC, regardless of clinical status, compared to controls (p < 0.01). PSEN1 (p.H163Y) presymptomatic MC had a decrease of plasma Aβ1–38 compared to controls (p < 0.05). There was no difference in Aβ1–42/1–40 ratio between APPswe MC (PMC and SMC), PSEN1 MC (PMC) and controls at baseline. Notably, both cross-sectional data and repeated-measures analysis suggested that APPswe MC have a stable Aβ1–42/1–40 ratio with increasing age, in contrast to the decrease seen with aging in both controls and PSEN1 (p.H163Y) MC.ConclusionThese data show very strong mutation-specific effects on Aβ profiles in blood, most likely due to a ubiquitous production outside of the CNS. Hence, analyses in an unselected clinical setting might unintentionally disclose genetic status. Furthermore, our findings suggest that the Aβ ratio might be a poor indicator of brain Aβ pathology in selected genetic cases. The very small sample size is a limitation that needs to be considered but reflects the scarcity of longitudinal in vivo data from genetic cohorts.

Состояние здоровья подростков, находящихся под стражей, по данным 2019–2023 годов

The problem of the health of adolescents causes a special concern of the state, since they constitute a reserve of human resources in the socio-economic development of the country. The existing negative phenomena in a teenage environment, especially in people who are in custody, have an impact on their health. The study of the characteristics of the health status of adolescents in places of imprisonment will contribute to the development of recommendations aimed at maintaining their health, the possibility of their future adaptation in society. Objective. To study and summarize the health data of adolescents detained, and to identify the most characteristic of this group of children's population. Material and methods. This clinical observational non-finished cross-sectional study was conducted from November 2019 to November 2023 (5 full years) on the basis of the Temporary detention center of minor offenders of the Russian Ministry of Interior in the Khabarovsk Krai. 470 people have participated in the. Results. The detained adolescents had poor health indicators against the backdrop of a rooted unfavorable socio-economic situation: among children of the studied group, infectious diseases and parasitosis, mental disorders, trophic hypostature and protein- energy deficiency, the consequences of propmiscitable behavior and alcoholization, the lack of basic knowledge about about the consequences of the base and alcoholization were reliably more common. Self-and mutual assistance, hygiene standards, nutritional rules and a healthy lifestyle. Conclusions. An increase in investment for a regular comprehensive examination of all adolescents in custody, in combination with scientifically based treatment in places of imprisonment will help reduce the burden of preventive diseases among these young people and increase the possibility of their adaptation in society upon release.