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OBJECTIVES: Autoimmune rheumatic diseases (AIRD) are concerned to be underlying affecting the severity of COVID-19 and post COVID-19 conditions. In this study, we assessed aggravation factors and post COVID-19 conditions in patients with AIRD who developed COVID-19 and were treated in our hospital. METHODS: From January 2020 to Augst 2023, we conducted a retrospective survey of 1567 patients with rheumatic diseases (RA: n=788, others: n=779) treated in our hospital. In addition, among them, 66 patients developed COVID-19, confirmed by SARS-Cov2-ART (RA patients: n=43, other patients: n=23). We divided these patients into two groups, moderate to severe group (n=24) and mild group (n=42), and compared exacerbating factors based on clinical features and laboratory parameters between the two groups. In addition, we also assessed the appearance of post-COVID-19 conditions such as symptoms, lasting for more than 3 months after the onset, and compared between the two groups. RESULTS: The moderate to severe group was significantly older than the mild group (73.7±15.2 vs 61.4±13.6 yrs, p=0.0014), received higher dose of corticosteroid (5.37±2.57 vs 2.95±1.45 mg/day, p=0.0398), and showed higher rate of complicating with interstitial pneumonia (33.3 vs 13.0 %, p=0.0216). Post COVID-19 conditions were observed in 15 patients (22.7%). Its incidence was significantly higher in the moderate to severe group (n=10; 41.7%), compared with the mild group (n=5; 11.9%) (p=0.0017). CONCLUSION: In COVID-19 patients complicated with autoimmune rheumatic diseases, older age, corticosteroid dosage, and interstitial pneumonia were thought to be aggravating factors. Post COVID-19 conditions were frequently observed in moderate to severe patients.

Gastrointestinal stromal tumor (GIST) is the most prevalent mesenchymal tumor of the digestive tract. Its growth is primarily influenced by mutations in KIT or PDGFRA. Surgery is the primary treatment option for GIST; however, KIT inhibitors, such as imatinib, are used for inoperable cases. Resistance to imatinib is an upcoming challenge, especially because the effectiveness of alternative drugs is limited. Enhancement of the glycolysis pathway in cancer cells has been identified as a key feature in cancer. This unique metabolic activity has implications on tumor growth, prognosis, and resistance to therapy, even in GIST. Members of the glucose transporter (GLUT) family (particularly GLUT-1) play a significant role in GIST progression and response to treatment. Diagnostic imaging using 18F-fluorodeoxyglucose positron emission tomography/computed tomography, which enables visualization of glucose metabolism, can aid in GIST diagnosis and risk assessment. The interplay between glycolysis and GIST can lead to the development of various therapeutic strategies, especially those involving glycolysis-related molecules, such as hexokinase and lactate dehydrogenase. However, further research is required to understand the full spectrum of glycolysis in GIST and its therapeutic potential. Herein, we present an exhaustive overview and analysis of the role of glycolysis in GIST, especially as a therapeutic target.

IntroductionCleft lip and/or palate (CL/P), the most prevalent congenital anomaly, has been associated with higher rates of child maltreatment. In particular, the presence of cleft lip has more of an impact on external appearance and may increase the risks of negative health outcomes such as parental postpartum depression; however, this concept remains controversial. Item #10 of the Edinburgh Postpartum Depression Scale is the assessment of parental self-harm ideation, and its presence in postpartum mothers merits risk assessments as an emergent issue that may affect the health of both mothers and infants. This study focused on the impact of CL/P on maternal self-harm ideation.MethodsOf 100,300 live births from a nationwide birth cohort in Japan, 238 mothers of infants with CL/P [186 children born with cleft lip (CL ± P) and 52 born with isolated cleft palate (CP)] were included in the analyses. The prospective association of children with CL/P and maternal self-harm ideation, which were acquired using item #10 in the Edinburgh Postpartum Depression Scale at 1 and 6 months postpartum, was examined using binomial logistic regression analyses after multiple imputations and with adjustments for several maternal (age at delivery, smoking habit, and alcohol intake) and child-related (sex and prevalence of other congenital diseases) variables.ResultsThe prevalence of self-harm ideation in 238 mothers of infants with CL/P at 1 and 6 months were 14.7% (35/238) and 18.8% (45/238) [8.2% (8,185/100,062) and 12.9% (12,875/100,062) in the control group], respectively. The odds ratio (95% confidence interval) for maternal self-harm ideation increased with CL/P prevalence [1.80 (1.22–2.65) and 1.47 (0.98–2.18)] at 1 and 6 months of age, respectively. After stratified by the prevalence of cleft lip, we found significant differences in the CL ± P group but not in the CP group. Furthermore, persistent self-harming ideation was associated with a higher risk in the CL ± P group [2.36 (1.43–3.89)].ConclusionCL/P, particularly cleft lip, which is more noticeable externally, was associated with an increased prevalence of maternal self-harm ideation. The findings in this study indicate some potential benefits of increasing support for mothers who have infants with CL/P.

Background: Adult spinal deformity (ASD) surgery has gained popularity, with significant improvements in patient-reported outcomes. Posterior lumbar interbody fusion with multiple grade II osteotomies (PLIF + MOs) and lateral lumbar interbody fusion (LLIF) have been utilized to correct ASD; however, no studies have compared these methods with regard to the pre- and postoperative changes in length and volume of the spinal canal. This study aimed to investigate the 3-dimensional changes in the anterior vertical column length (AVCL), spinal canal length (SCL), and spinal canal volume (SCV) in patients with ASD after surgery, employing LLIF and PLIF + MOs. Methods: This retrospective study examined 44 patients with ASD who underwent surgery between 2010 and 2021 using two corrective surgical methods, LLIF and PLIF + MOs. Radiographic parameters and clinical outcomes were assessed, and three-dimensional models were created from computed tomography images to analyze changes in AVCL, SCL, and SCV. Results: We compared the effects of LLIF and PLIF + MOs on spinal canal dimensions during ASD surgery. LLIF demonstrated an increase in lumbar segment (L1-S1) AVCL and whole spine (T1-S1) SCL by 6.5 ± 8.0 mm and 13.8 ± 7.6 mm, respectively, compared with PLIF + MOs. However, PLIF + MOs exhibited a reduction in the lengths of the lumbar segment AVCL. Postoperative differences were significant for AVCL (L1-S1), SCL fusion level, and first-standing lumbar lordosis between the groups ( p < 0.0001, 0.002, and 0.016, respectively). LLIF significantly increased the SCV at the fusion level and whole spine T1-S1 by 14.5% and 10.6%, respectively, outperforming PLIF + MOs. Despite changes in dimensions, the postoperative Oswestry disability index scores showed no significant difference between the two groups. Conclusions: Our study suggests that LLIF can increase spinal canal space, lumbar lordosis, and anterior column length in the lumbar spinal segment. Knowledge of these variations may be critical for enhancing surgical outcomes and preventing neurological complications.

Background Mineralocorticoid receptor (MR) induces cardiac inflammation cooperatively with nuclear factor‐κB and signal transducer and activator of transcription 3 (STAT3); MR blockers exert anti‐inflammatory effects. However, the underlying mechanism remains unclear. We investigated the anti‐inflammatory effect of esaxerenone, a novel MR blocker, in experimental myocardial infarction (MI) and its underlying mechanisms. Methods and Results Male C57BL/6J mice subjected to ligation of the left anterior descending artery were randomly assigned to either the vehicle or esaxerenone group. Esaxerenone was provided with a regular chow diet. The mice were euthanized at either 4 or 15 days after MI. Cardiac function, fibrosis, and inflammation were evaluated. Esaxerenone significantly improved cardiac function and attenuated cardiac fibrosis at 15 days after MI independently of its antihypertensive effect. Inflammatory cell infiltration, inflammatory‐related gene expression, and elevated serum interleukin‐6 levels at 4 days after MI were significantly attenuated by esaxerenone. In vitro experiments using mouse macrophage‐like cell line RAW264.7 cells demonstrated that esaxerenone‐ and spironolactone‐attenuated lipopolysaccharide‐induced interleukin‐6 expression without altering the posttranslational modification and nuclear translocation of p65 and STAT3. Immunoprecipitation assays revealed that MR interacted with both p65 and STAT3 and enhanced the p65–STAT3 interaction, leading to a subsequent increase in interleukin‐6 promoter activity, which was reversed by esaxerenone. Conclusions Esaxerenone ameliorated postinfarct remodeling in experimental MI through its anti‐inflammatory properties exerted by modulating the transcriptional activity of the MR–p65–STAT3 complex. These results suggest that the MR–p65–STAT3 complex can be a novel therapeutic target for treating MI.

Background This study was conducted to determine optimal predictive ability of National Institutes of Health Stroke Scale (NIHSS) measurements at baseline, 24 hours, and change from baseline to 24 hours after thrombolysis on functional recovery in patients with acute ischemic stroke who participated in the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). Methods and Results ENCHANTED was an international, multicenter, 2×2 quasifactorial, prospective, randomized open trial of low‐dose versus standard‐dose intravenous alteplase and intensive versus guideline‐recommended blood pressure lowering in thrombolysis‐eligible patients with acute ischemic stroke. Absolute (baseline minus 24 hours) and percentage (absolute change/baseline × 100) changes in NIHSS scores were calculated. Receiver operating characteristic curve analyses assessed performance of different NIHSS measurements on 90‐day favorable functional recovery (modified Rankin Scale [mRS] score 0–2) and excellent functional recovery (mRS score 0–1). Youden index was used to identify optimal predictor cutoff points. A total of 4410 patients in the ENCHANTED trial were enrolled. The 24‐hour NIHSS score had the highest discriminative ability for predicting favorable 90‐day functional recovery (mRS score 0–2; area under the curve 0.866 versus 0.755, 0.689, 0.764; P

Background: Although the prevalence rate of valvular heart disease (VHD) is high in patients with systemic lupus erythematosus (SLE), the predictive factors of concomitant VHD have not been fully evaluated. Methods and results: Among 288 patients with SLE who underwent transthoracic echocardiography at Kumamoto University Hospital from 2016 to 2021, 241 patients with sufficient echocardiographic data were retrospectively analysed. Among them, 22 (9 %) had VHD (10 had mitral regurgitation, 3 had aortic regurgitation, 6 had tricuspid regurgitation, 1 had mitral regurgitation and tricuspid regurgitation, and 2 had a prosthetic cardiac valve). After excluding the two patients with a prosthetic cardiac valve, we divided the remaining patients into two groups: the VHD group and non-VHD group. Multivariate logistic regression analysis revealed that age and the platelet count were significantly and independently associated with having VHD (age: odds ratio, 1.06; 95 % confidence interval, 1.02–1.10; p

This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to the Russian invasion of Ukraine in February 2022 and monitoring this reaction for the first six months of the attack through a six-round survey. Each round involved a representative sample of approximately 1010 (1007–1015) Italian adult citizens. Participants were asked questions about emotional reactions to the Russian invasion, coping strategies used, solidarity behaviour toward Ukrainian refugees, perceptions of refugees as a threat to the country, trust in national and international authorities to manage the international situation, and prospects for the future. Demographic data on the respondents were also collected. The survey design was developed by a research group from two universities (the University of Salento and the University of Foggia) and a European research centre, EICAP (European Institute of Cultural Analysis for Policy). The data provided in this article is a resource for researchers, public authorities, and other parties interested in surveying and studying public opinion. This dataset can be used to explore a wide range of topics, including prosocial behaviour and attitudes towards refugees in humanitarian emergencies.

Introduction: Condoliase-based chemonucleolysis is a minimally invasive intermediate treatment option between conservative approaches and surgical interventions for lumbar disk herniation (LDH). In this study, the effects of psychological factors on the clinical outcomes of condoliase therapy for LDH were assessed. Methods: This study involved patients with LDH who received condoliase injections over a 1-year follow-up period. Data from the visual analog scale (VAS) scores for leg and back pain, Oswestry Disability Index, and Hospital Anxiety and Depression Scale (HADS), which was utilized for the psychological assessment, were collected. Using magnetic resonance imaging, changes in disk height and degeneration were evaluated. Data were assessed at baseline and 1-month, 3-month, and 1-year follow-ups. Condoliase therapy was considered effective in patients whose VAS score for leg pain improved by 50% at 1 year from baseline and who did not require surgery. The patients were divided into two groups: those who reported effective treatment (Group E) and those who did not (Group I). Between these two groups, comparative analyses were carried out. Results: In this study, a total of 102 patients (70 men; mean age, 43.8±18.2 years) were included. Condoliase therapy was effective in 76 patients (74.5%). Thirty-five patients (34.3%) showed psychological factors (HADS-Anxiety [HADS-A]8 or HADS-Depression [HADS-D]8) preoperatively and had a significantly lower rate of effectiveness than did those without psychological factors. Group I demonstrated significantly higher baseline back pain VAS, HADS, and HADS-D scores when compared with Group E. Logistic regression analysis identified females and the baseline HADS-D score as independent factors that were related to the effectiveness of condoliase therapy. Conclusions: The patients with psychological factors tended to experience residual pain resulting in adverse effects on the clinical outcomes of chemonucleolysis with condoliase.

Single crystals of alkali aluminoboracites, A4B4Al3O12Cl (A = Li, Na), were grown using the self-flux method, and their isotypic cubic crystal structures were determined by single-crystal X-ray diffraction. Na4B4Al3O12Cl is the first reported sodium boracite, and its lattice parameter [13.5904 (1) Å] is the largest among the boracites consisting of a cation–oxygen framework reported so far. For both crystals, structure models refined in the cubic space group F\overline{4}3c, which assume that all cubic octant subcells in the unit cell are equivalent, converged with R1 factors of ∼0.03. However, the presence of weak hhl reflections with odd h and l values indicates that refinements in the space group F23, which presume a checkerboard-like ordering of two types of subcells with slightly different atomic positions, are more appropriate.

Background/Aims Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. Methods The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. Results In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p

Meander Line Antenna (MLA) is widely employed in compact electronic devices, such as cellular phones and WLAN terminals, owing to its electrically small size. To facilitate practical antenna design, essential equations encompassing self-resonant structure, input resistance, antenna efficiency, and Q factor have been systematically developed. However, the prior self-resonant equations included only inductive reactance (XC), neglecting the capacitive reactance (XD) equation. This manuscript addresses this gap by introducing new design equations, presenting a newly derived $\rm X_{D}$ equation and an improved Q factor expression. The inadequacies of the existing Q factor equation, reliant on the radius of a sphere encompassing the antenna, are addressed by proposing a more fitting expression that incorporates antenna structural parameters using the ratio of reactance to resistance. The overview of existing design equations sets the stage for the introduction of these newly developed equations. To assess the accuracy of electromagnetic (EM) simulation results, a comparative analysis is conducted between simulated and theoretically calculated input resistance values. The derivation of new reactance equations involves the development of $\rm X_{C}$ equations based on electromagnetic theory. The $\rm X_{D}$ equation is established by deriving the stored charge equation from electrical near-field distributions obtained through EM simulations. By applying the relationship between charge and capacitance, a new $\rm X_{D}$ equation is obtained. Subsequently, a new self-resonant equation is derived, and the validity of the newly derived equations is confirmed through EM simulation results, ensuring their accuracy. Two MLA prototypes, with lengths of 0.05 and 0.1 wavelengths at 405 MHz, are fabricated and experimentally validated. Smith chart measurements confirm the self-resonant condition and input resistance. By correlating with the VSWR characteristics, the obtained Q factor of approximately 100 aligns successfully with the results from the reactance equation. The antenna gain is verified at −7.7 dBi and −3.5 dBi for antennas with lengths of 0.05 and 0.1 wavelengths, respectively. These findings establish the practical applicability of the proposed equations for antenna design and elucidate the performance of practical antennas.

Immune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs) in several organs including endocrine glands. Among endocrine irAEs, thyroid and pituitary irAEs are frequently observed, followed by primary adrenal insufficiency, insulin-dependent diabetes mellitus, and hypoparathyroidism. These conditions could lead to life-threatening consequences, such as adrenal crisis and diabetic ketoacidosis. On the other hand, several types of irAEs including thyroid and pituitary irAEs are reported to be associated with better overall survival. Therefore, it is important to understand and manage endocrine irAEs, which differ depending on the ICI regimen used. In this review, we describe the clinical features, potential biomarkers, management strategies, and possible mechanisms of thyroid and pituitary irAEs.

Latar Belakang :Hiperbilirubin merupakan suatu keadaan yang sering terjadi pada neonatus. Ikterus merupakan gambaran klinis berupa pewarnaan kuning pada kulit dan mukosa karena unconjugated bilirubin yang tinggi. Tingginya kasus ikterus neonatorum yang dirawat di rumah sakit kartinidengan persentase (15,09%) menyebabkan perlunya penanganan yang lebih intensif untuk menurunkan kadar bilirubin pada neonates.Tujuan: Untuk mengetahui Efektivitas fototerapi dan sinar matahari terhadap penurunan kadar bilirubin derajat III pada neonatus di Rumah Sakit Kartini Jakarta Tahun 2020. Metodologi :Penelitian ini menggunakan metode quasi experiment dengan melakukan pretest sebelum dan posttest setelah diberikan perlakuan.Populasinya yaitu neonatus dipoli anak RS Kartini Jakarta tahun 2020 pada bulan Januari sebanyak 30 neonatus. Pengambilan sampel menggunakan teknik qouta sampling yaitu seluruh populasi dijadikan sampel semuanya sebanyak 30 neonatus dengan nilai kadar bilirubin >11 mg/dl. Sampel dalam penelitian ini yaitu 15 neonatus dilakukan fototerapi dan 15 neonatus dilakukan terapi sinar matahari. Hasil : Bahwa rata-rata kadar bilirubin pada kelompok intervensi fototerapi dari 13,107 turun sebesar 3,2 menjadi 9,900. Sedangkan kelompok intervensi terapi sinar matahari dari 12,213 turun sebesar 0,74 menjadi 11,473. Kesimpulan:Bahwa teknik fototerapi lebih efektif jika dibandingkan sinar matahari terhadap penurunan kadar bilirubin pada bayi. Saran :Diharapkan rumah sakit dapat memberikan pendidikan kesehatan yang diberikan kepada orang tua bayi baru lahir untuk mengetahui ciri-ciri bayi hiperbilirubin. Serta memberikan bimbingan kepada ibu tentang cara pencegahan atau meminimalisir kejadian ikterik pada bayi baru lahir

Wheelchair basketball players often develop shoulder pain due to repetitive wheelchair propulsion motion. Wheelchair propulsion involves two phases, push and recovery, with several different muscles simultaneously active in each phase. Although differences in the coordinated activity of multiple muscles may influence the mechanism of injury occurrence, there have been no studies investigating muscle synergy in wheelchair propulsion motion. Twelve healthy adult males with no previous wheelchair driving experience were included. The surface electromyography data of 10 muscles involved in shoulder joint movements were measured during a 20 m wheelchair propulsion motion. Muscle synergies were extracted using non-negative matrix factorization analysis of the electromyography data. Four muscle synergies were identified during wheelchair propulsion. Synergy 1 reflects propulsion through shoulder flexion and elbow flexion, while Synergy 2 involves shoulder flexion and elbow extension. Synergy 3 describes shoulder extension returning the upper limb, which has moved forward during the push, back to its original position, and Synergy 4 relates to stabilize the shoulder girdle during the recovery phase. This study is the first to explore muscle synergy during wheelchair propulsion, and the data from healthy participants without disabilities or pain will provide a baseline for future comparisons with data from wheelchair basketball players.

ObjectiveTo summarise evidence of the effects of blood pressure (BP)-lowering interventions after acute spontaneous intracerebral haemorrhage (ICH).MethodsA prespecified systematic review of the Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE databases from inception to 23 June 2020 to identify randomised controlled trials that compared active BP-lowering agents versus placebo or intensive versus guideline BP-lowering targets for adults 6 mL) and proportional (>33%) haematoma growth at 24 hours. Meta-analysis used a one-stage approach, adjusted using generalised linear mixed models with prespecified covariables and trial as a random effect.ResultsOf 7094 studies identified, 50 trials involving 11 494 patients were eligible and 16 (32.0%) shared patient-level data from 6221 (54.1%) patients (mean age 64.2 [SD 12.9], 2266 [36.4%] females) with a median time from symptom onset to randomisation of 3.8 hours (IQR 2.6-5.3). Active/intensive BP-lowering interventions had no effect on the primary outcome compared with placebo/guideline treatment (adjusted OR for unfavourable shift in modified Rankin scale scores: 0.97, 95% CI 0.88 to 1.06; p=0.50), but there was significant heterogeneity by strategy (pinteraction=0.031) and agent (pinteraction6 ml, adjusted OR 0.75, 95%CI 0.60 to 0.92; p=0.0077) and relative (≥33%, adjusted OR 0.82, 95%CI 0.68 to 0.99; p=0.034) haematoma growth.InterpretationOverall, a broad range of interventions to lower BP within 7 days of ICH onset had no overall benefit on functional recovery, despite reducing bleeding. The treatment effect appeared to vary according to strategy and agent.Prospero registration numberCRD42019141136.