Impact of potentially inappropriate medications on emergency ambulance admissions in geriatric patients after discharge.

This study aimed to determine the risk of emergency admission by ambulance in patients taking potentially inappropriate medications (PIMs). We included 273,932 patients aged over 75 years of age admitted between January 1, 2019, and December 31, 2019, using the Japan Medical Data Center medical insurance database containing anonymized patient data. We excluded patients without a history of admission.

hUC-MSCs Prevent Acute High-Altitude Injury through Apoe/Pdgf-b/p-Erk1/2 Axis in Mice.

Background: The hypobaric hypoxic atmosphere can cause adverse reactions or sickness. The purpose of this study was to explore the preventive effect and mechanism of human umbilical cord mesenchymal stem cells (hUC-MSCs) on acute pathological injury in mice exposed to high-altitude.

Methods: We pretreated C57BL/6 mice with hUC-MSCs via the tail vein injection, and then the mice were subjected to hypobaric hypoxic conditions for five days.

Design and Validation of a High-Fidelity Left Atrial Cardiac Simulator for the Study and Advancement of Left Atrial Appendage Occlusion.

Purpose: Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia that increases the risk of stroke, primarily due to thrombus formation in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) devices offer an alternative to oral anticoagulation for stroke prevention. However, the complex and variable anatomy of the LAA presents significant challenges to device design and deployment.

Acute Concurrent Exercise Improves Inhibitory Control Without Mediating the Role of Lactate: An Event-Related Potential Study.

Background: Concurrent exercise (CE), an emerging exercise modality characterized by sequential bouts of aerobic (AE) and resistance exercise (RE), has demonstrated acute benefits on executive functions (EFs) and neuroelectric P3 amplitude. However, the effect of acute CE on inhibitory control, a sub-component of EFs, and P3 amplitude remains inconclusive. Moreover, exploring the mechanisms underlying the effects of acute exercise on EFs contributes to scientific comprehension, with lactate recognized as a crucial candidate positively correlated with EFs.

Effects of obstructive sleep apnea on nocturnal changes in blood pressure - a retrospective study.

To explore the effects of obstructive sleep apnea (OSA) on nocturnal changes in blood pressure (BP), we enrolled 2037 participants who underwent polysomnography (PSG) between 2019 and 2020 and examined BP changes before and after sleep. BP was measured in the evening and the following morning using an electronic wrist sphygmomanometer in the supine position. The severity of OSA was determined by PSG and graded based on the apnea/hypopnea index (AHI).

Relationship between intraoperative blood pressure variability and postoperative acute kidney injury in pediatric cardiac surgery.

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a notably common complication in pediatrics, with an incidence rate ranging from 15 to 64%. This rate is significantly higher than that observed in adults. Currently, there is a lack of substantial evidence regarding the association between intraoperative blood pressure variability (BPV) during cardiac surgery with cardiopulmonary bypass (CPB) and the development of AKI in pediatric patients.

Determining the QRS axis: visual estimation is equal to calculation.

Background: The QRS axis of the electrocardiogram (ECG) is often considered in clinical practice, but its determination is frequently limited to a rough estimation, such as "normal", with left or right deviation, and superior or inferior in the case of premature ventricular complexes (PVCs). However, a more exact determination of the QRS axis may be warranted in certain scenarios, such as to determine the origin of PVCs more precisely, and is attainable by visual estimation using the hexaxial reference system.

Objectives: The aim of this study was to determine how well such an estimation of the QRS axis would correlate with the axis calculated by formulas.

Exposomics: a review of methodologies, applications, and future directions in molecular medicine.

The exposome is the measure of all the exposures of an individual in a lifetime and how those exposures relate to health. Exposomics is the emerging field of research to measure and study the totality of the exposome. Exposomics can assist with molecular medicine by furthering our understanding of how the exposome influences cellular and molecular processes such as gene expression, epigenetic modifications, metabolic pathways, and immune responses.

RNA-sequencing unveils FLT4 splice site variants in variable congenital heart disease.

The etiology of congenital heart disease (CHD) is complex, comprising both genetic and environmental factors. Despite documented familial occurrences, the genetic etiology remains largely elusive. Trio exome sequencing identified a heterozygous FLT4 splice site variant in two families with respectively tetralogy of Fallot (TOF), and variable CHD comprising both the TOF spectrum and aortic coarctation.

Description of current status of implementation and management of cardiac arrest in China.

Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in China is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of cardiac arrest in China but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe Chinese management of cardiac arrest, particularly from the perspective of compression, ventilation, monitoring, treatment, and extracorporeal cardiopulmonary resuscitation.

Implementation of intraoperative procedures to prevent anastomotic leak in low anterior rectal resections: a pilot study for a novel technique to evaluate anastomotic vascularization.

Introduction: Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI).

Long-term burden of body mass index since childhood and impaired physical performance in midlife.

Background: The impact of long-term burden of body mass index (BMI) since childhood on physical performance in midlife remains unclear. We aimed to investigate the association between cumulative exposure to BMI since childhood and midlife physical performance by using data from the Bogalusa Heart Study (BHS).

Methods: This longitudinal study consisted of 749 participants (aged 37.

Optimal frequency bands for pupillography for maximal correlation with HRV.

Assessing cognitive load using pupillography frequency features presents a persistent challenge due to the lack of consensus on optimal frequency limits. This study aims to address this challenge by exploring pupillography frequency bands and seeking clarity in defining the most effective ranges for cognitive load assessment. From a controlled experiment involving 21 programmers performing software bug inspection, our study pinpoints the optimal low-frequency (0.

Genetic coupling of enhancer activity and connectivity in gene expression control.

Gene enhancers often form long-range contacts with promoters, but it remains unclear if the activity of enhancers and their chromosomal contacts are mediated by the same DNA sequences and recruited factors. Here, we study the effects of expression quantitative trait loci (eQTLs) on enhancer activity and promoter contacts in primary monocytes isolated from 34 male individuals. Using eQTL-Capture Hi-C and a Bayesian approach considering both intra- and inter-individual variation, we initially detect 19 eQTLs associated with enhancer-eGene promoter contacts, most of which also associate with enhancer accessibility and activity.

Downregulation of HDAC2 attenuates ventricular arrhythmias in a mouse model of cardiac hypertrophy through upregulation of KCHIP2 expression.

Aims: Decrease in repolarizing K+ currents, particularly the fast component of transient outward K+ current (Ito,f), prolongs action potential duration (APD) and predisposes the heart to ventricular arrhythmia during cardiac hypertrophy. Histone deacetylases (HDACs) have been suggested to participate in the development of cardiac hypertrophy, and class I HDAC inhibition has been found to attenuate pathological remodeling. This study investigated the potential therapeutic effects of HDAC2 on ventricular arrhythmia in pressure overload-induced cardiac hypertrophy.

Prediction of Radiation Therapy Induced Cardiovascular Toxicity from Pretreatment CT Images in Patients with Thoracic Malignancy via an Optimal Biomarker Approach.

Rationale And Objectives: Cardiovascular toxicity is a well-known complication of thoracic radiation therapy (RT), leading to increased morbidity and mortality, but existing techniques to predict cardiovascular toxicity have limitations. Predictive biomarkers of cardiovascular toxicity may help to maximize patient outcomes.

Methods: The machine learning optimal biomarker (OBM) method was employed to predict development of cardiotoxicity (based on serial echocardiographic measurements of left ventricular ejection fraction and longitudinal strain) from computed tomography (CT) images in patients with thoracic malignancy undergoing RT.

Conduction system metastasis in a patient with carcinoma oesophagus.

A young man in his 30s presented to us with multiple episodes of syncope and exertional dyspnoea for the last 2 weeks. He was diagnosed with squamous cell carcinoma of the lower one-third of the oesophagus in 2021 for which he was treated with neoadjuvant chemoradiotherapy, followed by McKeown oesophagectomy. At 2-year follow-up, he had developed a soft tissue swelling in the scalp, which was diagnosed as a tumour recurrence and radiotherapy was initiated.

Retinoic acid homeostasis and disease.

Retinoids, particularly all-trans-retinoic acid (ATRA), play crucial roles in various physiological processes, including development, immune response, and reproduction, by regulating gene transcription through nuclear receptors. This review explores the biosynthetic pathways, homeostatic mechanisms, and the significance of retinoid-binding proteins in maintaining ATRA levels. It highlights the intricate balance required for ATRA homeostasis, emphasizing that both excess and deficiency can lead to severe developmental and health consequences.

Early retinoic acid signaling organizes the body axis and defines domains for the forelimb and eye.

All-trans RA (ATRA) is a small molecule derived from retinol (vitamin A) that directly controls gene expression at the transcriptional level by serving as a ligand for nuclear ATRA receptors. ATRA is produced by ATRA-generating enzymes that convert retinol to retinaldehyde (retinol dehydrogenase; RDH10) followed by conversion of retinaldehyde to ATRA (retinaldehyde dehydrogenase; ALDH1A1, ALDH1A2, or ALDH1A3). Determining what ATRA normally does during vertebrate development has been challenging as studies employing ATRA gain-of-function (RA treatment) often do not agree with genetic loss-of-function studies that remove ATRA via knockouts of ATRA-generating enzymes.

Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy - a delphi methodology.

Introduction: Psoriasis (PsO) is a common chronic, inflammatory, immune-mediated disease. In 2023, a 4.4% prevalence of PsO was reported in Portugal.

The Autonomic Nervous System and Inflammation in Chronic Kidney Disease.

The autonomic nervous system plays a crucial role in regulating physiological processes and maintaining homeostasis through its two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system. Dysregulation of the autonomic system, characterized by increased sympathetic activity and reduced parasympathetic tone, is a common feature in chronic kidney disease (CKD) and cardiovascular disease. This imbalance contributes to a pro-inflammatory state, exacerbating disease progression and increasing the risk for cardiovascular events.

Assessing the Health Impact of Low Seafood Omega-3 Intake on Ischemic Heart Disease: Trends, Demographic Disparities, and Forecasts.

Background: The burden of ischemic heart disease (IHD) due to low intake of seafood omega-3 fatty acids is a major global health concern, particularly impacting mortality and disability rates. Understanding these trends and demographic variations offers insights for targeted public health interventions.

Methods: This study used data from the Global Burden of Disease (GBD) 2021 database to analyze the IHD burden attributable to low omega-3 intake across 204 countries from 1990 to 2021, stratified by age, sex, and region.

Glutamate-mediated antidepressant effects of Jieyu I Formula via modulation of PFC-LHb circuitry in lipopolysaccharide-induced depression model.

Ethnopharmacological Relevance: Jieyu I Formula (JY-I) is an improved version of the classic formula "Sini San" documented in the books Shanghan Lun, which is known for regulating the liver and treating depression. However, the disturbance of neuronal signal transmission in the neural circuit of the brain is closely related to the occurrence of depression, yet its neural mechanism is still unclear.

Aim Of The Study: This study aimed to observe the antidepressant effect of JY-I on depressed mice induced by lipopolysaccharide and its underlying central nervous system mechanisms, focusing on the prefrontal cortex (PFC) to lateral habenular nucleus (LHb) neural circuit in the depressed mice model.

Informed Consent and Shared Decision-Making in Modern Medicine. Case-based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.