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In March 2023, the Society of Abdominal Radiology (SAR) Disease Focused Panel (DFP) on Cholangiocarcinoma (CCA) was formed. One of its initial tasks was for creation of a lexicon specific for CCA to complement the terms related to the Liver Imaging Reporting and Data System (LI-RADS) category M. A committee was formed and vetted 15 unique terms for CCA. The multidisciplinary members of the DFP passed each term by over 90% approval. The purpose of this paper is to describe the process for developing the lexicon, introduce the lexicon terms, and provide a pictorial atlas of the 15 vetted terms relating to the imaging findings of CCA., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background and Study Aims: Colorectal cancer (CRC) is the third most common type of cancer worldwide and the second leading cause of cancer-related death. CRC represents a major public health problem in many countries, and its incidence is increasing worldwide. In Morocco, CRC is the third most common cancer. However, epidemiological data on CRC in Morocco, especially in the north, are very limited. This study aimed to describe the epidemiological and clinicopathological characteristics of CRC in northern Morocco., Patients and Methods: This retrospective study was conducted at the Ahmed Ben Zayed Al Nahyan Regional Oncology Center of Tangier between April 2017 and December 2019. Data were collected from the medical records of confirmed CRC patients and analyzed using SPSS computer software version 23., Results: CRC was detected in 142 patients, accounting for 13.0 % of all cancers identified during the study period in the center. The sex ratio (male/female) of all patients was 1.1. The mean age was 58 years, and the most affected group was 60-69 years old (29.0 %). The rectum was the most common anatomical site (44.0 %) compared to the left and right colon. Histologically, adenocarcinomas were the most common type (91.3 %), half of the tumors were moderately differentiated, and only 4.9 % of the patients presented with poorly differentiated tumors. At diagnosis, 83.0 % of patients were already in advanced stages (stage III, or IV), including 40.3 % presenting with metastatic disease. The liver (64.8 %) was the most affected site by metastasis in our series. Relapse was observed in 11.9 % of patients., Conclusion: Our results showed a younger age at diagnosis and a higher incidence of cancer at the rectal site compared to the Western literature, as well as a high frequency of patients who presented with late-stage disease and other characteristics. However, larger multicenter studies are still needed to confirm our results., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.)

While advancements in critical care and burn treatment have improved over the decades, elderly burn victims continue to face high mortality rates. Measurements of frailty among patients have become popular tools for predicting burn outcomes over chronological age. In this report, we provide a case of a non-frail octogenarian burn victim who deteriorated rapidly during treatment, suggesting that frailty alone is not sufficient in predicting outcomes in older burn patients. An active 86-year-old male with hypertension presented to the emergency department with 35% total body surface area (TBSA) burns following a welding accident. He experienced second and third degree burns to his face, thorax, chest, back, and arms and had possible inhalation injury. Despite wound cleaning and fluid resuscitation, the patient's vitals and pain worsened while waiting for transfer to the burn unit, requiring an oxygen mask and intravenous hydromorphone to be administered multiple times. In the emergency department (ED), the patient also experienced myoglobinuria, decreased urine output, and progressive confusion. Frailty involves understanding how patient comorbidities and functional status influence the body's ability to respond to stressors. Unlike their younger counterparts, octogenarian patients appear to be vulnerable to worse burn outcomes even when non-frail. Thus, physicians should consider injury severity and systemic responses to injury on admission in addition to an elderly patient's pre-burn physiology to guide prognosis and treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bali et al.)

This paper sets out a framework for exploring flourishing in older age through the lens of social support and gratitude. Flourishing is a relatively new concept in positive psychology. Social support and gratitude are as potential predictors of flourishing among older individuals that considers hedonic and eudaimonic aspects of well-being. The current study evaluated the relationship between social support and gratitude associated with flourishing among elderly people. The proposed relationship was assessed among 413 elderly people from north India aged 60-90 years with a mean age of 67.94 years. The data were analysed using a two-step approach to structural equation modeling. The findings revealed that gratitude as a mediator in the relationship between social support and flourishing. Additionally, a significant indirect relationship was also found between perceived social support and flourishing via gratitude. To the best of our knowledge, the current study is one of the first studies that conceptualizes and assesses flourishing among older adults in India. The findings from the present study make important contributions to the existing literature on well-being among elderly population. It is suggested that health and social care professionals working with older adults adopt a comprehensive approach to identify and propel non-flourishing people toward flourishing in life., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The aim of this study is to examine how gene mutation diversity and disease severity affect physical capacity and quality of life in children/adolescents with Familial Mediterranean Fever (FMF)., Methods: Eighty children/adolescents (42 female, 38 male) diagnosed with FMF according to Tell-Hashomer diagnostic criteria were included in this study. Disease severity score (PRAS), running speed and agility and strength subtests of Bruininks-Oseretsky Test of Motor Proficiency Second Edition Short Form (BOT-2 SF), Physical Activity Questionnaire, Pediatric Quality of Life Inventory 3.0 Arthritis Module (PedsQL) was used for evaluation. Participants were divided into 2 groups as M694V and other mutations according to MEFV gene mutation and were divided into 3 groups as mild, moderate and severe according to PRAS., Results: When the data were compared between groups; in terms of gene mutation, a significant difference was observed in treatment subtest of PedsQL-parent form in favor of the M694V gene mutation group (p<0.05). In terms of PRAS, significant difference was seen in the pain, treatment subtests and total score of the PedsQL-child form, and in the pain, treatment, worry subtests and total score of the PedsQL-parent form in favor of the mild group (p<0.05)., Conclusions: MEFV gene mutations in children and adolescents with FMF did not differ on physical capacity and quality of life. PRAS was not effective on physical parameters, but quality of life decreased as the severity score increased. Encouraging children/adolescents with FMF to participate in physical activity and to support them psychosocially can be important to improve their quality of life., (Copyright © 2024 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.)

Neck injury fractures are commonly associated with high-impact trauma, such as motor vehicle accidents or falls from heights. However, this case underscores that it is possible to sustain such a fracture even from minor falls. As of now, there are no such reported cases. This case report highlights the importance of a thorough medical history when assessing patients with neck pain following falls. A 59-year-old male experienced a fainting episode after suffering from vomiting and diarrhea, resulting in him hitting his head. The patient attributed his neck pain to a sudden twisting of his neck. The pain originated from the base of his skull, primarily on the left side, extending to the scalp and the left shoulder. After enduring four days of intense pain that limited his ability to rotate his neck and bend to tie his shoes, he sought medical attention and underwent a neck CT scan, which led to the diagnosis of a "hangman's fracture." This injury was diagnosed in a clinical setting. Healthcare providers should inquire about the circumstances of the fall, the patient's position, associated symptoms, and any relevant pre-existing conditions. This approach ensures an accurate diagnosis and timely treatment. Comprehensive history-taking is essential for identifying high-risk situations and preventing complications that may arise from overlooked minor falls, ultimately enhancing patient safety, especially in cases of neck and spine injuries., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Frezza et al.)

Diabetes is a chronic metabolic disease that endangers the entire body's tissues and organs. Diabetes impairs glucose and insulin regulation in the human body by causing pancreatic cell damage. Diabetes modifies pathways such as serine/threonine protein kinase (Akt) and Protein kinase C (PKC)/- glucose transporter 4 (GLUT4), peroxisome proliferator-activated receptor (PPAR) glucose absorption, and inhibits α-amylase and α-glucosidase, Sodium/glucose cotransporter 1 (SGLT-1), and Na + -K + -ATPase activity. Diabetes may also be caused by a decrease in the expression of sterol regulatory element binding protein 1 (SREBP-1) and its target genes, fatty acid synthase (FAS), stearoyl-CoA desaturase-1 (SCD-1), and acetyl-CoA carboxylase α (ACC), as well as a decrease in the levels of C/EBP homologous protein (CHOP), Caspase12, and Caspase3 proteins. Diabetes has long been linked to diseases of the cardiovascular, nervous, skeletal, reproductive, hepatic, ocular, and renal systems. Diosgenin, a steroidal compound derived from fenugreek, aids in the prevention of diabetes by altering cellular pathways in favor of healthy bodily functions. Diosgenin is a new nutraceutical on the market that claims to cure diabetes in particular. This article focuses on diosgenin extraction and purification, fenugreek bioactive compounds, pharmacological properties of diosgenin, mode of action of diosgenin to cure diabetes, and dosages., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tak, Kaur, Chitranashi, Samota, Verma, Bali and Kumawat.)

Objectives: Posttransplant erythrocytosis affects 8% to 26% of kidney transplant recipients. In this study, our aim was to define associations among hypercalcemia, persistent hyperparathyroidism, and posttransplant erythrocytosis. We also investigated the effects of biologic sex, age, and dialysis modality before transplant on posttransplant erythrocytosis development., Materials and Methods: We enrolled 247 patients [159 (64%) male and 88 (36%) female] who underwent kidney transplant between 2009 and 2018. All demographic and laboratory parameters were retrospectively analyzed as possible factors associated with posttransplant erythrocytosis., Results: Fifty-nine (24%) of total patients had posttransplant erythrocytosis. The median time to posttransplant erythrocytosis development was 16 months (range, 8-34 mo). Male sex, the use of peritoneal dialysis as maintenance renal replacement therapy before kidney transplant, and persistent hyperparathyroidism were defined as independent risk factors for posttransplant erythrocytosis development in our multivariate logistic regression analyses (odds ratio = 5.228, 3.963, and 4.109, respectively). In addition, high serum creatinine levels were associated with a lower incidence of posttransplant erythrocytosis (odds ratio = 0.253). Although significance did not remain after multivariate analysis, hypercalcemia was found to be significantly associated with posttransplant erythrocytosis in univariate analyses (odds ratio = 1.768). In subgroup analyses, where only male patients were evaluated, persistent hyperparathyroidism and peritoneal dialysis were found to be independent risk factors for posttransplant erythrocytosis development (odds ratio = 4.176 and 5.003)., Conclusions: Persistent hyperparathyroidism and hypercalcemia could precipitate development of posttransplant erythrocytosis. The preserved residue renal function may be associated with increased endogenous erythropoietin, which could lead to posttransplant erythrocytosis development.

Our objective was to predict the outcome of peptide receptor radionuclide therapy (PRRT) using multimodality imaging and tumor dosimetry on gastroenteropancreatic neuroendocrine tumor (GEP-NET) lesions and patients. Methods: This prospective study included patients with progressive GEP-NETs. Treatment consisted of 4 cycles of 7.4 GBq of 177 Lu-DOTATATE. Imaging parameters were measured on 68 Ga-DOTATATE PET/CT (SUV max/mean , somatostatin receptor [SSTR] tumor volume [TV], total lesion SSTR expression, and tumor-to-blood and tumor-to-spleen ratios), 18 F-FDG PET/CT (SUV max/mean , metabolically active TV, and total lesion glycolysis), and diffusion-weighted MRI (apparent diffusion coefficient) in a maximum of 5 target lesions per patient at approximately 10 wk after each injection. Tumor dosimetry was performed using SPECT/CT at 3 time points for every cycle. Baseline imaging parameters, their relative changes after PRRT cycle 1 (C1), and the tumor-absorbed dose at C1 were correlated with lesion morphologic outcome. The average values of the imaging parameters and the minimal, maximal, and mean C1 tumor-absorbed dose in each patient were tested for association with progression-free survival (PFS) and best objective response (RECIST 1.1). Results: In the 37 patients, the median PFS was 28 mo. Eleven of the 37 (30%) achieved a partial response (RECIST 1.1). After a median follow-up of 57 mo, the median time to lesion progression had not been reached in 84 morphologically evaluable lesions, with only 12 (14%) progressing (size increase ≥ 20% from baseline). Patients receiving a minimal C1 dose of 35 Gy in all target lesions exhibited a significantly longer PFS (48.1 vs. 26.2 mo; hazard ratio, 0.37; 95% CI, 0.17-0.82; P = 0.02). Volumetric 68 Ga-DOTATATE PET parameters correlated with lesion and patient outcome: patients with an SSTR TV decrease of more than 10% after C1 had a longer PFS (51.3 vs. 22.8 mo; hazard ratio, 0.35; 95% CI, 0.16-0.75; P = 0.003). There was no statistical evidence of an association between other dosimetric or imaging parameters and the lesion or patient outcome. Conclusion: Minimal tumor-absorbed dose at C1 is predictive of outcome in patients with GEP-NETs treated with PRRT, providing a basis for personalized dosimetry-guided treatment strategies. An SSTR TV decrease after C1 could be used for early therapy response assessment as a predictor of PRRT outcome., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

Background: The aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data., Methods: 21 Systemic Sclerosis and 19 healthy were included.Berg Balance Scale (functional balance), Sensamove Sensbalance Maxiboard Software (static, dynamic balance:reaction time and travel time and proprioception), Scleroderma Health Assessment Questionnaire/Health Assessment Questionnaire (health status), Medsger's Disease Severity Scale, Modified Rodnan Skin Score were used in evaluation., Findings: Comparing the groups, there was significant difference in Berg Balance Scale (p:0.036); Health Assessment Questionnaire/Scleroderma Health Assessment Questionnaire (p:0.001); Static balance-center (p:0.001), front (p:0.001), back (p:0.001), left (p:0.001), right (p:0.021); proprioception-front (p:0.025);Reaction Time-front (p:0.031) and left (p:0.010);Travel Time-front (p:0.041) and left (p:0.014) in favor of healthy group.In Systemic Sclerosis, disease severity had moderate correlation with static balance-back (r:-0.504,p:0.020).Skin thickness had low correlation with Reaction Time-front (r:-0.449,p:0.041).Age had low correlation with Travel time-front (r:0.458,p:0.037) and proprioception-left (r:0.450,p:0.041); moderate with Travel time-back (r:0.515;p:0.017) and proprioception-front (r:0.539,p:0.012)., Interpretation: Compared to healthy, Systemic Sclerosis had worse health status, functional balance, static/dynamic balance and proprioception.This situation is related to disease severity, skin thickness and age. Evaluations made with objective methods may have the potential to determine the extent of the problem.Clinicians can guide the treatment of patients with SSc by evaluating their static/dynamic balance and proprioception.With early treatment, additional problems that may occur due to worsening of balance and proprioception can be prevented.Proprioception and dynamic balance evaluation can be performed for older patients, static balance when disease activity is high, and dynamic balance when skin thickness score is high., Competing Interests: Declaration of Competing Interest Author's declare that they have no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

Water pollution is a significant issue worldwide due to an increase in anthropogenic activities. Heavy metals and dyes are among the most problematic contaminants that threaten the environment and negatively impact human health. Iron oxide nanoparticles (IONPs) synthesized using green methods have shown potential in these areas due to their significant adsorption capacity and photocatalytic potential. The size and morphology of biogenic IONPs can be tailored depending upon the concentration of the reducing medium and metal salt precursor. Green-synthesized IONPs have been found to be effective, economical, and environmentally friendly with their large surface area, making them suitable for removing toxic matter from contaminated water. Furthermore, they exhibit antibacterial potential against harmful microorganisms. The study emphasizes the importance of using such environmentally friendly tools to remove heavy metal ions and organic compounds from contaminated water. The underlying mechanism for the adsorption of heavy metal ions, photocatalytic degradation of organic compounds, and antimicrobial action has been explored in detail. The future prospective for the beneficial utilization of biogenic IONPs has also been signified to provide a detailed overview., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: Incidence of new-onset diabetes after transplant negatively affects graft and patient survival. Obesity, impaired fasting glucose before transplant, and a history of diabetes in first-degree relatives are well-defined risk factors. TCF7L2 and CDKAL1 gene polymorphisms have been implicated in the pathogenesis.We investigated the effect of single gene polymorphisms of TCF7L2 (rs7903146) and CDKAL1 (rs7754840) on new-onset diabetes in renal transplant recipients., Materials and Methods: We evaluated 239 renal transplant recipients. TCF7L2 and CDKAL1 gene polymorphisms were assessed by polymerase chain reaction., Results: Mean patient age was 43 ± 13 years. There were 148 male patients (61.9%), and 91 were female (38.1%). New-onset diabetes was detected in 55 patients (23%). In 20 cases (36%), the glycemic disorder was transient; 61% of patients required insulin therapy. In terms of CDKAL1, 108 patients had the wild-type allele, 112 had a single-allele mutation, and 19 had a 2-allele mutation (45.2%, 46.9%, and 7.9%, respectively). In terms of TCF7L2, 163 of the patients had the wild-type allele, 49 had a single-allele mutation, and 27 had a 2-allele mutation (68%, 20%, and 11%, respectively). New-onset diabetes-related factors were age at transplant, body mass index after transplant (calculated as weight in kilograms divided by height in meters squared), tacrolimus, mycophenolate, andTCF7L2 polymorphism but not CDKAL1 polymorphism. After multiple regression analysis, the effect of TCF7L2 polymorphism persisted. A single allelic change resulted in a risk factor 1.4 times higher for new-onset diabetes after transplant (P = .043; 95% CI, 1.142-1.874) and a double allelic change was 2.7 times higher (P < .01; 95% CI, 1.310-4.073)., Conclusions: TCF7L2 (rs7903146) gene polymorphism is an independent risk factor for new-onset diabetes in Turkish renal transplant patients. This study is the first in Turkey to show the distribution and effect of these genes in kidney transplant patients.

The sequestration of contaminants from wastewater, such as heavy metals, has become a major global issue. Multiple technologies have been developed to address this issue. Nanotechnology is attracting significant interest as a new technology, and numerous nanomaterials have been produced for sequestrating heavy metals from polluted water due to their superior properties arising from the nanoscale effect. This study reports biosynthesis of iron oxide nanoparticles (IO-NPs) and their applications for adsorptive sequestration of various metal ions from aqueous solutions. Biosynthesis of IO-NPs has been carried out by using leaf extract of Spilanthes acmella, a medicinal plant. FTIR analysis of the leaf extract and biosynthesized IO-NPs marked the role of various functional groups in biosynthesis of IO-NPs. FESEM analysis revealed the average size range of IO-NPs as 50 to 80 nm, while polydisperse nature was confirmed by DLS analysis. EDX analysis revealed the presence of Fe, O, and C atoms in the elemental composition of the NPs. The antioxidant potential of the biosynthesized IO-NPs (IC 50  = 136.84 µg/mL) was confirmed by DPPH assay. IO-NPs were also used for the adsorptive removal of As 3+ , Co 2+ , Cd 2+ , and Cu 2+ ions from aqueous solutions with process optimization at an optimized pH (7.0) using dosage of IO-NPs as 0.6 g/L (As 3+ and Co 2+ ) and 0.8 g/L (Cd 2+ and Cu 2+ ). Adsorption isotherm analysis revealed the maximum adsorption efficiency for As 3+ (21.83 mg/g) followed by Co 2+ (20.43 mg/g), Cu 2+ (15.29 mg/g), and Cd 2+ (13.54 mg/g) using Langmuir isotherm model. The biosynthesized IO-NPs were equally efficient in the simultaneous sequestration of these heavy metal ions signifying their potential as effective nanoadsorbents., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Gastrointestinal (GI) bleeding (GIB) in athletes has previously been reported in several studies, as an important factor of underperformance in competitive sports events. Yet it is still underreported, partly because it is usually occult and self-limited soon after the effort. It can originate in either the upper or the lower GI tract and can be proportionally related to the amount and duration of effort. Key pathophysiological factors seem to include splanchnic hypoperfusion, mechanical trauma of the GI wall, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Appropriate nutrition, hydration and regulation of exercise, along with substances such as arginine and citrulline can relieve upper and lower GI symptoms, including nausea, vomiting, cramping, diarrhea, and possibly hemorrhage. Cessation of NSAIDs, use of proton pump inhibitors and H 2 -receptor-antagonists, as well as "training" the gut, also seem to be effective in reducing the incidence of GIB in athletes. Maintenance of hemodynamic stability and identification of the source of bleeding are key elements in the management of this condition. Endoscopy might be necessary for both. GIB should not be immediately attributed to endurance exercise, and endoscopy should always be performed to rule out other existing pathology., Competing Interests: Conflict of Interest: None, (Copyright: © Hellenic Society of Gastroenterology.)

The rapid increase in global population and shrinkage of agricultural land necessitates the use of cost-effective renewable sources as alternative to excessive resource-demanding agricultural crops. Microalgae seem to be a potential substitute as it rapidly produces large biomass that can serve as a good source of various functional ingredients that are not produced/synthesized inside the human body and high-value nonessential bioactive compounds. Microalgae-derived bioactive metabolites possess various bioactivities including antioxidant, anti-inflammatory, antimicrobial, anti-carcinogenic, anti-hypertensive, anti-lipidemic, and anti-diabetic activities, thereof rapidly elevating their demand as interesting option in pharmaceuticals, nutraceuticals and functional foods industries for developing new products. However, their utilization in these sectors has been limited. This demands more research to explore the functionality of microalgae derived functional ingredients. Therefore, in this review, we intended to furnish up-to-date knowledge on prospects of bioactive metabolites from microalgae, their bioactivities related to health, the process of microalgae cultivation and harvesting, extraction and purification of bioactive metabolites, role as dietary supplements or functional food, their commercial applications in nutritional and pharmaceutical industries and the challenges in this area of research., Competing Interests: Conflict of interestThe author(s) do not have any conflict of interest., (© The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Amyloid protein aggregation is commonly associated with progressive neurodegenerative diseases, however not all amyloid fibrils are pathogenic. The neuronal cytoplasmic polyadenylation element binding protein is a regulator of synaptic mRNA translation and has been shown to form functional amyloid aggregates that stabilize long-term memory. In adult Drosophila neurons, the cytoplasmic polyadenylation element binding homolog Orb2 is expressed as 2 isoforms, of which the Orb2B isoform is far more abundant, but the rarer Orb2A isoform is required to initiate Orb2 aggregation. The N terminus is a distinctive feature of the Orb2A isoform and is critical for its aggregation. Intriguingly, replacement of phenylalanine in the fifth position of Orb2A with tyrosine (F5Y) in Drosophila impairs stabilization of long-term memory. The structure of endogenous Orb2B fibers was recently determined by cryo-EM, but the structure adopted by fibrillar Orb2A is less certain. Here we use micro-electron diffraction to determine the structure of the first 9 N-terminal residues of Orb2A, at a resolution of 1.05 Å. We find that this segment (which we term M9I) forms an amyloid-like array of parallel in-register β-sheets, which interact through side chain interdigitation of aromatic and hydrophobic residues. Our structure provides an explanation for the decreased aggregation observed for the F5Y mutant and offers a hypothesis for how the addition of a single atom (the tyrosyl oxygen) affects long-term memory. We also propose a structural model of Orb2A that integrates our structure of the M9I segment with the published Orb2B cryo-EM structure., Competing Interests: Conflict of interest D.S.E. is a SAB member and equity holder in ADRx, Inc., (Copyright © 2022. Published by Elsevier Inc.)

BACKGROUND The purpose of this study was to identify the prevalence and risk factors of post-transplant erythrocytosis (PTE) and its relationship with cytomegalovirus (CMV). MATERIAL AND METHODS The study consisted of patients who received a kidney allograft and followed-up in our nephrology transplantation clinic from 2000 to 2014. Patient age, sex, length of dialysis, etiology of end-stage kidney disease, date of transplantation, medications, types of donors, the development of PTE were recorded. RESULTS Among 185 adult kidney recipients, 43 (23.2%) had PTE. The average time between transplantation and diagnosis was 36 months. PTE was more common in male patients (P<0.05) and patients with living donors and those who had been treated with ganciclovir after transplantation (P<0.05). There were 79 patients treated for CMV - 54 in the non-PTE group and 24 in the PTE group. There was no significant difference in patient age, etiology of end-stage kidney disease, and immunosuppressive therapy when comparing the PTE group and non-PTE group. Univariate analysis showed ganciclovir therapy was significantly associated with PTE. However, this was not seen in the multivariate analyses. CONCLUSIONS Treatment with ganciclovir can precipitate development of PTE. Prospective studies are needed to assess the association of between PTE and CMV infection, valganciclovir, and ganciclovir.