Severe Reduction Research Articles

Susceptibility of olive cultivars and selections to Colletotrichum species causing anthracnose in Spain.

Anthracnose, the most critical fruit disease affecting olive crops, necessitates the evaluation of the susceptibility of traditional and new varieties. In Spain and Portugal, Anthracnose is caused by several Colletotrichum species, with C. godetiae and C. nymphaeae being dominant and C. acutatum and C. fioriniae being secondary. This study explores the susceptibility of fruits from an F1 progeny resulting from a cross between 'Picual' (resistant) and 'Arbequina' (moderately susceptible) cultivars to C. godetiae. While most genotypes showed resistance levels comparable to their parents, seven showed a 50% reduction in disease severity compared to 'Picual.' The normal distribution of genotypes' response to the pathogen suggests a complex resistance mechanism. Furthermore, we assessed the susceptibility of four traditional cultivars, two new cultivars ('Sikitita-2' and 'Martina'), and five advanced selections (pre-commercial genotypes) to C. godetiae and C. nymphaeae. Despite the significant interaction between the olive genotype and Colletotrichum species in this experiment, the new cultivars and advanced selections were classified as susceptible or moderately susceptible against both species. A subsequent analysis of the interaction between 'Picual' (resistant) and 'Hojiblanca' (susceptible) fruits with the four mentioned Colletotrichum species revealed significant differences among cultivars but no interaction between genotype and pathogen species. Colletotrichum species were categorized as follows: i) C. godetiae and C. nymphaeae as highly virulent, ii) C. acutatum as moderately virulent, and iii) C. fioriniae as weakly virulent. Finally, C. nymphaeae exhibited an enhanced ability to infect and develop acervuli in olive leaves, potentially serving as an inoculum source for this species. The absence of a correlation between leaf and fruit susceptibilities to the pathogen suggests differences in resistance mechanisms. In conclusion, this study provides valuable insights into the complex interactions between olive genotype and Colletotrichum species, essential for cultivar selection and understanding the disease cycle.

Enhancing apple postharvest protection: Efficacy of pectin coatings containing Cryptococcus laurentii against Penicillium expansum

The aim of this work is the application of pectin coatings containing Cryptococcus laurentii as a method of biocontrol of Penicillium expansum for postharvest protection of apples. For this purpose, the yeast was incorporated into a pectin matrix, and its viability and biocontrol activity in vitro and in vivo against P. expansum was evaluated over time. In addition, the influence of the sterilization process on coating thickness was studied. Results showed that pectin coating with C. laurentii enhanced mycelial growth inhibition in vitro studies, while no significant differences were observed in disease incidence and severity reduction in vivo studies. The sterilization process reduced the viscosity of the pectin solution, resulting in coating thicknesses ranging from 0.5 to 1 μm. As a general evaluation, in vitro and in vivo, biocontrol assays were useful in demonstrating better postharvest protection of the yeast at 7 °C concerning 25 °C.

Adapted Low-FODMAP Diet in IBS Patients with and without Fibromyalgia: Long-Term Adherence and Outcomes.

A low-FODMAPs Diet (LFD) is considered a "second line" dietary strategy for irritable bowel syndrome (IBS) but, after a period of strict restriction of all FODMAP foods, it has to be adapted and tailored to each patient (AdLFD). Fibromyalgia often coexists with IBS in up to 65% of cases. Our aims were to evaluate if comorbid fibromyalgia influenced the long-term clinical outcomes and adherence to an AdLFD in IBS patients. IBS patients with or without fibromyalgia who had started an AdLFD were enrolled. Patients had been evaluated before starting the LFD (T0). After a mean follow-up of 62.5 ± 22.7 months (T1), they were re-evaluated using questionnaires on disease severity, bowel habits, psychological status, and adherence to AdLFD. In total, 51 IBS patients entered the study. Nineteen of them had comorbid fibromyalgia. Thirty patients reported a reduction in symptom severity at T1 in comparison with T0. Despite some slight differences in single IBS Symptom Severity Score items, comorbid fibromyalgia did not influence the IBS-SSS total score at T1. Patients with comorbid fibromyalgia showed a higher Hospital Anxiety and Depression Scale (HADS) score at baseline. A total of 44 patients showed good long-term adherence to the AdLFD. All patients improved their HADS score and had long-term adherence to the AdLFD. Comorbid fibromyalgia showed only a slight influence on long-term outcomes of an AdLFD on IBS symptoms, without affecting the relief of global symptoms. No influence on long-term adherence to AdLFD was detected. Hence, this approach can be taken into account in fibromyalgia patients for a nonpharmacological management of IBS symptoms. However, multicentric studies on larger samples would be welcome in the future.

Headache and Visual Aura Outcomes After Stereotactic Radiosurgery for Patients With Occipital Lobe Arteriovenous Malformations: A Single-Center Retrospective Cohort Study.

Patients with brain arteriovenous malformations (BAVMs) sometimes experience migraine-like chronic headaches. Reportedly, this symptom is common in occipital lobe BAVMs; however, the exact prevalence has not been clarified, and the details of visual auras have been scarcely reported. Furthermore, no comprehensive studies exist on the improvement of migraine associated with visual auras in occipital lobe BAVMs after stereotactic radiosurgery (SRS). Therefore, this study investigated the prevalence of headache with visual aura in patients with occipital lobe BAVMs and evaluated the impact of SRS on preexisting symptoms. As a single-center retrospective cohort study, a total of 104 patients with occipital lobe BAVMs treated with SRS from 1990 to 2024 were analyzed. Pre-SRS and post-SRS symptoms of headache and visual aura were documented. The outcomes measured were headache severity, frequency, aura characteristics, and BAVM obliteration rates. Of the 104 patients, 41 (39%) reported chronic headache pre-SRS, and 37 (36%) experienced migraine with visual aura. Compared with pre-SRS, 90% (28/31) of the patients experienced a >50% reduction in headache severity and frequency at a median follow-up of 11 months, and 89% (25/28) experienced a >50% reduction in aura frequency. Complete headache remission was achieved in 35% (13/31) of patients. Complete obliteration of BAVMs was confirmed in 75% (76/102) of the patients at a median of 33 months. A smaller nidus volume was associated with both complete headache remission and BAVM obliteration, whereas age and sex were not significant predictors of headache outcome. Patients with occipital lobe BAVMs frequently experience migraine-like headaches with visual aura, which may be more prevalent than in the general population. SRS for occipital lobe BAVMs could not only achieve favorable BAVM obliteration with minimal adverse effects but also significantly improve migraine-like symptoms, including visual aura, particularly in patients with smaller nidus volumes.

Bicuspid Valve Aortopathy: Is It Reasonable to Define a Different Surgical Cutoff Based on Different Aortic Wall Mechanical Properties Compared to Those of the Tricuspid Valve?

In this study, we examined and compared ex vivo mechanical properties of aortic walls in patients with bicuspid (BAV) and tricuspid (TAV) aortic valve aortopathy to investigate if the anatomical peculiarities in the BAV group are related to an increased frailty of the aortic wall and, therefore, if a different surgical cutoff point for ascending aortic replacement could be reasonable in such patients. Ultimate stress tests were performed on fresh aortic wall specimens harvested during elective aortic surgery in BAV (n. 33) and TAV (n. 77) patients. Three mechanical parameters were evaluated at the failure point, under both longitudinal and circumferential forces: the peak strain (Pstr), peak stress (PS), and maximum elastic modulus (EM). The relationships between the three mechanical parameters and preoperative characteristics were evaluated, with a special focus on evaluating potential risk factors for severely impaired mechanical properties, cumulatively and comparatively (BAV vs. TAV groups). The patient populations were inhomogeneous, as BAV patients reached surgical indication, according to the maximum aortic dilatation, at a younger age (58 ± 15 vs. 64 ± 13; p = 0.0294). The extent of the maximum aortic dilatation was, conversely, similar in the two groups (52 ± 4 vs. 54 ± 7; p = 0.2331), as well as the incidences of different phenotypes of aortic dilatation (with the ascending aorta phenotype being the most frequent in 81% and 66% of the BAV and TAV patients, respectively (p = 0.1134). Cumulatively, the mechanical properties of the aortic wall were influenced mainly by the orientation of the force applied, as both PS and EM were impaired under longitudinal stress. An age of >66 and a maximum dilatation of >52 mm were shown to predict severe Pstr reduction in the overall population. Comparative analysis revealed a trend of increased mechanical properties in the BAV group, regardless of the position, the force orientation, and the phenotype of the aortic dilatation. BAV aortopathy is not correlated with impaired mechanical properties of the aortic wall as such. Different surgical cutoff points for BAV aortopathy, therefore, seem to be unjustified. An age of >66 and a maximum aortic dilatation of >52 mm, however, seem to significantly influence the mechanical properties of the aortic wall in both groups. These findings, therefore, could suggest the need for more accurate monitoring and evaluation in such conditions.

12408 Efnb2 Controls Pituitary Gland Development By Regulating Proliferation Of Pituitary Stem Cells

Abstract Disclosure: A. Gualtieri: None. L. Gomez-Corral: None. J. Nicholson: None. R. Tan: None. L. Guasti: None. C. Gaston-Massuet: None. Efnb2 encodes for the ligand Ephrinb2 that binds to its cognate Eph receptor, which plays an integral role in angiogenesis, stem cell regulation and tumorigenesis. Using a pituitary-specific Cre-driver (Hesx1Cre), we conditionally deleted Efnb2 from the early pituitary stem/progenitor cells (PSCs) of the developing pituitary gland. We found that Efnb2 is expressed in PSCs both during embryogenesis and adulthood, suggesting its involvement in PSCs maintenance. Here we show that genetic ablation of Efnb2 (Efnb2fl/fl;Hesx1Cre/+) results in severe pituitary hyperplasia, abnormal gland morphogenesis and delay in the terminal differentiation of hormone-producing cells. In order to understand the underlying molecular mechanisms by which Efnb2 deletion leads to pituitary abnormalities during embryogenesis, we performed transcriptomic analyses using mRNA-Seq at early stages of pituitary development on Efnb2+/+ and Efnb2−/− cell populations. Interestingly, unsupervised gene set enrichment analyses of the transcriptomic results identified Efnb2 as a key negative regulator of PSCs proliferation, whilst involved in the regulation of epithelial integrity and epithelial to mesenchymal transition (EMT). Functional assays performed to validate transcriptomic analyses revealed that Efnb2-null PSCs hyper-proliferate both in vitro and in vivo and downregulate the expression of genes involved in EMT, indicating a role of Efnb2 in these two developmental pathways. Indeed, whilst Efnb2-null PSCs within the marginal zone hyper-proliferate, they downregulate genes of epithelial integrity, resulting in an abnormal EMT transcriptomic profile. Additionally, these events lead to a significant delay of the pituitary cell lineage commitment program, leading to severe reduction in the expression of Pit1, Pomc1 and Gsu commitment markers. Taken together, our results reveal a novel role for Efnb2 (Ephrinb2) as key regulator of pituitary gland development. Efnb2 negatively regulates the proliferation of pituitary stem/progenitor cells controlling pituitary organ size while controlling the epithelial integrity of the stem cell niche. Presentation: 6/2/2024

Impact and Effectiveness of COVID-19 Vaccines Based on Machine Learning Analysis of a Time Series: A Population-Based Study.

Background: Although confirmed cases of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been declining since late 2020 due to general vaccination, little research has been performed regarding the impact of vaccines against SARS-CoV-2 in Spain in terms of hospitalizations and deaths. Objective: Our aim was to identify the reduction in severity and mortality of coronavirus disease 2019 (COVID-19) at a nationwide level due to vaccination. Methods: We designed a retrospective, population-based study to define waves of infection and to describe the characteristics of the hospitalized population. We also studied the rollout of vaccination and its relationship with the decline in hospitalizations and deaths. Finally, we developed two mathematical models to estimate non-vaccination scenarios using machine learning modeling (with the ElasticNet and RandomForest algorithms). The vaccination and non-vaccination scenarios were eventually compared to estimate the number of averted hospitalizations and deaths. Results: In total, 498,789 patients were included, with a global mortality of 14.3%. We identified six waves or epidemic outbreaks during the observed period. We established a strong relationship between the beginning of vaccination and the decline in both hospitalizations and deaths due to COVID-19 in all age groups. We also estimated that vaccination prevented 170,959 hospitalizations (CI 95% 77,844-264,075) and 24,546 deaths (CI 95% 2548-46,543) in Spain between March 2021 and December 2021. We estimated a global reduction of 9.19% in total deaths during the first year of COVID-19 vaccination. Conclusions: Demographic and clinical profiles changed over the first months of the pandemic. In Spain, patients over 80 years old and other age groups obtained clinical benefit from early vaccination. The severity of COVID-19, in terms of hospitalizations and deaths, decreased due to vaccination. Our use of machine learning models provided a detailed estimation of the averted burden of the pandemic, demonstrating the effectiveness of vaccination at a population-wide level.

Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel in Participants With Moderate-to-Severe Acne: The Patient Journey.

Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel is the only fixed-dose, triple-combination formulation approved for acne treatment. In 3 clinical studies of participants with moderate-to-severe acne, CAB demonstrated superior efficacy to vehicle and component dyads, with good safety and tolerability. Detailed efficacy/safety data from individual clinical study participants are presented. In two phase 3 (NCT04214652, NCT04214639) randomized, double-blind, 12-week studies, participants aged at least 9 years with moderate-to-severe acne were randomized to once-daily CAB or vehicle gel. Descriptive data - including lesion count changes, treatment success (at least 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin), compliance, treatment-emergent adverse events (AEs), and cutaneous safety/tolerance assessments - were summarized from 6 CAB-treated cases. By week 12, all cases achieved >70% lesion reductions, 4/6 achieved treatment success, and 1/6 achieved a 2-grade reduction in severity. All cases were compliant with CAB treatment. No cases reported serious AEs. Transient increases occurred on cutaneous safety and tolerability assessments, with scores generally decreasing back to/below baseline levels by week 12. In two phase 3 clinical trials, fixed-dose, triple-combination CAB demonstrated good efficacy/safety. All 6 CAB-treated cases achieved substantial (>70%) lesion reductions, with 5/6 achieving treatment success or 2-grade reduction in severity by week 12. Transient cutaneous safety/tolerability severity increases generally resolved to baseline values by week 12. These clinical study cases reinforce the importance of patient education regarding adherence, expectations, and AEs. J Drugs Dermatol. 2024;23(11):1017-1024. doi:10.36849/JDD.8639.

Aggregate-Dominated Dilute Electrolytes with Low-Temperature-Resistant Ion-Conducting Channels for Highly Reversible Na Plating/Stripping.

Developing rechargeable batteries with high power delivery at low temperatures (LT) below 0°C is significant for cold-climate applications. Initial anode-free sodium metal batteries (AFSMBs) promise high LT performances because of the low de-solvation energy and smaller Stokes radius of Na+, nondiffusion-limited plating/stripping electrochemistry, and maximized energy density. However, the severe reduction in electrolyte ionic conductivity and formation of unstable solid electrolyte interphase (SEI) hinder their practical applications at LT. In this study, a 2-methyltetrahydrofuran-based dilute electrolyte is designed to concurrently achieve an anion-coordinated solvation structure and impressive ionic conductivity of 3.58mScm-1 at -40°C. The dominant aggregate solvates enable the formation of highly efficient and LT-resistant Na+ hopping channels in the electrolyte. Moreover, the methyl-regulated electronic structure in 2-methyltetrahydrofuran induces gradient decomposition toward an inorganic-organic bilayer SEI with high Na+ mobility, composition homogeneity, and mechanical robustness. As such, a record-high Coulombic efficiency beyond 99.9% is achieved even at -40°C. The as-constructed AFSMBs sustain 300 cycles with 80% capacity maintained, and a 0.5-Ah level pouch cell delivers 85% capacity over 180 cycles at -25°C. This study affords new insights into electrolyte formulation for fast ionic conduction and superior Na reversibility at ultralow temperatures.

Biological Control of Anthracnose in Capsicum annuum Using Inoculants in Hydroponics: A Mechanistic Review

The Colletotrichum species that causes anthracnose poses a significant threat to the growth of Capsicum annuum, or ringer pepper, resulting in significant yield losses. Conventional produced control systems can give rise to ecological and economic difficulties, necessitating the need for alternative, workable solutions. This study explores the feasibility and parts of natural inoculants in controlling anthracnose ailment in Capsicum annuum filled in chipped away at hydroponics structures. As organic inoculants, we utilized a wide variety of useful microorganisms, such as Trichoderma harzianum, Bacillus subtilis, and mycorrhizal parasites. At various stages of the Capsicum annuum plant's development, these inoculants were incorporated into the supplement arrangements for tank farming. Anthracnose was observed and compared to untreated controls and synthetically treated plants in terms of its severity. Plants treated with natural inoculants show a significant reduction in sickness rate and severity, as shown by our findings. In fact, Trichoderma harzianum outperformed Bacillus subtilis and mycorrhizal parasites in terms of biocontrol productivity. Through a series of biochemical and sub-atomic tests, the fundamental instruments were examined. Natural inoculants, according to important discoveries, increase the plant's intrinsic safe reaction by causing fundamental obstruction. This is affirmed by the upregulation of pathogenesis-related (PR) characteristics and extended activity of shield impetuses like peroxidase (Unit), polyphenol oxidase (PPO), and phenylalanine antacid lyase (Amigo). In addition, the inoculants improved root development and supplement absorption, enhancing overall establish health and resistance to microorganisms. This study demonstrates that natural inoculants can be a reasonable and effective method for controlling anthracnose in Capsicum annuum grown in improved tank farms. In accordance with the goals of a potential agribusiness, incorporating these biocontrol specialists into aquafarming frameworks can increase crop productivity and reduce the use of compound pesticides.

The influence of the NRG1/ERBB4 signaling pathway on pulmonary artery endothelial cells.

This study aimed to examine the influence of the Neuregulin-1 (NRG1)/ERBB4 signaling pathway on the function of human pulmonary artery endothelial cells (HPAECs) and investigate the underlying mechanisms. Enzyme-linked immunosorbent assay indicated that ERBB4 levels in the serum of patients with pulmonary embolism (PE) were significantly higher than those of healthy controls (p < 0.05). In cellular studies, thrombin stimulation for 6 h led to a significant decrease in cell viability and overexpression of ERBB4 compared to control (p < 0.05). In the NRG1 group, apoptosis of HPAECs was reduced (p < 0.05), accompanied by a decrease in ERBB4 expression and an increase in p-ERBB4, phosphorylated serine/threonine kinase proteins (Akt) (p-Akt), and p-phosphoinositide 3-kinase (PI3K) expression (p < 0.05). In the AG1478 group, there was a significant increase in HPAEC apoptosis and a significant decrease in p-ERBB4 and ERBB4 expression compared to the Con group (p < 0.05). In the AG1478 + NRG1 group, there was an increase in the apoptosis rate and a significant decrease in the expression of p-ERBB4, ERBB4, p-Akt, and phosphorylated PI3K compared to the NRG1 group (p < 0.05). In animal studies, the PE group showed an increase in the expression of ERBB4 and p-ERBB4 compared to the Con group (p < 0.05). NRG1 treatment led to a significant reduction in embolism severity with decreased ERBB4 expression and increased p-ERBB4 expression (p < 0.05). Gene set enrichment analysis identified five pathways that were significantly associated with high ERBB4 expression, including CHOLESTEROL HOMEOSTASIS, OXIDATIVE PHOSPHORYLATION, and FATTY ACID METABOLISM (p < 0.05). Therefore, NRG1 inhibits apoptosis of HPAECs, accompanied by a decrease in ERBB4 and an increase in p-ERBB4. NRG1 inhibition in HPAECs apoptosis can be partially reversed by inhibiting ERBB4 expression with AG1478. ERBB4 has the potential to be a novel biological marker of PE.

Clinical outcomes in chronic conditions: An observational case series at a US complementary medicine student clinical facility employing the MYMOP outcome measure

Objective/purposeThis study reports on a case series of clients using individualized homeopathy on a wide variety of health complaints seen in cases from a supervised teaching clinical setting between 2017 and 2020 at the Academy of Homeopathy Education. This teaching clinic sees self-selecting clients of all ages, and cases were taken by faculty or advanced students and subsequently managed by advanced students under supervision. MethodsThe cohort study evaluated n = 85 cases using the patient-generated outcome measure, the Measure Yourself Medical Outcome Profile (MYMOP). Average MYMOP values for initial and final consultations were analyzed for degree of change across the intervention period. Principle ResultsScores from initial consultation to last follow up showed a positive change in 80.23 % of cases. Clinically significant improvements were seen in all profile areas. The average profile score at last reported follow up of all cases showed a reduction in symptom severity of.56, and the greatest change between first and last average MYMOP scores showed a reduction of 1.2 after the homeopathic intervention. The greatest positive change was seen in Skin (1.88) followed by Respiratory (1.83) and Digestive-related (1.71) complaints. ConclusionsClinically significant improvement in physical and psychological health is found across a diverse population of people with a wide variety of long-term conditions. These results suggest that individualized homeopathic care in a teaching clinic setting proved to be valuable for complex chronic health problems, and that further similar, confirmatory research is warranted.

The Effectiveness of Cognitive Behavioral Therapy versus Notched Sound Therapy in Adults with Chronic Subjective Tinnitus and Normal Hearing.

Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation. Objective To evaluate the effect of CBT and NST and compare their results in the management of chronic subjective tinnitus. Methods The present prospective study involved 64 adults with normal hearing and chronic subjective tinnitus. They were subjected to history taking, basic audiological evaluation, and extended high-frequency audiometry at 10 and 12.5 kHz. The participants were divided into two equal groups, the first treated with CBT and the second treated with NST. The psychoacoustic measures of tinnitus and the Arabic Questionnaire for Tinnitus Reaction (Arabic-QTR) were used to monitor the outcomes of both therapies. Results Both groups showed significant reduction in tinnitus severity according to the Arabic-QTR and tinnitus loudness matching. Improvement in the Arabic-QTR was better in the CBT group, while tinnitus loudness improvement was better in the NST group. Conclusion Both CBT and NST are effective in the management of chronic subjective tinnitus. In a comparison of the effect of the two therapies, CBT was found to be more effective in decreasing tinnitus-related distress, whereas SNT was found to be more helpful in reducing tinnitus loudness.

Potentiality of Formulated Pseudomonas Fluorescens and Bacillus Subtilis for the Management of Sheath Blight Disease of Rice Under Field Condition

Rice production is severely affected by sheath blight disease in Bangladesh which is caused by a fungus Rhizoctonia solani that is still merely managed by synthetic chemical fungicides. In this study, different isolates of Pseudomonas fluorescens and Bacillus subtilis were evaluated to assess their inhibitory effects against R. solani both in- vitro and field condition following dual culture method in order to formulate technique for the management of sheath blight of rice. Among all the isolates, P. fluorescens (Pf- 7 and Pf- 8) and B. subtilis (Bs-17 and Bs-21) showed the highest in –vitro mycelial growth suppression of the pathogen. Based on the in-vitro mycelial growth suppression performance, fourteen treatments combinations, either single or in consortia of antagonistic bacteria in talc-based formulations were applied by root dipping. All the formulated bacterial isolates showed significant reduction in disease and severity compared to untreated control and chemical fungicide. At 90 DAT, both the disease incidence and severity were found lowest in T11 (31.67 % and 37.33 % respectively) where the seedlings were treated for 24 hours with consortium of Pf-7 + Pf- 8 formulated in talc followed by in T12 (32.00 % and 38.00 %) where the seedlings were treated for 24 hours with consortium of Bs-17 + Bs-21 formulated in talc respectively. Vegetative and yield parameters were also significantly increased in both T11 and T12. The highest yield as well as Benefit Cost Ratio (BCR) were found in T11 (2.50 kg/ m2 and 2.20) followed by T12 (2.49 kg/m2 and 2.18). Thus, the consortia of bacterial isolates (Pseudomonas fluorescens and Bacillus subtilis) with seedling dipping time for 24 hour represents a promising alternative to chemical fungicides for the management of sheath blight of rice in field condition. J Bangladesh Agril Univ 22(3): 342-351, 2024

Intraoperative dexmedetomidine administration and acute kidney injury in patients undergoing unilateral partial nephrectomy: a retrospective study

Partial nephrectomies are associated with an increased risk of acute kidney injury (AKI), but dexmedetomidine administration may improve renal outcomes. We hypothesized that intraoperative dexmedetomidine administration would be associated with a decrease in AKI development in patients undergoing unilateral partial nephrectomy. In this retrospective study, adult patients who underwent unilateral partial nephrectomy from April 2016 to October 2023 were included. Exclusion criteria were a history of end-stage renal disease, ineligible procedures (i.e., aborted procedure, conversion to radical nephrectomy, surgery on a horseshoe kidney), and reoperation within three days of the initial nephrectomy. Patients were categorized according to whether they received intraoperative dexmedetomidine. The primary outcome was AKI incidence within three days of surgery; AKI was defined according to the Kidney Disease Improving Global Outcomes definition. Propensity score matching (PSM) was conducted to account for potential confounders (age, body mass index, sex, American Society of Anesthesiologists score, final surgical approach, clamping-related ischemia for >15 min). We included 1,632 patients; 214 received dexmedetomidine and 1,418 did not. Before PSM, the AKI rate was 31.2% in patients who received dexmedetomidine and 25.7% in patients who did not (p = 0.081). After PSM, the AKI rate was 31.3% in patients who received dexmedetomidine and 27.6% in those who did not (p = 0.396). The post-PSM odds ratio for AKI following dexmedetomidine administration during unilateral partial nephrectomy was 0.910 (95% CI: 0.585–1.142; p = 0.677). Intraoperative dexmedetomidine was not associated with a reduction in postoperative AKI incidence or severity after unilateral partial nephrectomy.

Development and longevity of naturally acquired antibody and memory B cell responses against Plasmodium vivax infection.

Plasmodium vivax malaria causes significant public health problems in endemic regions. Considering the rapid spread of drug-resistant parasite strains and the development of hypnozoites in the liver with potential for relapse, development of a safe and effective vaccine for preventing, controlling, and eliminating the infection is critical. Immunity to malaria is mediated by antibodies that inhibit sporozoite or merozoite invasion into host cells and protect against clinical disease. Epidemiologic data from malaria endemic regions show the presence of naturally acquired antibodies to P. vivax antigens during and following infection. But data on the persistence of these antibodies, development of P. vivax-specific memory B cells (MBCs), and their relation to reduction of malaria severity and risk is limited. This review provides an overview of the acquisition and persistence of naturally acquired humoral immunity to P. vivax infection. Also, we summarize and discuss current progress in assessment of immune responses to candidate vaccine antigens in P. vivax patients from different transmission settings. Longitudinal studies of MBC and antibody responses to these antigens will open new avenues for developing vaccines against malaria infection and its transmission.

Determinan Tingkat Kemiskinan Masyarakat di Provinsi Sumatera Utara: Peran Zakat sebagai Variabel Pemoderasi

Poverty remains a significant issue in North Sumatra, with the percentage of poor people in urban areas reaching 4.93% in 2022 and 4.67% in the first semester of 2023. This phenomenon is influenced by various factors, including inflation, unemployment rate, per capita income, and Human Development Index (HDI). This study aims to examine the effects of these factors on poverty levels, measured by the Poverty Severity Index (PSI), and to evaluate the role of zakat as a moderating variable in the relationship between economic factors and poverty. The study findings reveal that inflation and per capita income have a significant negative impact on PSI, meaning that increases in inflation and per capita income are associated with a reduction in poverty severity. Conversely, HDI shows a significant positive impact on PSI, indicating that higher HDI in some regions can actually increase poverty severity. The unemployment rate does not show a significant effect on PSI. The role of zakat as a moderating variable was also found to be significant. Zakat weakens the negative effect of inflation on poverty and strengthens the negative effect of per capita income on poverty. However, zakat does not moderate the relationship between HDI and unemployment rate with poverty. This study provides insights into how zakat can function as a tool to enhance the effectiveness of economic factors in reducing poverty in North Sumatra.

Long-term safety and effectiveness of romiplostim for chronic idiopathic thrombocytopenic purpura in real-world settings.

Idiopathic thrombocytopenic purpura (ITP), an autoimmune hematologic disorder characterized by severe platelet count reduction, can be treated with romiplostim. However, post-marketing safety and effectiveness data for romiplostim in Japan are scarce. This prospective, observational, post-marketing Specified Use-Results Survey evaluated the real-world safety and effectiveness of romiplostim for 2years. All patients treated with romiplostim during the survey period were eligible. Of the 1622 patients in the safety analysis set, 94.08% (1526/1622) had chronic ITP. The mean single dose of romiplostim was stable after 12weeks and remained < 6μg/kg in approximately 70% of patients until 104weeks. Within 2years, 14.92% of patients discontinued romiplostim because of adverse events, while 6.47% discontinued because of suspected adverse drug reactions. In contrast, 14.00% of patients discontinued romiplostim because of symptom improvement. Before romiplostim initiation, platelet count was < 2.0 × 104/µL in 60.54% of patients, and the mean platelet count was 2.84 ± 5.76 × 104/µL. Platelet count was 9.19 ± 13.01 × 104/µL after 4weeks, and remained between 10.34 ± 10.72 and 12.38 ± 12.63 × 104/µL from 8 to 104weeks of treatment. No specific concerns were revealed regarding the safety and effectiveness of romiplostim in chronic ITP; the findings demonstrated a favorable risk-benefit balance for romiplostim in this population. Trial registration: UMIN000047864 ( www.umin.ac.jp/ctr ).

Epicutaneous immunotherapy for the treatment of peanut allergy.

Peanut allergy treatment options remain limited, but novel approaches are being studied, including epicutaneous immunotherapy (EPIT). EPIT uses the cutaneous immune system to promote tolerance to food allergens. Viaskin™ Peanut, an approach to EPIT in late-stage clinical development uses an occlusive patch with a condensation chamber that enables natural epidermal water loss to solubilize dry antigen on the patch, which is then absorbed and captured by skin Langerhans cells. This form of EPIT does not require disruption of the skin barrier, thus avoiding a proinflammatory cytokine response by targeting the nonvascularized epidermis and limiting systemic allergen exposure. Extensive preclinical research suggests that Viaskin Peanut has a distinct mechanism of desensitization, including the potential for disease modification, driven by a unique population of regulatory T cells. Numerous clinical studies of Viaskin Peanut have demonstrated desensitization and reductions in reaction severity, particularly in children aged 1 through 11 years, as well as a favorable safety profile with mostly mild-to-moderate skin reactions that were observed to decrease over time. EPIT with Viaskin Peanut may be a potential therapeutic option for peanut allergy that is clinically practical with long-term efficacy and tolerability.

Simulation modelling demonstrates differential performance of connectivity methods in their ability to predict genetic diversity in complex landscapes

ContextThere have been few evaluations of how well different connectivity modelling methods are able to predict the spatial genetic structure and genetic diversity of populations residing in complex landscapes. Given the wide application of connectivity modelling tools in applied conservation planning, it is crucial to broadly evaluate how these models perform across resistance, movement, and population structure conditions in predicting genetic diversity patterns. Such evaluations are critical to provide rigorous, biologically based guidance for conservation and management applications. ObjectivesOur goal was to investigate how the predictions of three connectivity models were related to spatial patterns of genetic diversity complex landscapes, considering factors such as population structure, resistance, genetic drift, genetic disequilibrium, and organism movement abilities. MethodsWe evaluated the performance of several connectivity methods across seven a priori landscape resistance surfaces to provide a broad assessment of their performance. We used CDPOP, an individual-based, spatially explicit population and genetic simulation model, to simulate genetic diversity across these resistance surfaces. This provided a pool of genetic diversity patterns that were the response factor in our simulation experiment. We then simulated landscape connectivity with several popular connectivity methods, including resistant kernels, Circuitscape, and Pathwalker, and evaluated how well they were able to predict spatial patterns of genetic diversity. ResultsResistant kernel outperformed other connectivity methods in predicting landscape patterns of genetic diversity. The strongest relationships occurred when the population process has created spatial structure but has not yet led to significant genetic diversity loss due to drift. The time lag disequilibrium was relatively short. Long simulation times resulted in severe reduction in prediction ability due to drift. ConclusionsResistant kernel predictions were much more strongly related to spatial patterns of genetic diversity than were predictions produced by Circuitscape and Pathwalker, across a large combination of population structures. Strong relationships exist between functional connectivity and genetic diversity, with clearer and stronger associations seen in spatial patterns of allelic richness compared to heterozygosity or spatial effective population size. Our results confirm the strong relationship between genetic diversity and population connectivity, and suggest that computationally efficient incidence function algorithms, such as resistant kernel methods, are well suited to predicting functional connectivity.