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Current chelation treatments used for cadmium poisoning may cause some serious side effects. Thus, safer novel treatments could be promising for clinical use. This study evaluated the effects of cannabidiol on Cd toxicity. Four groups of 10 mice were formed: Groups I and III were cadmium-free, while groups II and IV received 50 mg/L cadmium in drinking water. Groups III and IV received daily cannabidiol (25 mg/kg) via intragastric gavage. After 30 days, the animals were killed, and blood and tissue samples were collected. Oxidative stress and inflammation markers, including glutathione, catalase, myeloperoxidase, TNF-α, IL-1β and IL-6, were analysed using ELISA. Additionally, histological evaluations of the liver, kidney and testis were performed. Cadmium exposure reduced glutathione and catalase levels in the blood, liver, kidney and testis, while increasing myeloperoxidase. Cannabidiol mitigated these effects on oxidative stress markers. Cannabidiol also reduced the increase in proinflammatory cytokines. Histopathological analysis revealed reduced liver and kidney damage in cannabidiol-treated groups compared to cadmium-only groups. In addition, histopathological evaluation showed CBD had no protective effect on the testicular tissue against Cd toxicity. Our results indicate that cannabidiol protects against some toxic effects of cadmium. If confirmed by future studies, cannabidiol may be proposed as a novel treatment for cadmium toxicity., (© 2025 The Author(s). Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)

A new reversed phase high-performance liquid chromatography (RP-HPLC) method, with a short analysis time and easy to apply, was developed for the simultaneous detection of cimetidine (CIM), metoprolol tartrate (MT) and phenol red (PR) for use in intestinal perfusion studies. The analysis was performed with phosphate buffer (pH 5.0, 12.5 mM)-acetonitrile mixture as mobile phase and C 18 column (Inertsil ODS-3; 5 µm, 4.6 × 250 mm) as stationary phase. Gradient analysis conditions were used and the acetonitrile ratio in the mobile phase varied from 10 to 50% in 10 min. Total run time for analysis was 10 min and the injection volume was 20 µL. Detection of compounds was performed at 207 nm. Under optimum HPLC conditions, retention times were 4.03 min for CIM, 6.99 min for MT and 8.49 min for PR. The method was validated according to ICH Q2 (R1) guideline for specificity, linearity, sensitivity, precision, accuracy, stability and robustness. Developed method was linear and determination coefficients of the calibration curves were 0.9993, 0.9991 and 1.0 for CIM, MT and PR, respectively. The limits of quantification were 6.20, 2.78 and 0.45 μg/mL for CIM, MT and PR, respectively. The precision and accuracy values of the developed analytical method met the ICH Q2 (R1) limits. The applicability of the method was demonstrated by preliminary in-situ intestinal perfusion studies. In conclusion, samples obtained from in-situ intestinal perfusion studies performed to examine the absorption/permeability of CIM, MT, and PR can be analyzed with the developed HPLC method., 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 © 2025 Elsevier B.V. All rights reserved.)

Context: Artificial intelligence research in the field of neuroendocrinology has accelerated. It is possible to develop noninvasive, easy-to-use and cost-effective procedures that can replace invasive procedures for the differential diagnosis of adrenocorticotropin (ACTH)-dependent Cushing syndrome (CS) by artificial intelligence., Objective: This study aimed to develop machine-learning (ML) algorithms for the differential diagnosis of ACTH-dependent CS based on biochemical and radiological features., Methods: Logistic regression algorithms were used for ML, and the area under the receiver operating characteristics curve was used to measure performance. We used Shapley contributed comments (SHAP) values, which help explain the results of the ML models to identify the meaning of each feature and facilitate interpretation., Results: A total of 106 patients, 80 with Cushing disease (CD) and 26 with ectopic ACTH syndrome (EAS), were enrolled in the study. The ML task was created to classify patients with ACTH-dependent CS into CD and EAS. The average AUROC value obtained in the cross-validation of the logistic regression model created for the classification task was 0.850. The diagnostic accuracy of the algorithm was 86%. The SHAP values indicated that the most important determinants for the model were the 2-day 2-mg dexamethasone suppression test, greater than 50% suppression in the 8-mg high-dose dexamethasone test, late-night salivary cortisol, and the diameter of the pituitary adenoma. We have also made our algorithm available to all clinicians via a user-friendly interface., Conclusion: ML algorithms have the potential to serve as an alternative decision-support tool to invasive procedures in the differential diagnosis of ACTH-dependent CS., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background and Objectives : Bone and mineral disease (BMD) is a prevalent complication of advanced chronic kidney disease (CKD). The risk of fractures can be assessed via dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). This study aims to evaluate the effectiveness of two imaging modalities in identifying bone mineral status in individuals with pre-dialysis chronic renal disease and to assess their correlation with bone turnover markers. Materials and Methods : This controlled cross-sectional study, conducted at a single center from 2019 to 2022, assessed two groups of individuals aged 18 to 50. The patient cohort consisted of individuals with stage 4-5 chronic kidney disease, whereas the control cohort consisted of healthy participants. The participants' bone and mineral status was evaluated using both QCT and DXA methods. Diagnostic measurements of the lumbar spine and femoral neck, obtained using DXA and QCT, were compared. Z-scores were utilized to evaluate low bone mineral density, with low Z-scores identified in either lumbar spine or femoral neck measures being seen as indicative of low bone mineral density. Results : Data from 38 participants (patient group: 18; control group: 20) who underwent QCT and/or DXA were evaluated. Thirty-three subjects were assessed using both QCT and DXA (patient group: 14; control group: 19). The median age of the patient cohort was 44 (range: 22-50), whereas the median age of the control cohort was 42 (range: 27-48) ( p = 0.72). Women constituted 33% of the patient cohort and 50% of the control cohort ( p = 0.23). In the patient cohort, low bone mineral density was detected in four individuals (28%) through QCT, and in just two patients (14%) through DXA. Compared to DXA, QCT identified a higher number of cases of low bone mineral density in the CKD cohort; however, no statistically significant difference was observed ( p = 0.06). In addition, our study found that TRACP5b had a strong negative correlation with the DXA L1-L4 Z-score. Conclusions : This study revealed that QCT may be more sensitive than DXA for detecting low bone density in pre-dialysis CKD patients. Additionally, DXA may overestimate lumbar spine BMD in this population, and the strong negative correlation between TRACP5b levels and the DXA L1-L4 Z-score highlights the potential role of biochemical markers in assessing bone status in CKD.

Fitting rate constants to Hyperpolarized [1- 13 C]Pyruvate (HP C13) MRI data is a promising approach for quantifying metabolism in vivo. Current methods typically fit each voxel of the dataset using a least-squares objective. With these methods, each voxel is considered independently, and the spatial relationships are not considered during fitting. In this work, we use a convolutional neural network, a U-Net, with convolutions across the 2D spatial dimensions to estimate pyruvate-to-lactate conversion rate, k PL , maps from dynamic HP C13 datasets. We designed a framework for creating simulated anatomically accurate brain data that matches typical HP C13 characteristics to provide large amounts of data for training with ground truth results. The U-Net is initially trained with the digital phantom data and then further trained with in vivo datasets for regularization. In simulation where ground-truth k PL maps are available, the U-Net outperforms voxel-wise fitting with and without spatiotemporal denoising, particularly for low SNR data. In vivo data was evaluated qualitatively, as no ground truth is available, and before regularization the U-Net predicted k PL maps appear oversmoothed. After further training with in vivo data, the resulting k PL maps appear more realistic. This study demonstrates how to use a U-Net to estimate rate constant maps for HP C13 data, including a comprehensive framework for generating a large amount of anatomically realistic simulated data and an approach for regularization. This simulation and architecture provide a foundation that can be built upon in the future for improved performance., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Peder Larson reports a relationship with GE Healthcare that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Background: Overweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women., Methods: In this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations., Results: Of the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines., Conclusions: Pre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed., Competing Interests: Declarations. Human Ethics and Consent to participate declarations: This study was conducted in accordance with the principles of the Declaration of Helsinki, and all procedures involving human participants were approved by “Buca Seyfi Demirsoy Training and Research Hospital, Non-invasive Research Ethics Committee”. According to the national regulations, in retrospective studies, consent to participate is unneccessary. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Data sharing statement: The datasets generated and/or analysed during the current study are not publicly available due to privacy issues and national regulations but are available from the corresponding author on reasonable request. Clinical trials registration: This is not a clinical trial but is a retrospective study investigating medical records. As this retrospective study look back at existing data, such as medical records, to find associations or outcomes, we did not get a Clinical Trials registration number., (© 2025. The Author(s).)

Sepsis is a clinical condition causing tissue damage as a result of infection and an exaggerated immune response. Sepsis causes 11 million deaths annually, a third of which are associated with acute lung injury (ALI). Rapid and effective treatment is crucial to improve survival rates. Punica granatum (pomegranate) is rich in polyphenols and demonstrates strong antioxidant activity, while amifostine acts as a free radical scavenger. This study aimed to investigate the antioxidant and anti-inflammatory effects of P. granatum peel extract (PGPE) and amifostine in sepsis-related ALI. Experimental groups included Control, CLP (cecal ligation and puncture-induced sepsis), Amf (200 mg/kg amifostine, intraperitoneally), and PGPE250, and PGPE500 (250 and 500 mg/kg PGPE via oral gavage, respectively). Thiobarbituric acid reactive substances (TBARS), total thiol (TT), tumor necrosis factor-alpha (TNF-α) levels, and metalloproteinases 2 and 9 (MMP-2 and MMP-9) were assessed in the lung tissue. Biochemical analysis demonstrated that TBARS and TNF-α levels significantly decreased in both the PGPE and amifostine treatment groups compared to the CLP group, while TT levels showed notable improvement. Histopathological evaluation revealed reduced MMP-2 and MMP-9 immunopositivity in the PGPE250 and PGPE500 groups. These findings highlight the lung-protective properties of PGPE, underscoring its potential as a therapeutic agent for sepsis-induced acute lung injury.

Objective: The objective of the systematic review will be to evaluate the effect of paternity leave or fathers' parental leave on infant mortality rate, hospitalization, vaccination compliance, and breastfeeding duration., Introduction: Current studies indicate that paternity leave positively affects infant health, but there is a significant lack of synthesized research on its impact on key infant health indicators. A systematic review of the existing evidence will help identify best practices and guide further research and policy development in this area., Inclusion Criteria: The proposed systematic review will include studies such as experimental, quasi-experimental, and analytic observational studies, conducted among infants less than 1 year of age, exploring the effect of fathers' paternity leave or fathers' parental leave on the identified infant health outcomes., Methods: The review will follow the JBI methodology for systematic reviews of effectiveness. A 3-step search strategy will be used, with no date or language restrictions. Study selection will also follow a 3-step process, including critical appraisal to determine methodological quality. Each step will be conducted by 2 independent reviewers; disagreements will be resolved through discussion or with other team members. The team will extract data using standardized templates from JBI SUMARI, then synthesize and conduct meta-analysis, if possible. If not, narrative synthesis will be conducted. Finally, the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to determine certainty of evidence will be used to create a summary of findings., Review Registration Number: This protocol has been registered in PROSPERO: CRD42024502533., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. On Behalf of JBI.)

Background: The coexistence of primary glomerulonephritis and autoimmune thyroid disease has not been investigated., Objective: This study aimed to assess thyroid morphology using sonography, determine the prevalence of autoimmune thyroid disorders, and evaluate thyroid function status in patients diagnosed with primary glomerulonephritis., Materials and Methods: This single-center cross-sectional and observational study included 58 consecutive patients with primary glomerulonephritis and 58 healthy controls (HC). All participants underwent thyroid examination through laboratory tests and thyroid ultrasonography. The findings were subsequently compared between the two groups., Results: Among the patients, 17.2% (n = 10) exhibited subclinical hypothyroidism, while 8.6% (n = 5) had overt hypothyroidism. None of the HCs showed overt hypothyroidism, whereas 3.4% (n = 2) of them exhibited subclinical hypothyroidism. Patients displayed significantly lower free triiodothyronine (FT3) levels than HCs (p < 0.001). A linear correlation was observed between patients' thyroid-stimulating hormone (TSH) levels and the degree of proteinuria (p = 0.044). Furthermore, thyroid volume (p < 0.001), hypoechogenicity (p < 0.001), heterogeneous structure (p < 0.001), pseudonodular hypoechoic infiltration (p = 0.05), and the presence of nodules (p < 0.001) were notably higher in patients compared to HCs., Conclusion: The prevalence of both overt and subclinical hypothyroidism, along with the frequency of nodular goiter, was found to be elevated in patients with primary glomerulonephritis. Considering that primary glomerulonephritis predominantly afflicts young individuals, and these patients bear the lifelong burden of chronic kidney disease, we underscore the significance of routine thyroid function tests and sonographic examinations for the early detection of thyroid disorders., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: Juvenile SLE (jSLE) is an autoimmune disease characterised by the presence of high levels of autoantibodies, predominantly targeting nuclear antigens, resulting in a breakdown of self-tolerance. However, its pathogenesis is multifactorial and poorly understood. The aim of this study was to evaluate the potential of nuclear factor-kappa B (NF-κB) and peroxisome proliferator-activated receptor-gamma (PPAR-γ) as biomarkers for jSLE., Methods: In this study, serum NF-κB and PPAR-γ levels were determined by immunoassay in 42 patients with jSLE. In addition, 19 juvenile systemic sclerosis (jSSc) and 25 age-matched healthy children were selected as patient control and healthy control, respectively., Results: Serum NF-κB levels in patients with jSLE demonstrated a positive trend towards elevation compared with the controls with no significant difference (p=0.030). In addition, serum NF-κB levels in patients with jSSc were significantly higher than that of the healthy controls (p=0.005). Serum PPAR-γ levels were tend to be lower in both patients with jSLE and jSSc compared with the controls, with no significant difference. Specifically, NF-κB levels were significantly higher in patients with jSLE with cumulative damage (PedSDI≥1) compared with those without, at p=0.044. Logistic regression showed that PPAR-γ levels lower than 2.42 ng/mL were associated with the development of jSLE (OR 7.59) and lower than 2.16 ng/mL for jSSc (OR 10.90). The combined high levels of NF-κB with low PPAR-γ increased the risk of developing jSSc by 21.33-fold., Conclusions: The observed trend of elevated NF-κB levels and decreased PPAR-γ levels in our study suggests their potential as biomarkers associated with increased proinflammatory signalling in jSLE and jSSc. However, our findings must be regarded as hypothesis-generating and confirmed in larger datasets. Moreover, their roles in monitoring the course of a disease and guiding therapeutic strategies in juvenile systemic autoimmune diseases need to be clearly investigated. Further extension of these findings may lead to better management and improvement in the outcomes of such patients., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: In this study, we aimed to evaluate and compare the characteristics of pediatric and adult rhupus patients., Methods: Thirty pediatric patients with rhupus syndrome and 15 adult patients with rhupus syndrome were included in this study. Similarities and differences between both groups were evaluated., Results: The time elapsed between the diagnosis of juvenile idiopathic arthritis (JIA)/rheumatoid arthritis (RA) and the diagnosis of systemic lupus erythematosus (SLE) was longer in adults than in pediatric patients (p < 0.001). While the most common phenotypes at disease onset were JIA/RA in both adults and children, SLE was more prevalent in pediatric patients and RA in adult patients at the last visit (both p < 0.001). Cutaneous findings, oral ulcers, hematological and renal involvement, hypocomplementemia, and antidouble-stranded DNA positivity were more frequent in pediatric patients, whereas constitutional findings, nonscarring alopecia, neuropsychiatric involvement, and anticyclic citrullinated peptide positivity were more common in adults (all p < 0.001). Asymmetric polyarthritis was more prevalent in pediatric patients, whereas symmetric polyarthritis was more common in adult patients (both p < 0.001). Erosive arthritis was more frequently observed in adult patients (p < 0.001). In the treatment, mycophenolate mofetil was more commonly prescribed to pediatric patients, while rituximab was more frequently used for adult patients in the treatment of SLE compared to pediatric patients (both p < 0.001). Additionally, leflunomide was more commonly used in JIA/RA treatment in adult patients compared to pediatric patients (p < 0.001)., Conclusion: This is the first study comparing pediatric and adult patients with rhupus syndrome. Revealing these differences and similarities will contribute significantly to the literature., (© 2025 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Study Objectives: Whereas previous research has primarily focused on the immediate effects of concussion within the first year postinjury, this study examines the persistent effects of concussion on subsequent sleep quality in adolescent soccer players., Methods: This study used a cross-sectional design, recruiting a convenience sample of adolescent athletes from US Youth Soccer camps. Participants completed a self-reported questionnaire including the Pittsburgh Sleep Quality Index to assess their sleep quality. Athletes were also asked to report sport participation information, any past occurrence of concussion or knee injury, and any sport-related injury in the past 12 months. Independent samples t tests were performed to identify significant differences in Pittsburgh Sleep Quality Index scores between injured and noninjured participants., Results: A total of 177 participants (103 male, 14.61 ± 1.88 years of age) were included in the analysis. The concussion injury group exhibited later bedtimes (difference: 0.32 ± 0.05 hours, P = .047), fewer hours of sleep (difference: 0.56 ± 0.11 hours, P = .015), and more frequent sleep disturbances ( P = .012). Furthermore, these athletes reported lengthened sleep latency (difference: 2.55 ± 3.36 minutes, P = .016) and higher levels of daytime dysfunction ( P = .041) following their concussion injuries. Moreover, athletes in the concussion injury group displayed worse sleep quality scores (difference: 0.42 ± 0.06, P < .001) and higher total Pittsburgh Sleep Quality Index scores (difference: 1.91 ± 0.41, P < .001). No significant differences were found based on past knee injury or sport-related injury in the past 12 months., Conclusions: These findings suggest the need for targeted interventions aimed at improving sleep quality in adolescent athletes with a history of concussion., Citation: Sahin S, Erdman AL, Loewen A, et al. Concussion history is associated with poor sleep quality in adolescent athletes: a cross-sectional study. J Clin Sleep Med. 2025;21(1):129-135., (© 2025 American Academy of Sleep Medicine.)

Phantoms representing anatomical deformations are necessary to investigate and improve dynamic treatments. In this study, we aimed to produce a deformable liver phantom by simulating respiratory motion. The dynamically DEformable Liver Phantom (DELP) is designed to create a human-specific respiratory model and to produce synchronised, repeatable motion with this model. For the deformation effect of this movement, an artificial liver was created using silicone material and mold. A stepper motor was used to compress the liver in the inferior direction according to an adjustable respiratory motion. Reference markers (fiducial) placed on the DELP helped to verify the movement and calculate the deformation. In dynamic deformation tests, the greatest amount of deformation was found in the edge region of the silicone liver. The average deformation was 3.45 ± 0.93 mm when 5 mm amplitude movement was applied and 5.98 ± 0.01 mm when 10 mm amplitude movement was applied. DELP is a deformable liver phantom with motion reproducibility. Its performance in radiotherapy application was evaluated using dosimetric equipment., 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 Elsevier Ltd. All rights reserved.)