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[Display omitted] Doxorubicin (DOX) is a vital anthracycline chemotherapeutic drug, yet presenting significant challenges due to its severe cardiotoxicity. While Doxil enhances the pharmacokinetics and reduces the cardiotoxicity of DOX solution (DOX sol), it shows limitations of low drug loading capacity and inadequate cellular uptake. To overcome these issues, this study developed a novel disulfide bond-linked DOX-maleimide prodrug (DSSM). DSSM could self-assemble into nanoparticles (NPs) with a high drug loading capacity (58.89 %, w/w). DSSM could rapidly bind to endogenous albumin through the maleimide group. Compared to DOX sol, DSSM had increased area under the curve (AUC) by approximately 60-fold, and similarly, quadrupled tumor accumulation after 4 h of administration, achieving efficient tumor targeting. With only 5 % DSPE-mPEG 2K , the cellular uptake of DSSM NPs was better than Doxil. Furthermore, the high reduction sensitivity of the disulfide bond enabled bio-activation of DSSM at the tumor site, while maintaining stability in normal cells. Compared with DOX sol and Doxil, DSSM NPs significantly improved safety and demonstrated better anti-tumor effect at tolerated doses. Our findings present a promising strategy for achieving effective tumor targeting and bio-activation, addressing key limitations of current DOX nanoformulations. [ABSTRACT FROM AUTHOR]

BACKGROUND RESULTS CONCLUSION Nitrogen application is recognized as a principal factor influencing rice quality. However, there remains a paucity of research on the effects of different N levels on quality, particularly within the context of the improvement of rice varieties.This study examined 14 mid‐season japonica rice varieties cultivated in Jiangsu province over the past 80 years under five N application levels (0, 90, 180, 270, and 360 kg N ha−1). The results showed that yield increased steadily as varieties improved at all N levels. For varieties from the 1950s to the 1990s, yields initially rose and then declined as N application rates increased, peaking at 270 kg N ha−1. In contrast, modern varieties (post‐2000) exhibited a consistent increase in yield with higher N application rates. Fitted equations indicated that maximum yields were achieved at optimal N levels of 237–278 kg N ha−1 for varieties from the 1950s–1990s and 229.25 kg N ha−1 for post‐2000 varieties.As varieties improved, the content of brown, milled, and head milled rice, as well as albumen, gluten, and overall quality, increased. Conversely, chalkiness, protein content, gliadin and amylose content decreased, whereas gel consistency, breakdown, peak viscosity, and globulin showed no consistent pattern. Likewise, there was no consistent pattern in the tendency of starch to retrograde (as indicated by ‘setback’ values). Increasing N application rates enhanced the content of brown and milled rice, chalkiness, protein and its components, and the tendency of starch to retrograde (indicated by higher setback values). In contrast, amylose content, gel consistency, breakdown, peak viscosity, and overall taste quality declined with higher N levels.The study compared rice varieties with high yields (exceeding 10 t ha−1) and good comprehensive taste scores (above 52), revealing that modern varieties Wuyunjing 24, Lianjing 7, Yanjing 4038, and Nanjing 9108 performed exceptionally well with 180 kg N ha−1 and 270 kg N ha−1.Modern varieties, with optimal N application and management, can achieve both high yield and good quality effectively. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Background: Cisplatin binds to serum albumin in the body at a rate of 90%, and high levels of free cisplatin are a significant cause of its nephrotoxicity. Therefore, hypoalbuminemia theoretically poses a significant risk factor for cisplatin-induced acute kidney injury (CIA) and can be easily corrected. However, existing research results are inconsistent. Our aim is to confirm the association between hypoalbuminemia and CIA through a meta-analysis and a dual-center real-world data study. Methods: First, we used a random-effects meta-analysis to summarize the odds ratio (OR) of the risk relationship between hypoalbuminemia and CIA. Then, we conducted a retrospective analysis of patients using cisplatin from Xiangya Third Hospital of Central South University (2014–2023) and Hunan Cancer Hospital (2019–2023) to analyze the relationship between hypoalbuminemia and CIA. Results: The meta-analysis, which included six studies involving 4,359 cases, showed that hypoalbuminemia is associated with an increased risk of CIA (OR, 2.13; 95% CI, 1.37–3.32). A total of 5,452 and 25,214 patients from Xiangya Third Hospital and Hunan Cancer Hospital, respectively, were included. Both centers found a significant association between hypoalbuminemia and an increased risk of CIA (OR, 2.76; 95% CI, 1.94–3.93; OR, 2.88; 95% CI, 2.17–3.81), and the sensitivity analysis results were consistent. Conclusion: Through meta-analysis and dual-center real-world data studies, we confirmed that hypoalbuminemia is an independent risk factor for CIA. Therefore, it is recommended that patients using cisplatin undergo serum albumin level testing and regular monitoring during treatment. Actively adjusting albumin levels may reduce the risk of CIA. [ABSTRACT FROM AUTHOR]

Introduction: In China, an increasing number of patients with end-stage renal disease are undergoing hemodialysis treatment. While this treatment yields relatively positive outcomes, the prevalence of cognitive impairment in patients receiving maintenance hemodialysis ranges from 24 to 80%, which is significantly higher than the general population. Method: In this retrospective study, a total of 120 patients with kidney disease undergoing maintenance hemodialysis (MHD) were enrolled. The cognitive status of these patients was assessed using the C-MoCA score, which allowed categorization into two groups: the no cognitive impairment (NCI) group and the cognitive impairment (CI) group. Relevant clinical data, laboratory test results, as well as HIF-1α levels, were collected and analyzed to determine their relationship with the cognitive status of the patients. Results: In this study, a total of 45 patients (37.5%) developed CI, and their C-MoCA scores were significantly lower (21.6 ± 2.43) compared to patients in the NCI group (27.56 ± 1.48) (P < 0.001). The CI group was characterized by older age, lower levels of education, as well as lower levels of serum total bilirubin, serum total protein (TP), albumin, serum creatinine, and serum phosphorus in comparison to the NCI group. Additionally, CI patients exhibited higher levels of HIF-1α, received fewer monthly hemodiafiltration or hemoperfusion treatments, and had a lower rate of rosacastat treatment. Furthermore, univariate and multivariate logistic regression analyses demonstrated that older age (OR = 11.266 [95% CI: 2.775–45.747], P = 0.001) and higher HIF-1α (OR = 20.654 [4.831–88.298], P < 0.001) increased the risk of developing CI, while higher educational attainment reduced the risk of developing CI (> 12 years, OR = 0.004 [95% CI: 0.016–0.619], P ≤0.001; 6–12 years, OR = 0.099 [95% CI: 0.000–0.049], P = 0.013). Discussion: Cognitive impairment in patients undergoing maintenance hemodialysis (MHD) was found to be associated with older age, lower level of education, and higher HIF-1α levels. These factors should be taken into consideration by clinicians to monitor the cognitive status of MHD patients. [ABSTRACT FROM AUTHOR]

Background: The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS. Methods: In this single-center retrospective study, we enrolled 105 patients with influenza A virus pneumonia into the study and divided the patients into an ARDS group (74 patients) and a non-ARDS group (31 patients) during hospitalization. Clinical characteristics and laboratory data were collected within 24 h after admission. We explored the risk factors for ARDS using logistic regression analysis. The predictive performance of potential risk factors for ARDS and ARDS-associated complications were evaluated by receiver operating characteristic (ROC) curves, and Pearson's correlation analysis was used to evaluate the correlations between risk factors and clinical and laboratory variables. Results: LAR was an independent predictor for the development of ARDS in patients with influenza A virus pneumonia and was significantly predictive for ARDS. LAR's area under the curve (AUC) was higher than that of lactate and albumin alone; its AUC was 0.878, with a sensitivity of 71.6% and a specificity of 96.8%. The optimal ROC threshold for distinguishing ARDS from non-ARDS cases was 44.81 × 10− 3. Correlation analysis indicated that LAR was positively associated with duration of invasive ventilation, and APACHE II and SOFA scores in ARDS patients but was negatively associated with PaO2/FiO2 (p < 0.001). Subsequent ROC curve analysis determined that LAR was a robust predictor for the 14-day invasive ventilation (AUC = 0.924), septic shock (AUC = 0.860), and hepatic injury (AUC = 0.905) in hospitalized ARDS patients. It also showed a promising predictive value for 28-day mortality (AUC = 0.881). Conclusion: LAR strongly predicted ARDS development in patients with influenza A virus pneumonia. It showed a significant correlation with disease severity and provided promising predictive efficiency for extrapulmonary complications and 28-day mortality in patients with influenza A virus-induced ARDS. [ABSTRACT FROM AUTHOR]

The orthalicoidean genus Kora Simone, 2012 is reviewed. Three of the four known species are redescribed, including their anatomy. These species are K. corallina (the type species), K. nigra, and K. rupestris. Eight new species are introduced, all of which occur in the region of the São Francisco River, from the northern of Minas Gerais to the southern of Bahia, Brazil. They are K. tupan, K. ajar, K. aetheria, K. jimenezi, K. uhlei, K. kremerorum, K. vania, and K. curumim. All of them are described, including anatomical features, except the last three, which are based solely on shell characters. Another related genus is also described, Koltrora, with a single new species, K. pyrostoma. They are compared to an Andean genus, Neopetraeus (N. lobbii, N. tesselatus), which also exhibit similarities. This detailed phenotypic study was performed in several comparative ways, including a morphological phylogenetic approach, using other orthalicoideans with the same level of phenotypic details known. The single objective is to justify the current taxonomic scheme, and to provide a brief comparison with recent results based on molecular approaches. According to these preliminary results, the triad Neopetraeus-Koltrora-Kora is monophyletic, supported by 10 synapomorphies. Koltrora and Kora are sister taxa, supported by 11 synapomorphies. Kora is monophyletic, with strong support from 25 synapomorphies. Discussions on classification, phylogeny, anatomy, and comparison with other recent orthalicoidean literature are also included. Some newly identified and diagnostic structures are described, such as the odontophore pair of muscles m8, the accessory albumen chamber, a different kind of spermatophore, the exclusive kind of radula of Kora and Koltrora, and a calcified epiphragm, a rare feature in South American snails. Register ZooBank: urn:lsid:zoobank.org:pub:2F13D53C-0A36-42FB-B936-D80E7C958259. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The aim is to contrast the serum levels of thiol‐disulfide homeostasis and ischemic modified albumin between patients with leiomyoma and healthy individuals and to assess the impact of oxidative stress on the etiopathogenesis of leiomyoma.In this prospective case‐control study, a total of 154 participants were included, consisting of 77 cases diagnosed with leiomyoma and 77 healthy individuals without leiomyoma. The demographic characteristics and ultrasonographic findings of the participants were recorded, and parameters such as albumin, ischemia‐modified albumin, and thiol‐disulfide homeostasis were evaluated. The results obtained from the analyses were compared between the two groups.No significant differences were observed in the demographic characteristics between the groups. A significant difference was observed between the leiomyoma and control groups regarding serum albumin parameters, serum ischemic modified albumin, and serum dynamic thiol‐disulfide parameters (P < 0.001). No significant difference was found in the ratios of disulfide/total thiol, disulfide/native thiol, native thiol/total thiol (P > 0.05).There was a notable contrast in the levels of albumin, ischemic modified albumin, albumin/ischemic modified albumin ratio, total thiol, native thiol, and disulfide between individuals with uterine leiomyomas and healthy individuals in the control group. Oxidative stress is believed to play a causative role in the etiopathogenesis of uterine leiomyomas. [ABSTRACT FROM AUTHOR]

Background: Prior studies have established that macroaggregated albumin (MAA)-SPECT/CT offers more robust lung shunt fraction (LSF) and lung mean absorbed dose (LMD) estimates in 90Y radioembolization in comparison to planar imaging. However, incomplete SPECT/CT coverage of the lungs is common due to clinical workflows, complicating its potential use for LSF and LMD calculations. In this work, lung truncation in MAA-SPECT/CT was addressed via correction strategies to improve 90Y treatment planning. Methods: Lung truncation was simulated in 56 cases with adequate (> 90%, mean: 98%) lung coverage in MAA-SPECT/CT by removing slices in ~ 5 mm increments from the lung apices to the diaphragm. A wide range of lung coverages from 100% to < 1% in ~ 2% increments were created. LSF and LMD were calculated with four methods. (1) 2D planar imaging standard (not truncated), truncated lung SPECT/CT data was: (2) used with no corrections (SPECTTrunc), (3) uniformly extrapolated to full lung coverage (SPECTUniform), (4) fit with an empirical model to predict lung counts at full lung coverage (SPECTFit). To determine counts for LSF, full lung volumes, those modified at the lung/liver boundary (Lungs 2-cm), and those isolated to the left lung (Left Lung) were used. The correction methods were then applied to 31 independent cases without full lung coverage (< 90%, mean: 74%). The variations in LSF and LMD estimates from each correction method were analyzed. Results: Averaged across simulated lung coverages from 40 to 80%, percent errors relative to non-truncated data for SPECTTrunc were (mean ± σ) − 22% ± 15% for LSF and 34% ± 29% for LMD. SPECTUniform had similar errors with 29% ± 26% for both LSF and LMD. SPECTFit yielded the most accurate and precise estimates for LSF and LMD, with errors of 11% ± 20% for both. The Left Lung approach equalized LMD errors in all three correction methods, with percent errors of 3% ± 17% (SPECTTrunc), 2% ± 17% (SPECTUniform), and 4% ± 13% (SPECTFit). In the 31 cases without ground truth LSF or LMD, Left Lung produced highly comparable LMD estimates, with a mean (max) coefficient of variation across the three correction methods of 4% (20%). Conclusion: LSF and LMD can be estimated for 90Y radioembolization using truncated lung coverage data in MAA-SPECT/CT. Empirical models to predict lung counts at full lung coverage produced LSF and LMD estimates with minimal bias and uncertainty. With lung/liver boundary adjustments, all SPECT/CT methods assessed in this work yielded LMD estimates comparable to ground truth, even down to 50% lung coverage. [ABSTRACT FROM AUTHOR]

Background: Patellar fractures are a common knee injury among elderly patients, with a high risk of developing surgical site infections (SSI) postoperatively, which severely affects patient prognosis and quality of life. Elderly patients are more susceptible to SSI due to various factors such as decreased immune function and chronic diseases. Therefore, identifying the risk factors for SSI is of great clinical significance for prevention. Objective: This study aims to analyze the risk factors for postoperative SSI in elderly patients with patellar fractures, providing a basis for developing more effective clinical prevention and treatment strategies. Methods: This retrospective study collected data from 856 elderly patients who underwent patellar fracture surgery at Baoding First Central Hospital between January 2017 and December 2023. Patients were divided into SSI and non-SSI groups based on the occurrence of SSI, and their demographic data, comorbidities, and laboratory results were analyzed. Logistic regression was used to identify independent risk factors for SSI, and ROC curve analysis was conducted to determine the optimal cutoff point for predictive indicators. Results: The incidence of SSI was found to be 2.1%. Univariate analysis showed that BMI, surgical delay, diabetes, hematocrit (HCT), and albumin (ALB) were significantly associated with SSI. Logistic regression analysis further confirmed that BMI (p = 0.043), surgical delay (p = 0.000), HCT (p = 0.038), ALB (p = 0.015), and diabetes (p = 0.022) were independent risk factors for SSI. ROC curve analysis indicated that the optimal cutoff points for BMI, HCT, and ALB were 25.39 kg/m2, 35.62%, and 39.3 g/L, respectively, with an AUC of 0.794 for the combined predictive indicators. Conclusion: High BMI, surgical delay, diabetes, low HCT, and low ALB are independent risk factors for postoperative SSI in elderly patients with patellar fractures. Preoperative management targeting these high-risk factors, such as optimizing patient weight, controlling diabetes, and improving nutritional status, can effectively reduce the incidence of SSI and improve postoperative outcomes. Future multicenter studies may further validate these findings and provide additional prevention strategies. [ABSTRACT FROM AUTHOR]

Exercise‐induced muscle damage (EIMD) can affect athlete performance and is a risk factor for major muscle injury. The temporal profile of thiol‐oxidized albumin, a marker of oxidative stress, has shown potential in assessing recovery from EIMD in non‐athletically trained participants but not yet in trained participants. Our primary aim was to assess whether there are changes in the level of thiol‐oxidized albumin after a marathon in athletically trained participants. Twenty participants completed a marathon and collected daily dried blood spots from 3 days prior to and 7 days after the marathon to measure thiol‐oxidized albumin using a novel methodology (OxiDx). Participants were also assessed for indirect markers of EIMD prior to and on days 2 and 5 post‐marathon. The level of thiol‐oxidized albumin peaked at 2 days and remained elevated until 5 days after the marathon and correlated with indirect measures of EIMD. Furthermore, time of recovery for thiol‐oxidized albumin varied between participants, some recovered at 3 days post‐marathon whereas others extended beyond 7 days post marathon. Tracking temporal changes in the level of thiol‐oxidized albumin has potential to be useful in managing recovery from EIMD in athletes, particularly considering the ease of the OxiDx methodology. [ABSTRACT FROM AUTHOR]

Nine manganese(II) complexes with a series of non-steroidal anti-inflammatory drugs (namely sodium diclofenac, diflunisal, flufenamic acid, sodium meclofenamate, mefenamic acid, and tolfenamic acid) were prepared in the presence of diverse nitrogen donors, i.e., pyridine, 1,10–phenanthroline, 2,2′–bipyridine and neocuproine, as co-ligands and were characterized with spectroscopic techniques and single-crystal X-ray crystallography. The biological profile of the resultant complexes was investigated regarding their antioxidant potency and their interaction with DNA and serum albumins. The complexes interact with calf–thymus DNA in an intercalative mode and bind tightly and reversibly to human and bovine serum albumins studied. In order to assess the antioxidant activity of the Mn(II) complexes, their ability to scavenge 2,2′–azinobis(3–ethylbenzothiazoline–6–sulfonic acid) free radicals was monitored. [ABSTRACT FROM AUTHOR]

Simple Summary: Hepatocellular carcinoma (HCC) remains a significant clinical challenge, with limited progress in reducing recurrence rates and improving patient survival. Selecting appropriate treatment modalities for HCC requires careful consideration of the risks and benefits associated with each option. In this study, we investigated factors influencing recurrence and prognosis in treatment-naïve patients with HCC undergoing radiofrequency ablation (RFA). Our analysis identified age, Child–Turcotte–Pugh class B, and the albumin–bilirubin (ALBI) grade as independent predictors of tumor recurrence. Additionally, the ALBI grade emerged as the sole significant predictor of overall survival. These findings emphasize the importance of incorporating the ALBI grade into the decision-making process to optimize treatment outcomes for patients with HCC undergoing RFA. Background/Objectives: Radiofrequency ablation (RFA) is an important local treatment for hepatocellular carcinoma (HCC). This study aimed to evaluate the characteristics of tumor recurrence after RFA and analyze predictors of tumor recurrence and survival in patients with HCC. Methods: We retrospectively reviewed data from treatment-naïve patients with HCC who underwent RFA for HCC treatment between 2008 and 2017 at four tertiary hospitals in South Korea. Results: A total of 636 patients with HCC treated with RFA were enrolled in the study. The mean age was 66.3 ± 10.4 years, with 75.0% of patients being male. Most patients (96.7%) had underlying liver cirrhosis, and viral hepatitis (types B and C) accounted for most cases. The average maximum tumor size was 2.2 ± 0.9 cm, with 84.3% of tumors being single lesions. During the follow-up period, 331 patients experienced recurrence, with 95.5% of cases being intrahepatic and one-fifth occurring at the RFA site. Most patients underwent RFA or transarterial chemoembolization as subsequent therapy for recurrence. Multivariate analysis revealed that age, the albumin–bilirubin (ALBI) grade, and Child–Pugh class B status were independent factors associated with tumor recurrence. Only the ALBI grade was significantly associated with mortality. Additionally, the ALBI grade differentiated between recurrence-free survival and overall survival in the Kaplan–Meier survival curve. Conclusions: The ALBI grade was independently associated with tumor recurrence and prognosis in patients with HCC following RFA. This grading system can help clinicians identify high-risk patients, optimize treatment strategies, and enhance patient care. [ABSTRACT FROM AUTHOR]

The study aims to synthesize benzamide derivatives of p‐aminophenol (PAP) by reacting with 4‐benzoyl chloride. The reaction of PAP yields four derivatives: P‐1 [N‐(4‐hydroxyphenyl)benzamide], P‐2 [4ˊ‐bromo‐N‐(4‐hydroxyphenyl)benzamide], P‐3 [4ˊ‐nitro‐N‐(4‐hydroxyphenyl)benzamide] and P‐4 [3ˊ,5ˊ‐dintro‐N‐(4‐hydroxyphenyl)benzamide] and evaluation of biological activity. PAP derivatives hot plate analgesic test produced a significant analgesic effect. The higher analgesic activities were observed at 60 min for all derivatives P‐1, P‐2, P‐3, and P‐4 at 47.65, 48.13, 47.08, and 45.47%, respectively. Derivatives of PAP were also shown to have statistically significant (p < 0.001) analgesic efficacy in the writhing test. The maximum percent inhibition of the writhing by P‐2 (82.11%). In vivo anti‐inflammatory examination confirmed that P‐1, P‐2, and P‐4 prevented carrageenan‐induced rat paw edema for 60–240 min. The toxicity of PAP derivatives P‐1 and P‐4 was lower than paracetamol. Experiments demonstrate that derivatives exhibit less cytotoxicity. The compounds P‐3 and P‐4 inhibited egg and bovine albumin denaturation better at lower dosages in anti‐inflammatory experiments. Molecular docking and ADMET showed that derivatives might inhibit COX‐1 and COX‐2. Also, P‐4 demonstrated the highest binding affinity (−8.2 kcal/mol) for COX‐1 and P‐1 (−8.4 kcal/mol) for COX‐2. According to computational and experimental studies, PAP derivatives may inhibit cyclooxygenase to relieve pain, inflammation, and fever. [ABSTRACT FROM AUTHOR]

Aims: This work aimed to analyse retrospective data on hypotension incidence and associated factors among patients requiring continuous renal replacement therapy. Background: The incidence and risk factors of continuous renal replacement therapy‐related hypotension have not been adequately explored. Design: The study was designed as a retrospective analysis. Methods: Patients who required continuous renal replacement therapy in the ICU between January 2017 and June 2021 were reviewed. The multivariate logistic regression model was used to determine the associated factors of hypotension. Results: Hypotension occurred in 242 out of 885 circuits (27.3%) among 140 patients. The logistic regression analysis identified seven factors associated with the occurrence of hypotension during CRRT: serum albumin (OR = 0.969, 95%CI: 0.934–0.999), serum calcium (OR = 0.514, 95%CI: 0.345–0.905), CO2CP (OR = 0.933, 95%CI: 0.897–0.971), use of vasopressors (OR = 5.731, 95%CI: 4.023–8.165), hypotension before CRRT initiation (OR = 2.779, 95%CI:1.238–6.242), age (OR = 1.016, 95%CI: 1.005–1.027), and fluid removal rate (OR = 1.002, 95%CI: 1.001–1.003). Conclusions: Hypotension frequently occurs in patients receiving continuous renal replacement therapy, especially in the early stages. Multiple factors can be associated with cardiac output or peripheral resistance changes, including excessive ultrafiltration, vasopressors, serum albumin and serum calcium levels, and carbon dioxide combining power. Summary statement: What is already known about this topic Continuous renal replacement therapy (CRRT) has been widely used in intensive care units for patients with acute kidney injury sepsis, acute pancreatitis, severe electrolyte and metabolic disturbances.Hypotension during CRRT has been reported as one of the most common adverse events.The incidence and risk factors of CRRT‐associated hypotension have not been adequately explored. What this paper adds? Despite its reputation as the dialysis modality with better haemodynamic tolerance, hypotension frequently occurs in patients receiving CRRT, and at any time during the treatment, especially in the early stage.Multiple factors leading to cardiac output or peripheral resistance changes can be linked with hypotension during CRRT include excessive ultrafiltration, vasopressor use, serum albumin and serum calcium level, and carbon dioxide combining power. The implications of this paper: It might not always be an appropriate response to lower the ultrafiltration rate for preventing hypotension during CRRT.There remains a lack of evidence in critically ill patients for CRRT‐related interventions to limit the occurrence of hypotension. [ABSTRACT FROM AUTHOR]

Background and Aims: Little is known about the ability of serological biomarkers to monitor clinical outcomes in patients with Guillain‐Barré syndrome (GBS). The objective of this study was to determine the associations of liver function, easily available and convenient biomarkers, with the clinical course and outcome of severe GBS in patients. Methods: A prospective data collection was conducted in a cohort of 343 GBS patients from multi‐centers between September 2019 and December 2023. Serum samples were obtained at four‐time points for mechanical ventilation (MV) patients and two‐time points for non‐MV patients. The primary endpoint was the need for MV during hospitalization, while secondary outcomes included the ability to walk independently and the mortality at 26‐week follow‐up. Results: (i) A total of 208 patients were eligible, of whom 50 required MV with a median (interquartile range) ventilation duration of 15 (8–27) days. (ii) Hypohepatia, as evidenced by reduced total protein (OR 0.913 [95% CI 0.862–0.967]) and albumin (0.775 [0.679–0.884]) 1 week after treatment, along with raised liver enzymes (2.732 [1.007–7.413]), was associated with the risk of MV after adjusting for confounders. (iii) After 26‐week follow‐up, patients with hypohepatia were less likely to regain independent walking and exhibited higher mortality in survival analysis (all log‐rank p <.05). (iv) In a cross‐sectional study spanning up to 4 years of follow‐up, patients with prolonged MV (≥15 days) experienced a longer time to regain independent ambulation than those with shorter MV (167 [46–316] vs. 69 [24–106], p =.036). However, no relationships between liver function and prolonged MV were revealed. Interpretation: Dynamically monitoring hepatic metabolism and promptly adjusting, it can aid the improvement of GBS in patients. [ABSTRACT FROM AUTHOR]

The current study evaluates the effect of sequential hydrolysis on degree of hydrolysis and antioxidant activity of Chachafruto (Erythrina edulis) storage proteins hydrolysates, which is an endemic South American legume. Besides, sequential enzymatic hydrolysis of Chachafruto, storage proteins was studied to determine the type of protein and combination of proteases that would produce hydrolysates with the highest in vitro antioxidant activity. In order to obtain each of the storage proteins of Chachafruto separately, sequential extraction was carried out. A 500 mL reactor with a magnetic stirrer at 960 rpm was used, which were controlled by means of an automatic titrator. The reaction was monitored through the degree of hydrolysis, calculated by the pH-stat method. First, each enzyme as single enzyme was used in hydrolysis process, then Flavourzyme followed by Alcalase 2.4L® and Neutrase followed by Alcalase 2.4L® were used to produce hydrolysates from albumins, globulins and glutelins from Chachafruto. Antioxidant activity was evaluated in each hydrolysate by oxygen radical antioxidant capacity (ORAC), 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2' -azino-bis(3-ethylbenzothiazoline)-6-sulfonic acid (ABTS) methods. The results showed that Chachafruto seeds flour have above 20% of protein, which contain 46.36%, 11.39%, 42.01% and 0.23%, of albumins, globulins, glutelins, and prolamins, respectively. Besides, it is possible to increase the degree of hydrolysis and antioxidant activity by sequentially using Flavourzyme-Alcalase and Neutrase-Alcalase, compared to hydrolysis with a single enzyme, for all storage protein evaluated. Among the storage proteins from Chachafruto, the albumins hydrolyzed showed the highest antioxidants. Both, Neutrase-Alcalase and Flavourzyme-Alcalase hydrolysates showed antioxidant activity, being Flavourzyme-Alcalase combination which showing the higher antioxidant activity. In conclusion, Chachafruto seed can produce a flour with high protein contained, which storage protein are potential source for functionals compound with antioxidant activity, when are subjected to enzymatic hydrolysis by Alcalase, Flavourzyme and Neutrase enzymes, either as single and sequential enzymatic hydrolysis process. [ABSTRACT FROM AUTHOR]

Background: An ideal glucose-lowering drug is expected to not only improve glycemic control, but also have positive effects on weight, blood pressure, dyslipidemia, and also cardiovascular and renal outcomes. Objective: To investigate and compare the impact of Sodium-glucose transport protein 2 (SGLT2) inhibitors on glycemic and extraglycemic laboratory parameters and the parameters which affect this impact. Methods: This retrospective study was conducted between January 2022 and December 2022. A total of 250 patients diagnosed with type 2 diabetes mellitus (T2DM) using SGLT2i were included in the study. Results: Patients had a mean age of 55.4 ± 9.6, and 53.6% (n = 134) were male. Among the patients, 19.6% (n = 49) used dapagliflozin and 80.4% (n = 201) used empagliflozin. Glucose, HbA1c, and triglyceride levels at 3 and 6 months showed significant reductions compared to baseline, while serum sodium and HDL-C levels showed significant increases (p < 0.001). Additionally, creatinine and serum potassium levels at 6 months were significantly higher than baseline, while LDL-C and urine albumin-to-creatinine ratio levels were significantly lower. Empagliflozin users exhibited significantly higher creatinine levels only at 3. months, higher serum sodium levels only at 6. months, and lower HbA1c levels only at 6. months compared to dapagliflozin users. Conclusion: While SGLT2i seem to provide positive effects on the lipid profile, as well as their well-recognized effects on glycemic parameters, there may be value in further evaluating renal safety and the long-term alterations in lipid profile. [ABSTRACT FROM AUTHOR]

Objective: In this systematic review, we determined the association of selected inflammatory cytokines in blood and urine with diabetic nephropathy (DN). Methods: A literature search using the key terms "tumor necrosis factor-alpha," "interferon-gamma," and "diabetic nephropathy" was conducted in PubMed from December 2020 to January 2021. Relevant findings from these studies were collated for qualitative synthesis. Results: Based on the synthesis of results, TNF-α and IFN-γ levels were consistently higher among DN patients than T2DM patients with no renal complications and healthy individuals. A negative correlation with the estimated glomerular filtration rate (eGFR) and a positive correlation with the albumin-to-creatinine ratio (ACR) were also noted by most studies which assessed their relationship with renal markers. Conclusion: The findings of this systematic review suggest the association of serum and urinary TNF-α and IFN-γ levels with diabetic nephropathy. However, further studies must be conducted to confirm these findings. [ABSTRACT FROM AUTHOR]

Daidzein (Da), an isoflavone, resembles natural oestrogen in structure and activity. We investigated the effects of dietary Da on the reproductive performance, egg quality, and bone mineralisation of hens in the pre-peak laying period. A total of 432 laying hens (110 days) were randomly allocated to control (CON) or Da-supplemented diet (10, 25, and 50 mg/kg). Each treatment had six replicates of 18 birds/replicate, and the feeding trial lasted 8 weeks. Supplementation of dietary Da significantly improved laying rate, egg weight, egg mass, and feed-to-egg ratio (p < 0.05). Likewise, dietary Da significantly improved albumen quality (Haugh unit, thick albumen fraction, and albumen proportion) and eggshell quality (eggshell; strength, eggshell thickness, gloss, and colour) (p < 0.05). Dietary Da exerted a notable significant increase (p < 0.05) on magnum weight, follicle numbers, serum levels of growth hormones, thyroid hormones (T3 and T4), reproductive hormone (oestrogen, follicle-stimulating hormone, luteinizing hormone), and mRNA expression of related genes (ESR1, FSHR1, PRL1, GNHR1). Also, Da significantly increased serum levels of superoxide dismutase, catalase, glutathione and decreased malondialdehyde (p < 0.05). Furthermore, the Da groups showed enhanced tibia strength, length, phosphorus, and bone mineral content (p < 0.05). In summary, dietary Da enhanced early onset of lay and improved albumen, eggshell, and bone quality in laying hens during the pre-peak period. Positive outcomes may be due to the efficient metabolism of Da and the safety level of inclusion. The enhancement of reproductive hormones, related genes, and antioxidant enzymes may explain daidzein's effects on laying hens. Highlights: Daidzein improved egg production significantly. Albumen, eggshell and tibia quality were enhanced. Optimal inclusion level at 25 or 50 mg/kg was safe. [ABSTRACT FROM AUTHOR]

Specific characteristics of the eggs from nucleus populations of Ancona (AN), Bianca di Saluzzo (BS), Bionda Piemontese (BP), Livorno, Mericanel della Brianza (MB), Mugellese (MU), Siciliana (SI) and Valdarnese (VA) chicken breeds kept in University Research Centres across Italy were evaluated. The physical characteristics considered were whole egg weight and shell, yolk and albumen proportion. The chemical characteristics considered were dry matter (DM), ash and protein content of the yolk and albumen, and the yolk fat. Among the breed groups evaluated in this study, BS and BP produce large eggs that are rich in total crude protein and lipids, with abundant egg whites. MB and MU produce small eggs with a high yolk percentage. AN and SI hens produce medium-small-sized eggs. The heaviest yolks were observed in AN eggs, and the highest shell percentage was found in SI eggs. LB and VA produce medium-large-sized eggs with low yolk lipid content. HIGHLIGHTS: Basic information on the egg characteristics of some Italian local chicken breeds kept in University Research Centres across Italy. Expanding the dataset pertaining to the egg characteristics of diverse chicken breeds is essential for crafting a more accurate and comprehensive egg profile unique to each breed. Detailed knowledge about all aspects of local chicken breeds may help promote their use as well as maintain or even increase biodiversity. [ABSTRACT FROM AUTHOR]

The document discusses the integrative role of albumin, a major protein in blood plasma, beyond its traditional functions. It covers albumin's structural features, esterase activity, modulation, modification, diagnostic biomarker role, and interaction with macromolecules. The text emphasizes the importance of albumin in various physiological processes, disease pathogenesis, and therapeutic development, highlighting its significance in modern diagnostics and treatment strategies. The research presented in the document underscores albumin's pivotal role as a molecular core that influences overall organism health. [Extracted from the article]

Objectives: This study aimed to investigate the frequency and characteristics of a rare variant of Guillain-Barré syndrome (GBS), isolated bilateral facial paralysis (iBFP), and the impact of the COVID-19 (coronavirus disease 2019) pandemic on the frequency of GBS and iBFP. Patients and methods: This retrospective study reviewed 1,986 patients who were hospitalized, followed up, and treated between March 11, 2020, and August 11, 2023, and included 32 patients (22 males, 10 females; mean age: 51.6±19.3 years; range, 18 to 87 years) diagnosed with GBS in the analyses. Additionally, information was obtained from hospital records regarding admission dates, length of stay, age, sex, and diagnoses of patients admitted between January 1, 2019, and March 11, 2020, and five patients diagnosed with GBP were identified during this period. Results: Eleven patients presented with facial paralysis, and iBFP was observed in five (15.6%) of them (4 males, 1 female). In iBFP patients, albuminocytological dissociation was detected in three cases, and the anti-GD1b IgG antibody was detected in one case. Electromyography findings of iBFP patients showed bilateral facial nerve involvement in only two cases, bilateral facial nerve involvement along with multiple A waves in other peripheral motor nerves in two cases, and facial nerve involvement along with AIDP findings in one case. The incidence of GBS was notably higher compared to the 15-month period before the COVID-19 pandemic (0.29% vs. 1.6%). Conclusion: The frequency of iBFP was found to be higher than expected in our inpatient GBS patient group. It was noted that these patients were not associated with a specific anti-ganglioside antibody and had a good prognosis. [ABSTRACT FROM AUTHOR]

Amaç: İnflamatuar indekslerin ülseratif kolitte (ÜK) hastalık aktivitesi ile ilişkili oldukları bilinmektedir. Bu çalışma nötrofil-lenfosit oranı (NLR), C-reaktif protein (CRP)-albümin oranı (CAR), CRP-lenfosit oranı (CLR) ve sistemik immün-inflamasyon indeksini (SIII) içeren inflamatuar indekslerin ÜK'de mukozal inflamasyonun şiddetini tahmin edip edemeyeceğinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif vaka kontrol çalışmasına 184 ÜK hastası ve 101 sağlıklı kontrol dahil edilmiştir. ÜK'nin klinik ve endoskopik özellikleri için Mayo klinik skoru ve Mayo endoskopik skoru kullanılmıştır. Mukozal inflamasyon şiddeti, Truelove ve Richards yöntemine göre histolojik aktivite indeksi (HAI) ile belirlenmiştir. Bulgular: ÜK hastalarında, inflamatuar indeks değerleri kontrol grubuna göre daha yüksek bulunmuştur (NLR için p=0,007 ve diğerleri için p<0,001). Endoskopik, klinik ve histolojik olarak aktif hastalığı olan vakaların inflamatuar indeks değerleri remisyonda olan vakalardan daha yüksek idi (tümü için p<0,001). Yaygın hastalığı olan ÜK hastalarının sınırlı hastalığı olan hastalardan daha yüksek inflamatuar indeks değerleri vardı (tümü için p<0,001). HAI değerleri tüm inflamatuar indekslerle pozitif korelasyon göstermekteydi ve en güçlü korelasyon HAI ile CLR arasında idi (rho=0,737; p<0,001). HAI ile ilişkili olarak, klinik olarak aktif hastalığın tespiti için tüm inflamatuvar indekslerin tanısal doğruluğu istatistiksel olarak anlamlıydı ve tanısal doğruluk açısından aralarında anlamlı bir fark yoktu. Sonuç: NLR, CAR, CLR ve SIII'i içeren inflamatuar indeskler, ÜK'de histolojik inflamasyonun şiddetini tahmin edebilir. [ABSTRACT FROM AUTHOR]

A comparative analysis of mass–volume characteristics of structural and morphological components of hen eggs before incubation and on the fifth (HH25–HH27) and 10th (HH36) days of incubation was carried out. During incubation, egg weight decreased by 9.25% (10 days), mainly due to a decrease in albumen weight (35.8%). The ratio of lipid‐soluble fraction (LSF) and water‐soluble fraction (WSF) in the mixed components and yolk did not change significantly. The total amount of solids in the mixed substances practically does not change during incubation. Antiradical activity of substances increased significantly by more than three times on the fifth day and additionally by 38.6% at the 10th day in relation to the fifth day. Total antioxidant activity increased by 18.9% on the fifth day and by 24.3% on the 10th day, compared to eggs before incubation. Transformation of the main components of WSF and LSF of albumin, yolk, and chicken embryo (CE) was studied using high‐performance liquid chromatography and gas chromatography with mass spectrometry. On the 10th day, an increase in the number of high‐molecular proteins is recorded, which indicates the activation of enzymatic processes of transformation of the main albumen proteins into proteins of organs and tissues of CE. This may cause an increase in the biological activity of substances. It was found that in conditions of in vitro digestion, antiradical activity increases by two times, anti‐inflammatory activity increases by 2.4 times, and an angiotensin‐converting enzyme inhibitory effect occurs in the mixed components of a 10‐day incubation egg. [ABSTRACT FROM AUTHOR]

As no unified treatment protocol or evidence yet exists for plasmapheresis without plasma, this study explored the outcomes of using 4% human albumin (ALB) solution as a replacement solution in patients undergoing plasma exchange for multiple myeloma (MM) patients with acute kidney injury (AKI). This study was prospectively registered (ChiCTR2000030640 and NCT05251896). Bortezomib-based chemotherapy plus therapeutic plasmapheresis (TPP) with 4% human ALB solution was assessed for three years in patients with MM aged >18 years, with AKI according to the Kidney Disease Improving Global Outcomes criteria, and without previous renal impairment from other causes. The primary endpoints were changes in renal function over 18 weeks and survival outcomes at 36 months. The secondary endpoints were the incidence of adverse reactions and symptom improvement. Among the 119 patients included in the analysis, 108 experienced renal reactions. The M protein (absolute changes: median −12.12%, interquartile ranges (IQRs) −18.62 to −5.626) and creatine (median −46.91 μmol/L, IQR −64.70 to −29.12) levels decreased, whereas the estimated glomerular filtration rate (eGFR) increased (median 20.66 mL/(min·1.73 m2), IQR 16.03–25.29). Regarding patient survival, 68.1% and 35.3% of patients survived for >12 and >36 months, respectively. The three symptoms with the greatest relief were urine foam, poor appetite, and blurred vision. All 11 patients (7.6%) who experienced mild adverse reactions achieved remission. In conclusion, in MM patients with AKI, plasma-free plasmapheresis with 4% human ALB solution and bortezomib-based chemotherapy effectively alleviated light chain damage to kidney function while improving patient quality of life. [ABSTRACT FROM AUTHOR]

To delineate the efficacy and safety profile of hemodiafiltration with endogenous reinfusion (HFR) for uremic toxin removal in patients undergoing maintenance hemodialysis (MHD). Patients who have been on MHD for a period of at least 3 months were enrolled. Each subject underwent one HFR and one hemodiafiltration (HDF) treatment. Blood samples were collected before and after a single HFR or HDF treatment to test uremic toxin levels and to calculate clearance rate. The primary efficacy endpoint was to compare uremic toxin levels of indoxyl sulfate (IS), λ-free light chains (λFLC), and β2-microglobulin (β2-MG) before and after HFR treatment. Secondary efficacy endpoints was to compare the levels of urea, interleukin-6 (IL-6), P-cresol, chitinase-3-like protein 1 (YKL-40), leptin (LEP), hippuric acid (HPA), trimethylamine N-oxide (TMAO), asymmetric dimethylarginine (ADMA), tumor necrosis factor-α (TNF-α), fibroblast growth factor 23 (FGF23) before and after HFR treatment. The study also undertook a comparative analysis of uremic toxin clearance between a single HFR and HDF treatment. Meanwhile, the lever of serum albumin and branched-chain amino acids before and after a single HFR or HDF treatment were compared. In terms of safety, the study was meticulous in recording vital signs and the incidence of adverse events throughout its duration. The study enrolled 20 patients. After a single HFR treatment, levels of IS, λFLC, β2-MG, IL-6, P-cresol, YKL-40, LEP, HPA, TMAO, ADMA, TNF-α, and FGF23 significantly decreased (p < 0.001 for all). The clearance rates of λFLC, β2-MG, IL-6, LEP, and TNF-α were significantly higher in HFR compared to HDF (p values: 0.036, 0.042, 0.041, 0.019, and 0.036, respectively). Compared with pre-HFR and post-HFR treatment, levels of serum albumin, valine, and isoleucine showed no significant difference (p > 0.05), while post-HDF, levels of serum albumin significantly decreased (p = 0.000). HFR treatment effectively eliminates uremic toxins from the bloodstream of patients undergoing MHD, especially protein-bound toxins and large middle-molecule toxins. Additionally, it retains essential physiological compounds like albumin and branched-chain amino acids, underscoring its commendable safety profile. [ABSTRACT FROM AUTHOR]

Malnutrition and inflammation are associated with mortality in peritoneal dialysis (PD) patients. Serum albumin and non-high-density lipoprotein cholesterol (non-HDL-C) are independently associated with mortality in PD patients. Combining albumin and non-HDL-C with mortality may be more plausible in clinical practice. This retrospective cohort study included 1954 Chinese PD patients from 1 January 2009 to 31 December 2016. Kaplan–Meier curve was used to determine the relationship between albumin to non-HDL-C ratio and all-cause mortality. Cox regression analysis was applied to assess the independent predictive value while adjusting for confounding factors. Competitive risk analysis was used to examine the effects of other outcomes on all-cause mortality prognosis. In the 33-month follow-up period, there were 538 all-cause deaths. Kaplan–Meier analysis presented significant differences in all-cause mortality. Multivariate Cox regression showed that the risk of all-cause mortality was lower in the moderate group (9.36–12.79) (HR, 0.731; 95% CI, 0.593–0.902, p = 0.004) and the highest group (>12.79) (HR, 0.705; 95% CI, 0.565–0.879, p = 0.002) compared to the lowest group (≤9.36). Competitive risk analysis revealed significant differences for all-cause mortality (p < 0.001), while there was no statistical significance for other competing events. Low albumin to non-HDL-C ratio was associated with a high risk of all-cause mortality in PD patients. It may serve as a potential prognostic biomarker in PD patients. [ABSTRACT FROM AUTHOR]

Background: Temporal trends of routinely obtained parameters may provide valuable information for predicting BSIs, but this association has not yet been established in LVAD patients. Methods: This retrospective analysis included data from 347 consecutive recipients of three rotary LVAD types. Study endpoints included the incidence of BSI, the association of temporal trends of routinely obtained blood biomarkers with the development of BSIs, the incidence of BSIs, and survival on LVAD support. Results: During follow‐up, 47.8% (n = 166) of the patients developed BSI. In multivariate analyses, the development of BSI was a significant predictor of mortality (HR 5.78, 95% CI 4.08–8.19, p < 0.0001). In univariate analyses, after adjusting for potential confounders, albumin (SHR 0.94, 95% CI 0.91–0.97, p < 0.00010), creatinine (SHR 1.49, 95% CI 1.03–2.15, p = 0.033), and C‐reactive protein (SHR 1.19, 95% CI 1.08–1.32, p = 0.0007) significantly predicted the development of BSIs during LVAD support. Notably, the strength of the association of parameter changes with the prediction of BSIs demonstrated a time‐dependent correlation in the cases of albumin (p = 0.045) and creatinine (p = 0.003). Conclusion: Bloodstream infections are highly prevalent among LVAD recipients and are independent predictors of mortality. Temporal biomarker trends significantly predict the development of BSIs. These findings suggest opportunities for interventions aiming to reduce the incidence of BSIs. [ABSTRACT FROM AUTHOR]

Simple Summary: Head and neck cancer (HNC) patients often experience serious side effects from treatments like chemotherapy and radiotherapy, which can lead to malnutrition and impact their overall health status. Men and women may face different nutritional challenges during these treatments, potentially affecting their treatment outcomes. This study investigates the gender-specific nutritional status of HNC patients over the course of their treatment, examining differences in body weight, body composition, and their impact on survival. While we found significant declines in albumin and total protein levels in both genders, females exhibited a more notable decrease in albumin levels. Survival analysis revealed that for males, the phase angle, an indicator of cellular health, was linked to survival. For females, albumin levels at the end of treatment were significant predictors of survival. Background/Objectives: This analysis aims to evaluate gender-specific differences in nutritional status, body weight changes, and their impact on overall survival (OS) in head and neck cancer (HNC) patients undergoing (chemo)radiotherapy (CRT). Methods: Between 2018 and 2020, 61 HNC (17 female and 44 male) patients were prospectively recruited to receive curative (chemo)radiotherapy. Nutritional assessments included dietary questionnaire screenings and records, anthropometric methods (body mass index, BMI, body composition via bioelectrical impedance analysis (BIA)), and the determination of biomarkers like albumin and CRP. Assessments were conducted before, during, and after (chemo)radiotherapy. Results: Gender differences were observed at baseline in Karnofsky performance status (p = 0.01), daily calorie intake (p = 0.04), phase angle (PA) (p = 0.003), and fat-free mass index (FFMI) (p < 0.001). During CRT, males showed a larger increase in calorie deficit (p < 0.001) and greater reductions in BMI, FFMI, and PA compared to females. Malnutrition risk (MUST score) increased significantly in males (p = 0.008) but not in females. Albumin and total protein declined in both genders, with a more pronounced drop in albumin for females. Survival analysis revealed that, for males, several factors, including baseline calorie deficit, BMI, PA, and FFMI, were linked to survival. For females, only albumin at therapy end was significantly associated with survival (p < 0.001). In multivariable analysis, baseline PA remained a significant predictor of survival for males (p = 0.026). Conclusions: Our findings suggest distinct gender differences in the nutritional and biochemical responses of HNC patients undergoing CRT, indicating the importance of tailored, gender-specific nutritional support during treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, pembrolizumab has become applicable for recurrent and metastatic head and neck cancer (RMHNC), but only a limited number of patients can benefit from it. In this study, we explored predictive markers for the therapeutic effect and prognosis of pembrolizumab for RMHNC. The results showed that the immune-modified Glasgow Prognostic Score (imGPS), which we previously proposed, is a better predictive marker than the previously known neutrophil-to-lymphocyte ratio (NLR) and mGPS. The imGPS can be easily evaluated with just a blood test, so we hope that it will become more widely used in the clinical environment. Background: Previously, we proposed that the immune-modified Glasgow Prognostic Score (imGPS), which adds the lymphocyte count to the mGPS, is helpful as a prognostic marker for patients with head and neck squamous cell carcinoma. In this study, we investigated the imGPS as a marker for the therapeutic effect of pembrolizumab in treating recurrent and metastatic head and neck cancer (RMHNC). Methods: This study included RMHNC patients who were treated with pembrolizumab from December 2019 to April 2024. ALB, CRP, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLRs), mGPSs, and imGPSs were extracted as biomarkers, and the response rate and prognosis were analyzed for each. Results: A total of 54 patients were enrolled. Lymphocyte counts were correlated with the overall response rates (ORRs) (p = 0.0082). Although the mGPS did not show significant differences in ORRs, imGPSs revealed a significant difference (p = 0.013). CRP, ALB, and lymphocyte counts were correlated with overall survival (OS) and/or progression-free survival (PFS). NLRs, mGPSs, and imGPSs were also correlated with OS and/or PFS, with imGPSs showing the greatest area under the curve (OS; AUC = 0.795, PFS; AUC = 0.754). Conclusions: This study demonstrates that the imGPS is an excellent predictive marker for the therapeutic effect and prognosis of pembrolizumab for RMHNC. The imGPS can be employed with daily blood tests, highlighting the potential to forecast the impact of the ICI with high reliability. [ABSTRACT FROM AUTHOR]

The integrity of the blood–CSF barrier plays a major role in inflammation, but also in shielding the CNS from external and systemic—potentially toxic—factors. Here we report results of measurements of the albumin quotient—which is thought to mirror the integrity of the blood-CSF barrier—in 1059 patients with amyotrophic lateral sclerosis. The results were compared with groups of patients suffering from Alzheimer's disease, facial palsy and tension headache. The albumin quotient, an accepted measure of the blood-CSF barrier integrity, was not significantly different from control populations. In addition, we found that the albumin quotient correlated with survival of the patients; this effect was mainly driven by male patients and influenced by age, body mass index and diabetes mellitus. We conclude that the blood-CSF barrier is intact in this large cohort of patients with amyotrophic lateral sclerosis and that the albumin quotient correlates with survival. Whether this is important for the pathogenesis of the disease, requires mechanistic studies. [ABSTRACT FROM AUTHOR]

Purpose: High-dose methotrexate (HDMTX) therapy is an important component in treatment regimens for acute lymphoblastic leukemia (ALL). Courses are associated with a risk of renal injury, delayed elimination, and increased systemic toxicity. Recently hypoalbuminemia has been recognized as yet another risk factor. Methods: To examine the impact of serum albumin we reviewed 325 HDMTX 5 g/m2 courses in a cohort of 51 children treated on the NOPHO ALL 2008 protocol, dividing the courses into four groups with different levels of baseline albumin (A < 25 g/L, B 25–29 g/L, C 30–34 g/L and D ≥ 35 g/L). Results: Hypoalbuminemia was present in 51% of the courses, mostly in the early phases of chemotherapy while asparaginase therapy is ongoing, and especially if given less than 2 weeks after a dose (78%). Hypoalbuminemia had a significant impact on the end-of-infusion serum MTX, depending on the degree of hypoalbuminemia: MTX > 150 µM was seen in 37%, 32%, 20% and 8% in groups A to D. Serum albumin < 30 g/L was significantly associated with low MTX clearance < 10 L/h/1.73m2 (78% vs. 36%) and high AUC ≥ 1000 µM*h (44% vs. 31%). The frequency of rising creatinine or prolonged elimination was not increased, but the risk of stomatitis was significantly higher (42% vs. 19%). Conclusion: Low serum albumin is caused by concurrent asparaginase therapy and has a clinically significant impact on MTX disposition. Guidelines for administering HDMTX may need adjustment if serum albumin < 30 g/L, and, if possible, HDMTX courses should not be scheduled soon after asparaginase doses. [ABSTRACT FROM AUTHOR]

Background: In patients with steroid-resistant nephrotic syndrome (SRNS), the presence of monogenic variants influences therapeutic strategies. Large cohort studies reported the detection of monogenic variants in approximately 30% of patients with SRNS. However, these cohorts included many patients, such as those with symptomatic proteinuria, who did not meet the strict diagnostic criteria for pediatric nephrotic syndrome (NS). Therefore, we investigated the proportion of causative monogenic variants detected in patients who strictly met the diagnostic criteria of SRNS and explored their clinical characteristics. Methods: We examined pediatric SRNS cases with genetic analysis conducted in our hospital. Cases satisfying all of the following criteria were included: (1) age at onset 1–18 years, (2) serum albumin at onset ≤ 2.5 g/dl, (3) persistent heavy proteinuria, and (4) no complete remission after 4 weeks of steroid monotherapy. Results: The proportion of detected monogenic variants was 12% (22/185) among all patients. The proportion was only 7% (9/129) in patients with edema at disease onset compared with 38% (9/24) in those without (p < 0.0001). Monogenic variants were rare in patients with acute kidney injury associated with NS (1% (1/11)) or a history of complete remission (4% (2/51)). Conclusions: Our study revealed a monogenic cause in 12% of individuals with strictly defined SRNS, a much smaller proportion than previously reported. The presence or absence of edema at the onset was an important factor to distinguish SRNS with monogenic cause from SRNS without. Our results provide further evidence of the SRNS types attributable to monogenic causes. [ABSTRACT FROM AUTHOR]

Objective • This study aims to explore the impact of immune-enhanced enteral nutrition on postoperative outcomes, focusing on inflammatory response, intestinal mucosal barrier integrity, and immune function following laparoscopic colon cancer surgery in elderly patients. Methods • In this single-center, randomized controlled trial, ninety-six elderly patients undergoing laparoscopic resection of colon tumors were enrolled and equally divided into two groups by random allocation. The control group (n=48) received standard enteral nutrition, while the experimental group (n=46) was administered immune-enhancing enteral nutrition. We assessed and compared specific metrics such as nutritional status (e.g., albumin levels), cellular immune status (CD4+ and CD8+ T-cell counts), inflammatory markers (e.g., C-reactive protein), and indicators of intestinal mucosal barrier function (e.g., D-lactate levels) before and after the intervention in both groups. Results • Initial comparison of baseline characteristics between the two groups showed no significant differences (P > .05). Postoperatively, the experimental group demonstrated significantly lower levels of inflammatory markers and an improved ratio of CD4+/CD8+ T-cells compared to the control group at day 7 (P < .05). Furthermore, nutritional status and markers indicative of intestinal mucosal barrier integrity were notably better in the experimental group at this time point. Conclusion • Immune-enhanced enteral nutrition is effective in enhancing intestinal mucosal barrier function, boosting immune response, and improving nutritional status in elderly patients post-laparoscopic colon cancer surgery. It also contributes to mitigating the inflammatory response, proving its safety and tolerability for clinical use. [ABSTRACT FROM AUTHOR]

Background • Diabetic nephropathy (DN) is one of the most common and severe complications in patients with type 2 diabetes mellitus (T2DM). Thyroid dysfunction has been associated with diabetes and its complications but the relationship between thyroid autoantibodies and T2DM-DN remains unclear. Objective • The study aims to investigate the association between thyroid autoantibodies and diabetic nephropathy in patients with T2DM and analyze the expression of serum thyroid hormone levels in T2DM-DN patients and its prognostic value. Methods • 117 patients with T2DM who visited our hospital from December 2020 to December 2022 were recruited and assigned to group A (65 patients with T2DM-DN) and group B (52 patients with T2DM without DN). Serum TH levels of patients with DN and normal diabetic patients were analyzed, and the prognosis of patients was evaluated. Results • The results demonstrated that compared to group B, group A had higher serum cystatin C (cysC), serum creatinine (SCr), thyroglobulin antibody (TgAb), and urinary microalbumin/creatinine (UACR) levels, while the levels of free triiodothyronine (FT3), albumin (ALB), and estimated glomerular filtration rate (eGFR) were lower (P < .05). FT3 in group A2 was inferior to that in group A0 and group A1 (P < .05). After correction, the results demonstrated that the level of thyroid peroxidase antibody (TPOAb) in group A1 was superior to that in group A0 (P < .05). The positive rates of TPOAb (20%) and TgAb (23.08%) in patients with T2DM-DN were drastically superior to those in patients with T2DM without DN. Among the independent risk factors for DN, the OR of positive TPOAb was 8.125. Conclusion • The level and positive rate of thyroid autoantibodies in patients with T2DM-DN were high and TPOAb positivity might be a risk factor for the occurrence of T2DM-DN. [ABSTRACT FROM AUTHOR]

Objective • To study the effects of acupuncture combined with the formula of Yi Qi Yang Yin and blood activating (A-YBF) on blood glucose levels and renal function in patients with early diabetic nephropathy. Methods • 96 patients with early diabetic nephropathy treated in our hospital from April 2021 to April 2022 were included in the study and divided into the control group (conventional medical treatment) and the study group (A-YBF), with 48 cases in each group. The efficacy and adverse effects were recorded by comparing the Chinese medicine symptom points, blood glucose level, renal function, and inflammatory factor level between the two groups before and after the treatment. Results • The clinical efficacy of the study group was significantly higher than that of the control group (P < .05). Before treatment, no difference was found between the primary and secondary symptom scores of the two groups (P > .05); after treatment, the primary and secondary symptom scores of the study group were lower than those of the control group (P < .05). Before treatment, there was no difference in fasting blood glucose (FPG) and 2h postprandial glucose (2hPG) levels; 24h urine protein quantification, cystatin C (Cys-C), urinary albumin excretion rate (UAER), and estimated glomerular filtration rate (eGFR) levels; and growth differentiation factor-15 (GDF-15), interleukin-1β (IL-1β), interleukin-17 (IL-17), and serum amyloid A (SAA) levels between the two groups (P > .05). After treatment, FPG and 2hPG levels; 24h urine protein quantification, Cys-C and UAER levels; and GDF15, IL-1β, IL-17, and SAA levels were lower in the study group than in the control group, while eGFR levels were higher than those in the control group (P < .05). Conclusion • A-YBF can effectively reduce blood glucose levels and improve renal function in patients with early diabetic nephropathy and can be promoted in clinical application. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Kirkuk University for Agricultural Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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.)

Copyright of Journal of Kirkuk University for Agricultural Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) 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.)

Background: The management of ureteric obstruction secondary to pelvic malignancies (UOPM) presents a significant challenge. Objectives: Our study aimed to assess the factors affecting the feasibility of interventions for patients with UOPM - including retrograde and antegrade double J (DJ) stenting, and percutaneous nephrostomy (PCN) insertion. Methods: We conducted a retrospective analysis of patients who underwent intervention for UOPM over two years, from January 2022 to December 2023. Patients were categorized into groups based on intervention type: Group l: Retrograde DJ stenting, group 2: Antegrade DJ stenting, and group 3: PCN insertion. Demographic, clinical, radiological, cystoscopic, and laboratory data were compared between the three groups. Analysis of Variance (ANOVA), logistic regression, and marginal mean plots were utilized for statistical analysis. Results: Fifty-nine patients were included in the study, consisting of 14 males and 45 females, and the mean age of the study population was 60.1 ± 10.8 years. Retrograde DJ stenting was successfully achieved in 593% of patients, with 10.2% undergoing antegrade DJ stenting and 30.5% needing PCN insertion. Serum albumin (P = 0.04), serum creatinine (P = 0.02), albumin creatinine ratio (P < 0.001), and severity of hydroureteronephrosis (HDUN) (P = 0.02) were significantly associated with intervention outcomes. There was an increased likelihood of PCN insertion in higher serum creatinine and lower serum albumin levels. Multinomial logistic regression with univariate and multivariate analysis revealed significance among the above-mentioned variables. Conclusions: Even though DJ stenting remains common, a significant proportion of patients require PCN insertion. Serum albumin, serum creatinine, albumin creatinine ratio, and HDUN severity are significant predictors of intervention success. Further research is warranted to validate these findings and enhance management strategies for UOPM. [ABSTRACT FROM AUTHOR]

Background: The use of albumin resuscitation in septic shock is only recommended in patients who have received large volumes of crystalloid resuscitation regardless of serum albumin concentration. The role of albumin is still largely debated and evidence to support its use still lacking. Objective: The objective of this study was to evaluate whether albumin replacement increases the number of vasopressor-free days in patients with septic shock and hypoalbuminemia. Methods: A retrospective analysis was conducted to assess the effect of albumin replacement in septic shock. Hypoalbuminemic patients with septic shock who received albumin were retrospectively compared with a cohort who did not. The primary outcome was number of vasopressor-free days at day 14 from shock presentation, which was analyzed using an adjusted linear regression model to adjust for confounders. Results: There was no difference in vasopressor-free days at day 14 in patients who received albumin versus those who did not, after adjusting for confounders of exposure (0.50, 95% CI = −0.97 to 1.97; P = 0.502). There also was no difference in secondary outcomes except for need for invasive mechanical ventilation (MV), which was significantly lower in patients who received albumin (61 [54.4%] vs 88 [67.7%]; P = 0.035). Conclusions and Relevance: We observed no difference in vasopressor-free days at day 14 in patients with hypoalbuminemia who received albumin compared with those who did not. However, patients who received albumin required significantly less MV although further studies are warranted to assess this effect. [ABSTRACT FROM AUTHOR]

In patients with right-sided breast cancer the liver can be partially irradiated during adjuvant radiotherapy (RT). We aimed to determine breast cancer RT effects on liver using with magnetic resonance elastography (MRE) and biological results. This retrospective study enrolled 34 patients diagnosed with right-sided breast cancer who underwent adjuvant RT. Liver segment assessments were conducted using MRE for all participants. Additionally, a complete blood count and liver enzyme analysis were performed for each patient. All measurements were taken both prior to the initiation and upon completion of RT. A statistically significant difference was found in ALT (p = 0.015), ALP (p = 0.026), total protein (p = 0.037), and albumin (p = 0.004) levels before and after RT. The highest mean liver stiffness (kPa) value was recorded in segment 8, while the lowest was observed in segment 6. A weak but statistically significant positive correlation was found between segment 5 stiffness and liver volume (p = 0.039). Additionally, a statistically significant positive correlation was detected between ALP levels and the stiffness values in segment 4A (p = 0.020) and segment 6 (p = 0.003). Conversely, a weak negative correlation was observed between the stiffness values in segment 8 and post-RT total protein levels (p = 0.031). MRE can help us identify the level of fibrotic stiffness in the liver segments within the RT area without establishing clinical symptoms. MRE can support the clinician in evaluating the liver functions of right breast cancer patients who underwent RT. We assume these results will facilitate new studies with a large number of patients on MRE imaging at certain intervals in the follow-up of patients with right breast cancer who received RT before the development of radiation-induced liver disease (RILD). [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Introduction: Therapeutic plasma exchange (TPE) may involve complications. We aimed to review the demographic data, indications, technical information, and complications. Methods: Data for TPE procedures (TPEPs) performed between 2004 and 2018 were retrospectively. Results: This study covered 2505 TPEPs performed on 338 patients; 55% of them were female (n = 186), and the median age was 36 years (range, 11–93 years). Most TPEPs were administered for hematological (40.6%) indications. The incidence of complications on the first procedure was 3.2% (n = 80); only 16 procedures (0.6%) were failed. The complication incidence was 19.8% (n = 497), with 789 total complications. Most of the complications were patient‐related (90.4%), and the most of them were urticaria (29.1%), occlusion (3.2%), and faulty systems (1.01%), respectively. The use of only fresh frozen plasma as replacement fluid caused a higher complication rate (22.1%, p < 0.01). Conclusion: The number of TPEPs is increasing every day. Hematologic indications for TPE and the use of fresh frozen plasma may increase the risk of complications. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effectiveness of the REPRISE care bundle (CB) model for pressure ulcer (PU) prevention in intensive care patients and to determine the impact of the training provided to nurses on their knowledge base and attitudes. This study has an experimental design. The study was conducted in the anaesthesia and resuscitation intensive care unit on a total of 72 patients. The prevalence of PU was compared between the control group and the REPRISE‐CB group. For the nurses, 50 nurses working in the ICU were included in the study. The nurses' knowledge and attitudes towards PU were compared before and after the training. The data were analysed using a statistical program. The incidence of IW was significantly lower in the intervention group (13.9%) compared to the control group (38.9%) (p < 0.05). The study showed that oedema, low albumin levels, low mean blood pressure and low Braden Scale scores were significant risk factors for the development of PU. In addition, the training provided to nurses was found to significantly improve their knowledge and attitudes (p < 0.05). It was concluded that REPRISE‐CB was effective in the prevention of PU and that nurses' knowledge increased with training. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine 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.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Simple Summary: This study evaluated the prognostic role of the advanced lung cancer inflammation (ALI) index, lung immune prognostic index (LIPI), prognostic nutritional index (PNI), and systemic inflammation score (SIS) in 191 metastatic NSCLC patients receiving immunotherapy alone or in combination with chemotherapy as first-line at Santa Chiara Hospital of Trento, from 2017 to 2024. After a median follow-up of 27.7 months, a significantly longer OS was associated with an ALI score >18 vs. ≤18 (18.0 vs. 7.3 months; p = 0.00111), LIPI score 0 vs. 1 and 2 [18.9 vs. 8.2 and 4.2 months; (p = 0.001)], PNI ≥ 45 vs. <45 (22.7 vs. 9.6 months; p = 0.002), and SIS score 0 vs. 1 and 2 (27.4 vs. 7.1 and 8.6 months, respectively; p < 0.001). The study confirmed that the ALI, LIPI, PNI, and SIS represent useful tools to prognosticate survival in metastatic lung cancer patients treated with immunotherapy alone or in combination with chemotherapy. Introduction: In recent years, several inflammation-related factors and nutritional parameters have been evaluated to develop prognostic scores as potential biomarkers in non-small-cell lung cancer (NSCLC) patients receiving immune checkpoint inhibitors (ICIs). The aim of this study was to retrospectively investigate the prognostic role of the advanced lung cancer inflammation (ALI) index, lung immune prognostic index (LIPI), prognostic nutritional index (PNI) and systemic inflammation score (SIS) in metastatic NSCLC patients receiving ICI alone or in combination with chemotherapy. Methods and patients: We retrospectively included 191 patients with advanced NSCLC who received first-line ICI with or without chemotherapy from 2017 to 2024. The association between pretreatment ALI, LIPI, PNI, and SIS and overall survival (OS) was evaluated using the Kaplan–Meier method and Cox regression models. Results: After a median follow-up of 27.7 months, significantly longer OS was associated with an ALI score > 18 vs. ≤18 (18.0 vs. 7.3 months; p = 0.00111), LIPI score 0 vs. 1 and 2 [18.9 vs. 8.2 and 4.2 months; (p = 0.001)], PNI ≥ 45 vs. <45 (22.7 vs. 9.6 months; p = 0.002), and SIS score 0 vs. 1 and 2 (27.4 vs. 7.1 and 8.6 months, respectively; p < 0.001). The OS benefit was independent of treatment (ICI vs. ICI + chemotherapy). At multivariate analysis, pretreatment albumin was positively associated with OS, while ECOG PS 1 and liver metastases were negatively associated with OS. Conclusions: Inflammatory and nutritional biomarkers such as the ALI, LIPI, PNI, and SIS represent useful tools to prognosticate survival in metastatic lung cancer patients treated with ICI alone or in combination with chemotherapy as first-line. [ABSTRACT FROM AUTHOR]

Introduction: AD is a progressive neurodegenerative disorder causing significant cognitive decline and impaired daily functioning. Current treatments offer only modest relief, and many amyloid-targeting therapies have failed, prompting exploration of alternative approaches such as PE with albumin replacement. Objectives: This scoping review systematically maps the literature on PE with albumin replacement in AD management, focusing on outcomes, methodologies, and reported benefits and risks. Methods: A comprehensive search in PubMed, supplemented by reference scanning and hand-searching, identified studies involving PE with albumin replacement in AD patients. Data charting and critical appraisal were conducted using standardized tools. Results: Seven primary studies from the AMBAR (Alzheimer Management by Albumin Replacement) trial met the inclusion criteria, consistently reporting improvements in cognitive function, positive neuroimaging results, and favorable neuropsychiatric outcomes. For instance, one study found a significant slowing of cognitive decline (p < 0.05) among patients receiving PE with albumin replacement. Another study showed better preservation of hippocampal volume and improved brain perfusion metrics in the treatment group (p < 0.05). The intervention was generally well-tolerated with manageable side effects. Conclusion: PE with albumin replacement is a promising therapeutic approach for AD, warranting further investigation to confirm its efficacy and safety across broader settings. Scoping review registration: https://osf.io/v6dez/?view_only=1cd9637e7e0347d39713bf19aac0dfe8. [ABSTRACT FROM AUTHOR]

Background: Obesity is a serious health problem with increasing incidence. worldwide and remains one of the most important causes of preventable deaths. We aimed to examine the relationship between Vitamin B12 and Folic acid, which have an important role for human life, and homocysteine is widely recognized for its association with the development of cardiovascular disease, although its role as an independent risk factor remains a topic of ongoing debate. Materials and methods: We evaluated 126 patients who underwent bariatric metabolic surgery between September 2019-September 2020. In addition to demographic characteristics of the patients, weight, Vitamin B12, folate, HbA1c, cholesterol, triglyceride, ferritin, serum iron, albumin levels at preoperative, postoperative 1st month, 6th month, 12th month follow-ups were analyzed. Results: Patients with the desired biochemical parameters at the determined follow-up points were identified and two groups were formed as RYGB(n = 43) and SG(n = 7) patients. When biochemical parameters were analyzed between the groups, homocysteine, HbA1c, HDL Cholesterol, VLDL Cholesterol, Total Cholesterol, Triglycerides, Ferritin, Serum Iron levels showed a statistical difference (p < 0.001). Folate (p = 0.064) and albumin (p = 0.257) did not show a significant difference over time. The change in vitamin B12 (p = 0.409) over time was not significant in the SG group, whereas a significant difference was observed in the RYGB group (p < 0.001). When we established a marginal model to determine the factors affecting the change in homocysteine over time, vitamin B12 and folate values. Conclusions: The relationship between Vitamin B12, folate and homocysteine is important in order to better understand the complications that develop in bariatric metabolic surgery patients, to prevent possible complications and to better manage the process. [ABSTRACT FROM AUTHOR]