Search

Intracranial atherosclerotic disease (ICAD) involves the build-up of atherosclerotic plaques in cerebral arteries, significantly contributing to stroke worldwide. Diagnosing ICAD entails various techniques that measure arterial stenosis severity. Digital subtraction angiography, CT angiography, and magnetic resonance angiography are established methods for assessing stenosis. High-resolution MRI offers additional insights into plaque morphology including plaque burden, hemorrhage, remodeling, and contrast enhancement. These metrics and plaque traits help identify symptomatic plaques. Techniques like transcranial Doppler, CT perfusion, computational fluid dynamics, and quantitative MRA analyze blood flow restrictions due to ICAD. Intravascular ultrasound or optical coherence tomography have a very high spatial resolution and can assess the structure of the arterial wall and the plaque from the lumen of the target vascular territory. Positron emission tomography could further detect inflammation markers. This review aims to provide a comprehensive overview of the spectrum of current modalities for atherosclerotic plaque analysis and risk stratification., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Introduction: Understanding the relationship between aneurysm wall enhancement (AWE), wall shear stress (WSS), and wall tension (WT) across different brain aneurysm compartments may improve the assessment of rupture risk and vessel wall dynamics. Our comprehensive analysis aimed to evaluate these characteristics across different brain aneurysm compartments., Methods: Patients with intracranial aneurysms underwent 3-T high-resolution magnetic resonance imaging (MRI). T1-weighted images were obtained before and after administering gadolinium (Gd) contrast. 3D segmentations of the aneurysms were generated using 3D Slicer. AWE was quantified based on the signal intensity of the aneurysm wall on T1+Gd images. Finite element analysis calculated WT, while computational fluid dynamics assessed WSS metrics, including time-averaged wall shear stress (TAWSS), wall shear stress gradient (WSSG), and oscillatory shear index (OSI). AWE, WT, and WSS metrics were compared among aneurysms compartments and aneurysms stratified by size, aspect ratio (AR), and size ratio (SR)., Results: AWE was elevated in aneurysms with greater size and AR. WT and OSI were higher in aneurysms with larger sizes and higher AR and SR. Aneurysm necks exhibited higher WT, TAWSS, and WSSG compared to the aneurysm body. Irregular aneurysms displayed lower TAWSS, WSSG, and higher OSI in areas of high AWE. The bleb had the highest AWE and lowest WT and WSSG, while necks showed the lowest AWE and highest WT and WSSG., Conclusion: Aneurysm necks typically exhibit high WT and WSS, while the body often shows low WSS. Blebs express elevated AWE alongside diminished WSS and WT which potentially increases rupture risk KEY POINTS: Question Areas of high wall enhancement in irregular aneurysms are characterized by low wall sheer stress and high oscillatory sheer index. Findings High risk structures such as daughter sacs exhibit the highest wall enhancement and lowest wall sheer stress. Clinical relevance Comprehensive morphomechanical and wall enhancement analysis of brain aneurysms have the potential to offer valuable new insights into aneurysm biology., Competing Interests: Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Doctor Edgar Samaniego. Conflict of interest: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was waived by the Institutional Review Board because of the retrospective nature of the study. Ethical approval: Institutional Review Board approval was obtained – (IRB: 201803866). Study subjects or cohorts overlap: None study subjects or cohorts have been previously reported. Methodology: Retrospective Observational Performed at one institution, (© 2025. The Author(s), under exclusive licence to European Society of Radiology.)

Background: Interprofessional relationships between general practitioners (GPs) and dental surgeons with a doctorate in dental surgery are essential for the optimal management of the oral health of patients. The objectives of this study were to describe the factors associated with the referral of patients from GPs to dental surgeons in France, and to improve referral practices by establishing a standardized set of items to be included in a referral letter., Methods: A nationwide, observational, survey-based, cross-sectional study was conducted from 9 February 2023 to 6 April 2023. Two 13-item questionnaires were sent to GPs and dental surgeons. Data on practitioner characteristics, frequency, and perceived usefulness of medical correspondence between the two healthcare professionals were collected. Candidate items selected by expert medical opinion for a standardized referral letter template were appraised by the responding oral surgeons., Results: A group of 245 dental surgeons (mean age: 38.2 ± 11.1 years, 64.5% female) and 235 GPs (mean age: 36.8 ± 9.8 years, 71.9% female) participated in this study. Medical correspondence between GPs and dental surgeons was reported to be insufficient by most dental surgeons (91.4%). Dental surgeons agreed that GP correspondence could decrease the occurrence of adverse events linked with dental care (mean score: 7.36 ± 2.4, for a maximum of 10). Only 20% of GPs indicated that they had regular communication with dental surgeons. The physician characteristics under study were not statistically associated with initiating referrals. The items most frequently selected by dental surgeons for inclusion in a template referral letter were the presence of diabetes (99.6%), of immunosuppression (98.8%), and medication by anticoagulant or antiplatelet agents (98.3%)., Conclusions: Despite known links between oral and general health, most healthcare professionals did not engage in correspondence or referrals with the other specialty. Standardized referral letters could include the list of items for which interest was confirmed by dental surgeons (including presence of diabetes, immunosuppressants and anticoagulants or antiplatelet agents)., Competing Interests: Declarations. Ethics approval and consent to participate: In accordance with the French legislations No. 2021 − 300 (March 5, 2012), this observational study did not require approval by an ethics committee. This study was also not subject to Jardé law since it did not fall within the scope of Article R.1121-1 of the French Public Health Code. Informed consent was obtained from all physicians to participate in the study. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Autosomal recessive deficiency of the IFNAR1 or IFNAR2 chain of the human type I IFN receptor abolishes cellular responses to IFN-α, -β, and -ω, underlies severe viral diseases, and is globally very rare, except for IFNAR1 and IFNAR2 deficiency in Western Polynesia and the Arctic, respectively. We report 11 human IFNAR1 alleles, the products of which impair but do not abolish responses to IFN-α and -ω without affecting responses to IFN-β. Ten of these alleles are rare in all populations studied, but the remaining allele (P335del) is common in Southern China (minor allele frequency ≈2%). Cells heterozygous for these variants display a dominant phenotype in vitro with impaired responses to IFN-α and -ω, but not -β, and viral susceptibility. Negative dominance, rather than haploinsufficiency, accounts for this dominance. Patients heterozygous for these variants are prone to viral diseases, attesting to both the dominance of these variants clinically and the importance of IFN-α and -ω for protective immunity against some viruses., (© 2024 Al Qureshah et al.)

Introduction: As one means to avoid waste in research investment, involving patients as full partners in research has become increasingly frequent. There is clearly a low level of investment in palliative care research. Following the guidance from the James Lind Alliance and the UK public consultation ('Palliative and End of Life Care Research Priorities Project'), we developed a 3-step protocol aimed at prioritising 10 unanswered questions in palliative care (PC) research in France, from the viewpoint of patients, volunteers, healthcare professionals and family caregivers., Methods and Analysis: To identify unanswered questions in PC (stage 1), an unstructured questionnaire will be used. This questionnaire will be tested on patients and healthcare professionals and modified, if necessary, before being made available online for a period of 6 months. A multidisciplinary steering committee including board-certified PC physicians, methodologists, nurses, a sociologist, an anthropologist and an information specialist will analyse the data collected in order to delete duplicate questions, do a thematic and population classification of the responses, modify questions using the PICO (patient problem, intervention, comparison and outcome) format and perform a literature review on each question to identify any relevant systematic review., Ethics and Dissemination: We expect the results to have wide-ranging benefits, for example, by prompting investment in the 10 prioritised research questions. There are also potential benefits for patients and caregivers, by including them as partners in future research. Regarding the current bill being examined by the government planning to legalise euthanasia and assisted suicide in France, this study will provide new insights into how patients and caregivers are prioritising those themes. The major benefit of this study is to involve patients and family caregivers as partners in PC research. They will be consulted and their choices will be valuable resources and may prompt researchers to focus on different topics. In view of the limited funding available, PC research needs to prioritise major issues and raise its visibility.The second stage of the study is the first-round prioritisation using a fixed format questionnaire, which will last 4 months. The third stage will consist of reaching a consensus regarding the top 10 unanswered questions in PC research, using the nominal group technique. A secondary objective during this third step is to study the reasons for the prioritisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Due to the global growth of its prevalence and its impact on patient health, obesity is considered a near-epidemic condition by the World Health Organization (WHO). Its overall prevalence has now reached 17 % in France. The impact of obesity is also a concern for pregnant women, due to the risk of maternal and fetal complications. Obesity increases the risk of cesarean delivery. However, few data are available regarding risk factors for failed attempted vaginal delivery in obese women., Objective: The purpose of this study was to examine predictors associated with caesarean delivery among class III obese women undergoing labor., Methods: Retrospective and multicentric cohort study at the Reims University Hospital and Troyes Hospital from 1 January 2018 to 31 December 2023. All women aged 18 years or older, with body mass index of 40 or higher at booking, with a singleton pregnancy and cephalic presentation and a vaginal delivery attempt after 24 weeks were included in the study. Demographic, obstetrical and neonatal factors were compared between women having a successful vaginal delivery and women having a cesarean delivery after a failed vaginal delivery attempt. A multivariable analysis by logistic regression was performed to evaluate the probability of a change to cesarean section., Results: Overall, 236 obese women attempting vaginal delivery met all inclusion criteria. Among them, 166 (70.3 %) had a successful vaginal delivery, while 70 (29.7 %) had a cesarean section. Women having a cesarean delivery were more likely to be nulliparous (55.7 % vs. 33.1 %, p = 0.001), to have a weight gain of more than 9 kg during the pregnancy (32.9 % vs. 19.9 %, p = 0.028), to have a diagnosis of preeclampsia (12.9 % vs. 3.6 %, p = 0.008) and to have had induced labor (64.3 % vs. 42.2 %, p = 0.002), when compared to women with successful vaginal delivery. In multivariable analysis, pre-eclampsia was a significant risk factor for cesarean delivery (adjusted OR 4.08; 95 % CI 1.09 - 16.88; p = 0.04). In contrast, having a history of at least one successful vaginal delivery was a protective factor (adjusted OR 0.20; 95 % CI 0.08 - 0.44; p < 0.001)., Conclusion: Preeclampsia was associated with cesarean delivery in class III obese women attempting a vaginal delivery, while a history of previous vaginal delivery reduced this risk. Although vaginal delivery remains the recommended route by default in preeclampsia patients, our results suggest that obese patients with preeclampsia, especially if they are nulliparous, should be warned of the high risk of cesarean delivery., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Aneurysm wall enhancement (AWE) has the potential to be used as an imaging biomarker for the risk stratification of intracranial aneurysms (IAs). Radiomics provides a refined approach to quantify and further characterize AWE's textural features. This study examines the performance of AWE quantification combined with clinical information in detecting symptomatic IAs. Ninety patients harboring 104 IAs (29 symptomatic and 75 asymptomatic) underwent high-resolution magnetic resonance imaging (HR-MRI). The assessment of AWE was performed using two different methods: 3D-AWE mapping and composite radiomics-based score (RadScore). The dataset was split into training and testing subsets. The testing set was used to build two different nomograms using each modality of AWE assessment combined with patients' clinical information and aneurysm morphological data. Finally, each nomogram was evaluated on an independent testing set. A total of 22 radiomic features were significantly different between symptomatic and asymptomatic IAs. The 3D-AWE mapping nomogram achieved an area under the curve (AUC) of 0.77 (63% accuracy, 78% sensitivity, and 58% specificity). The RadScore nomogram exhibited a better performance, achieving an AUC of 0.83 (77% accuracy, 89% sensitivity, and 73% specificity). The comprehensive analysis of IAs with the quantification of AWE data through radiomic analysis, patient clinical information, and morphological aneurysm metrics achieves a high accuracy in detecting symptomatic IA status., Competing Interests: Declarations. Ethical Approval: Institutional Review Board number 202310190 was obtained for this retrospective analysis. Informed consent was not required for the study. Conflict of Interest: The authors declare no competing interests. Disclosures: SSV, AS, DJO, ES, SS, AG: None EIL: Board Membership: Stryker, NeXtGen Biologics, MedX Health, Cog-nition Medical, EndoStream; Consultancy: Claret Medical, GLG Con-sulting, Guidepoint, Imperative Care, Medtronic, Rebound Therapeu-tics, StimMed; Employment: University at Buffalo Neurosurgery Inc;Expert Testimony: renders medical/legal opinions as an expert witness;Stock/Stock Options: NeXtGen Biologics, Cognition Medical, RapidMedical, Claret Medical, Imperative Care, Rebound Therapeutics,StimMed AHS: inancial interest/investor/stock options/ownership: Adona Medical, Inc., Amnis Therapeutics, BlinkTBI, Inc.,Boston Scientific Corp. (for purchase of Claret Medical), BuffaloTechnology Partners, Inc., Cardinal Consultants, LLC, CerebrotechMedical Systems, Inc., Cognition Medical, Endostream Medical,Ltd, Imperative Care, Inc., International Medical Distribution Part-ners, Neurovascular Diagnostics, Inc., Q’Apel Medical, Inc., RadicalCatheter Technologies, Inc., Rebound Therapeutics Corp. (purchased2019 by Integra Lifesciences, Corp.), Rist Neurovascular, Inc., SenseDiagnostics, Inc., Serenity Medical, Inc., Silk Road Medical, Spin-naker Medical, Inc., StimMed, Synchron, Three Rivers Medical, Inc.,Vastrax, LLC, VICIS, Inc., Viseon, Inc.; consultant/advisory board:Amnis Therapeutics, Boston Scientific, Canon Medical Systems USA,Inc., Cerebrotech Medical Systems, Inc., Cerenovus, Corindus, Inc.,Endostream Medical, Ltd, Imperative Care, Inc., Integra LifeSciencesCorp., Medtronic, MicroVention, Minnetronix Neuro, Inc., North-west University—DSMB Chair for HEAT Trial, Penumbra, Q’ApelMedical, Inc., Rapid Medical, Rebound Therapeutics Corp., SerenityMedical, Inc., Silk Road Medical, StimMed, Stryker, Three RiversMedical, Inc., VasSol, W.L. Gore & Associates; national PI/steeringcommittees: Cerenovus LARGE trial and ARISE II trial, MedtronicSWIFT PRIME and SWIFT DIRECT trials, MicroVention FRED Trialand CONFIDENCE study, MUSC POSITIVE trial, Penumbra 3D Sep-arator trial, COMPASS trial, INVEST trial; research grants: co-inves-tigator, NIH/NINDS 1R01NS091075 Virtual Intervention of Intracra-nial Aneurysms; role: co-principal investigator, NIH-NINDS R21NS109575-01 Optimizing Approaches to Endovascular Therapy ofAcute Ischemic Stroke VMT: Financial interest/investor/stockoptions/ownership: Neurovascular Diagnostics, Inc., QAS.AI, Inc.;Consultant/advisory board: Canon Medical Systems USA; Researchgrants: Principal investigator, National Science Foundation Award No.1746694 and NIH NINDS award R43 NS115314-0; awardee of a Brain Aneurysm Foundation grant, a Center for Advanced Technology grant, and a Cummings Foundation grant EAS: Consultant for Medtronic, Microvention, Cerenovus, iSchemaView, and Rapid Medical, (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Emerging evidence indicates that aneurysmal subarachnoid hemorrhage (aSAH) elicits a response from both innate and adaptive immune systems. An upregulation of CD8 + CD161 + cells has been observed in the cerebrospinal fluid (CSF) after aSAH, yet the precise role of these cells in the context of aSAH is unkown. CSF samples from patients with aSAH and non-aneurysmal SAH (naSAH) were analyzed. Single-cell RNA sequencing (scRNAseq) was performed on CD8 + CD161 + sorted samples from aSAH patients. Cell populations were identified using "clustering." Gene expression levels of ten previously described genes involved in inflammation were quantified from aSAH and naSAH samples using RT-qPCR. The study focused on the following genes: CCL5, CCL7, APOE, SPP1, CXCL8, CXCL10, HMOX1, LTB, MAL, and HLA-DRB1. Gene clustering analysis revealed that monocytes, NK cells, and T cells expressed CD8 + CD161 + in the CSF of patients with aSAH. In comparison to naSAH samples, aSAH samples exhibited higher mRNA levels of CXCL10 (median, IQR = 90, 16-149 vs. 0.5, 0-6.75, p = 0.02). A trend towards higher HMOX1 levels was also observed in aSAH (median, IQR = 12.6, 9-17.6 vs. 2.55, 1.68-5.7, p = 0.076). Specifically, CXCL10 and HMOX1 were expressed by the monocyte subpopulation. Monocytes, NK cells, and T cells can potentially express CD8 + CD161 + in patients with aSAH. Notably, monocytes show high levels of CXCL10. The elevated expression of CXCL10 in aSAH compared to naSAH indicates its potential significance as a target for future studies., Competing Interests: Declarations. Ethics Approval: The Institutional Review Board of the University of Iowa approved this study under IRASH (IRB ID number: 201902739). Informed Consent: Informed Consent was acquired for every patient under supervision of the Institutional Review Board of the University of Iowa. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Huntington's disease (HD) is caused by a CAG repeat expansion in the HTT gene, leading to altered gene expression. However, the mechanisms leading to disrupted RNA processing in HD remain unclear. Here we identify TDP-43 and the N6-methyladenosine (m6A) writer protein METTL3 to be upstream regulators of exon skipping in multiple HD systems. Disrupted nuclear localization of TDP-43 and cytoplasmic accumulation of phosphorylated TDP-43 occurs in HD mouse and human brains, with TDP-43 also co-localizing with HTT nuclear aggregate-like bodies distinct from mutant HTT inclusions. The binding of TDP-43 onto RNAs encoding HD-associated differentially expressed and aberrantly spliced genes is decreased. Finally, m6A RNA modification is reduced on RNAs abnormally expressed in the striatum of HD R6/2 mouse brain, including at clustered sites adjacent to TDP-43 binding sites. Our evidence supports TDP-43 loss of function coupled with altered m6A modification as a mechanism underlying alternative splicing in HD., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: CFTR modulator therapies have positive clinical outcomes, yet chronic inflammation and bacterial infections persist in people with CF (pwCF). How elexacaftor-tezacaftor-ivacaftor (ETI) fails to improve innate immune signaling responsible for bacterial clearance and inflammation resolution remains unknown., Methods: We used an unbiased proteomics approach to measure the effect of ETI on inflammatory proteins. Plasma from 20 pediatric pwCF and 20 non-CF (NCF) was collected during routine examination and 3 months after ETI initiation. Protein screening was performed with an inflammation panel (Target 96, Olink ® ). Bioinformatics analysis was used to determine changes in protein expression., Results: There were significantly fewer pulmonary exacerbations after ETI initiation, along with sustained improvement in lung function and reduced bacterial colonization. Unpaired analysis of CF pre-ETI and NCF resulted in 34 significantly different proteins. Of these, CCL20, MMP-10, EN-RAGE, and AXIN1 had a log 2 fold change of 1.2 or more. There was a modest shift in overall CF protein profiles post-ETI toward the NCF cluster. Unpaired analysis of protein differential expression between NCF and CF post-ETI identified a total of 24 proteins significantly impacted by ETI therapy ( p -value ≤ 0.05), with only CCL20 having a log 2 fold change higher than 1.2. Paired analysis (CF pre- and CF post-ETI) of differential protein expression demonstrated significant expression changes of MMP-10, EN-RAGE, and IL-17A. Pathway analysis identified significantly impacted pathways such as the NF-κB pathway., Conclusion: This study showed that ETI in a pediatric cohort had a modest effect on several inflammatory proteins with potential as biomarkers. Pathways significantly impacted by ETI can be further studied for future therapies to combat persistent inflammation and dysregulated immunity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Ozuna, Bojja, Partida-Sanchez, Hall-Stoodley, Amer, Britt, Sheikh, Frank, Wang, Kang, Miralda, Durfey and Kopp.)

Introduction: There is substantial interest in the association of vaping e-cigarettes with the risk of cancer. We analyzed this risk in different populations by updating the Kings College London (KCL) review to include the period between July 2021 and December 2023., Methods: We searched six databases and included peer-reviewed human, animal, and cell/ in vitro original studies examining the association between e-cigarettes and cancer risk, but we excluded qualitative studies. We summarized findings on three types of e-cigarette exposure: acute, short- to medium-term, and long-term. Additionally, we assessed whether the health effects differ between subgroup populations based on various sociodemographic factors, for which we also screened the previously included studies in the KCL review. Different risk-of-bias tools were used to assess the quality of the included human studies., Results: We included 39 studies in the main analysis and 12 in the subgroup analysis. Of these, 2 were longitudinal observational studies, 9 were cross-sectional studies, 1 case report and 27 were cell/ in vitro and animal studies. All human studies were conducted in adults, and about half of them had a low risk of bias. No significant incident or prevalent risk of lung cancer or other types of cancer was found in the never smoker current vapers population. However, there was substantial biomarker-based evidence of a significant association between e-cigarette exposure and oxidative stress, cellular apoptosis, DNA damage, genotoxicity, and tumor growth, particularly following acute exposure. We did not find any age or sex-based differences in cancer risk, and findings on race and education-based differences were insufficient., Conclusions: There is substantial evidence that e-cigarette exposure is associated with biomarkers reflective of cancer disease risk. However, the overall evidence on cancer risk is still limited and should be further investigated by future research, particularly rigorously designed clinical trials and population-based research., Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. All the authors report that since the initial planning of the work this study was funded by the Health Canada’s Substance Use and Addiction Program (Arrangement # 2223-HQ-000150). K. Sachdeva also reports that since the initial planning of the work this study was funded by CAMH Summer Studentship. M. Chaiton reports that in the past 36 months the institution received funds from National Institutes of Health, Heart and Stroke, and Canadian Institutes of Health Research. Finally, M. Chaiton declares that he participated on a Data Safety Monitoring Board or Advisory Board (Ottawa Heart Institute) with no payment., (© 2025 Kundu A. et al.)

Purpose: Improvements in the treatment of advanced cancer have increased life expectancy but have also increased the costs to healthcare systems, patients and their families. A systematic review is needed to summarize research work on the cost of cancer. The primary objective was to describe the characteristics and methodology of studies investigating the cost of cancer during the palliative phase. Secondary objectives were to assess whether palliative care interventions influence the costs of advanced cancer and to describe the costs explored and models used in cost-effectiveness studies., Method: According to the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), Pubmed, Web of Science, NHS, EconLit and Google Scholar databases were screened from 11/01/2020 to 03/01/2024. All types of methods about the costs of the palliative phase of solid cancer were accepted. Study characteristics, economic perspective, time horizon and the type of costs explored were collected., Results: Of the 498 studies identified, 66 were included in the final analysis. Most (60%) used a retrospective methodology. Almost all (65, 98%) studied direct costs, and only 12 (18%) studied indirect costs. No article assessed intangible costs or the total cost of the palliative phase of cancer. The payer's perspective was most commonly adopted (39, 59%). The time horizon was less than 6 months in most cases (41, 63%). Eighteen studies (86%) highlighted that PC interventions were cost-effective., Conclusion: Existing evidence suggests that palliative care is cost-effective from the hospital and payer's perspective. More research is needed to evaluate the cost of informal caregiving and out-of-pocket expenses borne by patients., Competing Interests: Declarations. Ethics approval: This is a systematic review, no ethical approval is needed. Consent to participate: This is a systematic review, no consent to participate is needed. Consent for publication: This is a systematic review, no consent to publish is needed. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Blebs significantly increase rupture risk of intracranial aneurysms. Radiomic analysis offers a robust characterization of the aneurysm wall. However, the unique radiomic profile of various compartments, including blebs, remains unexplored. Likewise, the correlation between these imaging markers and fluid/mechanical metrics is yet to be investigated. To address this, we analyzed the radiomic features (RFs) of bleb-containing aneurysms and their relationship with wall tension and shear stress metrics, aiming to enhance risk assessment., Methods: Aneurysms were imaged using high-resolution magnetic resonance imaging (MRI). A T1 and a T1 after contrast (T1+Gd) sequences were acquired. 3D models of aneurysm bodies and blebs were generated, and RFs were extracted. Aneurysms with and without blebs were matched based on location and size for analysis. Univariate regression models and Spearman's correlations were used to establish associations between bleb-dependent RFs and mechanical/fluid dynamics metrics., Results: Eighteen aneurysms with blebs were identified. Fifty-five RFs were significantly different between blebs and body within the same aneurysms. Of these RFs, 9% (5/55) were first-order, and 91% (50/55) were second-order features. After aneurysms with and without blebs were matched for location and size, five RFs 5% (5/93) were significantly different. Forty-one out of the 55 RFs different between bleb and body sac of the primary aneurysm were moderately and strongly correlated with mechanical and fluid dynamics metrics., Conclusion: Aneurysm blebs exhibit distinct radiomic profiles compared with the main body of the aneurysm sac. The variability in bleb wall characteristics may arise from differing mechanical stresses and localized hemodynamics. Leveraging radiomic profiling could help identify regions with a heightened risk of rupture., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Considering the limitations of monotherapies due to chemoresistance and side effects, this research aimed to determine whether low doses of sulforaphane (SFN) combined with docetaxel (DCT) could enhance therapeutic efficacy. Prostate cancer cell lines LNCaP and PC-3 were treated with individual IC50 doses of SFN and DCT and half-reduced IC50 values for the SFN:DCT combination. Metabolic markers, including glucose consumption, lactate production, reactive oxygen species (ROS), mitochondrial mass, and caspase activity, were assessed. In LNCaP cells, the SFN:DCT combination reduced cell viability to 50%, comparable to DCT monotherapy (48%). Caspase 3 activation was also higher with SFN:DCT (2.4 ± 0.75 RFU) than DCT alone (2.1 ± 0.47 RFU), while caspase 8 activation remained comparable, indicating equivalent effectiveness at lower concentrations. In PC-3 cells, the combination induced caspase 3 activation (1.16 ± 0.0484 RFU) at levels slightly lower than DCT (1.51 ± 0.2062 RFU) but achieved greater reductions in mitochondrial mass, reflecting its ability to target metabolic vulnerabilities in aggressive phenotypes. Our findings suggest that the SFN:DCT combination is a promising strategy for early-stage prostate cancer. By achieving comparable efficacy to DCT monotherapy at low doses, the SFN:DCT combination maintains the therapeutic impact, mitigating the adverse effects of conventional DCT treatment.

Immune cells express a variety of ion channels and transporters in the plasma membrane and intracellular organelles, responsible of the transference of charged ions across hydrophobic lipid membrane barriers. The correct regulation of ion transport ensures proper immune cell function, activation, proliferation, and cell death. Cystic fibrosis (CF) is a genetic disease in which the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) chloride channel gene is defective, consequently, the CFTR protein is dysfunctional, and the chloride efflux in CF cells is markedly impaired. Cystic fibrosis is characterized by chronic inflammation in the airways, mainly triggered by neutrophilic infiltration and recurring bacterial infections, causing the decline of lung function and eventually respiratory failure. Novel modulator-based therapies have improved lung function in people with Cystic Fibrosis (pwCF) by increasing expression and function of CFTR in the plasma membrane of lung cells, however, the effects of these drugs in the lung recruited inflammatory cells, specifically neutrophils, remains unknown. Given the complex biology of neutrophils and their short lifespan, we aimed to develop a fluorometric method to evaluate CFTR-mediated chloride transport in human neutrophils by using flow cytometry and the intracellular chloride-binding MQAE dye. Our results show that CFTR-mediated chloride transport in human neutrophils or human neutrophil-like cell lines can be consistently evaluated in vitro by this methodology. Additionally, this assay measured increased chloride efflux in neutrophils collected from pwCF under modulator therapy, as compared to healthy donors, indicating this method can evaluate restoration of CFTR-mediated chloride transport in CF neutrophils., (© The Author(s) 2025. Published by Oxford University Press on behalf of Society for Leukocyte Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

After horseshoe kidney, crossed renal ectopia (CRE) is the most common fusion anomaly of the kidney, with an incidence of 1:7000 autopsies. Most frequently the left kidney is the crossed ectopic component. In this article we present the first case of retroperitoneoscopic resection of a CRE and left ectopic multicystic dysplastic kidney with severely dilated ureter., Competing Interests: None., (© 2025 The Authors.)

Biofilms are ubiquitous surface-associated bacterial communities embedded in an extracellular matrix. It is commonly assumed that biofilm cells are glued together by the matrix; however, how the specific biochemistry of matrix components affects the cell-matrix interactions and how these interactions vary during biofilm growth remain unclear. Here, we investigate cell-matrix interactions in Vibrio cholerae, the causative agent of cholera. We combine genetics, microscopy, simulations, and biochemical analyses to show that V. cholerae cells are not attracted to the main matrix component (Vibrio polysaccharide, VPS), but can be attached to each other and to the VPS network through surface-associated VPS and crosslinks formed by the protein Bap1. Downregulation of VPS production and surface trimming by the polysaccharide lyase RbmB cause surface remodeling as biofilms age, shifting the nature of cell-matrix interactions from attractive to repulsive and facilitating cell dispersal as aggregated groups. Our results shed light on the dynamics of diverse cell-matrix interactions as drivers of biofilm development., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Vitiligo is an autoimmune disorder that causes melanocyte damage and pigment loss. The clinical presentation of vitiligo consists of patchy areas of lighter skin and results from a loss of functioning melanocytes and may be more visible in darker skin toned patients. Vitiligo affects approximately 2 percent of children and adolescents in the United States, with half of the affected cases undiagnosed. Pediatric patients are at a high risk of experiencing psychosocial adverse events such as depression and anxiety if the vitiligo is not quickly or effectively treated due primarily to the visual presentation of the disease. These adverse events may be seen especially in patients with a darker skin tone. Treatments for pediatric vitiligo in the past has usually included phototherapy, topical corticosteroids, vitamin D and calcineurin inhibitors; topical ruxolitinib has been approved more recently for nonsegmental vitiligo in patients 12 years of age and older. In cases where disease is recalcitrant, the need for additional therapies is warranted. Roflumilast cream 0.3% is a highly selective, non-steroidal and potent topical phosphodiesterase 4 inhibitor approved in 2022 by the United States Food and Drug Administration for the treatment of psoriasis, in 2023 as a foam for the treatment of seborrheic dermatitis and in 2024, roflumilast cream 0.15% was approved for the treatment of atopic dermatitis, including in children down to six years of age. Topical roflumilast is well tolerated with a favorable safety profile among pediatric dermatology populations. We describe four cases of pediatric skin of color patients with facial vitiligo that were refractory to topical corticosteroids, ruxolitinib and phototherapy. All patients were started on roflumilast cream 0.3% once daily and demonstrated improvement in repigmentation., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2025. Matrix Medical Communications. All rights reserved.)

Icelandic native ecosystems and soils have been severely degraded since settlement in the 9th century. Today, barren landscapes occupy about 45 % of the land surface and only 1.5 % is covered by native birch woodlands versus 20-40 % in pre-settlement times. Iceland's soils are mainly Andisols, among the most carbon-rich soil orders owing to their unique colloidal characteristics. Hence, there is tremendous potential to sequester soil carbon in degraded soils through revegetation activities. The restoration of birch woodlands is considered a national priority, which may significantly impact the nation's carbon budget. The objective of this study was to determine soil carbon concentrations and stocks across chronosequences (0 to 60+ years) of birch woodlands under diverse geographical conditions comprised of ten study areas across Iceland. The highest carbon stocks were found in old birch woodlands with a mean of 7.4 kg C m -2 in the top 30 cm soils, which is unusually high compared to other Nordic deciduous woodlands. We attribute this to andic soil properties that effectively stabilize and sequester soil organic matter. Calculated soil carbon accumulation rates were 0.01 kg m -2  yr -1 for the first 30 years of birch woodland establishment and 0.04-0.07 kg m -2  yr -1 in mature woodlands (30-60 years old). These accumulation rates, if applied to large-scale birch woodland restoration plans, would amount to 20 % of the current total CO 2 emissions of Iceland (not counting LULUCF). Importantly, we found a significant impact of dust deposition (up to 1 mm yr -1 ) on soil carbon stocks, contributing to carbon burial (∼26 g m -2  yr -1 ) in areas close to dust hotspots. Birch restoration further stabilizes soils from erosion and the above-ground biomass serves as an efficient dust collector. This study documents the potential of birch restoration as a highly effective strategy to address soil degradation and promote soil carbon sequestration across Iceland., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Asa L. Aradottir, Olafur Arnalds, and others reports financial support was provided by The Icelandic Centre for Research. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)