Spontaneous Occurrence Research Articles

Study on hand disinfection in inpatient geriatric care on the superiority of cold plasma aerosol versus alcohol-based disinfection methods in a parallel group design

The introduction of fundamental hygiene protocols within the healthcare sector during the nineteenth century led to a significant reduction in mortality rates. Contemporary advancements, such as alcohol-based sanitizers, have further enhanced hand hygiene practices. However, these measures are often overlooked in nursing facilities, resulting in low staff compliance rates and increased cross-infection rates. Novel approaches, such as cold plasma hand disinfection, present promising alternatives due to their minimal skin damage and economic benefits. This study aims to compare the disinfectant efficacy of cold plasma aerosol under practical application conditions with an alcoholic hand disinfectant listed by the Association for Applied Hygiene. The microbial count on participants’ hands was measured, with particular attention paid to the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria. A t-test for independent samples was conducted to determine whether there was a significant difference between the two cohorts regarding the research question. Statistical analysis revealed that the mean log colony-forming unit (CFU) values were significantly lower in the test cohort using only the cold plasma method for hand disinfection compared to the cohort using conventional alcohol-based hand disinfection. Moreover, it was demonstrated that, unlike alcohol-based hand disinfection, cold plasma application ensures the effective elimination of Staphylococcus aureus. The findings indicate that staff utilizing plasma disinfection have an average bacterial count that is 0.65 log units lower than those who regularly use alcohol-based hand disinfection. In addition to the efficacy of cold plasma disinfection, its superiority over alcohol-based hand disinfection was also established. Beyond offering economic and logistical advantages, cold plasma disinfection provides additional health benefits as it does not induce skin damage, unlike alcohol-based hand disinfection.

Do school-aged children spontaneously use refreshing as maintenance strategy in working memory? Testing the effects of free time and motivation.

Working memory is the system responsible for maintaining information that is no longer available. Given the long-term impact of working memory in people's lives, it is fundamental to understand which mechanisms underlie it and how these develop with age. A recently proposed mechanism to explain working memory development is attentional refreshing. Refreshing is an attention-based maintenance mechanism that improves the accessibility of mental representations. It is assumed to operate serially, with attention cycling from one mental representation to the other, in order to reactivate all to-be-maintained items. Although it has been suggested that its efficiency increases in children between 7 and 14 years old, recent results contradict this notion. In this article, we modify several important task characteristics of a recently developed paradigm used to detect whether refreshing is spontaneously used in children and to examine whether evidence for spontaneous refreshing could be found. All participants were recruited in public schools in Geneva (Switzerland). In Experiment 1 (68 8-year-olds, 32 girls and 36 boys, and 62 12-year-olds, 35 girls and 27 boys) and Experiment 2 (26 8-year-olds, 11 girls and 15 boys, and 49 12-year-olds, 27 girls and 22 boys), we show that increasing children's motivation and providing more explicitly free time do not result in the spontaneous occurrence of refreshing in 8- and 12-year-olds. The absence of evidence for refreshing in a simple, commonly-used working memory task, despite theory-driven modifications aimed at encouraging it, casts some doubts on the notion that refreshing is crucially involved in children's working memory functioning and development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Outcomes of newly diagnosed atrial fibrillation in patients with acute coronary syndromes.

Acute coronary syndrome (ACS) is frequently accompanied by newly diagnosed atrial fibrillation (AF). We aimed to compare the risk of major adverse cardiovascular events (MACE) in ACS patients presenting with known, newly diagnosed, or no AF. In our multicentre, prospective registry study, we included patients with confirmed ACS. Patients are classified as having known, newly diagnosed or no AF. Newly diagnosed AF is subdivided according to the duration of the episode, time of onset, post-coronary artery bypass graft (CABG) or spontaneous occurrence, and treatment with oral anticoagulants (OAC). The primary endpoint is MACE at 1 year. Key secondary endpoints include ischaemic stroke and bleeding complications. Amongst 4,433 patients with confirmed ACS, 3,598 (81.2%) had no AF, 438 (9.9%) had newly diagnosed AF, and 397 (9.0%) had known AF. The rates of OAC treatment at discharge were 53.4% in patients with newly diagnosed AF and 89.2% in patients with known AF. After adjusting for baseline imbalances, only new AF was independently associated with increased rates of MACE, whereas known AF was not (hazard ratio [HR] 1.52, 95% confidence interval [CI]: 1.19-1.90 and HR 0.93, 95% CI: 0.70-1.23). For ACS patients with newly diagnosed AF, episodes lasting >24 hours were associated with a higher risk of MACE compared to episodes <24 hours (HR 1.99, 95% CI: 1.36-2.93). Episodes of new AF occurring post-CABG had more favourable outcomes compared to spontaneously occurring new AF (HR for MACE 0.52, 95% CI: 0.31-0.86). OAC treatment rates were higher in the new AF subcategories with higher rates of MACE and ischaemic stroke. Newly diagnosed AF in ACS patients was associated with higher rates of MACE and ischaemic stroke compared to ACS patients without or with known AF. Among the ACS patients with new AF, an episode lasting >24 hours was associated with worse outcomes than shorter episodes, while post-CABG occurrence of AF showed relatively better outcomes compared to spontaneously occurring AF. Only 53% of new AF patients were discharged on OAC therapy versus 89% with known AF.

Different Effects of Strong-Bonded Water with Different Degrees of Substitution of Sodium Sulfobutylether-β-cyclodextrin on Encapsulation.

The encapsulation of sodium sulfobutylether-β-cyclodextrin (SBE-β-CD) is influenced not only by the degree of substitution (DS) but also by the presence of strong-bonded water (SBW). Guests compete with SBW for positions within the cavity of SBE-β-CD. However, the correlation between DS and SBW was not clear. This study revealed a positive correlation between DS and SBW utilizing Karl Fischer titration. The mechanism may be attributed to molecular polarizability. To explore the impact of SBW inside SBE-β-CD with different DS on encapsulation, density functional theory was employed. Throughout the release process, an increase in enthalpy is unfavorable, while an increase in entropy favors spontaneous reaction occurrence. For SBE-β-CD (DS = 2, 3), enthalpy increase is the primary factor, leading to the retention of SBW within the cavities and consequently hindering guest entry. In contrast, for SBE-β-CD (DS = 4, 7), the situation differs. For SBE10-β-CD, the influence of SBW is minimal. This study aims to elucidate the relationship between DS and SBW, as well as the effect of SBW inside SBE-β-CD with different DS on encapsulation. It is crucial for a comprehensive understanding of the factors affecting the encapsulation of SBE-β-CD, thereby promoting quality control and functional development of SBE-β-CD.

Spontaneous atrial fibrillation occurrence following transesophageal atrial burst pacing in rats

Abstract Purpose Animal models play a crucial role in elucidating the complex pathophysiology of atrial fibrillation (AF) and in identifying and testing novel antiarrhythmic strategies. We aimed to develop and characterize a new experimental rat model of AF, induced by long-term transesophageal atrial electrical stimulation, and to investigate whether the "AF begets AF" concept applies to small rodent hearts. Method Twelve adult male Wistar rats were randomized into two groups: Sham (n = 5) and AF (n = 7). All rats were implanted at the beginning of the study with ECG radiotelemetry devices and underwent continuous ECG monitoring throughout the study. To induce AF, the rats in the AF group underwent atrial pacing for 10 consecutive days (15 successive cycles of stimulation/day, 20 s each, with a free interval of 5 min between cycles; 4,000 stimuli/min, stimulus duration 6 ms, voltage 3 V above the diastolic threshold). A similar procedure was applied to the Sham group, but without performing the actual electrical stimulation. The number and duration of spontaneous AF episodes were evaluated based on continuous ECG monitoring prior to, during, and for one week after transesophageal atrial pacing. The inducibility of AF and the occurrence and duration of spontaneous AF episodes were evaluated and compared between the two groups. Results Atrial fibrillation was induced in 85.7% of the rats subjected to atrial electrical pacing (Figure, A), with an average global inducibility of 44.0% ± 16.9% and a mean AF duration of 123.2 ± 96.3 s. No induced or spontaneous AF episodes were recorded in any of the Sham animals. In the AF group, none of the animals presented spontaneous AF before transesophageal atrial pacing. However, in the AF rats, after atrial electrical stimulation initiation, the number of atrial premature beats significantly increased (21.3 ± 6.8 / 24-h post-stimulation vs. 7.3 ± 6.5 / 24-h at baseline; p&amp;lt; 0.01; Figure, B), and all rats presented spontaneous AF episodes (Figure, C). At the end of the study, AF rats presented a total number of 23.9 ± 2.3 AF episodes / 24-h (Figure, D), with a mean AF burden of 337.7 ± 25.06 s / 24-h. Conclusions Our data demonstrate that, despite the small size of the atria, the "AF begets AF" concept is applicable in small rodents. The study presents a novel rat model of AF, in which spontaneous AF occurs following long-term atrial electrical stimulation. Given that the model is relatively rapid and easy to implement, it provides a setup for further investigation of AF pathophysiology, and for identifying and testing novel therapeutic strategies for AF.Figure 1

The A2ml1-Knockout mouse as an animal model for non-syndromic otitis media

BackgroundInflammation and infection of the middle ear, known as otitis media (OM), is a leading cause of hearing loss and the most frequently diagnosed disease in children worldwide. Traditionally, mouse models for OM rely on inducing acute infection through inoculation of the middle ear, e.g. with the human otopathogen non-typeable Haemophilus influenzae (NTHi), and with very few genetic models with spontaneous or chronic OM. A2ML1 variants, including loss-of-function variants, were associated with susceptibility to OM in humans, but no animal model has been reported for A2ml1-related OM. Here, we report our middle ear findings in a mouse line with a CRISPR-induced knockout (KO) of A2ml1. MethodsMice were X-rayed prior to harvest to determine if there are craniofacial or skeletal abnormalities. Tissue from mouse middle ears, as well as other upper respiratory mucosal tissues, were harvested. The harvested middle ear bullae were examined under microscope and submitted for histologic preparation to study phenotypic indications of OM. RNA samples isolated from middle ear tissue were assayed for expression of genes correlated with A2ML1 expression in humans. ResultsData from a total of 119 mice (35 wildtype, 40 heterozygous, 44 homozygous) are presented here, with each analyses being performed on subsets of these mice. There were no significant craniofacial differences by genotype (n = 22). Findings in mice with the A2ml1-KO indicated an increased incidence of OM (n=29; odds ratio = 11; CI: 1.1, 573.6; Fisher exact two-sided p = 0.02) with tympanic membrane perforations or thickening, as well as cases of middle ear effusion, inflammatory cells, or fluid from histologic sections. Dsp was upregulated in the middle ear tissues of homozygous mice (Wilcoxon test p = 0.001). ConclusionThus far, our results in this A2ml1-KO mouse line indicate spontaneous occurrence of OM and dysregulation of Dsp in the middle ear as a potential disease mechanism for A2ml1-related OM.

Exploring the contrasts: in-depth analysis of human and canine mammary tumors - discoveries at the frontier.

We have examined genomic and transcriptomic abnormalities in human and canine samples to evaluate the canine model's validity for breast cancer research, emphasizing similarities and differences. Both species commonly utilize serum tumor markers and noncoding microRNAs. Immunohistochemistry and immunocytochemistry were employed to illustrate and compare results based on histological diagnoses. In addition to these factors, similarities exist in spontaneous tumor occurrence, age of onset, hormonal influences, and disease progression, including tumor size, clinical stage, and lymph node involvement. Molecular traits such as hormone receptor status, Epidermal Growth Factor Receptor (EGFR), and proliferation markers (Ki67) further endorse the canine model's utility in breast cancer studies. The advancement of technologies facilitates the identification of new cancer-associated molecules, both coding and non-coding genes, underscoring their potential as prognostic/diagnostic biomarkers and therapeutic targets.

Emergence of a hexagonal pattern in shear-thickening suspensions under orbital oscillations

A dense particle suspension under shear may lose its uniform state to large local density and stress fluctuations, which challenge the mean-field description of the system. Here, we explore the novel dynamics of a non-Brownian suspension under orbital oscillations, where localized density waves along the flow direction appear beyond an excitation frequency threshold and self-organize into a hexagonal pattern across the system. The spontaneous occurrence of the inhomogeneity pattern arises from a coupling between particle advection and the shear-thickening nature of the suspension. Through linear stability analysis, we show that they overcome the stabilizing effects of particle pressure at sufficient particle volume fraction and oscillation frequency. In addition, the long-standing density waves degenerate into random fluctuations when replacing the free surface with rigid confinement. It indicates that the shear-thickened state is intrinsically heterogeneous, and the boundary conditions are crucial for developing local disturbance.

The multimodal psychotherapy of the anxiety disorders patients

IntroductionAnxiety disorders are a common type of mental pathology with severe social and medical consequences in the lives of people suffering from them. General population studies indicate their prevalence ranges from 1.7% to 4.7% of the population. According to data from a US national study among the population aged 15 to 54 years, only 2.7% and 4.7%, respectively, suffered from panic disorder, one of the common types of anxiety disorders, during their lifetime. At the same time, the features of the emotional structure of anxiety disorders and the effectiveness of their psychotherapy among the population of low-income countries, especially in countries in a situation of prolonged bloody war and environmental disaster, remain poorly studied.ObjectivesThe purpose of the study was to identify the features of the emotional symptomatic structure of anxiety disorder and evaluate the effectiveness of their psychotherapeutic correction. For this purpose, 180 patients with anxiety disorders who were hospitalized in Ukraine (during the period 2022 - 2023) were examined.Methods The basic method was group psychotherapy with elements of rational, positive, suggestive and family psychotherapy. Regarding emotional disorders, cognitive behavioural therapy (CBT) was used for phobic-depressive and anxiety-depressive syndromes.ResultsMost patients experienced a decrease in the level of general anxiety and internal anxiety. Almost no spontaneous occurrence of fear was observed. During active interviewing, patients stated that their previous anxieties and fears had lost their relevance and acquired clear emotional overtones. There was also a significant decrease in the symptoms of the depressive cycle, and patients began to feel joy and optimism.Conclusions To correct emotional dysfunction in patients with episodic paroxysmal disorders, generalized anxiety disorders and mixed anxiety-depressive disorders, it is optimal to use a system of psychotherapeutic correction built on stepwise and multimodal principles.Disclosure of InterestNone Declared

Interaction of sodium dodecyl sulfate and triton X-100 with ofloxacin drug using conductivity and UV–visible spectroscopic techniques in aqueous alcohols media at several temperatures

The current investigation explores the association and complexation of the mixture of anionic surfactant, sodium dodecyl sulfate (SDS), and antibiotic drug, ofloxacin (OFC) as well as nonionic surfactant, Triton X-100 (TRX) and OFC drug respectively in several additive solutions. The investigations were performed by applying conductivity and UV-Visible spectroscopic techniques. The impacts of drug concentration, types of solvents, and composition of aq. solutions of alcohols (methanol (MeOH), ethanol (EtOH), and 1-propanol (1-PrOH)) as well as temperature change have been investigated on the micelle formation of SDS + OFC mixture. The micellization of SDS + OFC and TRX + OFC systems has been characterized by the determination of critical micelle concentration (CMC) from conductivity vs. SDS concentration (conductivity technique) and Absorbance vs log[TRX] (UV-Visible spectroscopic technique) plots respectively. The micellization of SDS was delayed owing to the introduction of the OFC drug while the effect has been intensified as a function of OFC concentration. At a fixed OFC concentration and temperature, the CMC values were acquired to be augmented with the upsurge of alcohol concentration. The enhancement of the CMC changes has been perceived with the escalation of temperature at a definite concentration of OFC in water and 5% (w/w) aq. alcohols media. The disfavor of micellization of TRX in aq. EtOH solutions in comparison to aqueous solution also detected from UV-Visible spectroscopic technique. The binding constant (Kb) for the complexation of TRX with OFC drug was determined using the Benesi-Hildebrand plot. The Kb values were obtained to be affected by the change of solvent and temperature. The negative free energy change (∆Gmo/ ∆Gbo) of the micellization and complexation demonstrate the spontaneous occurrence of micelle formation and complex development. The enthalpy changes (∆Hmo) of micellization were negative (exothermic process) and entropy changes (∆Smo) were positive (highly disordered and entropy-dominated micellization). Other thermodynamic properties ((∆Hbo and ∆Sbo) and thermodynamics of transfer) have been evaluated and illustrated as well, for the working systems.

Anti-Mullerian Hormone Assessment in Assisted Reproductive Technique Outcome and Natural Conception.

In recent years, the prevalence of infertility has increased, and appears to affect approximately one in six couples. Some of them must perform assisted reproductive techniques (ART) in order to achieve pregnancy. As a result, growing interest has arisen about predictive factors of pregnancy and live birth with and without ART. Anti-Mullerian hormone (AMH) is a glycoprotein discovered in the 1950s in male embryonic sexual differentiation. Later, in 1984, its role in folliculogenesis was reported: secreted by granulosa cells, this hormone is involved in the regulation of the recruitment of primordial follicles and in follicular growth. AMH assays were developed for women in 1990s, and the serum AMH level has rapidly become a crucial element in managing women's fertility. Based mainly on its ability to be a quantitative but indirect marker of ovarian reserve, the serum AMH assay is widely used in reproductive medicine and ART. This review summarizes current knowledge of the AMH assessment in the field of reproductive medicine. We focus on the role of AMH level to predict spontaneous pregnancy occurrence, ART outcomes, and fertility preservation outcomes.

Interstitial Doping of SnO2 Film with Li for Indium-Free Transparent Conductor

SnO2 films exhibit significant potential as cost-effective and high electron mobility substitutes for In2O3 films. In this study, Li is incorporated into the interstitial site of the SnO2 lattice resulting in an exceptionally low resistivity of 2.028 × 10−3 Ω⋅cm along with a high carrier concentration of 1.398 × 1020 cm−3 and carrier mobility of 22.02 cm2/V⋅s. Intriguingly, Li i readily forms in amorphous structures but faces challenges in crystalline formations. Furthermore, it has been experimentally confirmed that Li i acts as a shallow donor in SnO2 with an ionization energy ΔE D1 of −0.4 eV, indicating spontaneous occurrence of Li i ionization.

COMPLEXATION OF SILVER (I) C 2-ETHYLIMIDAZOLE

The acid-base properties of 2-ethylimidazole were studied by pH-metric titration (EM). Using the literature data and our own results, a number of changes in the acid-base properties (pКa) of imidazoles have been established: ethylimidazole (7,93)&gt; imidazole (7.05)&gt;2-phenylimidazole (6,48)&gt;2-aminobenzimidazole (6,11)&gt; benzimidazole (5,53)&gt;2-phenylbenzimidazole (5,23)&gt;2-mercaptoimidazole (2,97)&gt;1-methyl-2-mercaptoimidazole (2,11). Method The process of complexation of silver(I) with 2-ethylimidazole in the temperature range of 273-318K was investigated using potentiometric titration using a silver electrode. It has been established that the increase in temperature does not affect the stoichiometric composition of complex particles formed in the Ag-EM-H2O system. The results obtained show that as the temperature increases, the stability constants decrease. On the basis of diagrams, the distribution of complex particles depending on the ligand concentration is shown that in System Ag-EM-H2O is mainly dominated by the bis-substituted complex, the yield of which at EM concentrations above 1·10-2 mol/l is 100%. The thermodynamic functions of the formation of 2-ethylimidazole silver complexes have been calculated. It has been established that complexation reactions are exothermic. Spontaneous occurrence of complexation reactions in the system Ag-EM-H2O contributes to a negative change in enthalpy.

Cortical Spreading Depolarization in Moyamoya Vasculopathy: A Case Series.

Spreading depolarization describes a near-complete electrical discharge with altered local cerebral blood flow. It is described in association with acute and chronic diseases like hemorrhagic stroke or migraine. Moyamoya vasculopathy is a chronic, progressive cerebrovascular disorder leading to cerebral hypoperfusion, hemodynamically insufficient basal collateralization, and increased cortical microvascularization. In a prospective case series, we monitored for spontaneous spreading depolarization activity by using intraoperative laser speckle imaging for real-time visualization and measurement of cortical perfusion and cerebrovascular reserve capacity during cerebral revascularization in 4 consecutive patients with moyamoya. Spontaneous spreading depolarization occurrence was documented in a patient with moyamoya before bypass grafting. Interestingly, this patient also exhibited a marked preoperative increase in angiographic collateral vessel formation. The spontaneous occurrence of SDs in moyamoya vasculopathy could potentially provide an explanation for localized cortical infarction and increased cortical microvascular density in these patients.

A rare case of atraumatic CSF leak into brachial plexus elements

We present the case of a patient with unexplained postural headaches who was found to have an atraumatic Cerebrospinal Fluid (CSF) leak from the foraminal and extraforaminal epidural spaces at the levels of C5-C6, C6-C7, C7-T1, and T1-T2, with contrast tracking along the brachial plexus elements as well as the bilateral scalene and paraspinal musculature. This is a rare presentation as the etiology was not connected to brachial plexus injury or surgical trauma but rather was a spontaneous occurrence. The patient was successfully treated with a CT-guided epidural blood patch that conferred complete resolution of the symptoms. We hope this case study offers clinical utility with the diagnosis and management of patients with orthostatic headaches.

Clinical manifestations and spermatogenesis outcomes in Chinese patients with congenital hypogonadotropic hypogonadism caused by inherited or de novo FGFR1 mutations.

Fibroblast growth factor receptor 1 ( FGFR1 ) mutations are associated with congenital hypogonadotropic hypogonadism (CHH) through inheritance or spontaneous occurrence. We detected FGFR1 mutations in a Chinese cohort of 210 CHH patients at Peking Union Medical College Hospital (Beijing, China) using next-generation and Sanger sequencing. We assessed missense variant pathogenicity using six bioinformatics tools and compared clinical features and treatment outcomes between inherited and de novo mutation groups. Among 19 patients with FGFR1 mutations, three were recurrent, and 16 were novel variants. Sixteen of the novel mutations were likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines, with the prevalent P366L variant. The majority of FGFR1 mutations was inherited (57.9%), with frameshift mutations exclusive to the de novo mutation group. The inherited mutation group had a lower incidence of cryptorchidism, short stature, and skeletal deformities. In the inherited mutation group, luteinizing hormone (LH) levels were 0.5 IU l -1 , follicle-stimulating hormone (FSH) levels were 1.0 IU l -1 , and testosterone levels were 1.3 nmol l -1 . In contrast, the de novo group had LH levels of 0.2 IU l -1 , FSH levels of 0.5 IU l -1 , and testosterone levels of 0.9 nmol l -1 , indicating milder hypothalamus-pituitary-gonadal axis (HPGA) functional deficiency in the inherited group. The inherited mutation group showed a tendency toward higher spermatogenesis rates. In conclusion, this study underscores the predominance of inherited FGFR1 mutations and their association with milder HPGA dysfunction compared to de novo mutations, contributing to our understanding of the genetic and clinical aspects of FGFR1 mutations.

Let Me Take the Risk so You Won’t Have To: An Evolutionary Psychological Analysis of Spontaneous Occurrence of Division of Labor Across 14 Countries

Let Me Take the Risk so You Won’t Have To: An Evolutionary Psychological Analysis of Spontaneous Occurrence of Division of Labor Across 14 Countries

#107 : Association Between COVID-19 Vaccination Status and Spontaneous Abortion in Pregnant Women

Background and Aims: Pregnant women are at greater risks for morbidity and mortality if infected by the COVID-19. Vaccination is critical in mitigating the risks. However, there is still limited data around safety profiles of COVID-19 vaccines in pregnant women especially in Indonesia. Therefore, this study is aimed to determine the association of COVID-19 vaccination status on the occurrence of spontaneous abortion in pregnant women in Indonesia. Method: This cross-sectional study was carried out from March-June 2022 at a private maternity clinic in Medan, Indonesia. Participants who agreed to participate were asked to sign the informed consent. Participants then were interviewed, and their diagnosis was confirmed using ultrasonography. Demographic data, vaccination status, parity, gestational age and the diagnosis were collected and statistically analyzed. The Chi-square test or Fisher’s exact test were done to analyze the categorical variables. Results: Of the 319 participants, 267 (84%) vaccinated and 52 (16%) unvaccinated. All the vaccinated participants received at least 1 dose to 3 doses of COVID-19 vaccine before pregnancy confirmation. There were 70 (22%) participants with spontaneous abortion and 249 (78%) with normal pregnancy. All our participants were having &lt; 20 weeks of gestation, and majority were in reproductive age (82%) and primiparous (55%). Multiparity or gestational age were associated with spontaneous abortion occurrence (p &lt; 0.05). We did not find association between pregnant women vaccination status and spontaneous abortion occurrence (p &gt; 0.05). Conclusion: Our data indicated that COVID-19 vaccination history was not associated with spontaneous abortion occurrence, and thus, adding information regarding the safety of COVID-19 vaccination in pregnancy, especially in Indonesia.

ARIA‐E, ARIA‐H, and CAA‐related inflammation: time of reconsiderations?

AbstractBackgroundEvidence from published clinical trials suggests that high‐dose of monoclonal antibodies (mAbs) are needed to significantly remove parenchymal‐deposited Aβ plaques. However, high‐dosing mAbs resulted in a 25‐35% increased risk of amyloid‐related imaging abnormalities‐edema (ARIA‐E) and ARIA‐hemorrhage (ARIA‐H) side events. Although most ARIA‐E are incidentally recognized as clinically silent during pre‐planned safety monitoring MRI scans and suggested to be managed by dose reduction or suspension, it is noticeable that half of ARIA‐E progressed to symptomatic at continued dosing and to associate with late occurrence of ARIA‐H. Of particular importance, a few of them aggravated to potentially severe brain injury or death due to fatal CAA‐related events. Increased evidence from natural history studies suggests that ARIA‐E is the iatrogenic manifestation of cerebral amyloid angiopathy‐related inflammation (CAA‐ri), a rare autoimmune encephalopathy due to raised anti‐Aß autoAbs levels in the cerebrospinal fluid (CSF).MethodNatural history study of CAA‐ri demonstrated that immunotherapy‐related ARIA‐E share several commonalities with the spontaneous occurrence of autoAbs‐related ARIA‐E, including fluid, MRI, and PET biomarker changes and the potential response to treatment outcomes.ResultThe prospective longitudinal monitoring of patients with CAA‐ri provide evidence for a regional and temporal association of ARIA‐E on MRI with focal peaks of neuroinflammation on microglial‐PET imaging. This association was strong in patients with positive CSF markers of AD (ATN positive) and comorbid CAA pathology on MRI, while it was negligible in patients with CAA disease w/o AD (ATN negative). Raised CSF concentrations of anti‐Aß autoAbs were found in all patients at (sub)acute presentation, and reduced within 5 months from the ARIA‐E index event, in parallel with evidence of radiographic resolution of ARIA‐E. At follow‐up MRI scan, the occurrence of new hemorrhagic markers (aka ARIA‐H in trials) were found only in patients with coexisting CAA and AD comorbid pathology. The MRI scales for ARIA commonly used in clinical trials only partially paralleled the clinical, biological, and MRI findings.ConclusionThis suggests that to mitigate and monitor the risk of ARIA, more sensitive, specific, cost‐effective and easy to interpret diagnostic tools and biomarkers than MRI alone will be needed for precision drug‐dose tailoring.

Key genes and immune infiltration in chronic spontaneous urticaria: a study of bioinformatics and systems biology.

Chronic spontaneous urticaria (CSU) is defined by the spontaneous occurrence of wheals and/or angioedema for >6 weeks. The pathogenesis involves skin mast cells, but the complex causes of their activation remain to be characterized in detail. To explore disease-driving genes and biological pathways in CSU. Two microarray data sets, e.g., GSE57178 and GSE72540, with mRNA information of skin from CSU patients, were downloaded from the Gene Expression Omnibus (GEO) database. An integrated bioinformatics pipeline including identification of differentially expressed genes (DEGs), functional enrichment analysis, protein-protein interaction (PPI) network analysis, co-expression and drug prediction analysis, and immune and stromal cells deconvolution analyses were applied to identify hub genes and key drivers of CSU pathogenesis. In total, we identified 92 up-regulated and 7 down-regulated genes in CSU lesions. These were significantly enriched in CSU-related pathways such as TNF, NF-κB, and JAK-STAT signaling. Based on PPI network modeling, four genes, i.e., IL-6, TLR-4, ICAM-1, and PTGS-2, were computationally identified as key pathogenic players in CSU. Immune infiltration analyses indicated that dendritic cells, Th2 cells, mast cells, megakaryocyte-erythroid progenitor, preadipocytes, and M1 macrophages were increased in lesional CSU skin. Our results offer new insights on the pathogenesis of CSU and suggest that TNF, NF-κB, JAK-STAT, IL-6, TLR-4, ICAM-1, and PTGS-2 may be candidate targets for novel CSU treatments.