Causal relationship between chronic kidney disease, renal function, and venous thromboembolism: a bidirectional Mendelian randomization study

BACKGROUND

Chronic kidney disease (CKD) and impaired renal function have been implicated in venous thromboembolism (VTE), but their causal relationships remain uncertain. This study employs Mendelian randomization (MR) to elucidate the potential bidirectional causal effects between CKD, renal function biomarkers, and VTE.

METHODS

We collated datasets from genome-wide association studies conducted among European individuals to perform MR analyses. The primary method utilized was the random-effect inverse variance-weighted (IVW) approach, with MR-Egger and the weighted median approaches employed as supplemental techniques. Several sensitivity studies were performed to assess the findings' robustness.

RESULTS

We identified a link between elevated serum creatinine levels and both VTE (OR: 1.14, 95% CI: 1.05-1.24, p = 0.001) and PE (OR: 1.20, 95% CI: 1.08-1.33, p = 0.001). After outlier removal and Bonferroni correction, the Cr-VTE association lost significance (p = 0.005). A suggestive causal relationship was found between eGFR and VTE (OR: 0.38, 95% CI: 0.20-0.73, p = 0.004), DVT (OR: 0.37, 95% CI: 0.16-0.87, p = 0.022), and PE (OR: 0.29, 95% CI: 0.12-0.66, p = 0.004). No causal effects of CKD or BUN on VTE or its subtypes were observed. Reverse causality inferences did not reveal any meaningful results.

CONCLUSIONS

This MR analysis provides evidence that elevated serum creatinine is associated with a higher risk of VTE and PE, while reduced eGFR may be a potential risk factor for VTE and its subtypes. These findings highlight the need for proactive monitoring and preventive strategies in individuals with impaired renal function. Further studies are warranted to confirm these associations and explore underlying mechanisms.

Endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance dialysis

BACKGROUND

Vascular calcification is common and progressive in patients with chronic kidney disease. However, the risk factors associated with the progression of vascular calcification in patients receiving maintenance dialysis have not been fully elucidated. Here, we aimed to evaluate vascular calcification and identify the factors associated with its progression in patients receiving maintenance hemodialysis.

METHODS

This is a prospective longitudinal study that included 374 patients receiving maintenance hemodialysis. The participants received assessments of coronary artery calcification (CAC) and abdominal aortic calcification (AAC), as measured by computed tomography. After the baseline investigation, a 2 years follow-up was performed. We also detected the markers of endothelial injury [E-selectin and soluble intercellular adhesion molecule-1 (sICAM-1)]. Finally, the risk factors affecting the CAC and AAC progression were examined by multivariate logistic regression analysis.

RESULTS

Among 374 patients, the median [interquartile range (IQR)] age was 54.0 (40.0-62.0) years; 59.9% of patients were male. The median (IQR) follow-up time was 1.9 (1.8-2.0) years for all patients. By the end of 2-year follow-up, progression of vascular calcification (including CAC and AAC) was observed in 58.0% of patients. Further, compared with the patients without progression of vascular calcification, the endothelial injury (including E-selectin and sICAM-1) of patients with progression of vascular calcification was markedly enhanced. Moreover, after adjustment for the confounders, endothelial injury was a risk factor for the progression of vascular calcification.

CONCLUSION

The present study indicated that endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance hemodialysis.

Establishment of a lupus-prone mouse model of pulmonary arterial hypertension with intermittent hypoxia: functional, biochemical and histological verifications

Pulmonary arterial hypertension (PAH) is one of the most severe complications of systemic lupus erythematosus (SLE) with high mortality and limited treatment options, primarily due to its unclear pathogenesis. This study aims to investigate the role of intermittent hypoxia (IH) in exacerbating pulmonary arterial remodeling in SLE-PAH using MRL/lpr lupus-prone mouse. In this study, twelve female MRL/lpr mice and six female BALB/c mice were exposed to hypoxia for 2 hours daily over 28 days in a hypoxic chamber (FiO₂, 12%). Among them, six MRL/lpr mice received treatment with LW6, a HIF-1α inhibitor. Moreover, six MRL/lpr mice were exposed to normoxia (FiO2, 21%) and served as controls. As a result, IH MRL/lpr mice developed significant PAH, with right ventricular systolic pressure (RVSP) measuring 32.95 ± 2.08 mmHg, significantly higher than the 26.63 ± 2.72 mmHg observed in normoxic MRL/lpr mice (p < .001). Additionally, the right ventricular hypertrophy index (RVHI) and medial wall thickness (MWT) of pulmonary artery markedly elevated in IH MRL/lpr mice. The protein expression level of HIF-1a and P-NFκB were significantly upregulated in the lungs of these mice. However, treatment with LW6 during hypoxia reduced RVSP and alleviated pulmonary arterial remodeling in MRL/lpr mice. Notably, BALB/c mice subjected to 2 hours of daily hypoxia did not exhibit pulmonary arterial remodeling. This study establishes a reproducible SLE-PAH model, demonstrates the critical role of hypoxia in disease progression, and identifies HIF-1α as a potential therapeutic target for managing SLE-PAH.

Effectiveness of inactivated influenza vaccine against laboratory-confirmed influenza in elderly Chinese patients with diabetes: A test-negative design case-control study

Vaccination coverage for influenza among diabetic populations remains suboptimal. Various factors contribute to this low vaccination rate, with a prominent issue being skepticism among potential vaccine recipients regarding vaccine effectiveness. We conducted a retrospective test-negative case-control study among diabetic patients aged 60 years and older in Ningbo, Zhejiang Province, China, spanning for four influenza seasons from 2018-19 to 2021-22. A total of 2,204 elderly patients were tested for influenza virus nucleic acid or antigen during the study period. After applying exclusion criteria, 199 influenza-positive cases and 199 matched influenza-negative controls were included in the final analysis. Vaccine effectiveness (VE) was estimated using an unconditional multiple logistic regression model, adjusted for age, gender, household registration and underlying health status. VE was calculated as (1-odds ratio(OR)) × 100%. Overall, the adjusted VE against laboratory-confirmed influenza from inactivated influenza vaccines over the study period was 59.4% (95%CI, 36.3% to 74.4%). VE varied across seasons, with the highest observed in the 2020-21 season and the lowest in the 2019-20 season. Importantly, repeated vaccination did not diminish vaccine effectiveness (OR = 1.2; 95% CI: 0.6 to 2.5). These findings provide a robust basis for recommending annual influenza vaccination among all elderly individuals with diabetes, absent any known contraindications.

Enhanced near-infrared Ru (II) complex fluorescence sensor for sensitive sensing of Al3+ and cell imaging

A near-infrared (NIR) fluorescent sensor (λem = 790 nm), [Ru ((CH3O)2bipy)2 (BIMPY)]2+, was synthesized and thoroughly characterized, which can selectively recognize Al3+ ions in THF. The [Ru ((CH3O)2bipy)2 (BIMPY)]2+ has excellent sensitivity (LOD = 3.48 × 10-8 mol/L) towards Al3+ with a 2:1 (Ru complex/Al3+) complex ratio and opportune binding constant (K = 606.82 mol/L). The change mechanism of photophysical properties was determined by time-dependent density functional theory (TDDFT) method, which illustrates fluorescence enhancement sensing to Al3+ ions. The [Ru ((CH3O)2bipy)2 (BIMPY)]2+ was used as a field-deployable sensor, achieving on-site Al3+ monitoring via the RGB analysis. Furthermore, the [Ru ((CH3O)2bipy)2 (BIMPY)]2+ succeed in imaging Al3+ in living HepG2 cells.

The paradigm shifts of periodontal regeneration strategy: From reparative manipulation to developmental engineering

Ideal periodontal regeneration requires the integration of alveolar bone, periodontal ligament, and cementum, along with Sharpey's fibers for occlusal force resistance. However, physiological regeneration remains rare due to its intricate structure, making clinical regeneration a challenge. Periodontal ligament stem cells (PDLSCs), first isolated in 2004, hold the key to multi-directional differentiation into cementoblasts, fibroblasts, and osteoblasts. While traditional therapies like guided tissue regeneration (GTR) aim to activate PDLSCs, clinical outcomes are inconsistent, suggesting the need for additional strategies to enhance PDLSCs' functions. Advancements in molecular biotechnology have introduced the use of recombinant growth factors for tissue regeneration. However, maintaining their efficacy requires high doses, posing cost and safety issues. Multi-layered scaffolds combined with cell sheet technology offer new insights, but face production, ethical, and survival challenges. Immune regulation plays a crucial role in PDLSC-mediated regeneration. The concept of "coagulo-immunomodulation" has emerged, emphasizing the coupling of blood coagulation and immune responses for periodontal regeneration. Despite its potential, the clinical translation of immune-based strategies remains elusive. The "developmental engineering" approach, which mimics developmental events using embryonic-stage cells and microenvironments, shows promise. Our research group has made initial strides, indicating its potential as a viable solution for periodontal complex regeneration. However, further clinical trials and considerations are needed for successful clinical application. This review aims to summarize the strategic transitions in the development of periodontal regenerative materials and to propose prospective avenues for future development.

Systemic complications and management strategies in liver cancer patients undergoing interventional therapy

Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities. Patients often experience a range of complications, including cardiovascular, renal, hematological, and metabolic abnormalities, which can significantly affect treatment outcomes and quality of life. This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics, which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications. A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications. This article offers an overview of systemic complications in liver cancer, focusing on pathophysiological mechanisms, risk factors, and strategies to improve care. By addressing gaps in the existing literature and proposing future research directions, it underscores the importance of comprehensive, patient-centered approaches to refine therapeutic strategies.

ALDOC and PGK1 coordinately induce glucose metabolism reprogramming and promote development of colorectal cancer

Colorectal cancer (CRC) remains a significant health challenge globally, demanding a comprehensive understanding of its molecular underpinnings for effective management. In this study, we investigated the role of Aldolase C (ALDOC), a glycolytic enzyme, in CRC pathogenesis. Transcriptomic analysis of CRC tissues from The Cancer Genome Atlas (TCGA) revealed a substantial upregulation of ALDOC, correlating with adverse clinical outcomes. Immunohistochemical (IHC) staining of locally collected patient-derived tissues corroborated these findings, demonstrating elevated ALDOC expression in tumor tissues, particularly in advanced stages. Functional studies elucidated the regulatory role of ALDOC in CRC cell phenotypes. ALDOC knockdown significantly inhibited cell proliferation, induced apoptosis, arrested cell cycle progression, and suppressed cell migration in vitro. Moreover, in vivo studies using xenograft models confirmed that ALDOC knockdown attenuated tumor growth. Mechanistically, ALDOC was found to interact with hypoxia-inducible factor 1 alpha (HIF1A) and enhance its transcriptional activity on phosphoglycerate kinase 1 (PGK1), a key glycolytic enzyme. Dual-luciferase reporter assays and chromatin immunoprecipitation experiments validated the ALDOC-mediated transcriptional activation of PGK1. Further functional rescue experiments revealed a synergistic interplay between ALDOC and PGK1 in regulating CRC cell phenotypes. Additionally, ALDOC was implicated in promoting aerobic glycolysis in CRC cells, potentially through PGK1 regulation. Collectively, our findings unveil ALDOC as a critical regulator of CRC pathogenesis, offering insights into its potential as a therapeutic target and highlighting the ALDOC/PGK1 axis as a promising avenue for further investigation in CRC.

Type 2 diabetes worsens the outcome of ischemia/reperfusion in female STEMI patients and female db/db mice with HFpEF cardiometabolic phenotype

BACKGROUND

Heart failure with preserved ejection fraction (HFpEF) poses a significant global health challenge, disproportionately affecting women. Diabetic women with HFpEF represent a high-risk subgroup, particularly after experiencing ST-segment elevation myocardial infarction (STEMI), exhibiting increased mortality compared to men. While prolonged door-to-balloon (DTB) times, reflecting delayed reperfusion, are a critical factor in STEMI outcomes, they alone do not fully capture the observed outcome variability in diabetic women. Using an integrated clinical and pre-clinical approach this study aimed to investigate the relative contributions of metabolic dysfunction and coronary artery disease (CAD) in type 2 diabetes (T2D) to STEMI outcomes in women, beyond the impact of DTB time.

METHODS

A retrospective case-control study analysed female STEMI patients undergoing primary percutaneous coronary intervention (pPCI, n = 40 T2D, n = 40 non-diabetic controls), comparing clinical characteristics, treatment strategies, and early outcomes. A preclinical model (female db/db mice) assessed cardiac function via echocardiography, Langendorff perfusions, and ischemia-reperfusion protocols. Metabolome of heart, liver, and skeletal muscle was assessed by 1H NMR spectroscopy.

RESULTS

Our study reveals significantly higher mortality, impaired left ventricular function post-pPCI, and increased implantable cardioverter-defibrillator (ICD) implantation rates in diabetic STEMI patients, irrespective of DTB time, when compared to non-diabetic controls. Elevated inflammatory markers, acute hyperglycaemia and evidence of cardio-hepatic damage were identified in T2D patients. db/db mice exhibited analogous T2D-associated pathophysiology, including increased ischemia-reperfusion injury exacerbated by metabolic disturbances in the myocardium, liver, and skeletal muscle versus non-diabetic controls.

CONCLUSIONS

In diabetic women, multiple factors beyond reperfusion delays exacerbate acute myocardial injury. This necessitates the development of sex-specific strategies to manage the cardiovascular complications of diabetic HFpEF. The db/db mouse model provides a relevant preclinical tool for future research as it mimics human T2D-associated HFpEF and STEMI outcome.

Co-exposure to triclosan and polystyrene nanoplastics on neurodevelopmental toxicity and gut microbiota dysbiosis in zebrafish (Danio rerio)

Triclosan (TCS) and nanoplastics (NPs) are emerging environmental pollutants frequently found in human-related samples. While prior research has investigated TCS's neuro and enterotoxicity, the combined effects of TCS and NPs remain unclear. The polystyrene nanoplastics (PS-NPs, 100 nm) were characterized by scanning electron microscopy (SEM) and nanoparticle tracking analysis, and the interaction and physical properties of polystyrene nanoplastic and TCS under co-exposure were characterized by Fourier transform infrared spectroscopy and SEM. We conducted acute exposure (6 hpf-5 dpf) and chronic exposure (6 hpf-90 dpf) experiments on zebrafish larvae, that is, co-exposure to TCS (250 μg/L) and PS-NPs (100 μg/L, 1000 μg/L). The distribution characteristics of PS-NPs and TCS+PS-NPs in vivo were studied using fluorescent PS-NPs. In addition, the results were evaluated by histopathology, behavioral tests, 16S rDNA sequencing and comparative toxicogenomic database analysis (CTD). In the co-exposure to TCS and PS-NPs, TCS did not alter the distribution characteristics of PS-NPs in zebrafish larvae. The co-exposure exacerbated neurodevelopmental inhibition, leading to neurodevelopmental abnormalities in zebrafish larvae, including developmental malformations, reduced spontaneous motor activity. Additionally, significant behavioral abnormalities were observed in adult zebrafish, such as reduced motor activity and delayed responses. Analysis of the CTD database suggested that the oxidative stress response pathway might mediate the neurotoxicity and gut microbiota dysbiosis caused by TCS+PS-NPs, with a focus on changes in neurodevelopmental genes (syn2a, ngn1, gap-43). Chronic co-exposure resulted in dysbiosis and decreased diversity of the gut microbiota in adult zebrafish, as well as various histopathological damages, such as partial shedding of intestinal villi and thinning of the intestinal wall. In general, the co-exposure of TCS and PS-NPs exacerbates the oxidative stress response and further induces neurodevelopmental toxicity and intestinal microbiota dysregulation. The assessment of the complex interaction between the two reveals the environmental risks of emerging pollutants and nanoplastics coexisting.

The bone-vascular axis: the link between osteoporosis and vascular calcification

Osteoporosis and vascular calcification are chronic metabolic diseases threatening the health of aging people. The incidence of osteoporosis and vascular calcification increases year by year, and has drawn much attention from the scientific and clinical area. Many studies have found that osteoporosis and vascular calcification are not completely independent, but there are close correlations between them in the pathogenesis and underlying mechanisms. The underlying mechanisms of osteoporosis and vascular calcification include aging, oxidative stress, inflammatory response, lipid metabolism, calcium and phosphorus metabolism, vitamins, autophagy, and extracellular vesicles. This review updates the current understanding of the correlation and underlying mechanisms of osteoporosis and vascular calcification, and highlights the complexity of the bone-vascular axis, aiming to provide novel ideas for the prevention and treatment of osteoporosis and vascular calcification.

Artificial intelligence (AI) in pharmacovigilance: A systematic review on predicting adverse drug reactions (ADR) in hospitalized patients

INTRODUCTION

Adverse drug reactions (ADRs) significantly impact healthcare systems, leading to increased hospitalization rates and costs. With the growing adoption of artificial intelligence (AI) in healthcare, machine learning (ML) models offer promising solutions for ADR prediction. However, comprehensive evaluations of these models remain limited.

METHODS

This systematic review synthesized findings from 13 studies that utilized various ML algorithms (regression-based, flexible, and ensemble models) to predict ADRs using data such as patient demographics, laboratory values, and comorbidities. Meta-analysis was conducted to assess the pooled sensitivity and specificity of the models, and a co-authorship and keyword analysis was performed to examine collaborative networks within the field.

RESULTS

The included studies primarily focused on model development (77 %), with only 23 % incorporating external validation, raising concerns about generalizability across clinical contexts. Meta-analysis showed pooled sensitivity and specificity of 78.1 % and 70.6 % for development-only studies, while studies with external validation achieved higher sensitivity (81.5 %) and specificity (79.5 %). Co-authorship analysis identified 67 contributors across eight collaboration clusters, indicating a specialized but emerging research field.

DISCUSSION

The findings highlight the need for multifactorial models that integrate diverse predictors to improve the performance and reliability of ML-based ADR prediction. Addressing these limitations through rigorous model development and validation processes could enhance the clinical applicability of AI-driven pharmacovigilance, ultimately advancing patient safety and healthcare outcomes.

The role of the leukocyte glucose index in predicting clinical outcomes in acute methanol toxicity

Introduction

Acute methanol poisoning signifies a global health issue. This study was designed to explore the role of the leukocyte glucose index (LGI) in predicting clinical outcomes; in-hospital mortality and visual impairment, and length of hospital stay, in acute methanol toxicity and to evaluate the association between LGI and all initial patient characteristics.

Patients and methods

This was a retrospective analysis that involved 82 acutely methanol-intoxicated patients, starting from January 2021 to December 2023. Patients were categorized by on-admission LGI tertiles into low, intermediate, and high groups.

Results

Approximately 27 % (22 out of 82) of patients died during hospitalization, with most of them belonging to the high LGI group. No significant differences existed in the proportions of patients with total vision loss, or the length of hospital stay. The majority of the undesirable findings were apparent in patients in either the intermediate or high LGI groups. LGI can distinguish exceptionally between survivors and non-survivors with an area under the curve of 0.808. However, LGI does not have any discriminatory power in predicting adverse visual outcomes.

Conclusion

LGI can serve as a valuable tool in predicting early in-hospital mortality in acute methanol poisoning.

Multiomics analysis demonstrated a strong correlation between lipid-mediated chronic kidney disease and stroke: Potential benefits of affected patient cohorts

OBJECTIVE

Patients with chronic kidney disease (CKD) exhibit a disproportionately elevated risk of stroke, frequently compounded by renal impairment. Therapeutic strategies for stroke based on Traditional Chinese Medicine's 'kidney-brain axis' theory demonstrate clinical efficacy, indicating that there may be a potential association between chronic kidney disease and stroke, which needs further exploration and verification.

METHODS

In this study, databases such as GEO, NHANES, and GWAS were used to collect data related to CKD and stroke. GEO gene data enrichment analysis was used to explore possible mediating factors between CKD and stroke. NHANES clinical data were used to verify the GEO data analysis results. Mendelian randomization was used to confirm the causal relationship between CKD and stroke and verify the association effect of mediating factors in these two diseases.

RESULTS

Cross-gene analysis and transcription factor analysis of GEO data revealed that lipid-related pathways may have a mediating effect on the relationship between CKD and stroke. Logistic regression analysis based on NHANES data revealed that changes in LDL-C, HDL-C, TC, and TG can affect the occurrence of stroke. Mendelian randomization analysis was used to determine the causal relationship between CKD and stroke and verified the mediating effects of lipid factors, such as LDL-C, HDL-C, TC, and TG, indicating that LDL-C, HDL-C, TC, and TG may be potential mediating factors for these two diseases. Our findings highlight the clinical relevance of lipid pathways in bridging CKD and stroke. By integrating predictive biomarkers and multi-level diagnostics, this study paves the way for AI-driven precision medicine in stroke prevention. Specifically, machine learning approaches could enhance risk stratification of high-risk CKD cohorts, enabling tailored interventions such as lipid-lowering therapies and personalized monitoring protocols. These strategies align with emerging paradigms in healthcare benefits and population-specific management.

CONCLUSION

This study provides new insights into the interactive relationship between CKD and stroke and provides a scientific basis for the process of syndrome differentiation and the treatment of stroke under the guidance of the "kidney-brain correlation". Moreover, the influence of mediating factors related to lipid metabolism on the occurrence of these two diseases was investigated, which deepened researchers' understanding of the potential association mechanism between the two diseases.

Progress in Basic Research and Clinical Strategies for Cementum Regeneration

Periodontitis is a chronic inflammatory disease that inflicts damage to periodontal tissues, leading to loss of teeth, and affects systemic health. Traditional treatments can delay inflammation, whereas regeneration of the periodontal complex (periodontal ligament, cementum, and alveolar bone) can better restore periodontal tissue function. In recent years, the regeneration of alveolar bone and the periodontal ligament has been widely reviewed although cementum has received less attention. As an avascular mineralised structure around the tooth, cementum can anchor periodontal ligament fibres to the root surface, thereby connecting teeth to alveolar bone. The supporting and stabilizing effects of cementum make its regeneration vital for restoring the functionality of the periodontal tissues. In this review, we discuss advancements in basic and clinical research appertaining to cementum regeneration. We describe the molecular mechanisms that contribute to cementum regeneration thereby providing a foundation for further basic research. Finally we summarise the clinical strategies employed for cementum regeneration, including regenerative surgery and utilisation of growth factors and stem cells.

Estradiol and vitamin D exert a synergistic effect on preventing osteoporosis via the miR-351-5p/IRS1 axis and mTOR/NFκB signaling pathway

This study aimed to investigate the antiosteoporotic effects and regulatory mechanisms of estradiol (E2) and vitamin D. MC3T3-E1 cells were treated with E2, vitamin D, or their combination, followed by a systematic assessment of cell proliferation and osteogenic differentiation capacity across the treatment groups. Subsequently, miRNA sequencing was performed to analyze differentially expressed miRNAs between the control and E2&vitamin D groups. The target relationship between miR-351-5p and IRS1 was validated, and the effects of the miR-351-5p/IRS1 axis on osteogenesis and mTOR/NFκB signaling pathway were determined after combination treatment. Additionally, an ovariectomized (OVX) osteoporosis mouse model was established to ‌systematically examine‌ the effects of E2, vitamin D, and their combination on osteoporosis and mTOR/NFκB signaling pathway. E2 and vitamin D synergistically promoted MC3T3-E1 cell proliferation and osteogenic differentiation. miR-351-5p was identified through miRNA sequencing analysis. miR-351-5p was downregulated in MC3T3-E1 cells after E2 and vitamin D combination treatment, and its overexpression partially reversed the effect of the combination treatment on osteogenesis. IRS1 was a target of miR-351-5p. When overexpressed, IRS1 partially mitigated the impact of miR-351-5p overexpression on osteogenesis and mTOR/NFκB signaling pathway under the combination treatment. Furthermore, in vivo experiments demonstrated that E2 and vitamin D could synergistically prevent osteoporosis in OVX mice by inhibiting the mTOR/NFκB signaling pathway. In conclusion, E2 and vitamin D exhibited a synergistic effect in preventing osteoporosis through the miR-351-5p/IRS1 axis and mTOR/NFκB signaling pathway. E2 and vitamin D combination treatment could be a potential anti-osteoporotic strategy for osteoporosis treatment.

Toxicological concerns regarding glyphosate, its formulations, and co-formulants as environmental pollutants: a review of published studies from 2010 to 2025

Over the last decade and worldwide, an enormous investment in research and data collection has been made in the hope of better understanding the possible ecological and toxicological impacts triggered by glyphosate (GLY). This broad-spectrum, systemic herbicide became the most heavily applied pesticide ever in the 2000s. It is sprayed in many different ways in both agricultural and non-agricultural settings, resulting in multiple routes of exposure to organisms up and down the tree of life. Yet, relatively little is known about the environmental fate of GLY-based herbicide (GBH) formulations, and even less on how GBH co-formulants alter the absorption, distribution, metabolism, excretion, and toxicity of GLY. The environmental fate of GLY depends on several abiotic and biotic factors. As a result of heavy annual GBH use over several decades, GLY residues are ubiquitous, and sometimes adversely affect non-target terrestrial and aquatic organisms. GLY has become a frequent contaminant in drinking water and food chains. Human exposures have been associated with numerous adverse health outcomes including carcinogenicity, metabolic syndrome, and reproductive and endocrine-system effects. Nonetheless, the existence and magnitude of GLY-induced effects on human health remain in dispute, especially in the case of heavily exposed applicators. A wide range of biochemical/physiological modes of action have been elucidated. Various GBH co-formulants have long been considered as inert ingredients relative to herbicidal activity but clearly contribute to GLY-induced hazards and risk gradients. In light of already-identified toxicological and ecosystem impacts, the intensive research focuses on GLY and GBHs should continue, coupled in the interim with commonsense, low-cost changes in use patterns and label requirements crafted to slow the spread of GLY-resistant weeds and reduce applicator and general-population exposures.

Association between heavy metal exposure and heart failure incidence and mortality: insights from NHANES data (2003-2018)

BACKGROUND

Environmental heavy metal exposure is a potential yet understudied risk factor for heart failure (HF), a global health burden with rising prevalence. While toxic metals like cadmium (Cd), mercury (Hg), and arsenic (As) are linked to cardiovascular diseases, their roles in HF incidence and prognosis remain unclear.

METHODS

The associations between heavy metals and HF outcomes were analyzed using NHANES 2003-2018 data (n = 11,592). Metals were measured in blood (Cd, Hg, Pb) and urine (As, Hg, others) using inductively coupled plasma mass spectrometry (ICP-MS). Confounding factors were addressed through propensity score matching (PSM). HF incidence was evaluated using logistic regression, while mortality was assessed via Cox regression. Mechanistic pathways were explored through causal mediation analysis.

RESULTS

After PSM (n = 987, 337 HF cases), blood Cd showed a positive association with HF incidence (OR:1.35, 95%CI:1.05-1.72), while urinary Hg (OR:0.78, 95%CI:0.63-0.98) and As (OR:0.84, 95%CI:0.72-0.99) exhibited protective effects. Urinary As correlated with elevated cardiovascular mortality in HF patients (HR:1.19, 95%CI:1.04-1.35). Mediation analysis indicated Cd's effect on HF was mediated via CHD/OMI, whereas Hg's protection involved reduced CHD/OMI incidence. As directly lowered HF risk without mediation.

CONCLUSION

These findings underscore cadmium's role as a risk factor and the paradoxical effects of mercury and arsenic: low to moderate concentrations of Hg/As may reduce HF risk through indirect pathways (e.g., reduced CHD/OMI for Hg) or direct cardioprotective mechanisms (for As), yet arsenic's association with mortality highlights its long-term cardiovascular toxicity. Findings advocate for preventive strategies targeting metal exposure and further research integrating cumulative biomarkers.

Protective Effects of a Probiotic Lacticaseibacillus paracasei MSMC39-1 on Kidney Damage in Aged Mice: Functional Foods Potential

Kidney fibrosis and inflammation are significant contributors to the decline in renal function associated with aging. These processes are characterized by structural changes, such as glomerular sclerosis and interstitial fibrosis, which exacerbate kidney injury and inflammation in aged individuals. Probiotics have gained increasing attention for their potential health-promoting effects. However, further investigation is required to fully understand the mechanisms underlying these benefits. We hypothesize that probiotics could ameliorate fibrosis through the immunomodulatory effects of probiotics and by improving kidney tissue inflammation. Sixteen-month-old aging mice were administered Lacticaseibacillus paracasei MSMC39-1 for four months compared to young mice (six-month-old) and aged mice (twenty-month-old). The research found that following the administration of probiotic MSMC39-1, there were significant improvements in kidney inflammation, as evidenced by reductions in pro-inflammatory cytokines, fibrosis, and inflammatory cells within the tissue. Moreover, the findings demonstrated that probiotic MSMC39-1 significantly normalized levels of malondialdehyde (MDA), and rescued antioxidant superoxide dismutase (SOD) and glutathione peroxidase (Gpx) in kidney tissue which was consistent with a low mitochondria biogenesis. Further investigations revealed that conditioned medium from MSMC39-1 rescued epithelial kidney cells with damage induced by high glucose. This research provides information and insights into the mechanisms underlying the beneficial health effects of probiotics, offering a deeper understanding of how these probiotics contribute to anti-aging processes in the kidney.

Particulate matter 2.5 (PM2.5) - associated cognitive impairment and morbidity in humans and animal models: a systematic review

Particulate matter with an aerodynamic diameter of less than 2.5 µm (PM2.5) is one of the criteria air pollutants that (1) serve as an essential carrier of airborne toxicants arising from combustion-related events including emissions from industries, automobiles, and wildfires and (2) play an important role in transient to long-lasting cognitive dysfunction as well as several other neurological disorders. A systematic review was conducted to address differences in study design and various biochemical and molecular markers employed to elucidate neurological disorders in PM2.5 -exposed humans and animal models. Out of 340,068 scientific publications screened from 7 databases, 312 studies were identified that targeted the relationship between exposure to PM2.5 and cognitive dysfunction. Equivocal evidence was identified from pre-clinical (animal model) and human studies that PM2.5 exposure contributes to dementia, Parkinson disease, multiple sclerosis, stroke, depression, autism spectrum disorder, attention deficit hyperactivity disorder, and neurodevelopment. In addition, there was substantial evidence from human studies that PM2.5 also was associated with Alzheimer's disease, anxiety, neuropathy, and brain tumors. The role of exposome in characterizing neurobehavioral anomalies and opportunities available to leverage the neuroexposome initiative for conducting longitudinal studies is discussed. Our review also provided some areas that warrant consideration, one of which is unraveling the role of microbiome, and the other role of climate change in PM2.5 exposure-induced neurological disorders.

Diagnostic challenges in peritoneal dialysis-associated peritonitis with atypical and rare pathogens: A new era of metagenomic next-generation sequencing precision diagnosis

Peritonitis caused by atypical and rare pathogens is challenging to diagnose. Although the International Society for Peritoneal Dialysis (ISPD) guidelines significantly improve the diagnostic rate by placing peritoneal dialysis fluid into blood culture bottles, peritonitis caused by atypical pathogens, such as tuberculosis and fungi, is difficult to diagnose due to challenges in culturing these organisms using traditional methods, leading to high mortality. Metagenomic next-generation sequencing (mNGS) technology has been widely used as an accurate diagnostic technique for infectious diseases. First used in identifying and quantifying environmental micro-organisms, mNGS technology can identify rare, novel, difficult-to-detect and mixed pathogens directly from clinical samples, and has potential in predicting antibiotic resistance. This paper summarizes the application of mNGS in atypical and rare pathogens peritonitis clinical cases in recent years, and provides reference for the diagnosis of peritonitis in combination with new ISPD guidelines and diagnostic techniques. The development and principles of mNGS technology, diagnostic efficiency in peritonitis, challenges in diagnosis of atypical and rare pathogen-associated peritonitis, and application of mNGS technology are discussed in detail. The development of mNGS technology provides clinicians with powerful tools to more accurately identify and treat peritonitis. Future research needs to focus on reducing costs, improving test accessibility, and developing new bioinformatics tools to better integrate mNGS results into clinical practice.

Astrocytic LCN2 drives uremic pruritus and morphine-induced pruritus via the GRP/GRPR pathway

BACKGROUND

Uremic pruritus (UP) is a distressing condition in hemodialysis patients with unclear mechanisms. This study investigates the role of LCN2 in pruritus, focusing on its interaction with GRP/GRPR signaling and astrocyte activation.

METHODS

Clinical skin biopsy samples from CKD patients with and without UP were analyzed for LCN2 expression. A chronic renal failure mouse model (UP model) was established through surgical kidney ablation, while a morphine-induced itch model was generated via intrathecal morphine injection. LCN2 knockout (LCN2-/-) mice were used to evaluate its functional role in itch modulation. Scratching behavior was recorded, and Western blot, qRT-PCR, immunohistochemistry, immunofluorescence, and ELISA were performed to assess LCN2 expression, GRP/GRPR signaling, and inflammatory cytokines in the spinal cord. Additionally, RC-3095 (a GRPR inhibitor) and GRP were administered to evaluate their effects on pruritus.

RESULTS

LCN2 expression was elevated in CKD patients with UP and positively correlated with itch severity. Similarly, UP model mice showed increased spinal LCN2 levels, while LCN2 deficiency (LCN2-/- mice) reduced scratching behavior. Mechanistically, LCN2 promoted pruritus by enhancing GRP/GRPR signaling and astrocyte activation. Blocking GRP/GRPR with RC-3095 reduced pruritus in both UP and morphine-induced models, confirming LCN2's role in itch transmission.

CONCLUSION

LCN2 mediates pruritus by promoting GRP/GRPR signaling, astrocyte activation, and neuroinflammation, making it a potential therapeutic target for CKD-related and opioid-induced pruritus.

The Impact of LDL Cholesterol, HDL Cholesterol, Triglycerides, and Vitamin D on Short-Term Implant Survival Rate: A Prospective Observational Study

Background/Objectives: Dental implant success is influenced by a range of systemic and local factors. Emerging evidence suggests that metabolic markers such as lipid profiles and vitamin D levels may play a role in osseointegration and implant survival. The aim of this study was to evaluate the influence of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and vitamin D levels on the short-term survival rate of dental implants. Materials and Methods: A prospective observational study was conducted on patients receiving dental implants. Preoperative serum levels of LDL, HDL, triglycerides, and vitamin D were recorded. A total of 556 conical, platform-switching implants were placed in 166 patients, smokers and no smokers with mean age 48 years ± 4.7. Implant survival was evaluated from 14 to 21 days after placement, at 6- and at a 12-month follow-up. Spearman's rank correlation was performed to assess potential correlations between the abovementioned systemic factors and implant loss. Results: Out of 556 implants, 13 (2.34%) were lost from 14 to 21 days after placement, a further two (0.35%) were lost after 6 months after surgery and a further eight (1.44%) were lost 12 months after placement. No significant correlation was found between HDL levels, cholesterol levels, triglyceride levels and implant loss. Spearman's correlation analysis revealed a strong negative correlation between vitamin D levels and implant loss with no statistical significance. Conclusions: Within the limitations of this study, no statistically significant associations were found between lipid profile markers or vitamin D levels and early dental implant loss. Further large-scale and long-term studies are warranted to validate these findings and better understand the interplay between systemic biochemical markers and implant survival rate.

Environmental Toxins and Oxidative Stress: The Link to Cardiovascular Diseases

Cardiovascular diseases (CVDs) remain a leading global health concern, responsible for substantial morbidity and mortality. In recent years, as our understanding of the multifaceted nature of CVDs has increased, it has become increasingly evident that traditional risk factors alone do not account for the entirety of cardiovascular morbidity and mortality. Environmental toxins, a heterogeneous group of substances ubiquitous in our surroundings, have now entered the spotlight as offenders in the development and progression of CVDs. Environmental toxins include heavy metals, air pollutants, pesticides, and endocrine-disrupting chemicals, among others. Upon exposure, they can elicit oxidative stress, a condition characterized by an imbalance between the production of reactive oxygen species (ROS) and the body's ability to detoxify and repair the resulting damage. Oxidative stress triggers a cascade of events, including inflammation, endothelial dysfunction, lipid peroxidation, and vascular remodeling, which can contribute to the development of atherosclerosis, hypertension, and other cardiovascular pathologies. This article delves into the molecular mechanisms underpinning oxidative stress-mediated cardiovascular damage induced by environmental toxins, emphasizing the role of specific toxins in this process. Further research is necessary to understand how individual susceptibility and genotype influence the impact of environmental toxins on oxidative stress and the risk of CVD.

Glycemic Control in Patients with Diabetes on Peritoneal Dialysis: From Glucose Sparing Approach to Glucose Monitoring

Optimized glycemic management is crucial for controlling atherosclerosis and consequent cardiovascular morbidity in patients with diabetes. Due to the continuous glucose burden from glucose-containing peritoneal dialysis (PD) solutions, PD patients with diabetes experience difficulties in glucose level regulation with glucose hypervariability and worsening dyslipidemia. Even in non-diabetic PD patients, glucose-containing PD solutions aggravate insulin resistance and cause overweight. Additionally, glucose degradation products (GDP) from glucose-based PD solutions provoke oxidative stress and complex inflammatory processes, leading to chronic deleterious and fibrotic peritoneal membrane changes. In this narrative review, we searched the literature using PubMed, MEDLINE, and Google Scholar over the last three decades to summarize the most important facts relevant to the presented issues, aiming to inform both endocrinologists and nephrologists in providing the best currently available care for people with diabetes on PD. We not only focus on adequate tailoring of insulin therapy adapted at the time of PD exchange with hypertonic glucose solution., but also emphasize the use of continuous glucose monitoring (CGM) that allows assessment of mean glucose values and time spent in normal, hypo, and hyperglycemia. However, the routine use of CGM in PD patients is limited due to high cost, and hemoglobin A1c (HbA1c) analysis is still recommended as a basic clinical tool for the assessment of glycemic control. Possible choices of antidiabetic drugs were considered given the narrowed choice due to contraindications for metformin and sulfonylurea. The other important therapeutic approach in PD patients with diabetes is using glucose-sparing PD regimens based on icodextrin and amino acid PD solutions with the addition of just one or two bags of low glucose concentration PD solution daily. This glucose-sparing approach not only reduces the glucose load and improves glycoregulation with correction of the lipid profile but also maintains the viability of the peritoneal membrane by reducing the harmful effects of GDPs.

Dialysis and the risk of early urological cancer: A nationwide population-based cohort study in Taiwan

Patients with end-stage renal disease (ESRD) are predisposed to a higher risk of developing malignancies. This study aimed to explore the association between chronic dialysis with ESRD treated and the subsequent development of urothelial cell carcinoma or renal cell carcinoma (UC/RCC). Data spanning 13 years were retrieved from Taiwan's National Health Insurance Research Database. A total of 11,820 patients with ESRD undergoing maintenance dialysis between January 1, 2000, and December 31, 2013, and 35,460 controls matched for sex, age, and index year, were identified. After adjusting for confounding factors, Cox proportional hazards analysis was performed to compare the risk of UC/RCC during the 13-year follow-up period, and Kaplan-Meier analysis was used to evaluate the cumulative UC/RCC incidence between the ESRD and non-ESRD cohorts. The average time before developing UC/RCC was 4.18 years after dialysis initiation in the ESRD group compared to 5.39 years in the control group. After adjusting for sex, age, monthly income, urbanization level, geographic region, and comorbidities, the hazard ratio for UC/RCC was 1.186 (95% confidence interval, 1.071-1.448; P = .005). Stratified by age, the odds ratios (ORs) for developing UC/RCC were 2.105, 1.498, 1.371, and 0.925 among patients with ESRD aged 40 to 49, 50 to 59, 60 to 69, and ≥ 70 years, respectively. Stratification by comorbidities revealed ORs of 1.204, 1.179, 1.186,1.172, 1.211, and 1.210 for patients without diabetes mellitus, hyperlipidemia, obesity, coronary artery disease, chronic obstructive pulmonary disease, and hematuria, respectively. The mean time to UC/RCC occurrence was 4.18 years after dialysis. Furthermore, younger male patients undergoing dialysis with fewer comorbidities were at higher risk of developing UC/RCC. Early or more intensive surveillance for urological cancers post-dialysis initiation is recommended for patients undergoing dialysis with longer life expectancies or a higher likelihood of undergoing renal transplantation.

Temporary Anchorage Devices in Clear Aligner Therapy: A Systematic Review

This systematic review analyzed the combined use of aligners and orthodontic temporary anchorage devices (TADs) in orthodontic treatment. The aim was to evaluate the effectiveness, benefits, and potential challenges of integrating the use of miniscrews with aligners. This review was conducted according to the PRISMA statement, and the protocol was registered at PROSPERO under the ID CRD42024576712. A comprehensive search on PubMed, Scopus, and Web of Science was conducted to identify relevant papers involving patients treated with aligners and TADs, dating from 1 January 2004 to 17 July 2024. The electronic database search identified a total of 458 articles. After eligibility, 14 records were selected for qualitative analysis. The findings suggest that the combination of aligners and miniscrews significantly enhances treatment precision and control, especially in cases requiring complex tooth movements, such as intrusion, extrusion, and distalization. The use of miniscrews allows greater control of movement and stability. The integration of these two techniques presents challenges, such as the need for precise miniscrew placement and potential discomfort during insertion. However, there was high satisfaction due to the aesthetic and comfort benefits of aligners. Further research is desirable to delve deeper into the topic to optimize clinical outcomes.

Effect of cypermethrin on thyroid follicular epithelial cell injury via the ROS-NF-κB-NLRP3 pathway

Cypermethrin (CYP, IUPAC name: [cyano-(3-phenoxyphenyl)methyl] 3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropane-1-carboxylate), a type II pyrethroid insecticide, is suggested to have potential adverse effects on human endocrine, immune, and neurotoxic systems.

OBJECTIVES

In this study, we aimed to investigate whether CYP causes oxidative stress and pyroptosis in thyroid follicle epithelial cells through the activation of the ROS-NFκB-NLRP3 pathway, thereby causing inflammatory responses.

METHODS

Nthy-ori 3-1 cells were used as an in vitro model and exposed to CYP at different doses (0, 100, 200, 400, 800, and 1600 μmol/L) for 24 h.

RESULTS

CYP treatment enhanced oxidative damage in Nthy-ori 3-1 cells, characterized by cellular crumpling, indistinct borders, increased cellular gaps, appearance of intercellular grease droplets, and increased pyroptosis. Subsequent treatment with the caspase-1 inhibitor VX-765 enhanced cell viability in the VX-765 +CYP group, improving cell morphology, reducing pyroptotic vesicles, suppressing oxidative stress, and downregulating Interleukin-18(IL-18) (an inflammatory factor) level.

CONCLUSION

The results demonstrate that CYP induces pyroptosis in Nthy-ori 3-1 cells through activation of the reactive oxygen species (ROS)-NF-κB-NLRP3 pathway.

Nanoplastics disrupt hepatic lipid metabolism via the inhibition of PPARγ: a study based on digestive system exposure

Nanoplastics (NPs) are emerging environmental contaminants capable of crossing biological barriers and accumulating in organs such as the liver, raising growing concerns about their potential contribution to nonalcoholic fatty liver disease (NAFLD). Notably, bottled water has been recognised as a major daily source of NP exposure. However, the associations between NP exposure and NAFLD onset, as well as the mechanistic basis, remain unclear. To investigate this, we analysed data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 cycles, using daily bottled water intake to estimate NP exposure and the hepatic steatosis index (HSI) as an indicator of liver fat accumulation. Animal and cellular experiments were conducted to evaluate NP-induced hepatic alterations. Additionally, transcriptomic analysis of liver tissues was performed, and integration with DisGeNET and the Comparative Toxicogenomics Database (CTD) enabled bioinformatic analyses and identification of key regulatory pathways. Epidemiological results revealed a significant positive correlation between bottled water consumption and HSI. Experimental findings demonstrated that NP exposure induced liver vacuolisation, oxidative damage, metabolic disruption, and inflammation in both in vivo and in vitro models. Transcriptomic and database integration revealed that NP exposure suppressed the PPAR signalling pathway, particularly by downregulating PPARγ expression, with excessive ROS generation likely contributing to this inhibition. These results were summarised in an adverse outcome pathway (AOP) framework, illustrating how NP exposure may impair PPARγ signalling and promote hepatic lipid accumulation. In conclusion, this study provides evidence that environmental NP exposure may be a contributing factor to NAFLD development and highlights the potential public health impact of the intake of NPs from bottled water.

Maternal probiotic supplementation and effects on the fetal placenta

Increasing number of pregnant women are consumi ng probiotics to promote their own health and that of their unborn fetuses. Such supplements are presumed to be safe for pregnant mothers and their unborn offspring. For pregnant mothers, such bioactive compounds might lower the risk of constipation, diarrhea, other gastrointestinal conditions, and pre-term birth, and prevent adverse pregnancy outcomes, including gestational diabetes mellitus and depression/anxiety. More research is needed to examine potential safety of probiotic consumption during pregnancy and long-term health consequences to offspring. The conceptus can also be indirectly affected by maternal probiotic supplementation through microorganism production of bioactive compounds. The placenta is in direct communication with the underlying uterine tissue. Thus, compounds in the maternal blood can easily transfer across the placenta and impact this hormonally sensitive organ. Select studies suggest that disruptions to the maternal microbiome dramatically affect the placenta. In the current review, we will therefore consider the evidence to date of how maternal probiotic supplementation affects the placenta. Three potential mechanisms we will explore include the possibility that maternal probiotic supplementation might impact the putative placenta microbiome. The second potential mechanism we will consider is that maternal probiotic consumption alters bacterial-derived metabolites, including short-chained fatty acids, polyamines, Vitamin B9, and Vitamin B12. The third potential mechanism to be discussed is that such supplements affect maternal and placental immune responses. Before probiotics are promoted for healthy pregnant women and those with gestational disorders, more studies, including those examining the effects on the placenta, are essential.

Relationship between bmi and glomerular filtration rate in a large cohort initiating a weight loss program: differential contributions of fat mass, fat-free mass, and abdominal fat compartments

BACKGROUND

The relationship between BMI and chronic kidney disease is controversial, likely due to the inability of BMI to accurately define body composition and adipose tissue distribution. Our objective was to evaluate the synergistic contribution of fat-free mass, fat mass, visceral (VAT) and subcutaneous (SAT) adipose tissue, to glomerular filtration rate (GFR) in a large cohort of subjects.

METHODS

A cross-sectional study of 9704 subjects (72% female, median age 47y, median BMI 28.1 kg/m2) was carried out. Each patient underwent an anthropometric assessment (weight, height, waist circumference, % of body fat by body skinfolds), an ultrasound measurement of VAT and SAT and blood sampling to measure metabolic syndrome (MS) parameters and serum creatinine. GFR was estimated using the EPI-CKD equation. MS was defined according to the harmonized criteria.

RESULTS

Among 9,704 subjects, 61.1% had a normal renal function, while 29.3% reported a reduction, from slightly to severely. The BMI was initially negatively associated with GFR in the univariate model (β = -0.32, 95% CI: -0.39, -0.25), but after adjusting for %body fat, the association was lost. We then split the BMI into its two components, Fat Mass Index (FMI) and Fat Free Mass Index (FFMI), and observed that FMI (β = -1.23, 95% CI: -1.35, -1.12) and FFMI (β = 0.79, 95% CI: 0.65, 0.92) were associated with a decrease and an increase in GFR, respectively. VAT (β = -1.83, 95% CI: -2.00, -1.67) and SAT (β = 3.21, 95% CI: 2.86, 3.57) were independently associated with a decrease and an increase in GFR, respectively. Similar results were obtained when studying the association between BMI, body composition, adipose tissue distribution, and the risk of reduced GFR (<90 ml/min/1.73 m2). Stratification by sex and MS did not substantially alter the results. A significant association between VAT and reduced GFR was observed only in women.

CONCLUSIONS

Our study highlights the importance of considering body composition and fat distribution when assessing renal function.

Mitochondrial coupling efficiency and myofiber type related to blood pressure 22 h after high-intensity exercise in premenopausal women

Previously we have shown that systolic blood pressure (SBP) increases in African American (AA) women but decreases in European American (EA) women ≈22 h after a high-intensity exercise bout, suggesting delayed recovery in the AA women. We, therefore, sought to determine whether myofiber type, systemic vascular resistance (SVR), and mitochondrial coupling efficiency may contribute to elevated blood pressure in AA women following a bout of high-intensity exercise. Premenopausal EA (9) and AA (7) women were aerobically trained for 8-16 weeks andV ˙ O 2peak was evaluated. After 2 days without exercise, participants were evaluated for myofiber type, mitochondrial respiration using high-resolution respirometry, and SVR 22 h following 1 h of high-intensity interval cycle ergometry. AAs had higher SBP and DBP and type IIx myofiber % but lower type IIa myofiber %. SBP was significantly related to SVR (0.71), RCR (0.44), type IIa myofiber type (- 0.48), and type IIx myofiber type (0.53). DBP was significantly related to SVR (0.58) and the respiratory acceptor control ratio (state 3/state 4, termed RCR, 0.69). SBP remained significantly higher in AAs even after adjusting for type IIx myofiber type, RCR, SVR, orV ˙ O 2peak adjusted for FFM, and additionally, DBP remained significantly higher after adjusting for type IIx myofiber type, RCR, orV ˙ O 2peak adjusted for FFM. These results support the premise that mitochondrial RCR, type IIx myofiber type, and SVR may contribute to increased blood pressure ≈22 h following a bout of high-intensity exercise. Still, racial differences were not explained by any of these variables.

Recent advances in screen-printed carbon electrodes for food additive analysis

Screen-printed carbon electrodes (SPCEs) are regarded as the actual and future sensing option for additive analysis in food samples; nonetheless, the sample preparation, selectivity, and detectability are key challenges to overcome for its technological development and wide application. In the present review, we inform, discuss, and compare some pivotal aspects associated with the fabrication of SPCEs, the presence of additives in foods, sample preparation, and voltammetric measurements of additives in food samples. Also, the proposed study has indicated that it is possible to develop suitable options for electroanalytical methodologies by using bare or modified SPCEs, which present affordable results in terms of selectivity, linear concentration range, and limit of detection for different classes of additives. Lastly, the review introduces challenging points that can be carefully evaluated for the next generation of SPCEs dedicated to additive analysis.

Biofilm Biology to Brain Health: Harnessing Microbial Wisdom to Uncover Amyloid Dissociating Bifunctional Nano Chaperones for Alzheimer's Therapeutics

Microbial infections have long been implicated in the gut-brain link to Alzheimer's disease (AD). These infections may influence AD development either directly, through brain invasion, or indirectly via bacterial metabolites crossing the blood-brain-barrier (BBB) or interacting with the enteric nervous system (ENS). Such findings have inspired clinicians to repurpose antimicrobial drugs for AD, yielding promising results. However, the sole bacterial link to AD may be insufficiently understood. Bacterial amyloid presence in biofilms is well-documented, with certain bacterial proteins exacerbating amyloid formation while others inhibit it. For instance, Curli-specific gene protein C (CsgC) in E. coli suppresses curli amyloid formation. This review investigates the possibility of human CsgC-like proteins, identifying beta-2 microglobulin (β2M) and E3 ubiquitin ligases (E3s) as potential analogs that may influence amyloid degradation. We propose that nanoparticles (NPs) could serve as platforms to anchor these proteins, forming Amyloid Dissociating Bifunctional NanoChaperones (ADBiNaCs) with enhanced antiamyloidogenic activity. This innovative approach holds promise for novel AD treatment strategies, meriting further investigation into the role of bacterial and human amyloid-modulating proteins in AD pathology.

Characterization of gut dysbiosis and intestinal barrier dysfunction in patients with metabolic dysfunction-associated steatotic liver disease and chronic kidney disease: a comparative study

The mechanistic role of gut microbiota in metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic kidney disease (CKD) is increasingly recognized. Despite their close association, comparative data regarding gut dysbiosis in these disorders are limited. This study included 22 healthy controls and 180 patients (90 MASLD, 60 CKD, and 30 both diseases with sex- and age-matched). Fecal bacterial 16 S ribosomal RNA sequencing and butyryl-CoA: acetate CoA transferase (BCoAT) gene expression were analyzed. Plasma intestinal fatty acid binding protein (I-FABP), representing intestinal barrier dysfunction, was assessed using the ELISA method. Our data showed that alpha and beta diversities of gut microbiota differed between MASLD and healthy controls. However, only beta diversities were different between CKD and healthy individuals. The MASLD and CKD groups displayed fewer SCFA-producing genera, particularly Bifidobacterium, than healthy controls. Fecal BCoAT levels were inversely correlated with eGFR and I-FABP levels. Patients with CKD had significantly enriched pathogenic bacteria, reduced BCoAT, and increased I-FABP levels versus MASLD. Combining significant bacterial genera discriminated MASLD from CKD with high diagnostic accuracy (AUC of 0.90). Among patients with both diseases, gut microbial alterations showed mixed characteristics of MASLD and CKD. These data highlighted the shared and distinct gut dysbiosis and related biomarkers, which could provide a better understanding of MASLD and CKD pathogenesis.

Restricted cubic spline analysis: Age-dependent relationship between MAGEA12 and hepatocellular carcinoma prognosis

OBJECTIVES

Currently, understanding of the nonlinear relationship between age and hepatocellular carcinoma (HCC) prognosis is insufficient. Thus, this study aimed to analyze the relationship between age at HCC diagnosis and overall survival (OS) and identify possible influencing mechanisms.

METHODS

Clinical data from the TCGA public database were analyzed. Restricted cubic spline and segmented logistic regression were employed to explore the nonlinear relationship between age at diagnosis and mortality risk following hepatectomy. Furthermore, bioinformatics methods were employed to understand the possible mechanisms of this nonlinear relationship at the genetic level.

RESULTS

The results indicated a nonlinear relationship between age at diagnosis and OS, with the age of 60 years identified as a critical point. Segmented regression showed that age ≥60 years is an unfavorable prognostic factor. The "DNA mismatch repair" pathway was considerably enriched in patients aged <60 years. However, the gene mutation rate of "APOB," "MUC16," "ALB," and "PCLO" and the median tumor mutation burden were relatively more evident in patients aged ≥60 years. MGEA12 was more highly expressed in tumor tissues than in normal ones, particularly in patients aged ≥60 years. The survival rate of the high-expression group was lower than that of the low-expression group. At the mRNA level, the MGEA12 expression in Huh-7 and SUN449 was higher than that in the HSC-LX2 cell line.

CONCLUSION

A nonlinear relationship was found between age at HCC diagnosis and OS, with the age of 60 years being the critical point. MGEA12 may affect the prognosis of elderly people.

Protective effect of deinoxanthin in sorafenib-induced nephrotoxicity in rats with the hepatocellular carcinoma model

Sorafenib is a synthetic compound and an orally administered multichines inhibitor that targets growth signaling and angiogenesis. It is widely recognized as the standard of care for advanced hepatocellular carcinoma (HCC) but has toxic side effects. Deinoxanthin, purified from the radioresistant bacterium Deinococcus radiodurans, has strong antioxidant characteristics. In this study, the protective effect of deinoxanthin against sorafenib-induced nephrotoxicity was investigated in a rat model of hepatocellular carcinoma. In this regard, the expressions of DDAH1, KIM1, and INOS genes were examined, histopathological and immunohistochemical analyses were performed, and various parameters such as SOD, MDA, GST, CAT, TAS, and TOS were tested biochemically. BUN and creatinine levels were measured in renal tissues. RT-qPCR, Western blot, and ELISA methods were used for all these analyses. As a result, the analyses show that deinoxanthin, which has a high antioxidant capacity, reduces kidney injury and can be used as a protective agent. The primary objective of this study is to evaluate the potential of deinoxanthin as a protective agent against the nephrotoxic side effects of sorafenib in HCC. Our study identified the potential synergistic effects of sorafenib and deinoxanthin on nephrotoxicity in rats with hepatocellular carcinoma.

Rhythm- and sex-dependent lipid accumulation in Drosophila melanogaster by phthalates

Phthalates (PAEs) have been linked to obesity prevalence. Their obesogenic effects were influenced by sexes and rhythm, while the underlying mechanisms remained to be explored. In the present study, dimethyl phthalate (DMP), dioctyl phthalate (DOP), diisopentyl phthalate (DIPP) and diisodecyl phthalate (DIDP) were chosen as the PAEs' representatives, and their obesogenic effects were measured in Drosophila melanogaster with consideration on sleep and eclosion rhythms and sex-dependent differences. Results showed that DMP and DOP stimulated body weight, and 4 PAEs commonly influenced the total sleep with less inhibition or more stimulation in males than in females. Biochemical analysis showed that 4 PAEs commonly elevated levels of triglyceride (TG), glucose and lactate with more significant effects in males than in females, with simultaneous more stimulated enzymes in males. Meanwhile, their stimulatory effects on cholesterol and pyruvate were more overwhelmed in females. In addition, the PAEs' effects on TG were more convincing in adults eclosed in afternoon (PM) than those in morning (AM), while their effects on glucose, lactate, cholesterol and pyruvate were more convincing in AM adults with simultaneous more stimulated enzymes than in PM ones. Further analysis on the expressions of the pdk-1/akt/foxo signaling pathway, and the results demonstrated that the PAEs' effects on lipid metabolism connected with their influences on rhythm and hormone regulations. The correlation analysis on the overall results demonstrated that the PAEs' toxicities were also influenced by the molecular weights.

Enantiomeric Excess Bupivacaine in a Lavender Oil NLC Tested in a Melanoma Model: Prolonged Release and Anticancer Effect

Recent studies have highlighted the potential of local anesthetics (LA) as adjuvants in cancer treatment, specifically by increasing survival rates when used in surgical excisions. However, the clinical use of LA is restricted due to their systemic toxicity. The development of drug delivery systems could address this issue and advance the utilization of these molecules. In this research, we explored the pharmacokinetics (using microdialysis probes) and antitumor properties of a nanostructured lipid carrier (NLC) formulation containing the commercially available enantiomeric excess form of bupivacaine (BVCS75). This NLC was prepared with lavender oil (NLC-L-BVC), an excipient with inherent antitumor properties. We compared this formulation to a control (NLC-BVC) using synthetic lipids. Pharmacokinetic assessments of the NLCs confirmed the sustained release of BVCS75 within the tumor, characterized by a reduced elimination rate constant and longer half-life (∼6×). The encapsulation of BVCS75 within nanoparticles (whether natural or synthetic) enhanced its effectiveness in treating the primary tumor, resulting in the inhibition of tumor growth (70% with NLC-L-BVC and 72% with NLC-BVC), outperforming free BVC (17% inhibition). However, the association of lavender oil with BVCS75 in an NLC did not yield synergistic properties. Furthermore, all BVCS75 treatments (whether free or encapsulated) improved animal survival rates. These findings confirm that encapsulation of bupivacaine in NLC can prolong drug action at the local site, contributing to improved local antitumor therapy while mitigating systemic effects.

Sensitive non-enzymatic sensing of creatinine in urine using a novel paper-based electroanalytical device

Accurate analysis of urinary creatinine levels is of great clinical significance. Non-enzymatic creatinine sensing systems (NECSs) have gained growing development because of higher stability and lower cost compared to enzymatic sensing systems. At present, there is a demand for simple approaches to develop NECSs with high sensitivity. In this study, we designed and fabricated an ingenious paper-based electroanalytical device for sensitive non-enzymatic creatinine sensing in urine. The device consisted of a paper-based chip and an integrated three-electrode system. The quantification of creatinine was performed based on the complexation of creatinine and copper sulfate (Cu2+), which was pre-stored on the paper-based chip in advance. Under optimum conditions, the detection limit of creatinine was 0.26 μM with a linear range of 1-5000 μM. The relative standard deviations of the electroanalytical results (n = 3) were within 1.2%-5.4%. The proposed device showed excellent reproducibility and stability, and the current response remained 92.17% of the initial response after a 30-day storage. Moreover, the device also exhibited high anti-interference ability to a variety of chemical components in urine. This study presents a simple and robust approach to engineering NECSs with high sensitivity. The preparation of the whole system is based on accessible and reliable commercial technologies and materials, which minimizes manual operation and ensures good reproducibility. The sensitivity of our method is two orders of magnitude lower than those of the previously reported NECSs based on the solution-modification strategy. It has been applied to the analysis of human urinary creatinine with satisfactory recoveries and without significant differences compared with commercial creatinine assay kits.

Suppression of cisplatin induced ATF3 expression and apoptosis by BK polyomavirus and its encoded microRNA in bladder cancer cells

Recent evidence links BK polyomavirus (BKPyV) infection to an increased risk of bladder cancer. This study investigates the role of BKPyV and its microRNA, miR-B1, in cisplatin-induced apoptosis. PCR analysis detected BKPyV DNA in 3 of 22 urothelial carcinoma (UC) samples from a non-transplant population. Bladder cancer cells infected with BKPyV showed increased proliferation and miR-B1-3p and -5p expression. Bioinformatics analysis identified a miR-B1-5p target site in the 3'-UTR of activating transcription factor 3 (ATF3), confirmed by a luciferase assay. The inhibitory effect was further validated by reduced ATF3 mRNA levels following overexpression of miR-B1 vectors or 5p mimics. Cisplatin treatment upregulated ATF3 expression, as shown by qPCR and immunoblotting. Overexpression of ATF3 mitigated the cisplatin-induced reduction in cell viability and elevated apoptotic markers, including cleaved caspase-3 and cleaved poly(ADP-ribose) polymerase (PARP). BKPyV infection or large T antigen (TAg) overexpression suppressed cisplatin-induced ATF3 expression, reducing its cytotoxicity and apoptotic marker expression. However, overexpression of ATF3 in BKPyV-infected bladder cancer cells attenuated BKPyV's inhibitory effects, restoring cisplatin-induced cytotoxicity and apoptotic marker expression, suggesting BKPyV infection promotes resistance to cisplatin cytotoxicity. Transfection with miR-B1 vectors or miR-B1-5p mimics decreased cisplatin-induced annexin V-positive cells, caspase-3 activity, and apoptotic marker expression, indicating that miR-B1 suppresses cisplatin-induced apoptosis. In conclusion, this study demonstrates that BKPyV promotes bladder cancer cell growth and impairs cisplatin-induced apoptosis, with miR-B1 targeting ATF3 as a key mechanism. Targeting BKPyV replication or regulating miR-B1 expression could offer potential therapeutic strategies for managing BKPyV-positive and cisplatin-resistant urothelial carcinoma.

Ferulic acid alleviates long-term avermectin-induced damage to the spleen of carp and restores its inflammatory response and oxidative balance

Extensive use of avermectin (AVM) in agriculture can seriously contaminate fish in aquaculture. Ferulic acid (FA) is a strong antioxidant sourced from plants and is widely applied in food and medicine, but its protective function on the immunological damage caused by AVM is still lacking. In this study, carp were chronically exposed to (1/10 96 hr LC50) AVM for 30 day(s), with a dietary supplement of FA (400 mg/kg) to assess its effects on carp spleen. The experimental groups (n = 10) included: control, AVM-exposed (2.404 µg/L), FA + AVM co-treated, and FA alone. Long-term AVM exposure altered spleen tissue, reducing serum complement C3 (p < 0.01) and immunoglobulin M levels (p < 0.001), and increasing pro-inflammatory tnf-α (p < 0.001), il-6 (p < 0.001), il-1β (p < 0.001), and inos mRNA levels, whilst down-regulating the anti-inflammatory tgf-β (p < 0.05). Additionally, it disrupted the balance of oxidative stress indicators such as MDA (p < 0.001), T-AOC, GSH, and CAT, leading to spleen tissue apoptosis (42.4%). However, the addition of FA reversed these conditions, elevated the anti-inflammatory factor, and improved spleen immune function following chronic exposure to AVM in carp. Moreover, the ability to restore oxidative homeostasis in carp by adjusting the Nrf2/NQO-1 axis protected the health of spleen tissues. This discovery also supports the development of fish feed for aquaculture.

Curcumin ameliorates cerulein‑induced chronic pancreatitis through Nrf‑2/HO‑1 signaling

Chronic pancreatitis (CP) is an invasive inflammatory disorder characterized by endocrine and exocrine dysfunction. There are currently no effective drugs for the treatment of CP. The present study investigated whether curcumin improves cerulein‑induced CP fibrosis in a mouse model and pancreatic stellate cells (PSCs). The CP mouse model was established by intraperitoneally injecting cerulein (50 µg/kg) for 3 weeks (six times at 1 h intervals/day; 4 days/week). To investigate the effects of curcumin, dimethyl sulfoxide or curcumin was injected intraperitoneally 1 h before the first daily injection of cerulein. To determine the severity of CP, the pancreas was harvested 24 h after the last cerulein injection for histological examination and assessment of PSC activation and collagen deposition. Additionally, levels of the nuclear factor erythroid 2‑related factor 2 (Nrf2) and heme oxygenase‑1 (HO‑1) were evaluated to determine the mechanism underlying the anti‑fibrotic effect of curcumin in PSCs. Curcumin improved pancreatic injury associated with CP by inhibiting PSC activation and collagen deposition. Moreover, curcumin increased HO‑1 expression levels via the activation of Nrf2 in PSCs, which suppressed the activation of PSCs. In conclusion, the present results suggest that curcumin can ameliorate pancreatic fibrosis induced by repetitive cerulein challenges via the induction of HO‑1 and is a beneficial agent for the treatment of CP.

Complex G-protein signaling of the adhesion GPCR, ADGRA3

ADGRA3 (GPR125) is an orphan adhesion G protein-coupled receptor (aGPCR) involved in planar cell polarity, primarily through recruitment of the signaling components disheveled (DVL) during vertebrate gastrulation and discs large homolog 1, implicated in cancer. Limited knowledge exists of the canonical G protein-coupled receptor pathways downstream of ADGRA3. Here, we employed a series of human cell line-based signaling assays to gain insight into the G protein-mediated signaling of ADGRA3. We designed ADGRA3 constructs based on transcript variant analysis in publicly available human liver and brain RNA-seq datasets. Cleavage in the GPCR autoproteolysis site (GPS) is an aGPCR hallmark; thus, we generated a truncated ADGRA3 (C-terminal fragment, CTF) corresponding to a potential cleavage at the GPS. We found low-level activation of Gi and Gs by ADGRA3 and slightly more by its CTF. As the N terminus of the CTF constitutes a class-defined tethered agonist (so-called stachel peptide), we removed the initial three amino acids of the CTF. This resulted in abrogated G protein-mediated signaling, as observed for other aGPCRs. Due to the central role of ADGRA3 in planar cell polarity signaling through DVL recruitment, we investigated the G-protein signaling in the absence of DVL1-3 and found it sustained. No transcriptional activation was observed in an assay of downstream β-catenin activity. Collectively, this establishes classical G protein-mediated signaling for ADGRA3.

Variations in provider practices in remote patient monitoring on peritoneal dialysis in the USA and Canada

Automation has allowed clinicians to program PD treatment parameters, all while obtaining extensive individual treatment data. This data populates in a centralized online platform shortly after PD treatment completion. Individual treatment data available to providers includes patients' vital signs, alarms, bypasses, prescribed PD treatment, actual treatment length, individual cycle fill volumes, ultrafiltration volumes, as well as fill, dwell, and drain times. However, there is no guidance about how often or if this data should be assessed by the clinical team members. We set out to determine current practice patterns by surveying members of the home dialysis team managing PD patients across the United States and Canada. A total of 127 providers completed the survey. While 91% of respondents reported having access to a remote monitoring platform, only 31% reported having a standardized protocol for data monitoring. Rating their perceived importance of having a standard protocol for remote data monitoring, on a scale of 0 (not important at all) to 10 (extremely important), the average response was 8 (physicians 7; nurses 9). Most nurses reported reviewing the data multiple times per week, whereas most physicians reported viewing the data only during regular/monthly visits. Although most of the providers who responded have access to remote monitoring data and feel that regular review is important, the degree of its utilization is variable, and the way in which the information is used is not commonly protocolized. Working to standardize data interpretation, testing algorithms, and educating providers to help process and present the data are important next steps.

Updates in chronic kidney disease management: A systematic review

Chronic kidney disease (CKD) is a significant global health challenge that impacts both patients and the health care system. This systematic review aims to evaluate the efficacy and safety of emerging therapeutic strategies for CKD management, including sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), finerenone, sacubitril/valsartan, and potassium binders. We conducted searches in databases including PubMed, Scopus, CINAHL Complete, and Web of Science Core Collection to identify experimental and observational studies pertaining to each of these agents. Included studies were those that enrolled adult patients with CKD who evaluated SGLT2i, GLP-1RA, finerenone, sacubitril/valsartan, and potassium binders compared to other medications or placebo and evaluated renal-related outcomes as a primary or secondary outcome. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias (version 2) tool for experimental studies and ROBINS-I for observational studies. After screening 2135 unique studies, 138 studies were eligible for this review. These studies describe a substantial and growing body of evidence focused on improving the management of CKD beyond renin-angiotensin system inhibitors (RASi), such as angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs). Currently, SGLT2i have demonstrated consistent benefits with large effect sizes in preventing the progression of CKD, solidifying this class as a first-line treatment along with RASi. Subsequent consideration for GLP-1RA, finerenone, and sacubitril/valsartan should be dependent on patient-specific comorbidities, while potassium binders may allow for longer use of RASi.

Methods for Diagnosing Proteinuria-When to Use Which Test and Why: A Review

Proteinuria plays a central role in the diagnosis of kidney disease and has a high prognostic value. The test methods used differ considerably regarding their impact on test accuracy, sensitivity, and specificity. Therefore, knowledge of the methodology is crucial for the interpretation of the results. In addition to the distinction between semiquantitative and quantitative tests, there are also relevant differences within the 2 methods. In general, semiquantitative tests are easy to handle but have limitations such as incomplete quantification, a lack of specificity regarding the type of proteinuria, and a high rate of false-positive results that require retesting with a quantitative method for verification. In contrast, quantitative methods, especially immunoassays, have the advantages of high test accuracy and the possibility of targeted detection of specific protein molecules in addition to albumin. However, these methods are more expensive and require access to a laboratory or an electronic point-of-care device. In this Review, the different types of tests for proteinuria and their underlying methodologies and strengths and weaknesses are discussed in detail to allow a rational decision of use and the correct interpretation of the results depending on the clinical context.

Obesity measurement methods estimated mortality risk in patients undergoing hemodialysis: a systematic review and meta-analysis

PURPOSE

The impact of obesity on mortality risk in patients undergoing hemodialysis (HD) remains uncertain due to conflicting findings across obesity measurement methods. This study aimed to assess the obesity measurements influence mortality risk in HD populations.

METHODS

Systematic review and meta-analysis were conducted following PRISMA guidelines, registered on PROSPERO (CRD42023429943). Relevant observational studies analyzing mortality risk using obesity measurements in adult HD patients up to March 27, 2023 were included from multiple databases, including EMBASE, MEDLINE (OVID), and CINAHL (EBSCO). Pooled analyses with a random-effects model were performed using RevMan 5.4.

RESULTS

Twenty-three studies involving 381,580 subjects were reviewed. A meta-analysis of 15 studies in event-based analysis showed contrasting results between anthropometry and body composition analysis in predicting all-cause mortality. Obese patients indicated by body mass index (BMI) had a lower mortality risk than non-obese patients (RR = 0.73, 95% CI: 0.70-0.76, p < 0.001). In contrast, abdominal obesity measured by waist circumference (WC) or waist-to-hip ratio (WHR) increased mortality risk (RR = 1.35, 95% CI: 1.01-1.80, p = 0.04). Studies using bioelectrical impedance analysis (BIA) demonstrated an increased mortality risk for obese patients (RR = 1.22, 95% CI: 1.05-1.41, p = 0.009).

CONCLUSIONS

Obese patients undergoing HD exhibit different mortality risks depending on the methods of obesity measurement. The observed 'obesity paradox' in patients on HD, where lower mortality is seen with obesity measured by BMI, may reflect BMI's limitations in differentiating fat mass. More studies with other anthropometry and body composition analysis are needed to clarify this phenomenon.

Advances in incretin therapies for targeting cardiovascular disease in diabetes

The global prevalence of obesity is skyrocketing at an alarming rate, with recent data estimating that one-in-eight people are now living with the disease. Obesity is a chronic metabolic disorder that shares underlying pathophysiology with other metabolically-linked diseases such as type 2 diabetes mellitus, cardiovascular disease and diabetic cardiomyopathy. There is a distinct correlation between type 2 diabetes status and the likelihood of heart failure. Of note, there is an apparent sexual dimorphism, with women disproportionately affected with respect to the degree of severity of the cardiac phenotype of diabetic cardiomyopathy that results from diabetes. The current pharmacotherapies available for the attenuation of hyperglycaemia in type 2 diabetes are not always effective, and have varying degrees of efficacy in the setting of heart failure. Insulin can worsen heart failure prognosis whereas metformin, sodium-glucose cotransporter 2 inhibitors (SGLT2i) and more recently, glucagon-like peptide-1 receptor agonists (GLP-1RAs), have demonstrated cardioprotection with their administration. This review will highlight the advancement of incretin therapies for individuals with diabetes and heart failure and explore newly-reported evidence of the clinical usefulness of GLP-1R agonists in this distinct phenotype of heart failure.