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The demand for stretchable strain sensors with customizable sensitivities has increased across a spectrum of applications, spanning from human motion detection to plant growth monitoring. Nevertheless, a major challenge remains in the digital fabrication of scalable and cost‐efficient strain sensors with tailored sensitivity to diverse demands. Currently, there is a lack of simple digital fabrication approaches capable of adjusting strain sensitivity in a controlled way with no changes to the material and without affecting the linearity. In this study, parallel microgates‐based strain sensors whose strain sensitivity can be adjusted systematically throughout an all‐laser‐based fabrication process without any material replacement are presented. The technique employs a two‐step direct laser writing method that combines the well‐established capabilities of laser ablation and laser marking, boasting a varying gauge factor of up to 433% (GF = 168), while paving the way for the mass production of nanocomposite strain sensors. Parallel microgates‐based strain sensors exhibit a remarkable signal‐to‐noise ratio at ultralow strains (ɛ = 0.001), rendering them ideal for monitoring the gradual growth of plants. As an application demonstration, the proposed sensors are deployed on tomato plants to capture their growth under varying planting conditions including hydroponic and soil mediums, as well as diverse irrigation regimens. [ABSTRACT FROM AUTHOR]

The impact of spatial and temporal evolution of nonlinear mixing of two Gaussian laser pulses propagating in plasma on generation of terahertz (THz) radiation have been investigated taking into account the ponderomotive nonlinearity. By calculating the modified electron density of plasma caused by the finite ponderomotive force of the pump lasers and using wave equation and paraxial ray approximation, two coupled governing equations for temporal and spatial pulse‐width parameters have been derived. The electric field of the THz wave as a result of nonlinear current density induced by the beat ponderomotive force of the pulses was extracted. Combined effects of initial laser and plasma parameters on the behavior of self‐compression and self‐focusing as well as THz radiation generation were investigated. The numerical results indicated a considerable spatiotemporal compression takes place within a specific range of laser intensity, exhibiting a saturation intensity point where the compression process reaches its maximum extent. It is observed that the generated THz radiation also strongly depends on the spatiotemporal dynamics of the pump pulses. The maximum THz amplitude corresponds to the strongest pump pulse compression extent. [ABSTRACT FROM AUTHOR]

Infants with a congenital anomaly of the kidney and urinary tract sometimes present with hyponatremia, hyperkalemia, and metabolic acidosis due to under-responsiveness to aldosterone, hereafter referred to as secondary pseudo-hypoaldosteronism. The purpose of this report is to investigate pseudo-hypoaldosteronism in infant urinary tract infection. A systematic review was conducted following PRISMA guidelines after PROSPERO (CRD42022364210) registration. The National Library of Medicine, Excerpta Medica, Web of Science, and Google Scholar without limitations were used. Inclusion criteria involved pediatric cases with documented overt pseudo-hypoaldosteronism linked to urinary tract infection. Data extraction included demographics, clinical features, laboratory parameters, management, and course. Fifty-seven reports were selected, detailing 124 cases: 95 boys and 29 girls, 10 months or less of age (80% of cases were 4 months or less of age). The cases exhibited hyponatremia, hyperkalemia, acidosis, and activated renin-angiotensin II-aldosterone system. An impaired kidney function was found in approximately every third case. Management included antibiotics, fluids, and, occasionally, emergency treatment of hyperkalemia, hyponatremia, or acidosis. The recovery time averaged 1 week for electrolyte, acid–base imbalance, and kidney function. Notably, anomalies of the kidney and urinary tract were identified in 105 (85%) cases. Conclusions:This review expands the understanding of overt transient pseudo-hypoaldosteronism complicating urinary tract infection. Management involves antimicrobials, fluid replacement, and consideration of electrolyte imbalances. Raising awareness of this condition within pediatric hospitalists is desirable. What is Known: • Infants affected by a congenital anomaly of the kidney and urinary tract may present with clinical and laboratory features resembling primary pseudo-hypoaldosteronism. • Identical features occasionally occur in infant urinary tract infection. What is New: • Most cases of secondary pseudo-hypoaldosteronism associated with a urinary tract infection are concurrently affected by a congenital anomaly of the kidney and urinary tract. • Treatment with antibiotics and parenteral fluids typically results in the normalization of sodium, potassium, bicarbonate, and creatinine within approximately 1 week. [ABSTRACT FROM AUTHOR]

Purpose: To investigate a possible link between acute Epstein-Barr virus infection and Lemierre syndrome, a rare yet life-threatening infection. Methods: A systematic review was conducted adhering to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Diagnosis criteria for Lemierre syndrome were established, and data extraction encompassed demographic data, clinical, and laboratory information. Results: Out of 985 initially identified papers, 132 articles were selected for the final analysis. They reported on 151 cases of Lemierre syndrome (76 female and 75 male patients with a median of 18 years) alongside interpretable results for Epstein-Barr virus serology. Among these, 38 cases (25%) tested positive for acute Epstein-Barr virus serology. There were no differences in terms of age, sex, or Fusobacterium presence between the serologically positive and negative groups. Conversely, instances of cervical thrombophlebitis and pulmonary complications were significantly higher (P = 0.0001) among those testing negative. The disease course was lethal in one case for each of the two groups. Conclusions: This analysis provides evidence of an association between acute Epstein-Barr virus infection and Lemierre syndrome. Raising awareness of this link within the medical community is desirable. [ABSTRACT FROM AUTHOR]

Inter-species emotional relationships, particularly the symbiotic interaction between humans and dogs, are complex and intriguing. Humans and dogs share fundamental mammalian neural mechanisms including mirror neurons, crucial to empathy and social behavior. Mirror neurons are activated during the execution and observation of actions, indicating inherent connections in social dynamics across species despite variations in emotional expression. This study explores the feasibility of using deep-learning Artificial Intelligence systems to accurately recognize canine emotions in general environments, to assist individuals without specialized knowledge or skills in discerning dog behavior, particularly related to aggression or friendliness. Starting with identifying key challenges in classifying pleasant and unpleasant emotions in dogs, we tested advanced deep-learning techniques and aggregated results to distinguish potentially dangerous human--dog interactions. Knowledge transfer is used to fine-tune different networks, and results are compared on original and transformed sets of frames from the Dog Clips dataset to investigate whether DogFACS action codes detailing relevant dog movements can aid the emotion recognition task. Elaborating on challenges and biases, we emphasize the need for bias mitigation to optimize performance, including different image preprocessing strategies for noise mitigation in dog recognition (i.e., face bounding boxes, segmentation of the face or body, isolating the dog on a white background, blurring the original background). Systematic experimental results demonstrate the system's capability to accurately detect emotions and effectively identify dangerous situations or signs of discomfort in the presence of humans. [ABSTRACT FROM AUTHOR]

Background: Silver-Russell Syndrome (SRS, MIM #180860) is a clinically and genetically heterogeneous disorder characterized by intrauterine and postnatal growth retardation; SRS is also accompanied by dysmorphic features such as triangular facial appearance, broad forehead, body asymmetry and significant feeding difficulties. The incidence is unknown but estimated at 1:30,000-100,000 live births. The diagnosis of SRS is guided by specific criteria described in the Netchine–Harbison clinical scoring system (NH-CSS). Case presentation: Hereby we describe four patients with syndromic short stature in whom, despite fitting the criteria for SRS genetic analysis (and one on them even meeting the clinical criteria for SRS), molecular analysis actually diagnosed a different syndrome. Some additional features such as hypotonia, microcephaly, developmental delay and/or intellectual disability, and family history of growth failure, were actually discordant with SRS in our cohort. Conclusions: The clinical resemblance of other short stature syndromes with SRS poses a risk of diagnostic failure, in particular when clinical SRS only criteria are met, allowing SRS diagnosis in the absence of a positive result of a genetic test. The presence of additional features atypical for SRS diagnosis becomes a red flag for a more extensive and thorough analysis. The signs relevant to the differential diagnosis should be valued as much as possible since a correct diagnosis of these patients is the only way to provide the appropriate care pathway, a thorough genetic counselling, prognosis definition, follow up setting, appropriate monitoring and care of possible medical problems. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis, a systemic skeletal disease, is characterized by a quantitative and qualitative, and progressive decrease in bone mass, which is related to inflammation. Since a cytokine storm is triggered in Coronavirus disease 2019 (COVID-19), this study aims to evaluate pro-inflammatory cytokines (TNF-α, IL-1β), Receptor activator of nuclear factor-κB ligand (RANKL)/serum osteoprotegerin (OPG) ratio, and their relationship in mild and severe COVID-19. Methods: This study was performed on 48 adult patients (18 mild, 18 severe COVID-19, and 12 healthy subjects as a control group). Serum OPG, RANKL, TNF-α, IL-1β, 25-OH vitamin D, and ALKp were measured by ELISA and colorimetric assay. Results: COVID-19 patients had a significant increase in RANKL, and RANKL/OPG in mild and severe form (p < 0.001) while OPG decreased significantly in severe form compared to healthy controls (p < 0.05). Inflammatory cytokines (TNF-α and IL-1β) increased in both groups of patients whereas Alkaline phosphatase (ALKp) increased only in severe patients (p < 0.001). Both groups had 25-OH vitamin D deficiency in comparison to healthy ones (p < 0.001). Pearson's correlation coefficient was performed to determine the relationship between RANKL, OPG, ALKp, and 25-OH vitamin D with TNF-α and IL-1β in mild and severe COVID-19, which was statistically significant. Conclusion: Serum RANKL/OPG ratio was elevated in COVID-19 individuals and is assumed to be a risk factor for BMD reduction and osteoporosis in these patients. Correlations between IL-1β, TNF-α, ALKp, 25-OH vitamin D, OPG, RANKL, and RANKL/OPG ratio offered the potential role of these proinflammatory markers in the mechanism of osteoporosis in COVID-19 patients. Summary: Since cytokine storm, can stimulate osteoclastic activity, favoring bone resorption, in this study, we decided to evaluate its molecular mechanisms in COVID-19. We found an elevation of RANKL/OPG ratio with a positive correlation with inflammatory cytokines in COVID-19 which can be assumed as a risk factor for osteoporosis. [ABSTRACT FROM AUTHOR]

Bifidobacteria are well known as common and abundant colonizers of the human gut and are able to exert multiple beneficial effects on their host, although the cooperative and competitive relationships that may occur among bifidobacterial strains are still poorly investigated. Therefore, to dissect possible molecular interactions among bifidobacterial species that typically colonize the human gut, three previously identified bifidobacterial prototypes, i.e., B. bifidum PRL2010, B. breve PRL2012, and B. longum PRL2022 were cultivated individually as well as in bi- and tri-association in a human gut-simulating medium. Transcriptomic analyses of these co-associations revealed up-regulation of genes predicted to be involved in the production of extracellular structures including pili (i.e., flp pilus assembly TadE protein gene), exopolysaccharides (i.e., GtrA family protein gene) and teichoic acids (i.e., ABC transporter permease), along with carbohydrate, amino acid and vitamin metabolism-related genes (i.e., exoalpha- sialidase; beta-galactosidase and pyridoxamine kinase), suggesting that co-cultivation of bifidobacteria induces a response, in individual bifidobacterial strains, aimed at enhancing their proliferation and survival, as well as their ability to cooperate with their host to promote their persistence. Furthermore, exposure of the selected prototypes to human cell line monolayers unveiled the ability of the bifidobacterial tri-association to communicate with their host by increasing the expression of genes involved in adherence to/interaction with intestinal human cells. Lastly, bifidobacterial tri-association promoted the transcriptional upregulation of genes responsible for maintaining the integrity and homeostasis of the intestinal epithelial barrier. [ABSTRACT FROM AUTHOR]

Background: Some chromatinopathies may present with common clinical findings (intellectual disability, brain and limb malformation, facial dysmorphism). Furthermore, one of their cardinal shared features is growth dysregulation.We aimed to assess and deepen this resemblance in three specific conditions, namely Wiedemann-Steiner (WDSTS), Kleefstra (KLEFS1) and Coffin-Siris syndrome (CSS1), with a particular focus on possible metabolic roots. Methods: Eleven patients were enrolled, three with WDSTS, five with KLEFS1 and three with CSS1, referring to Fondazione IRCCS Ca' Granda Ospedale Maggiore, Milan, Italy. We performed both a physical examination with detailed anthropometric measurements and an evaluation of the patients' REE (rest energy expenditure) by indirect calorimetry, comparing the results with age- and sex-matched healthy controls. Results: We observed new clinical features and overlap between these conditions suggesting that different disturbances of epigenetic machinery genes can converge on a common effect, leading to overlapping clinical phenotypes. The REE was not distinguishable between the three conditions and healthy controls. Conclusions: Epigenetic machinery plays an essential role both in growth regulation and in neurodevelopment; we recommend evaluating skeletal [craniovertebral junction abnormalities (CVJ) polydactyly], otolaryngological [obstructive sleep apnea syndrome (OSAs), recurrent otitis media], dental [tooth agenesis, talon cusps], and central nervous system (CNS) [olfactory bulbs and cerebellum anomalies] features. These features could be included in monitoring guidelines. Further studies are needed to deepen the knowledge about energy metabolism. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, particularly in low- and middle-income countries. Young adults are susceptible to CVD risk factors, especially in developing countries. This study aimed to compare CVD risk factors between medical and non-medical students. Methods: The present cross-sectional study was conducted on a sample of 302 students in Tehran, including 151 medical students and 151 non-medical students, in 2022. Data collection tools included four online questionnaires to collect demographic information, knowledge/attitudes, knowledge of risk factors, and risk factors. Data were analyzed using SPSS version 18 software at a 0.05 significance level. Results: Data analysis revealed that the mean age of medical and non-medical students was 22.06 ± 3.53 and 21.88 ± 4.20 years, respectively. The two groups were not significantly different in gender, age, marital status, and place of residence. Knowledge of CVD was significantly different between the two groups of students (P < 0.001), but attitudes were not significantly different (P = 0.208). A significant difference in the prognosis of diabetes and dyslipidemia was observed between the two groups (P < 0.001). Conclusions: As a large group of young adults in society, students are at risk for CVD. Poor knowledge and inappropriate attitudes regarding CVD risk factors are among the contributing factors. Therefore, it is recommended to design and implement a healthy diet, physical activity, stress management, and healthy lifestyle programs for the young group along with screening programs to prevent complications and mortality caused by CVD. [ABSTRACT FROM AUTHOR]

Background. In high-income countries, shopping for non-prescription multivitamin–multimineral supplements has tremendously increased. Objective and Methods. The purpose of this labeling analysis is to inform on the daily elemental iron (with or without vitamin C) supply provided by multivitamin–multimineral supplements sold online by Amazon in Western and Southern Europe (amazon.es®, amazon.de®, amazon.it®, and amazon.fr®). Results. We identified 298 iron-containing multivitamin–multimineral preparations sold by Amazon marketplaces: 153 preparations sourced from amazon.de®, 68 from amazon.fr®, 54 from amazon.it®, and 23 from amazon.es®. The daily iron dose provided by these preparations was 14 [5–14] mg (median and interquartile range), with no differences among the marketplaces. Approximately 90% (n = 265) of the preparations contained ferrous iron. Moreover, 85% (n = 253) of the preparations were fortified with vitamin C in a dose of 80 [40–100] mg daily. Conclusions. The median supply of iron (about 14 mg) and vitamin C (80 mg) in iron-containing multivitamin–multimineral preparations offered on Amazon platforms in Western and Southern Europe falls below that currently recommended for iron deficiency in review articles, namely 100 mg of iron and 500 mg of vitamin C per day. The iron supply of iron-containing multivitamin–multimineral preparations falls also below the dose of 30–60 mg advocated to prevent iron deficiency in menstruating women. [ABSTRACT FROM AUTHOR]

Considering the increasing demand for personalized surgical care, as well as current healthcare resources limitations, the use of anatomical accurate 3D physical phantoms is becoming increasingly important for the training of surgeons and the test of surgical instruments. A lack of physical models is nowadays denoted regarding the training in electrosurgery, despite its wide diffusion in medical practice. This work reports an extensive characterization of electrosurgical physical phantoms fabricated with tissue‐mimicking ionogels and hydrogels. A careful design of the conductive gels allow the fine tuning of their mechanical and electrical properties, in order to match those of biological tissues. The manufacturing of a novel multi‐material skin stratification bench‐top pad is reported together with its use for training in both cold and electrical surgery. Furthermore, a feasibility study is reported, showing the use of conductive ionogels for simulating the coagulation of cortical vessels during brain surgery. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is the most common malignant primary brain cancer that, despite recent advances in the understanding of its pathogenesis, remains incurable. GBM contains a subpopulation of cells with stem cell-like properties called cancer stem cells (CSCs). Several studies have demonstrated that CSCs are resistant to conventional chemotherapy and radiation thus representing important targets for novel anti-cancer therapies. Proton sensing receptors expressed by CSCs could represent important factors involved in the adaptation of tumours to the extracellular environment. Accordingly, the expression of acid-sensing ion channels (ASICs), proton-gated sodium channels mainly expressed in the neurons of peripheral (PNS) and central nervous system (CNS), has been demonstrated in several tumours and linked to an increase in cell migration and proliferation. In this paper we report that the ASIC3 isoform, usually absent in the CNS and present in the PNS, is enriched in human GBM CSCs while poorly expressed in the healthy human brain. We propose here a novel therapeutic strategy based on the pharmacological activation of ASIC3, which induces a significant GBM CSCs damage while being non-toxic for neurons. This approach might offer a promising and appealing new translational pathway for the treatment of glioblastoma. [ABSTRACT FROM AUTHOR]

Background: Early identification of immunoglobulin light-chain amyloidosis (AL) is crucial due to its rapid progression. Monoclonal light-chain (M-LC) testing is the first step in the diagnostic workup for patients with suspected cardiac amyloidosis (CA). We aimed to determine whether the time interval between the first CA suspicion and M-LC testing can be related to AL amyloidosis survival outcomes. Methods: All patients (n = 94) with isolated cardiac AL amyloidosis diagnosed at our center between 2016 and 2020 were included. Those with pre-existing known monoclonal protein (monoclonal gammopathy of undetermined significance or smoldering multiple myeloma) were excluded. Time intervals to diagnostic tests and diagnosis were calculated and assessed for their survival prediction ability. Results: The time interval between first CA suspicion (on echocardiography) and M-LC testing correlated with early mortality, and the best cutoff predicting survival, was 6 weeks. The 26 patients (∼28% of entire cohort) who underwent M-LC-studies >6 weeks after first suspicion more frequently presented Mayo stage IIIb (65% vs. 35%, p =.008), showing poorer overall survival than those (n = 68, 72%) referred for early M-LC studies (median 3 vs. 14 months, p =.039). Conclusions: Monoclonal protein testing should be the first-step in the diagnostic workup for patients with echocardiographic/other instrumental red flags raising CA suspicion. [ABSTRACT FROM AUTHOR]

Background: In the absence of a gold-standard diagnostic modality for cellulitis, sterile inflammatory disorders may be misdiagnosed as cellulitis. Objective: To determine the utility of skin biopsy and tissue culture for the diagnosis and management of patients admitted with a diagnosis of presumed cellulitis. Design: Pilot single-blind parallel group randomized controlled clinical trial in 56 patients with a primary diagnosis of presumed cellulitis. In the intervention group only, skin biopsy and tissue culture results were made available to the primary care team to guide diagnosis and management. Length of hospital stay and antibiotic use were evaluated as outcome measures. Results: Length of stay showed the greatest opportunity for further study as a primary outcome (intervention: 4, IQR (2–6) vs. control: 5 IQR (3–8) days; p = 0.124). Limitations: The COVID-19 pandemic placed limitations on participant enrollment and study duration; in addition, data was collected from a single medical center. Conclusion: This study demonstrates that length of stay and anti-pseudomonal antibiotic de-escalation are endpoints that may be influenced by biopsy and tissue culture results in presumed cellulitis patients; these outcomes warrant further study. [ABSTRACT FROM AUTHOR]

Background: In the absence of a gold-standard diagnostic modality for cellulitis, sterile inflammatory disorders may be misdiagnosed as cellulitis. Objective: To determine the utility of skin biopsy and tissue culture for the diagnosis and management of patients admitted with a diagnosis of presumed cellulitis. Design: Pilot single-blind parallel group randomized controlled clinical trial in 56 patients with a primary diagnosis of presumed cellulitis. In the intervention group only, skin biopsy and tissue culture results were made available to the primary care team to guide diagnosis and management. Length of hospital stay and antibiotic use were evaluated as outcome measures. Results: Length of stay showed the greatest opportunity for further study as a primary outcome (intervention: 4, IQR (2–6) vs. control: 5 IQR (3–8) days; p = 0.124). Limitations: The COVID-19 pandemic placed limitations on participant enrollment and study duration; in addition, data was collected from a single medical center. Conclusion: This study demonstrates that length of stay and anti-pseudomonal antibiotic de-escalation are endpoints that may be influenced by biopsy and tissue culture results in presumed cellulitis patients; these outcomes warrant further study. [ABSTRACT FROM AUTHOR]

Acne-prone skin is a common condition in adult women, and skin imperfections could affect quality of life and self-esteem. This study aimed to investigate the efficacy of a cosmetic combination regimen for face care (a cleanser gel and a serum containing niacinamide, retinol, and alpha hydroxy acids). A total of 20 women with acne-prone mixed or oily skin were enrolled in a prospective 42-day trial. Sebum content, skin radiance, skin profilometry, and evaluation of face area occupied by pores were evaluated at baseline and after 14, 28, and 42 days. In addition, a face lipidomic evaluation was performed at baseline and after 42 days. Finally, self-assessment questionnaires at each visit checkpoint were performed to evaluate efficacy and tolerability of the tested products. All the subjects but one concluded the study. Both products were very well tolerated and 84% of the subjects reported a global clinical improvement. Skin sebum content was significantly (p < 0.05) reduced at each of the evaluation time points (−9.9% at day 14, −19.4% at day 28, and −23.7% at day 42). The tested regimen significantly decreased the gloss parameter (mattifying effect) at day 14, 28, and 42, with a maximum reduction of 7.2% at the end of the study period. The pores area demonstrated a significant reduction at each of the checkpoint evaluations in comparison with baseline. Inflammatory and non-inflammatory lesions were significantly reduced by 16% at day 28 and day 42 (p < 0.01). Lipidomic analysis demonstrated that this cosmetic face care regimen induced significant and positive effects in face sebum lipids composition, characterized by a significant increase in ceramides and triacylglycerols and a decrease in fatty acids and oxidized fatty acids. [ABSTRACT FROM AUTHOR]

In this study, a hybrid nanoadsorbent (HnA), (PVA/TiO2-CeO2), was synthesized and amino-functionalized by 3-aminopropyltriethoxysilane (APTES) to produce AHnA, for use in an advanced selenium adsorption study focusing on nonlinear equilibrium and kinetics models. AHnA was characterized using XRD, FTIR spectroscopy, SEM, and EDX elemental analyses, as well as BET-BJH techniques. According to the FTIR results, APTES has successfully cross-linked the PVA chain and introduced amine groups on the surface. Moreover, the modification resulted in an increase in the total pore volume from 0.0061 cm3/g in HnA to 0.021 cm3/g in AHnA. Several adsorption experiments were conducted to determine the impact of varying contact times within a pH range of 1 to 8 and concentrations ranging from 5 to 200 mg/L, using a One-Variable-At-a-Time (OVAT) procedure. Accordingly, a dosage of 2 g/L of modified nanocomposite exhibits optimal performance for removing selenium from a 20 mg/L solution at an acidic pH of 3 during 300 minutes of contact with selenium ions, while conforming to a pseudo-second-order kinetic model. The assessment of various nonlinear isotherm models for analyzing equilibrium data revealed that the experimental data of selenium adsorption conformed to a generalized isotherm, showing a maximum monolayer adsorption capacity of 17.643 mg/g. [ABSTRACT FROM AUTHOR]

Aim: The occurrence of periodontal diseases is still to be determined in large samples of major Brazilian cities. This study aimed to assess the periodontal status of adults from Curitiba, Paraná, Brazil, using periodontitis definitions by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) and the recently published ACES 2018 Classification Framework. Materials and Methods: A multi‐stage probability sampling technique was applied to draw individuals aged 18 or older. A total of 566 individuals underwent a full‐mouth periodontal examination. Periodontitis cases were defined according to the CDC/AAP and the ACES 2018 Classification Framework. Non‐periodontitis cases were classified as healthy or gingivitis. The agreement between the two definitions was calculated. Results: Periodontal health was present in 33.6% and 13.8% of individuals, and gingivitis was found in 11.7% and 7.5%, according to CDC/AAP and ACES, respectively. Mild, moderate and severe periodontitis (CDC/AAP) were present in 2.1%, 33.4% and 19.1% of individuals, respectively. Using ACES, 34.3% had Stages I/II and 43.3% had Stages III/IV. The occurrence of periodontitis was higher when a subgroup of individuals aged 30+ were analysed, ranging from 69.6% (CDC/AAP) to 90.1% (ACES). CDC/AAP and ACES agreement for health, gingivitis and periodontitis accounted for 68.8% of the observations. Conclusions: Periodontal diseases affect more than 66% of the population aged 18+ years. Classic definition by the CDC/AAP and the recently published ACES Framework yielded moderate agreement. [ABSTRACT FROM AUTHOR]

Objective: To report our experience of fetal aortic valvuloplasty (FAV) for critical aortic stenosis (AS), with a focus on the postnatal evolution of the patients. Methods: This was a retrospective study including all fetuses with critical AS which underwent FAV in a single center between January 2011 and June 2022. FAV was performed under ultrasound guidance. Technical success was based upon balloon inflation across the aortic valve and improvement of the antegrade aortic flow across the aortic valve. At birth, a biventricular circulation (BVC) strategy was decided assuming the left ventricular (LV) systolic and diastolic function would ensure the systemic circulation. Results: Sixty‐three FAV procedures were performed in 58 fetuses, at a median (range) gestational age of 26.2 (20.3–32.2) weeks. The procedure was technically successful in 50/58 (86.2%) fetuses. There were 11/58 (19.0%) cases of in‐utero demise and 9/58 (15.5%) terminations of pregnancy. No patient was liveborn after an unsuccessful procedure. Thirty‐eight (65.5%) infants were liveborn, at a median (range) gestational age of 38.1 (29.0–40.6) weeks, of whom 21 (55.3%) required prostaglandin treatment. Twenty‐eight of the 38 (73.7%) liveborn children (48.3% of the study population) entered the BVC pathway at birth. Among them, 20 (71.4%) required an aortic valvuloplasty procedure at birth (11 (55.0%) percutaneous balloon, nine (45.0%) surgical) and eight (28.6%) did not require any treatment at birth, but, of these, five (62.5%) underwent surgical valvuloplasty between day 26 and day 1200 of age. Eleven (39.3%) of the infants with BVC at birth required a second intervention and four (14.3%) of them required a third intervention. Two (7.1%) infants who entered the BVC pathway at birth underwent conversion to univentricular circulation (UVC). None of the surviving children with BVC developed pulmonary hypertension. The overall survival rate in those with BVC at birth was 22/28 (78.6%) at a median (range) follow‐up of 23.3 (2.0–112.6) months. Ten of the 58 (17.2%) patients had UVC at birth. Among these, six (60.0%) received compassionate care from birth and four (40.0%) underwent surgery. Three of the 10 patients who had UVC at birth were still alive at the latest follow‐up assessment, at a median (range) gestational age of 24.3 (8.3–48.7) months. Conclusions: FAV for critical AS led to increase of antegrade aortic flow in 86.2% of fetuses, with BVC being achieved in 48.3% (73.7% of the liveborn cases). Among patients with BVC at birth, the rate of reintervention was high, but 78.6% of these children were alive at the latest evaluation. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

The continuously increasing accumulation of microplastics in the environment, such as polystyrene (PS), has posed an ecological and health threat. However, the information and biodegradation capability of plastics, including polystyrene, was still in the infancy stage in Indonesia. This study explored the potential of microbial consortia from Jakarta Bay to degrade polystyrene microplastics. The consortia were obtained from plastic waste with biofilms on their surfaces, collected from three stations in Jakarta Bay. The research enriched the biofilm's consortia using 1/10 Zobell marine broth media supplemented with 0.1% PS microplastics. Using enriched cultures, biodegradation tests were performed in a mineral salt medium with 0.2% PS microplastics as a sole carbon source for 60 days at 27°C, 120 rpm. Microbial consortia from Jakarta Bay showed an ability to perform polystyrene biodegradation. The calculated weight loss of the microplastics after 60 days of incubation was between 4% and 6.4%. The biodegradation of PS microplastics by the microbial consortium was also indicated by FTIR spectra, which showed changes in functional group transmittances and were confirmed by SEM data showing holes formation on PS surfaces. The results provide a baseline study for further research development in Indonesia's polystyrene biodegradation technology and management. [ABSTRACT FROM AUTHOR]

Background: Consumption of ultra‐processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated. Methods: We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines. Results: Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar‐sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end‐products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies. Conclusion: More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma. [ABSTRACT FROM AUTHOR]

Supernumerary chromosomes (B chromosomes) have been an intriguing subject of study. Our understanding of the molecular differentiation of B chromosomes from an interpopulation perspective remains limited, with most analyses involving chromosome banding and mapping of a few sequences. To gain insights into the molecular composition, origin, and evolution of B chromosomes, we conducted cytogenetic and next-generation sequencing analysis of the repeatome in the grasshopper Abracris flavolineata across various populations. Our results unveiled the presence of B chromosomes in two newly investigated populations and described new satellite DNA sequences. While we observed some degree of genetic connection among A. flavolineata populations, our comparative analysis of genomes with and without B chromosomes provided evidence of two new B chromosome variants. These variants exhibited distinct compositions of various repeat classes, including transposable elements and satellite DNAs. Based on shared repeats, their chromosomal location, and the C-positive heterochromatin content on the B chromosome, these variants likely share a common origin but have undergone distinct molecular differentiation processes, resulting in varying degrees of heterochromatinization. Our data serve as a detailed example of the dynamic and differentiated nature of B chromosome molecular content at the interpopulation level, even when they share a common origin. [ABSTRACT FROM AUTHOR]

This article contributes to ongoing discussions in the social sciences about how to interpret the incorporation of gender equality into integration policies – is it a form of state feminism or femonationalism? Drawing upon intersectionality, we analyse how gender equality is presented, discussed and negotiated in relation to ethnicity and nationality in Sweden. Methodologically, we employ a bifocal lens that combines (1) a quantitative investigation of representations of civic orientation programmes in Swedish policy documents and mainstream media, and (2) a qualitative analysis of ethnographic data collected in six civic orientation courses – three in English and three in Arabic – in three large municipalities. Such a two-pronged approach, which connects policy and media discourses with interactions in civic orientation classes, offers a granular picture of the complex and often ambivalent intersections of ethnicity and gender in relation to migration in Sweden. Ultimately, the co-optation of feminist values brings with it the risk of warping feminism into a trait of national/ethnic distinctiveness. Crucially, femonationalism is not the prerogative of far-right parties but is already becoming institutionalised, informing both mainstream media and educational practices in a feminist state like Sweden. [ABSTRACT FROM AUTHOR]

Porphyrazines (Pzs) are porphyrin derivatives that show potential application as photosensitizers for photodynamic therapy (PDT), but are still far less explored in the literature. In this work, we evaluate how the photophysics and phototoxicity of the octakis(trifluoromethylphenyl)porphyrazine (H2Pz) against tumor cells can be modulated by coordination with Mg(II), Zn(II), Cu(II) and Co(II) ions. Fluorescence and singlet oxygen quantum yields for the Pzs were measured in organic solvents and in soy phosphatidylcholine (PC) liposomes suspended in water. While H2Pz and the respective complexes with Cu(II) and Co(II) showed very low efficiency to fluoresce and to produce 1O2, the Mg(II) and Zn(II) complexes showed significantly higher quantum yields in organic solvents. The fluorescence of these two Pzs in the liposomes was sensitive to the fluidity of the membrane, showing potential use as viscosity markers. The cytotoxicity of the compounds was tested in HaCaT (normal) and A431 (tumor) cells using soy PC liposomes as drug carriers. Despite the low 1O2 quantum yields in water, the Mg(II) and Zn(II) complexes showed IC50 values against A431 cells in the nanomolar range when activated with low doses of red LED light. Their phototoxicity was ca. three times higher for the tumor cells compared to the normal ones, showing promising application as photosensitizers for PDT protocols. Considering that H2Pz and the respective Co(II) and Cu(II) complexes were practically non-phototoxic to the cells, we demonstrate the importance of the central metal ion in the modulation of the photodynamic activity of porphyrazines. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study is focused on identifying the most suitable sequence of machine learning-based models and the most promising set of input variables aiming at the estimation of heat transfer in evaporating R134a flows in microfin tubes. Utilizing the available experimental data, dimensionless features representing the evaporation phenomena are first generated and are provided to a machine learning-based model. Feature selection and algorithm optimization procedures are then performed. It is shown that the implemented feature selection method determines only six dimensionless parameters ( S u l : liquid Suratman number, B o : boiling number, F r g : gas Froude number, R e l : liquid Reynolds number, B d : Bond number, and e / D : fin height to tube's inner diameter ratio) as the most effective input features, which reduces the model's complexity and facilitates the interpretation of governing physical phenomena. Furthermore, the proposed optimized sequence of machine learning algorithms (providing a mean absolute relative difference (MARD) of 8.84% on the test set) outperforms the most accurate available empirical model (with an MARD of 19.7% on the test set) by a large margin, demonstrating the efficacy of the proposed methodology. [ABSTRACT FROM AUTHOR]

Background: The ethnobotanical analysis of two bordering areas allows for the in-depth understanding of the dynamics of Local Ecological Knowledge, which mirrors the naturalistic, historical, and sociopolitical features of each area. As part of the Interreg Italy-Switzerland B-ICE&Heritage and GEMME projects, this work is an ethnobotanical comparative study of two neighboring Alpine territories: Valmalenco (Italy) and Valposchiavo (Switzerland). Methods: A total of 471 informants were interviewed on different fields of use (medicinal, food, veterinary, etc.). All data were organized in Excel™ spreadsheets. Informant Consensus Factor was calculated for the pathologies reported. Jaccard's similarity indices were calculated to compare the Valmalenco and Valposchiavo areas. Subsequently, another comparison between Valmalenco/Valposchiavo and Italian/Swiss Alpine neighboring areas was carried out. Results: The number of taxa for Valmalenco was 227 (77 families) and 226 in Valposchiavo (65). Out of the 10 most cited species, 7 were mentioned in both. Arnica montana L. was the most cited in Valmalenco, and Sambucus nigra L. in Valposchiavo. The 5 most cited families were the same. Regarding the medicinal and food fields, the similarity indices were fairly low (0.31 and 0.34 for the species; 0.22 and 0.31 for the uses). Concerning the comparison with Italian and Swiss Alps, similarity values were slightly higher with Italy (Valmalenco food species: 0.38 with Italy and 0.26 with Switzerland, medicinal: 0.26 IT and 0.14 SW; Valposchiavo food species: 0.36 with IT and 0.26 with SW, medicinal: 0.21 IT and 0.14 SW). Conclusion: Although Valmalenco and Valposchiavo partly share natural environment, language, history, and culture, they had low similarity indices. They both seemed to have more similarities with Italy than Switzerland, maintaining low values with the surrounding territories too. They showed a common core of Local Ecological Knowledge with several divergent branches possibly due to pivotal historical happenings, as well as more modern external influences. [ABSTRACT FROM AUTHOR]

Aim of the Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes. Patients and Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts. Routine CT images were utilized to create a VR environment using advanced software platforms. The accuracy and fidelity of the VR simulations was validated through a multi-step process. This involved comparing the virtual anatomical models to the original medical imaging data and conducting feedback sessions with pediatric urology experts to assess VR simulations' realism and clinical relevance. Results: A total of six pediatric patients were reviewed. The median age of the participants was 5.5 years (IQR: 3.5–8.5 years), with an equal distribution of males and females across both groups. A minimally invasive laparoscopic approach was performed for adrenal lesions (n = 3), Wilms' tumor (n = 1), bilateral nephroblastomatosis (n = 1), and abdominal trauma in complex vascular and renal malformation (ptotic and hypoplastic kidney) (n = 1). Key benefits included enhanced visualization of the segmental arteries and the deep vascularization of the kidney and adrenal glands in all cases. The high depth perception and precision in the orientation of the arteries and veins to the parenchyma changed the intraoperative decision-making process in five patients. Preoperative VR patient-specific simulation did not offer accuracy in studying the pelvic and calyceal anatomy. Conclusions: VR patient-specific simulations represent an empowering tool in pediatric urology. By leveraging the immersive capabilities of VR technology, preoperative planning and intraoperative navigation can greatly impact surgical decision-making. As we continue to advance in medical simulation, VR holds promise in educational programs to include even surgical treatment of more complex urogenital malformations. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the effect of two methods of maintenance intravenous fluid therapy on hyponatremia in hospitalized infants with sepsis. Methods: In a double-blinded randomized clinical trial, 60 term infants with sepsis were enrolled. Blood samples were taken to determine sodium, potassium, Creatinine, and BUN levels before the initiation of treatment. Urine samples were taken to assess specific gravity and urinary output. Infants in the intervention group received half saline in 10% dextrose and infants in the control group were assigned to receive the conventional solution as maintenance. The above indicators were re-evaluated 24 and 48 h after the initiation of treatment. Two groups were compared concerning the incidence of hyponatremia, and other criteria such as urinary output and urinary specific gravity, blood urea nitrogen (BUN), and creatinine levels. Results: Hyponatremia was more common in the control group. Sodium levels were significantly higher in half saline recipients 24 h (137.83 ± 2.86 vs. 134.37 ± 1.91 mmol/L), and 48 h (138.10 ± 2.41 vs. 133.66 ± 1.98 mmol/L) after treatment (P < 0.001). Although BUN in the intervention group was significantly higher in comparison to the control group, the difference in urinary output, urine specific gravity, potassium, and Creatinine levels were not significant in the two groups. Conclusions: The use of a half-saline solution as maintenance fluid reduces the risk of hyponatremia after 48 h when compared to 0.18%NaCl. Trial registration: This has been registered at Iranian Registry of Clinical Trials (Retrospectively registered, Registration date: 2017-10-12, identifier: IRCT2017053034223N1, https://irct.behdasht.gov.ir/trial/26204). [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes (T2D) is a risk factor for female breast cancer (FBC). Obesity has also been associated with FBC, also depending on menopausal status. This study aimed to evaluate the impact of obesity and T2D on the development, aggressiveness, and invasiveness of FBC. Methods: Demographic, clinical, and histopathological data from 335 women with FBC were collected, and analyzed according to weight category (102 normal weight, 117 overweight, and 116 living with obesity) and the presence/absence of T2D. Results: Age at oncologic diagnosis was not statistically significantly different for body weight; women with overweight or obesity were more likely to have an oncologic diagnosis after menopause than normal weight (p < 0.001). The presence of overweight/obesity and T2D seemed to be associated with a higher incidence of metastasis, recurrence, and triple‐negative breast cancer (TNBC) subtype (p < 0.001). Excess body weight was also associated with high histologic grade (G3) (p < 0.005). Conclusions: These results confirm excess body weight and T2D as unfavorable prognostic factors in terms of the presence of the TNBC subtype, tumor metastasis, recurrence, and aggressiveness (G3 and Ki‐67 > 20%). This study highlights the importance of prevention in all women, with early screening, and adequate nutritional programs. [ABSTRACT FROM AUTHOR]

Copyright of Ecologia Austral is the property of Asociacion Argentina de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The global threat of antimicrobial resistance (AMR) is exacerbated by the mobilization of antimicrobial resistance genes (ARGs) occurring in different environmental niches, including seawater. Marine environments serve as reservoirs for resistant bacteria and ARGs, further complicated by the ubiquity of microplastics (MPs). MPs can adsorb pollutants and promote bacterial biofilm formation, creating conditions favorable to the dissemination of ARGs. This study explores the dynamics of ARG transfer in the marine bivalve Mytilus galloprovincialis within a seawater model, focusing on the influence of polyethylene MPs on the mobilization of the Tn916-carrying tetM gene and plasmid-encoded ermB. Experiments revealed that biofilm formation on MPs by Enterococcus faecium and Listeria monocytogenes facilitated the transfer of the tetM resistance gene, but not the ermB gene. Furthermore, the presence of MPs significantly increased the conjugation frequency of tetM within mussels, indicating that MPs enhance the potential for ARG mobilization in marine environments. These findings highlight the role of MPs and marine organisms in ARG spread, underscoring the ecological and public health implications. [ABSTRACT FROM AUTHOR]

Introduction: Internet Gaming Disorder (IGD) according to DSM-5 is a behavioral addiction needing additional study. IGD in youth is correlated with anxiety, depression, attention problems, interpersonal problems, social phobia, behavior problems and low academic achievement. The aim of the present research is to contribute to the understanding of the disorder, by providing preliminary data on the factorial structure of the IGD Questionnaire in the Italian version. Participants: 612 Italian students (323 females), mean of age = 13.94 (SD = 2.44). Instruments: a survey comprising IGD Questionnaire, Internet Addiction Test (IAT), Children's Coping Strategies Checklist (CCSC-R1), Assessment of Interpersonal Relations (AIR), and Child Behavior Checklist (CBCL). Results: 15.2% of participants showed a sub-clinical IGD and 2.1% met the full diagnostic criteria. Participants with IGD showed lower scores in interpersonal relationships, worse coping strategies and higher scores in externalization. The factorial structure of the IGD Questionnaire highlights 4 factors ("addiction", "gaming as coping", "impaired control" and "negative outcomes") that explain 52.14% of the variance. A single-factor solution was also tested and results seem to be coherent with the four-factor solution, explaining less variance. Conclusions: IGD is a complex clinical condition that can be thought both as a single-factored and as a multi-faceted condition. [ABSTRACT FROM AUTHOR]

COVID-19 may have residual consequences in multiple organs, including the cardiovascular system. The purpose of the present investigation is to quantify myocardial function in symptomatic individuals with long COVID and investigate the association between illness severity and myocardial function. A retrospective cross-sectional study was conducted in which symptomatic individuals with previous COVID-19 underwent echocardiographic analysis of left ventricle global longitudinal strain (LVGLS) and myocardial work (MW). Individuals also performed cardiopulmonary testing (CPX) to assess peak oxygen uptake (VO2peak). Differences between illness severity subgroups were analyzed by the Mann–Whitney test. Correlations were calculated using the Spearman correlation test. Multilinear regressions were performed to evaluate the influences of COVID-19 severity, body mass index, age, and sex on MW. Fifty-six individuals were included (critical subgroup: 17; moderate/severe subgroup: 39), 59% females; median age: 56 years (IQR: 43–63). CPX revealed a substantial reduction in VO2peak (median of 53% of predicted values). LVGLS were not statistically different between subgroups. Global wasted work (GWW) was higher in the critical subgroup [146 (104–212) versus 121 (74–163) mmHg%, p = 0.01], and global work efficiency (GWE) was lower in this subgroup [93 (91–95) versus 94 (93–96), p = 0.03]. Illness severity was the only independent predictor of GWW and GWE (GWW: r2 = 0.167; p = 0.009; GWE: r2 = 0.172; p = 0.005) in multilinear regressions. In our study with long COVID-19 individuals, despite having a similar LVGLS, patients had subclinical LV dysfunction, demonstrated only by an increase in GWW and a decrease in GWE. [ABSTRACT FROM AUTHOR]

The production of instant weaning food porridge is one of the most popular research topics. Granulation is the preferred method for producing instant foods. The advantages of granulation include easy storage, dissolution and shelf life. Whole-grain flour and high -fiber materials, in addition to replacing sugar with natural sweeteners, are a viable solution to reduce the adverse effects of a high -calorie diet. In this study, the effect of the granule content of almond oil cake oatmeal (65 - 70%), grape juice powder (25 -30%) and sugar (0 -5%) on the physicochemical properties, color brightness, emulsifying activity, stability and sensory parameters of the final porridge was investigated based on the statistical mixing design. According to the optimization results, the recipe of the instant porridge contains 69.9% almond oatmeal granules, 9.26% grape juice powder and 3.89% sugar to achieve emulsifying ability, emulsion stability, color brightness and overall acceptability of 65.82, 64.16, 3.75 and 89.89, respectively. According to the optimization results, for emulsifying ability, emulsion stability, color brightness and total acceptance 65.82, 64.16, 3.75 and 89.89, respectively, the instant porridge formulation was found to contain 69.9% almond oatmeal granules, 9.26% grape juice powder and 3.13% sugar. The fluctuations in blood sugar after 120 minutes of consumption of the optimal sample were significantly lower than in consumers with glucose sugar. Generally speaking, the combination of extrusion, foam mat and granulation technologies for the production of instant weaning food is considered an innovative idea for the development of healthy food technology. [ABSTRACT FROM AUTHOR]

While root canal anatomy in Middle Eastern populations is well‐studied, research on isthmi in mandibular permanent teeth from this region is limited. This retrospective study used cone‐beam computed tomography (CBCT) to examine isthmi prevalence and location, as well as root canal morphologies (per Vertucci's classification) in mandibular permanent teeth from a subpopulation in Ardabil, Iran. The study is aimed at enhancing our understanding of dental anatomical variations in Middle Eastern populations. A total of 3566 teeth from 384 CBCT scans were evaluated in this retrospective study. Mandibular teeth were evaluated on sagittal, coronal, and axial sections regarding the presence of isthmus and root morphology (Vertucci's classification). CBCT scans of 197 males (51.3%) and 187 females (48.7%) were evaluated, with a mean age of 41.1 ± 11.4 years. Isthmi were most prevalent in molar mesial roots, typically located in the middle third for anterior teeth and first premolars and cervical third for posterior teeth. While gender did not play a significant role, the presence of an isthmus in the mesial root of the left second molars was associated with a younger mean patient age (p < 0.05). Root morphology varied across tooth types. Central and lateral incisors predominantly showed Vertucci's Types I and III. Canines and premolars were mostly Type I, with some variation. Molar mesial roots frequently exhibited Types IV and II, while distal roots were predominantly Type I. Statistically significant differences were found between morphology and gender in the first left premolar (Type I more common in women; Type V in men; p < 0.001) and in the right canine (Type I more prevalent in men; Types III and V more prevalent in women; p < 0.001). The results revealed wide variations in root canal morphology and a relatively high prevalence of isthmi in the study population. Our findings suggest a potential difference in tooth anatomy based on sex and a relationship between age and the presence of isthmi. [ABSTRACT FROM AUTHOR]

Systemic light chain (LC) amyloidosis (AL) is a disease where organs are damaged by an overload of a misfolded patient-specific antibody-derived LC, secreted by an abnormal B cell clone. The high LC concentration in the blood leads to amyloid deposition at organ sites. Indeed, cryogenic electron microscopy (cryo-EM) has revealed unique amyloid folds for heart-derived fibrils taken from different patients. Here, we present the cryo-EM structure of heart-derived AL amyloid (AL59) from another patient with severe cardiac involvement. The double-layered structure displays a u-shaped core that is closed by a β-arc lid and extended by a straight tail. Noteworthy, the fibril harbours an extended constant domain fragment, thus ruling out the variable domain as sole amyloid building block. Surprisingly, the fibrils were abundantly concatenated with a proteinaceous polymer, here identified as collagen VI (COLVI) by immuno-electron microscopy (IEM) and mass-spectrometry. Cryogenic electron tomography (cryo-ET) showed how COLVI wraps around the amyloid forming a helical superstructure, likely stabilizing and protecting the fibrils from clearance. Thus, here we report structural evidence of interactions between amyloid and collagen, potentially signifying a distinct pathophysiological mechanism of amyloid deposits.Here the authors report the cryo-EM structure of heart-derived fibrils of an AL amyloidosis patient. Surprisingly, the fibrils form helical superstructures with collagen VI, potentially signifying a distinct pathophysiological mechanism for amyloidoses. [ABSTRACT FROM AUTHOR]