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Background: Systemic Lupus Erythematosus (SLE) patients are more likely than the general population to suffer from thyroid illness. The major goal was to assess the thyroid dysfunctions due to immunological factors in Egyptian SLE children and how they are related to the course and severity of the illness. Methods: Fifty children and adolescents with SLE are included in this cross-sectional observational study. Every patient underwent a thorough physical examination and a comprehensive history taking. An enzyme-linked immunosorbent assay (ELISA) approach was used to evaluate the thyroid profile, anti-thyroglobulin (Anti-TG), and anti-thyroid peroxidase (anti-TPO) antibodies. Results: Of the 50 patients, the female: male ratio (F: M = 7:1) was 44 females and 6 males (12%). They were between the ages of 5 and 17. Out of the patients, thirty-two (64%) had thyroid dysfunctions, 19 (38%) had euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none had hyperthyroidism. Of the 50 patients, one (2%) had increased anti-TPO, whereas all other patients had normal anti-TG levels. A statistically significant negative correlation (p-value 0.007) was seen between the disease duration and free thyroxine (FT4). Furthermore, a significant negative correlation (p-values 0.015 and 0.028) was found when comparing the disease duration with thyroid antibodies (anti-TG and anti-TPO). Conclusion: In Juvenile Systemic Lupus Erythematosus (JSLE), thyroid dysfunctions can be identified. The disease duration but not its activity was significantly correlated with thyroid antibodies. For children with JSLE, thyroid function testing should be done on a regular basis. It is preferable to carry out additional thyroid antibody tests when necessary. [ABSTRACT FROM AUTHOR]

This study examined the effects of time restricted eating (TRE) on sex hormones in males and females, versus daily calorie restriction (CR). Adults with obesity (n = 90) were randomized to 1 of 3 groups for 12-months: 8-h TRE (eating only between 12:00 to 8:00 pm, with no calorie counting); CR (25% energy restriction daily); or control. Body weight decreased (P < 0.01) in the TRE and CR groups, relative to controls, in males, premenopausal females, and postmenopausal females, by month 12. Total testosterone, dehydroepiandrosterone (DHEA), and sex hormone binding globulin (SHBG) levels did not change over time, or between groups, in males, premenopausal females, and postmenopausal females. Estradiol, estrone, and progesterone were only measured in postmenopausal females, and remained unchanged. These findings suggest that TRE produces significant weight loss but does not impact circulating sex hormone levels in males and females with obesity over 12 months, relative to CR and controls. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study explored the denaturation of 11S globulin, a protein known for its diverse functional properties in soy protein applications, at pH 3.0 and pH 10.0, followed by a gradual return to pH 7.0 to facilitate renaturation. It investigated the structural and functional changes during renaturation induced by a change in pH, revealing the stabilization mechanism of 11S globulin. RESULTS: The findings revealed that during pH adjustment to neutral, the denatured soybean 11S globulin – resulting from alkaline (pH 10.0) or acidic (pH 3.0) treatments – experienced a refolding of its extended tertiary structure to varying extents. The particle size and the proportions of α‐helix and β‐sheet in the secondary structure aligned progressively with those of the natural‐state protein. However, for the alkali‐denatured 11S, the β‐sheet content decreased upon adjustment to neutral, whereas an increase was observed for the acid‐denatured 11S. In terms of functional properties, after alkaline denaturation, the foaming capacity (FC) and emulsifying activity index (EAI) of 11S increased by 1.4 and 1.2 times, respectively, in comparison with its native state. The solubility, foamability, and emulsifiability of the alkali‐denatured 11S gradually diminished during renaturation but remained superior to those of the native state. Conversely, these properties showed an initial decline, followed by an increase during renaturation triggered by pH neutralization. CONCLUSIONS: This research contributes to the enhancement of protein functionality, offering a theoretical foundation for the development of functional soy protein products and expanding their potential applications. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyse changes in urinary kidney injury markers in children with Mycoplasma pneumoniae pneumonia (MPP), investigate the risk factors for MPP-related acute kidney injury (AKI) and establish a model to predict MPP-related AKI. Methods: Ninety-five children were enrolled based on the study's inclusion and exclusion criteria. They were divided into a severe MPP (SMPP) group and a non-SMPP group and then into an AKI group and a non-AKI group according to the presence of AKI. A univariate logistic regression analysis was performed to explore the early risk factors for AKI. Based on a multivariate logistic regression analysis and a least absolute shrinkage and selection operator regression analysis, appropriate variables were selected to establish a prediction model, and R 4.2.2 software was used to draw nomograms and generate a dynamic nomogram website. Results: Seven urinary kidney injury markers were abnormally elevated in the SMPP group and the non-SMPP group: urinary N-acetyl-β-D-glucosaminidase (NAG), β2-microglobulin, α1-microglobulin, retinol-binding protein, urinary immunoglobulin G, urinary transferrin and urinary microalbumin. Sixteen children were identified with AKI during hospitalisation. The AKI group had higher levels of urinary NAG, α1-microglobulin, β2-microglobulin, urinary microalbumin, urinary transferrin and retinol-binding protein than the non-AKI group (P < 0.05). The MPP-related AKI prediction model consists of four indicators (serum immunoglobulin M [IgM], C-reactive protein [CRP], urine NAG and sputum plug presence) and a dynamic nomogram. Conclusion: Urinary kidney injury markers are often elevated in children with MPP; urinary NAG is the marker most likely to be elevated, and it is especially evident in severe cases. The nomogram of the prediction model, comprising serum IgM, CRP, urinary NAG and sputum plug presence, can predict the probability of AKI in children with MPP. [ABSTRACT FROM AUTHOR]

Introduction: Oats, a highly nutritious cereal known for their health benefits, contain various macromolecules of significant biological value, including abundant and highly digestible proteins. Despite their importance, oat proteins have not been extensively studied. Here, we present a complete set of the expressed globulins genes, which code for the main storage protein in oats as well as their chromosomal positions. Methods: Published expressed sequence tags for globulins were used as queries in the Sang oat genome. In addition, globulin proteins were fractionated from oat flour by solvent extraction based on differential solubility with other classes of cereal proteins. The protein fractions were separated by gel electrophoresis and analyzed by tandem mass spectrometry to confirm their identity and expression in seed. Results and discussion: In total 32 globulin gene sequences were identified on the oat genome. Out of these, the expression on RNA level could be confirmed and 27 were also detected as expressed proteins by MS. Our results provide the most extensive set of salt-soluble oat globulin sequences to date, paving the way for further understanding their implications for human nutrition. In addition, a simple methodology to fractionate oat proteins is presented. [ABSTRACT FROM AUTHOR]

BACKGROUND: Soy 11S globulin has high thermal stability, limiting its application in the production of low‐temperature gel foods. In this study, the low‐frequency magnetic field (LF‐MF, 5 mT) treatment (time, 30, 60, 90, and 120 min) was used to improve the solubility, conformation, physicochemical properties, surface characteristics, and gel properties of soy 11S globulin. RESULTS: Compared with the native soy 11S globulin, the sulfhydryl content, emulsifying capacity, gel strength, water‐holding capacity, and absolute zeta potential values significantly increased (P < 0.05) after LF‐MF treatment. The LF‐MF treatment induced the unfolding of the protein structure and the fracture of disulfide bonds. The variations in solubility, foaming properties, viscosity, surface hydrophobicity, and rheological properties were closely related to the conformational changes of soy 11S globulin, with the optimum LF‐MF modification time being 90 min. CONCLUSION: LF‐MF treatment is an effective method to improve various functional properties of native soy 11S globulin, and this study provides a reference for the development of plant‐based proteins in the food industry. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Failure of passive transfer of immunity (FPT) is a prevalent concern in veterinary practice and can be assessed through various methodologies. Hence, the aim of this study was to assess different methodologies for determining FPT in calves, along with correlating these parameters with maternal and colostral parameters, with the intention of identifying alternative methods for FPT evaluation. Forty-five cows (16 primiparous and 29 multiparous) and their respective colostrum and calves were selected. Blood samples were obtained at birth and 24 h post-colostrum ingestion for biochemical evaluation, including IgG, total protein (TP), albumin, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and triglycerides. A Brix refractometer was employed for assessing samples. Calves from both primiparous and multiparous cows exhibited increased ALP, GGT, globulins, IgG, and TP levels post-colostrum ingestion. Calves born from multiparous cows demonstrated greater increases in TP and IgG levels and lower ALP activity compared to those from primiparous cows. Colostrum from multiparous cows exhibited lower Brix values and higher ALP activity than that from primiparous cows. There was a positive correlation between IgG and globulin levels in calves and maternal globulin levels. Maternal ALP activity showed a negative correlation with calf globulin, IgG, and TP levels via both biochemical and refractometric methods. Maternal TP levels were positively correlated with calf globulin, IgG, and TP levels. Brix and colostral globulin from multiparous cows positively correlated with calf globulin, IgG, and TP levels. Cost-effective and practical methodologies such as refractometry and biochemical assays can serve as reliable tools for FPT assessment in calves. Brix refractometry demonstrated a strong correlation with conventional parameters. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the chemical composition of two chickpea varieties, 'Costa 2004' and 'El Patrón', and to characterize their proteins to determine their technological potential for the food industry. For this purpose, chickpea samples of both varieties from the 2019 harvest region of Guanajuato, Mexico, were obtained and chemically characterized to determine the protein fractions using electrophoretic and amino acid profiling. The chickpea variety 'Costa 2004' contained 3% less protein and 7% less dietary fiber content than the variety 'El Patrón'; whereas, the carbohydrate content of 'Costa 2004' was 4% greater. Additionally, the chickpeas demonstrated an antioxidant capacity ranging from 319 to 387 µMET/g and total phenol levels exceeding 500 mg/g. Among the protein fractions, globulins represented the highest proportion in both varieties of chickpea, at approximately 8.73 g/100 g ('Costa 2004') and 10.42 g/100 g ('El Patrón'), followed by albumin, at approximately 1.24 g/100 g and 1.47 g/100 g, respectively. The chickpea proteins ranged in molecular weight between 100 and 25 kDa, with particularly strong signals in the albumin and globulin bands. Regarding the amino acid profile, histidine was predominant in both varieties. In conclusion, both varieties of chickpea have high nutritional value and broad potential for technological use in the food industry. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is characterized by local inflammatory conditions in the periodontium, its severe form has been associated with elevated systemic inflammatory markers. However, the long‐term effects of periodontal inflammation control on systemic inflammatory markers are unclear. Objective: This study aimed to investigate the long‐term effects of periodontal therapy on the levels of peripheral venous blood inflammatory markers in patients with generalized aggressive periodontitis (GAgP), all of whom were now diagnosed as Stage III or IV Grade C periodontitis. Methods: Patients with GAgP were consecutively recruited from April 2013 to August 2014 (T0). Active periodontal treatment (APT) was provided, and follow‐ups were conducted over a 3‐ to 5‐year period (T1). Clinical parameters were assessed and fasting venous blood was collected at T0 and T1. Complete blood cell counts were obtained, and biochemical analyses were performed to evaluate the levels of serum components. The correlations between probing depth (PD) and hematological parameters were analyzed. Results: A total of 49 patients with GAgP completed APT and follow‐ups. Probing depth (PD) reduced from 5.10 ± 1.07 mm at T0 to 3.15 ± 0.65 mm at T1. For every 1‐mm reduction in PD after treatment, the neutrophil count, neutrophil‐lymphocyte ratio, and total protein concentration were reduced by 0.33 × 109/L, 0.26, and 1.18 g/L, respectively. In contrast, the albumin/globulin ratio increased by 0.10. Conclusion: This study indicated that periodontal therapy may have beneficial effects on peripheral venous blood inflammatory markers in patients with GAgP during long‐term observation. [ABSTRACT FROM AUTHOR]

Scabies is a parasitic infestation of the skin with high prevalence in crowded spaces. In some instances, scabies becomes the underlying factor for complicated skin-borne opportunistic pathogens infections in both children and adults. Geographic area and socio-economic factors are determinants of the endemic pattern of this disease. Currently, the treatment of scabies has been under special attention. A combination of oral therapy with Ivermectin and sulfur-based ointments are the gold standard. However, caution is required in patients with kidney impairment. The renal involvement in children with scabies is mainly caused by acute glomerulonephritis. The severity of the nephritic syndrome can lead to other complications. Also, Ivermectin possesses a nephrotoxic effect. Severe hypertension can lead to neurological complications. The aim of our case report is to present two unusual complications in brothers with scabies. We report the cases of two brothers with scabies who presented with severe skin infection that developed acute post infectious glomerulonephritis (APIGN). In addition, one of the brothers presented with posterior reversible encephalopathy syndrome (PRES). The other one developed acute tubule-interstitial acute kidney injury following Ivermectin administration. The evolution of skin lesions was favorable, and kidney function returned to normal in both brothers. [ABSTRACT FROM AUTHOR]

Background: This study sought to investigate the correlation between serum sex hormone-binding globulin (SHBG) levels and nutrition indicators and the malnutrition exposure risk in men and postmenopausal women with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional analysis was conducted, involving patients diagnosed with T2DM at the Guangdong Provincial People's Hospital between May 2018 and December 2019. Results: The study comprised 551 participants (363 men, mean age of 55.55 ± 11.57 years), among whom 167 (30.31%) were classified as with malnutrition exposure risk (GNRI ≤ 98). Multivariable logistic regression analysis revealed that SHBG (OR = 1.04, 95% CI: 1.02–1.05, P < 0.001), glycated hemoglobin (OR = 1.36, 95% CI: 1.22–1.51, P < 0.001), hemoglobin (OR = 0.96, 95% CI: 0.94–0.97, P < 0.001), and non-alcoholic fatty liver disease (OR = 0.41, 95% CI: 0.23–0.73, P < 0.003) were independently associated with the malnutrition exposure risk. SHBG was inversely correlated with body mass index (males: r = -0.34; postmenopausal females: r = -0.22), albumin (males: r = -0.30; postmenopausal females: r = -0.20), transferrin (males: r = -0.28; postmenopausal females: r = -0.19), and prealbumin (males: r = -0.35; postmenopausal females: r = -0.30) (all P < 0.05). Conclusions: Serum SHBG levels are correlated with nutritional indicators and the risk of malnutrition in men and postmenopausal women with T2DM. A multicenter prospective study is imperative to verify this result in the future. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) presents a notable public health challenge on a global scale, exerting a considerable impact on individuals' health and quality of life. There is mounting evidence indicating a robust association between MetS and levels of sex hormones. Therefore, the study aims to explore the relationship between sex hormone binding-globulin (SHBG) and MetS, and to provide evidence that could inform the development of effective prevention strategies for MetS. Methods: Data for this cross-sectional investigation were collected during the 2013–2016 cycle of the National Health and Nutrition Examination Survey (NHANES), from which 5,499 adults were sampled. The criteria established by the Adult Treatment Program III of the National Cholesterol Education Program were utilized to define MetS. SHBG levels were measured using a standardized technique. Multivariate-adjusted logistic regression, multivariate restricted cubic spline, and threshold effect analyses were utilized to investigate the association between SHBG levels and MetS. Moreover, the stratified analyses and interaction tests of covariables were presented in a forest plot. Finally, sensitivity analysis was utilized to ensure the robustness of the results. Results: Overall, 1822 participants had MetS. After adjusting for possible confounders, SHBG levels were associated with MetS (Odds ratio [OR], 0.984; 95% confidence interval [CI], 0.981–0.986; P < 0.01). The multivariate restricted cubic spline analysis demonstrated a non-linear association between SHBG and MetS (P < 0.001). With two piecewise regression models, the adjusted OR of developing MetS was 0.964 (95% CI, 0.959–0.969; P < 0.001) among people with SHBG < 76.653 nmol/L, but there was no correlation between SHBG and MetS in participants with SHBG ≥ 76.653 nmol/L. The stability of the association between SHBG levels and MetS was confirmed using subgroup analysis and sensitivity analyses. Conclusions: Our results suggest that reduced SHBG levels are associated with an increased prevalence of MetS in adults, particularly when SHBG levels are below 76.653 nmol/L. More investigation is required to understand comprehend the mechanisms underlying these results and to delve into their clinical implications. [ABSTRACT FROM AUTHOR]

Background: Radioactive iodine (RAI) therapy is the standard treatment approach after total thyroidectomy in patients with papillary thyroid carcinoma (PTC). We aimed to identify predictive factors of response to the treatment in intermediate and high-risk patients with PTC. In addition, the impact of multiple RAI treatments was explored. Methods: In a 3-year retrospective study, data from intermediate and high-risk patients with PTC who received RAI therapy following total thyroidectomy, were analyzed by the end of year-one and year-three. Demographic data, tumor size, capsular/vascular invasion, extrathyroidal extension, local or distant metastasis, initial dose and cumulative dose of RAI, serum thyroglobulin(Tg), antithyroglobulin antibody(TgAb), and imaging findings were investigated. Patients with an excellent response to a single dose of RAI treatment, after three years of follow-up were classified as the "Responder group". Excellent response was defined as stimulated serum Tg less than 1 ng/ml, or unstimulated serum Tg less than 0.2 ng/ml in TgAb-negative patients with negative imaging scans. Results: 333 patient records with a complete data set were analyzed in this study. After three years of initial treatment, 271 patients were non-responders (NR) and 62 were responders (R). At baseline, the median pre-ablation serum Tg level was 5.7 ng/ml in the NR group, and 1.25 ng/ml in the R group (P < 0.001). TSH-Stimulated serum Tg greater than 15.7 ng/ml, was associated with response failure even after multiple RAI therapy, AUC: 0.717(0.660–0.774), sensitivity: 52.5%, specificity: 89.47%, P < 0.001. On the other hand, multiple RAI therapy was associated with excellent response in 16.2% of the patients. The chance of ER was decreased by 74% if initial post-operation ultrasound imaging confirmed the presence of locoregional involvement, OR 0.26, (95% CI: 0.12–0.55), P < 0.001. Conclusion: Stimulated serum Tg and locoregional involvement after total thyroidectomy are predictive factors of non-response to RAI therapy in intermediate and high-risk patients with PTC. In addition, a minority of patients achieve excellent response after multiple RAI therapy. [ABSTRACT FROM AUTHOR]

Background: Despite observational links between serum uric acid (SUA), sex hormone-related phenotypes, and female infertility, the causality behind these associations remains uncertain. Objective: This study utilizes Bidirectional Two-Sample and Mediation Mendelian Randomization to explore the causal relationships and mediation effects of sex hormone-binding globulin (SHBG), total testosterone (TT), and estradiol on these associations. Methods: We analyzed single-nucleotide polymorphisms (SNPs) associated with SUA and sex hormone levels using data from large-scale GWAS of European populations. Female infertility data were sourced from 6,481 cases and 75,450 controls in the FinnGen Consortium. We employed methods including Inverse Variance Weighted (IVW), Weighted Median, and MR-Egger regression to assess causality. Results: We found that elevated SUA levels causally increase the risk of female infertility (IVW OR: 1.13, P=0.047). Elevated SUA levels significantly decrease SHBG levels (b=-0.261; P=2.177e-04), with SHBG mediating 27.93% of the effect of SUA on infertility (OR=0.854; 95%CI, 0.793-0.920; P=2.853e-05). Additionally, elevated TT levels, which were associated with decreased SUA levels (b=-0.127), showed an indirect effect on infertility mediated by SUA (b=- 0.0187; 95% CI, -0.041 to -0.003; P=0.046). Conclusion: Our findings demonstrate causal links between high SUA and increased risk of female infertility mediated by hormonal factors such as SHBG and TT. These insights suggest new avenues for infertility treatment and highlight the need for further research into these mechanisms. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Anti‐thymocyte globulin (ATG) based graft versus host disease (GVHD) prophylaxis is widely used for mismatched unrelated donor allogeneic hematopoietic cell transplantation (HCT) although optimal dose remains unclear. Although recent literature suggested improved outcomes with PTCy‐based regimens when compared to ATG‐based regimens these studies used doses of ATG ≥5 mg/kg. Thus, we analyzed outcomes of HLA 9/10 MMUD allogeneic HCTs using lower‐dose ATG‐based regimens at our center.We retrospectively analyzed outcomes of HLA 9/10 MMUD allogeneic HCTs using lower dose ATG‐based regimens for all adults undergoing allogeneic HCT at The Ottawa Hospital from 2015 to 2022. Data regarding demographics, conditioning regimen, dose of ATG, rates of GVHD, duration of remission, and survival, were collected and analyzed.Seventy‐seven (n = 77) patients (males 62.3%; median age 50 years) underwent allogeneic HCT from MMUD. Majority(81%; n = 63) received 2.5 mg/kg of rabbit ATG and remaining 18.2% (n = 14) received 4.5 mg/kg. Grade II‐IV acute GVHD occurred in 24.7% (n = 19) while any chronic GVHD occurred in 32.5% (n = 25) patients. After a median follow‐up of 21 months, relapse occurred in 28.6% of patients. Two‐year OS, GRFS, CIR, and NRM were 60.6%, 45.3%, 16.9%, and 18.2% respectively. Dose of ATG (2.5 mg/kg vs. 4.5 mg/kg) was not associated with outcomes in either univariate or multivariate analyses.When compared to published studies using ATG doses ≥5 mg/kg, GVHD prophylaxis using lower dose ATG may potentially lead to improved outcomes in patients undergoing MMUD allogeneic HCT. Further studies are needed to directly compare lower dose ATG to PTCy‐based regimens to determine ideal GVHD prophylaxis for these patients. [ABSTRACT FROM AUTHOR]

AbstractThis retrospective analysis evaluated the use of anti-thymocyte globulin (ATG) with or without post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GvHD) prophylaxis in children with acute leukemia undergoing hematopoietic stem cell transplantation (HSCT). The study included 57 children, with 35 in the ATG-PTCy group and 22 in the ATG group. While overall incidence of acute and chronic GvHD did not differ significantly between groups, the ATG-PTCy group had lower rates of grade II-IV acute GvHD (p = 0.013) and moderate-to-severe chronic GvHD (p = 0.001) compared to the ATG group. Importantly, ATG-PTCy significantly improved GvHD/relapse-free survival (GRFS) compared to ATG (65.71% vs. 36.63%; p = 0.003). There were no differences in engraftment, infection rates, immune reconstitution, overall survival, leukemia-free survival, relapse rate, or non-relapse mortality between the two groups. Combining ATG with PTCy may reduce moderate-to-severe GvHD and improve GRFS in children undergoing HSCT for acute leukemia. [ABSTRACT FROM AUTHOR]

Introduction: Melanoma is the most aggressive skin cancer, with an increasing occurrence. Despite the recent important improvements due to novel immunotherapy approaches, when late diagnosed, melanoma prognosis is poor due to the metastatic progression and drug-resistance onset. Therefore, there is an urgent need to identify additional therapeutic targets. Melanoma invasive behavior is related to the activity of metalloproteases, able to degrade extracellular matrix leading to tumor dissemination. A recent study suggested that the most potent proteases inhibitor alpha-2-macroglobulin (A2MG) from plasma of hibernating fishes exerts potent antiproliferative effects. Our previous studies showed a significant reduction of A2MG in sera from mice/human melanoma models. Methods: Gene and protein expression studies have been performed by using platforms and databases available online containing expression data from thousands of patients and healthy controls. Results: We carried out an extensive bioinformatics analysis to evaluate the A2MG gene/protein expression on a large cohort of patients affected by many different cancer types, compared to healthy control subjects, and we found a highly significant difference of A2MG expression in 20 out of 31 cancer types (including melanoma) compared to healthy controls. Similar results were also confirmed at the proteomic level using another platform available online. Further, we found that higher A2MG expression is significantly related to overall survival in different cancers including melanoma. Conclusion: Our results strongly suggest A2MG as a novel molecular target in melanoma therapy, as well as in other cancer types. [ABSTRACT FROM AUTHOR]

Summary: The gel‐forming ability of the pulse proteins influences the formation of food products with desirable texture, structure, and stability. In this study, Bambara globulin was fractionated into legumin and vicilin for structural and physicochemical analyses, and heat‐induced gel rheological characterisation. Bambara globulin showed major vicilin (7S, Mw: 120 kDa) and minor legumin (11S, Mw: 410 kDa) components by size exclusion chromatography and gel electrophoresis analyses. Legumin had the lowest amount of all the charged amino acids. One basic subunit (22 kDa) was identified in the legumin fraction with predominant helical structures. The sol–gel transition temperatures increased in the order of globulin (40 °C) < legumin (50 °C) < vicilin (80 °C). The G′ and G″ of globulin showed relatively low dependency on heating time beyond the gel point compared to legumin and vicilin subfractions, suggesting a more rapid establishment of its gel network during gelation. Vicilin gel consisted of a microporous structure with a small lath sheet‐like structure compared to others. Bambara vicilin could be a prospective ingredient in the development of new products with defined textural characteristics. [ABSTRACT FROM AUTHOR]

Setting: Previous studies addressed the association between anti‐thyroid antibodies and recurrent miscarriage (RM), however, the role of anti‐thyroid antibodies in RM patients is debatable. Objectives: Therefore, we conducted this meta‐analysis and the aim of this current study was to assess whether anti‐thyroid peroxidase (anti‐TPO) and/or anti‐thyroglobulin (anti‐TG) antibody positivity was associated with RM. Design: A meta‐analysis was conducted. Participants: Recurrent miscarriage patients. Methods: STATA 12.0 software were applied to compute odds ratios (ORs)/relative risks (RRs) and 95% CIs regarding association between anti‐TPO and anti‐TG antibodies and the prevalence of RM. Results: N = 28 studies (8875 participants) explored effect of anti‐thyroid antibodies on RM. Analysis of the 28 studies revealed significant association between anti‐TPO, anti‐TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.02; 95% CI: 1.63–2.51, p < 0.001; I2 = 44.3%, p value for Q test = 0.004). Analysis of the 20 studies revealed significant association between anti‐TPO antibodies and the prevalence of RM with a random effects model (OR/RR = 1.59; 95% CI: 1.25–2.03, p < 0.001; I2 = 43.1%, p value for Q test = 0.022). Analysis of the 14 studies revealed significant association between anti‐TG antibodies and the prevalence of RM with a random effects model (OR/RR = 2.25; 95% CI: 1.56–3.23, p < 0.001; I2 = 49.2%, p value for Q test = 0.019). Conclusions: Based on the currently available analysis, our findings suggest that women with anti‐TPO and/or anti‐TG antibodies have a higher risk of RM than that in negative antibody women. Further investigation is needed to better clarify the exact role of the anti‐thyroid antibodies in RM and whether treatment is of benefit. Limitations: First, differences from various detection methods and reagents used in different studies may affect the diagnostic interpretation of anti‐thyroid antibodies, which might influence the accuracy of this meta‐analysis. Second, positive anti‐thyroid antibodies seem likely to be part of a more general disorder of maternal immune system, due to restrictions of funding and condition, a complete autoantibody screening investigation is hardly to conduct in all participants, and this could be a possible limitation of all included studies. Third, there is no mention of thyroxine therapy on RM, making the meta‐analysis even more limited. [ABSTRACT FROM AUTHOR]

• Early ovarian cessation even in young women play a role in development of unfavorably altered lipid profile. • Women with newly diagnosed POI exhibited adverse lipid profile along with higher fasting glucose level in contrary to age-matched healthy controls. • Women with non-idiopathic POI present unfavorably altered lipid profile when compared to women with unknown cause of POI. Hypoestrogenism related to the cessation of ovarian function increases the risk of metabolic disorders in postmenopausal women. Women with primary ovarian insufficiency (POI) are exposed to longer period of estrogen deficiency together with a subsequently higher risk of long-term comorbidities. To compare metabolic along with hormonal status among newly diagnosed women with POI with pre- and postmenopausal women. To investigate the impact of POI etiology on both metabolic and hormonal profiles. A case-control study with women assigned to one of the groups: 1) POI (n = 216), 2) age-matched premenopausal (n = 216), 3) postmenopausal (n = 227). Lipid profile, fasting glucose and insulin levels together with insulin resistance were determined among all participants. POI women exhibited increased both total cholesterol (TC, p = 0.04) and low-density lipoprotein cholesterol (LDL-C, p < 0.01) compared to the premenopausal women and higher triglycerides (TG, p < 0.001) than postmenopausal women. POI group showed higher fasting glucose level (p = 0.04) differently to premenopausal women. The idiopathic POI group showed both lower sex hormone binding globulin (p = 0.02) and dehydroepiandrosterone sulfate (p = 0.04) along with reduced TC (p = 0.03) and TG (p = 0.01) together with increased high-density lipoprotein cholesterol (p = 0.04) levels than non-idiopathic POI women. Women with newly diagnosed POI exhibited less favorable lipid profile than pre- or postmenopausal women. The association of negatively changed lipid profile in POI women is mostly mediated by women with unknown cause of premature ovarian cessation. [ABSTRACT FROM AUTHOR]

Serum globulin is associated with inflammatory or immune disorders. However, it has not been established whether it is associated with myasthenia gravis (MG). We investigated the association between globulin with relapse and prognosis in children with MG. A cohort of 148 MG cases and 150 healthy children were retrospectively enrolled from January 2015 to December 2021. Multivariate logistic and Cox regression models were used to analyze the treatment outcomes and recurrence of case group, exploring the influence of globulin. Compared with the control group, globulin levels in the MG group were slightly increased (t = 7.244, p < 0.001). After a mean follow-up of 2.25 ± 1.05 years, 35 cases relapsed, with a relapse rate of 23.65%. Logistic regression analysis showed that globulin levels at admission [adjusted odds ratio (OR) = 1.233, 95% confidence interval (CI) 1.028–1.472, p = 0.018] were independent risk factors for relapse. Cox regression analysis confirmed that globulin levels at admission affects relapse-free time [adjusted hazard ratio (HR) = 0.552, 95% CI 0.357–0.852, p = 0.007]. Receiver operating characteristic curve determined 25.10 as the optimal cutoff value for globulin. Cox regression showed that high globulin levels (>25.10) at admission (adjusted HR = 0.607, 95% CI 0.383–0.961, p = 0.033) were independent risk factors for poor therapeutic outcomes at follow-up. Ordinal logistic regression showed that globulin affects the treatment plan (OR = 1.445, 95% CI 1.223–1.847, p = 0.014). Elevated globulin levels in children with MG on admission predicts a high relapse rate and poor long-term therapeutic efficacies. Serum globulin in children with myasthenia gravis: predicting relapse and prognosis First, the globulin in the MG children was higher than in the healthy controls, and there was some correlation between the globulin and the level of systemic inflammation. Second, globulin has been associated with relapse of MG in children. The higher the globulin, the higher the relapse rate and the shorter the time to prevent a relapse. Third, both initial and final globulin were related to the effect of MG in children, and the higher the long-term effect, the worse the long-term effect. It also influenced the change in treatment plan. [ABSTRACT FROM AUTHOR]

Background: Septic shock, a condition caused by a dysregulated host response to systemic infection, may cause life-threatening organ dysfunction. During sepsis, concentrations of corticosteroid-binding globulin (CBG) in the serum progressively decrease. Therefore, the CBG nadir could play a role in septic shock-related organ failure and mortality. Non-thyroidal illness is a non-thyroidal illness syndrome that refers to changes in thyroid function tests in the inpatients of intensive care units having critical illnesses because of transient changes in the hypothalamicpituitary-thyroid axis that can be explained as a homeostatic mechanism to conserve energy. Aim of the Work: to evaluate the relation of serum CBG and thyroid hormone levels to organ dysfunction and mortality rates in pediatric patients with septic shock. Patients and Methods: We conducted a prospective observational study on 91 pediatric patients with proved sepsis during the period from May 2023 to November 2023 at pediatric intensive care unit (PICU) of Ain shams university hospitals, serum CBG level was measured after at least 6 hours of initiation of inotropes. Thyroid hormones were measured for all patients. The primary outcome was overall ICU mortality and morbidity. Secondary outcomes were 28 and 90-day-mortality, need for mechanical ventilation, renal replacement therapy, need for cardiac inotropic support including the dose and duration of cardiac support infusion, and the need for shock dose steroids. Results: Ninety-one patients were included and subdivided into two groups: survivors (42.9%) and non-survivors (57.1%). A cutoff value of 222.3 mg/dl was calculated for serum CBG levels using the Receiver Operating Characteristic curve (ROC) and Interactive Dot Diagram to differentiate between survivors and non-survivors creating a sensitivity and specificity of 98.08 and 3 1.58 % respectively. Primary outcome: The overall ICU mortality rate due to septic shock was significantly higher in patients with serum CBG levels less than 222.3 mg/dl, p-value=0.000. Secondary outcomes: 28-day mortality rates were higher in patients with CBG levels < 222.3 mg/dl, p-value = 0.00. Also, the need for mechanical ventilation was higher in patients with serum CBG levels < 222.3 mg/dl. There was no significant difference between patients with serum CBG levels <222.3 mg/dl and patients with serum CBG levels > 222.3 mg/dl regarding the need for noradrenaline and dopamine use However, patients with serum CBG <222.3 mg/dl needed higher noradrenaline and dopamine doses when used and a higher need for adrenaline and milrinone use, with longer infusion duration. The prevalence of non-thyroidal illness was 46.1%. Patients with non-thyroidal illness (changes in thyroid hormones levels during critical illness without clinical manifestations) had higher SOFA scores. There was no significant difference between the patients with normal thyroid profiles and non-thyroidal illness patients regarding mortality, dose of cardiac inotropic support, or organ dysfunction. Conclusion:Septic shock patients with CBG < 222.3 mg/dl had a higher need for ventilatory support, vasopressors, and 8.4-fold higher ICU mortality. Non-thyroidal illness is common in septic shock patients with higher SOFA scores but is not associated with a higher mortality rate. [ABSTRACT FROM AUTHOR]

Rh hemolytic disease of the fetus and newborn is a potential risk for D-negative mothers who produce anti-D during pregnancy, which can lead to morbidity and mortality in subsequent pregnancies. To prevent this hemolytic disease, Rho(D) immune globulin (RhIG) is generally administered to D-negative mothers without anti-D at 28 weeks of gestation and shortly after delivery. However, current guidelines suggest that pregnant mothers with molecularly defined weak D types 1, 2, 3, 4.0, and 4.1 do not need RhIG as they are unlikely to produce alloanti-D when exposed to fetuses with D-positive red cells. This issue and the necessity of RHD genotyping have been extensively discussed in Western countries, where these variants are relatively common. Recent evidence indicates that women with Asiantype DEL (c.1227G>A) also do not form alloanti-D when exposed to D-positive red cells. We report that mothers with molecularly defined Asian-type DEL, similar to those with weak D types 1, 2, 3, 4.0, and 4.1, do not require RhIG before and after delivery. Collectively, this review could pave the way for the revision of international guidelines to include the selective use of RhIG based on specific genotypes, particularly in women with the Asian-type DEL. [ABSTRACT FROM AUTHOR]

Phytalproteins have an immense role in plant’s growth and sustenance processes. They can be used as nutritional enhancers of foods we consume. Rheumatoid arthritis is an autoimmune disorder, prevalent in both sexes of humans and especially those above 50 years. Ayurveda suggests plant oils to reduce the pain and inflammation caused by Rheumatoid arthritis (RA). The current study is based on immunoprecipitation interactions between phytal proteins and gamma globulins of Rheumatoid arthritis subjects to assess their role in diagnostics or as immune modulators. A comparative study of proteins of Murraya koenigi, Basal alba (leaves), and Sapindus mukorossi (seed) has been considered for immunoassays. The protein-protein binding capability assessment has shown a positive response with Murraya koenigi phytal proteins than that of Basal alba. The globulins of Sapindus mukorossi seed proteins indicated more specific and prominent interactions than the previous two. The co-immunoprecipitation bands were subjected to LC/MS followed by Bioinformatic studies based on meta Hawkdock and PDB sum. Based on the docking study’s scores, hydrogen bonds and salt bridges, bonding capability between 10 selected gamma globulin proteins and unique proteins, and 4 phytal proteins of Indian soapberry were established. Q3KNS1(sperm function), unique protein Q7Z351(associated with the immune system) and A0A024617 (Alpha-1-antitrypsin) proteins of human serum showed an interaction with A0A0U1XK40, A0A7H1CQR4 of Sapindicus. Studies of RuBISCo (A0A0U1XK40) of Indian soap nut protein and Q3KNS1(Patched domain-containing protein 3 that controls sperm development or sperm function and affects Rheumatoidism of muscles) interactions, can be considered for further studies.

Background: Previous observational studies have indicated an inverse correlation between circulating sex hormone binding globulin (SHBG) levels and the incidence of polycystic ovary syndrome (PCOS). Nevertheless, conventional observational studies may be susceptible to bias. Consequently, we conducted a two-sample Mendelian randomization (MR) investigation to delve deeper into the connection between SHBG levels and the risk of PCOS. Methods: We employed single-nucleotide polymorphisms (SNPs) linked to serum SHBG levels as instrumental variables (IVs). Genetic associations with PCOS were derived from a meta-analysis of GWAS data. Our primary analytical approach relied on the inverse-variance weighted (IVW) method, complemented by alternative MR techniques, including simple-median, weighted-median, MR-Egger regression, and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) testing. Additionally, sensitivity analyses were conducted to assess the robustness of the association. Results: We utilized 289 SNPs associated with serum SHBG levels, achieving genome-wide significance, as instrumental variables (IVs). Our MR analyses revealed that genetically predicted elevated circulating SHBG concentrations were linked to a reduced risk of PCOS (odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.39–0.78, P = 8.30 × 10–4) using the IVW method. MR-Egger regression did not detect any directional pleiotropic effects (P intercept = 0.626). Sensitivity analyses, employing alternative MR methods and IV sets, consistently reaffirmed our results, underscoring the robustness of our findings. Conclusions: Through a genetic epidemiological approach, we have substantiated prior observational literature, indicating a potential causal inverse relationship between serum SHBG concentrations and PCOS risk. Nevertheless, further research is needed to elucidate the underlying mechanism of SHBG in the development of PCOS. [ABSTRACT FROM AUTHOR]

We measured cytomegalovirus (CMV)-specific antibodies that neutralize epithelial cell infection (CMV-AbNEIs) in 101 CMV-seropositive kidney transplant recipients (KTRs) at baseline and posttransplant months 3 and 6. All the patients received antithymocyte globulin and 3-month valganciclovir prophylaxis. There were no significant differences in pretransplant AbNEIs titers between KTRs that developed or did not develop any-level CMV infection or the composite of high-level infection and/or disease. One-year CMV infection-free survival was comparable between KTRs with or without pretransplant CMV-AbNEIs. No differences were observed by months 3 and 6. We observed no protective role for CMV-AbNEIs among CMV-seropositive KTRs undergoing T-cell–depleting induction. [ABSTRACT FROM AUTHOR]

This study investigated the impact of different preheat treatments on the emulsifying and gel textural properties of soy protein with varying 11S/7S ratios. A mixture of 7S and 11S globulins, obtained from defatted soybean meal, was prepared at different ratios. The mixed proteins were subjected to preheating (75 °C, 85 °C, and 95 °C for 5 min) or non-preheating, followed by spray drying or non-spray drying. The solubility of protein mixtures rich in the 7S fraction tended to decrease significantly after heating at 85 °C, while protein mixtures rich in the 11S fraction showed a significant decrease after heating at 95 °C. Surprisingly, the emulsion stability index (ESI) of protein mixtures rich in the 7S fraction significantly improved twofold during processing at 75 °C. This study revealed a negative correlation between the emulsifying ability of soy protein and the 11S/7S ratio. For protein mixtures rich in either the 7S or the 11S fractions, gelling proprieties as well as emulsion activity index (EAI) and ESI showed no significant changes after spray drying; however, surface hydrophobicity was significantly enhanced following heating at 85 °C post-spray drying treatment. These findings provide insights into the alterations in gelling and emulsifying properties during various heating processes, offering great potential for producing soy protein ingredients with enhanced emulsifying ability and gelling property. They also contribute to establishing a theoretical basis for the standardized production of soy protein isolate with specific functional characteristics. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) is the main cause of end-stage renal disease and has a high mortality rate. Currently, no effective treatments are available to reduce the progression of kidney damage associated with diabetes. Objectives: To explore the influence and predictive value of the atherogenic index of plasma (AIP) on early chronic kidney disease and liver injury in patients with type 2 diabetes mellitus (T2DM). Methods: Medical records of 1057 hospitalized adult patients with T2DM between January 2021 and December 2022 were collected. The predictive value of AIP, renal function, and liver injury in patients with T2DM were analyzed using Pearson's correlation, multiple logistic regression, and receiver operating characteristic (ROC) curve analyses. Results: AIP was a sensitive indicator of early liver and kidney injury in patients with T2DM. Patients in the DKD group showed increased AIP that positively correlated with serum creatinine, uric acid, and β2-microglobulin levels. Increased AIP negatively correlated with estimated glomerular filtration rate (eGFR). AIP significantly correlated with alanine aminotransferase and aspartate aminotransferase levels and glutamyl transpeptidase-to-platelet ratio (GPR). An eGFR of 60-100 mL/min/1.73 m2 significantly increased the risk of DKD as the AIP increased. At lower GPR levels, the risk of DKD significantly increased with increasing AIP. However, no significant difference was found between the 2 groups when the GPR was >0.1407. The ROC curve analysis showed that AIP could predict early liver injury. Conclusions: AIP is directly involved in early liver and kidney injury in T2DM and may be a sensitive indicator for early detection. Plain Language Summary: Diabetes and its complications are a global public health concern. Diabetic kidney disease (DKD) is the main cause of end-stage renal disease, and metabolism-related disease factors are found throughout the progression of DKD. This study identified common sensitive indicators of early metabolism-related damage to liver and kidney function in patients with T2DM. [ABSTRACT FROM AUTHOR]

Background: The causal relationship between sex hormone-binding globulin (SHBG) and infertility has remained unclear. Thus, we used Mendelian randomization (MR) to investigate this relationship. Methods: Risk factors for SHBG were extracted from European individuals within the UK Biobank using single-nucleotide polymorphism (SNP) data. Summary-level data for infertility outcomes were obtained from the FinnGen dataset. The causal relationship between SHBG and infertility was examined using inverse variance weighted, weighted model, weighted median, and MR-Egger regression analyses. Additionally, Cochran's Q test and Egger intercept tests were used to confirm the heterogeneity and pleiotropy of identified instrumental variables (IVs). Results: Our findings revealed a significant negative association between sex hormone-binding globulin (SHBG) levels and infertility, particularly with anovulation, a specific form of female infertility. However, SHBG did not exert a causal impact on male infertility or on female infertility of tubal origin. Conclusions: SHBG expression offers protection against the development of certain types of female infertility, suggesting it is a potential therapeutic target for infertility. [ABSTRACT FROM AUTHOR]

Haptoglobin (Hp) is a polymorphic protein that was initially described as a hemoglobin (Hb)-binding protein. The major functions of Hp are to scavenge Hb, prevent iron loss, and prevent heme-based oxidation. Hp regulates angiogenesis, nitric oxide homeostasis, immune responses, and prostaglandin synthesis. Genetic polymorphisms in the Hp gene give rise to different phenotypes, including Hp 1-1, Hp 2-1, and Hp 2-2. Extensive research has been conducted to investigate the association between Hp polymorphisms and several medical conditions including cardiovascular disease, inflammatory bowel disease, cancer, transplantation, and hemoglobinopathies. Generally, the Hp 2-2 phenotype is associated with increased disease risk and poor outcomes. Over the years, the Hp 2 allele has spread under genetic pressures. Individuals with the Hp 2-2 phenotype generally exhibit lower levels of CD163 expression in macrophages. The decreased expression of CD163 may be associated with the poor antioxidant capacity in the serum of subjects carrying the Hp 2-2 phenotype. However, the Hp 1-1 phenotype may confer protection in some cases. The Hp1 allele has strong antioxidant, anti-inflammatory, and immunomodulatory properties. It is important to note that the benefits of the Hp1 allele may vary depending on genetic and environmental factors as well as the specific disease or condition under consideration. Therefore, the Hp1 allele may not necessarily confer advantages in all situations, and its effects may be context-dependent. This review highlights the current understanding of the role of Hp polymorphisms in cardiovascular disease, inflammatory bowel disease, cancer, transplantation, hemoglobinopathies, and polyuria. [ABSTRACT FROM AUTHOR]

Objective: Fournier gangrene is a true urological emergency. This study aimed to evaluate the efficacy of biochemical diagnostic markers in predicting the prognosis of patients who presented to the hospital with Fournier gangrene. Materials and Methods: Sixty-eight male patients who underwent aggressive debridement and drainage for Fournier gangrene were included in the study. The patients were divided into two groups: Group 1 comprised patients who died and group 2 comprised those who survived. Fournier Gangrene Severity index (FGSI), Uludağ FGSI (UFGSI), and age-adjusted Charlson Comorbidity index (ACCI) scores, and urea, creatinine, sodium, potassium, hemogram, aspartat aminotransferaz (AST)/alanin aminotransferaz (ALT), total protein, albumin, globulin, alkaline phosphatase and lactate dehydrogenase values of all patients were recorded. The AST/ALT, albumin/globulin, neutrophil/lymphocyte, and platelet/lymphocyte ratios (PLR) were also noted. Results: The mean age of all patients was 59.04±13.99 (25-89) years. The FGSI, UFGSI, and ACCI scores of the patients in group 1 were found to be significantly worse than those in group 2. When we evaluated systemic inflammation parameters, there was a statistically significant difference between the groups in terms of the AST/ALT and neutrophil/lymphocyte ratios (NLRs) (p=0.042 and 0.023, respectively), but no significant difference was found in relation to the albumin/globulin and PLRs. Conclusion: Non-invasive serum markers, such as AST/ALT and NLR, appear to be useful in evaluating the prognosis of patients with Fournier gangrene. Therefore, we recommend the use of these ratios in the initial evaluation of this patient group. [ABSTRACT FROM AUTHOR]

The nitrogen application rate (NAR) has a significant effect on the contents of wheat grain protein and its composition. There is still no consensus regarding the appropriate NAR, given the differences in studied conditions and influence of factors such as geographical location, climate, and soil nutrient contents. In this study, 66 papers related to wheat grain protein and its composition published from 1984 to 2021 were selected for meta-analysis in comprehensively evaluating the response of wheat grain protein content and composition to NAR in China. The results reveal that NAR significantly increased total protein content by 9.49–28.6%, gliadin by 9.13–30.5%, glutenin by 12.9–45.4%, albumin by 5.06–15.8%, and globulin by 8.52–24.0% of wheat grain in China, respectively, compared to no nitrogen application. The optimal NAR is 240–300 kg ha−1 when specific planting conditions are not being considered. Under different growing conditions, the NAR that provided the greatest increase in wheat grain protein and its composition varied as follows: 180–240 kg ha−1 in Northwest China and at >100 m altitudes; >300 kg ha−1 in North China and at <100 m altitudes and lower soil base nutrient levels; 240–300 kg ha−1 in Southeast China, with higher soil nutrients levels and for all average annual temperatures and precipitation ranges. In conclusion, the results of the present study reveal that it is feasible to systematically enhance the contents of wheat grain protein and its related fractions by appropriate NAR under different cropping conditions. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate changes in erythrocyte morphology associated with alectinib and resulting hemolytic anemia. Methods: This was a retrospective analysis of patients with stage IV non-small-cell lung cancer (NSCLC) treated with alectinib. Erythrocyte morphology (by peripheral-blood film evaluation), hemogram, reticulocyte, direct Coombs tests, serum lactate dehydrogenase (LDH), haptoglobin, and indirect bilirubin levels were evaluated. Demographic characteristics of the patients were also collected. Results: In total, 13 patients (7 women) with a mean age of 52.0±10.5 years were included. Median pre-alectinib hemoglobin level was 12.1 g/ dL [minimum (min): 9.4, maximum (max): 16.2 g/dL]. In total, serum hemoglobin was decreased in 8 patients (61.5%) compared with pre-alectinib levels. The average serum hemoglobin level after alectinib use was determined as 11.6 g/dL (min: 8.5 g/dL, max: 13 g/dL). Serum hemoglobin was <10 g/dL in only 3 patients. De novo anemia developed in six patients. Peripheral blood examination revealed numerous microspheroacanthocytes, some echinocyte, rare fragmented erythrocytes, and generalized anisopoikilocytosis. Serum LDH levels were high in 6 of 13 patients (46.1%) receiving alectinib. Reticulocyte count was high in 10 of 13 patients (76.9%). A decrease in serum haptoglobin was observed in five patients (38.4%). Serum indirect bilirubin was high in two of the patients (15.3%). Conclusion: Alectinib caused changes in the erythrocyte membrane and non-immune hemolysis in almost all patients using it. Hemolytic anemia was not severe enough to require alectinib dose reduction or discontinuation. Physicians caring for patients receiving alectinib should be alert to hematological changes due to drug use. [ABSTRACT FROM AUTHOR]

Copper is an indispensable trace element in metabolism. This study aimed to investigate the relationship between copper and reproductive health, and possibly provide new insights for diagnosis and treatment. This study was based on data extracted from the NHANES database (2013–2014 and 2015–2016). The t-test, ANOVA, Chi-square test, multiple linear regression, and restricted cubic spline analysis were used. Serum copper levels were significantly higher in women with gestational diabetes than in those without gestational diabetes (P = 0.0150). Women with higher copper levels and smoking habits tended to deliver overweight babies (P = 0.028). Women with diabetes had higher serum copper and were prone to deliver overweight babies (P = 0.024). Serum copper levels showed a positive relationship with sex hormone-binding globulin (SHBG) levels (P < 0.0001). In this study, serum copper levels were found to be associated with reproductive health in women. Further studies are required to draw causal inferences. [ABSTRACT FROM AUTHOR]

Objective: Insulin autoimmune syndrome (IAS) is a rare condition that can be overlooked in the differential diagnosis of hypoglycemia. Hematologic malignancies such as multiple myeloma (MM) have been associated with IAS. Very few cases of IAS due to multiple myeloma have been reported in the literature. We wanted to present our case who applied to our clinic with severe hypoglycemia and was diagnosed with multiple myeloma-associated IAS. Case presentation: An 83-year-old male patient was admitted to our clinic with recurrent severe hypoglycemia episodes. When the patient's plasma glucose was 37 mg/dL, insulin level was high (2266 µIU/ml), C-peptide level was relatively normal (3.44 ng/ml); cortisol and ACTH levels were also normal. No pathologic finding was detected in the abdominal MRI and Ga-68 PET/CT. Anti-insulin antibody (IAA) was tested for IAS, and the antibody level was found to be 95.9%. The patient was evaluated in terms of possible conditions that may lead to IAS. Hematology consultation was made due to the fact that the patient had anemia, chronic renal failure, and albumin/globuline discordance, and he was diagnosed with IgG kappa multiple myeloma. Bortezomib and dexamethasone treatment was initiated. A decrease in hypoglycemic symptoms was observed with chemotherapy. Conclusion: IAS should be considered in the differential diagnosis of recurrent hypoglycemia cases of unknown cause. It should be kept in mind that IAS may develop due to multiple myeloma, especially in patients with advanced age and anemia. [ABSTRACT FROM AUTHOR]

To correlate the sexual desire levels with sexual hormone binding globulin and free androgen index in women taking different types of hormonal contraceptives (HCs) containing ethinylestradiol (EE), oestradiol valerate (E2V), 17β-oestradiol (E2), or estetrol (E4), combined or in phasic formulation with different progestogens having antiandrogenic properties. Three hundred and sixty-seven women (age range 18-46) participated in the study. SHBG and total testosterone (TT) were measured, and the Free Androgen Index (FAI) was calculated. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires were used to assess sexual function and distress, respectively. The highest SHBG values and the lowest FAIs were obtained of women on HCs containing EE than those of women on HCs containing E2V/17β E2 or E4 (p < 0.001). Desire scores and FSFI total scores were lower in women on HCs with EE than in those using HCs containing E2V, 17β E2, or E4 (p ≤ 0.001). The women who were on HCs containing EE reported FSDS levels higher than those containing all the other types of oestrogen. Finally, sexual desire and FSFI total scores had a negative correlation with the SHBG values and a positive correlation with FAI percentage (p ≤ 0.0001). A minority of women using HCs with EE might experience a decreased sexual desire. This was not observed in women on HCs containing E2V, 17 E2, or E4. To avoid HC discontinuation, due to sexual desire reduction, HCs having minor antiandrogenic effects could be taken into consideration. [ABSTRACT FROM AUTHOR]

• High-dose individualized ATG with TDM is safe. • Actual exposures of ATG can be well predicted. • The protocol is effective to prevent GvHD and rejection in this high-risk population. Graft-versus-host disease (GvHD) and rejection are main limitations of cord blood transplantation (CBT), more so in patients with severe inflammation or previous rejections. While rigorous T-cell depletion with antithymocyte globulin (ATG) is needed to prevent GvHD and rejection, overexposure to ATG leads to slow T-cell recovery after transplantation, especially in CBT. To evaluate high-dose, upfront ATG with individualized dosing and therapeutic drug monitoring (TDM) in pediatric CBT for patients at high risk for GvHD and rejection. Heavily inflamed patients and patients with a recent history of rejection were eligible for individualized high-dose ATG with real-time TDM. The ATG dosing scheme was adjusted to target a post-CBT exposure of <10 AU*day/mL, while achieving a pre-CBT exposure of 60–120 AU*day/mL; exposure levels previously defined for optimal efficacy and safety in terms of reduced GvHD and rejection, respectively. Main outcomes of interest included efficacy (target exposure attainment) and safety (incidence of GvHD and rejection). Other outcomes of interest included T-cell recovery and survival. Twenty-one patients were included ranging from 2 months to 18 years old, receiving an actual median cumulative dose of ATG of 13.3 mg/kg (range 6–30 mg/kg) starting at a median 15 days (range 12–17) prior to CBT. Dosing was adjusted in 14 patients (increased in 3 and decreased in 11 patients). Eighteen (86%) and 19 (91%) patients reached the target pre-CBT and post-CBT exposure, respectively. Cumulative incidence for acute GvHD was 34% (95% CI 23–45) and 5% (95% CI 0–10%) for grade 2–4 and grade 3–4, respectively; cumulative incidence of rejection was 9% (95% CI 2–16%). Overall survival was 75% (95% CI 65–85%). Individualized high-dose ATG with TDM is feasible and safe for patients with hyperinflammation in a CBT setting. We observe high target ATG exposure attainment, good immune reconstitution (despite very high doses of ATG) and acceptable rates of GvHD and rejection. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the prognosis of unrelated umbilical cord blood transplantation (UCBT) using low-dose anti-thymocyte globulin (ATG) in children diagnosed with severe aplastic anemia (SAA). Methods: This retrospective case series study was conducted involving pediatric SAA patients treated at the Capital Institute of Pediatrics from January 2020 to February 2023. All patients underwent a reduced-intensity conditioning (RIC) regimen alongside low-dose ATG. Results: The study comprised nine patients (five males) with a median age of 5 years (range: 1.7 to 7 years). The median follow-up duration was 799 days (range: 367 to 1481 days), during which all patients survived. The median time interval from diagnosis to transplantation was 3 months (range: 1 to 9 months). The median dosage of ATG administered was 5 mg/kg (range: 2.5 to 7.5 mg/kg). The median durations for granulocyte and platelet engraftment were 15 days (range: 12 to 23 days) and 26 days (range: 12 to 41 days), respectively. Three patients experienced grade 2–4 acute graft-versus-host disease (aGVHD). Epstein-Barr virus (EBV) reactivation was observed in three patients, while cytomegalovirus (CMV) reactivation occurred in seven patients, with no cases of CMV disease or post-transplant lymphoproliferative disorder (PTLD). One patient experienced recurrence 15 months after transplantation due to influenza A infection. Conclusion: These findings indicate that SAA patients may attain a favorable prognosis following UCBT with a RIC regimen combined with low-dose ATG. [ABSTRACT FROM AUTHOR]

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Objective: Black groups have increased prevalence and accelerated pathogenicity of systemic lupus erythematosus (SLE) compared to other ethnic/racial groups. The microbiome and systemic microbial translocation are considered contributing factors to SLE disease pathogenesis. However, racial differences in the plasma microbiome and microbial translocation in lupus remain unknown. Methods: In the current study, we investigated plasma levels of microbial translocation (lipopolysaccharide [LPS] and zonulin) and the plasma microbiome using microbial 16S RNA sequencing of Black and White patients with SLE and Black and White healthy controls. Results: Plasma microbial translocation was increased in Black patients versus in White patients and in patients with SLE versus healthy controls regardless of race. Compared to sex, age, and disease status, race had the strongest association with plasma microbiome differences. Black groups (Black controls and Black patients) had lower α‐diversity than White groups (White controls and White patients) and more distinct β‐diversity. Black and White patients demonstrated differences in plasma bacterial presence, including Staphylococcus and Burkholderia. Compared to White patients, Black patients had higher SLE Disease Activity Index (SLEDAI) scores and urinary protein levels as well as a trend for increased anti–double‐stranded DNA (dsDNA) antibody levels consistent with the known increased severity of lupus in Black patients overall. Certain plasma bacteria at the genus level were identified that were associated with the SLEDAI score, urinary protein, and anti‐dsDNA antibody levels. Conclusion: This study reveals racial differences in both quality and quantity of plasma microbial translocation and identified specific plasma microbiome differences associated with SLE disease pathogenesis. Thus, this study may provide new insights into future potential microbiome therapies on SLE pathogenesis. [ABSTRACT FROM AUTHOR]

Simple Summary: Allogeneic hematopoietic stem cell transplantation (allo-HCT) remains an effective treatment modality in many hematological malignancies. Few studies directly compare rabbit anti-thymocyte globulin (r-ATG) formulations Thymoglobuline (ATG-T) and Grafalon (ATG-G). Our retrospective analysis compared the outcomes in 87 adult allo-HCT patients receiving ATG-T or ATG-G. No significant differences were found in acute graft-versus-host disease (aGvHD) incidence. However, chronic GvHD (cGvHD) was less common with ATG-T (7.5% vs. 38.3%, p = 0.001). ATG-T patients had higher cytomegalovirus (CMV) reactivation rates (70% vs. 31.9%, p < 0.001) and a shorter time to CMV (<61 days, 77.8% vs. 33.3%, p = 0.008), but were mostly asymptomatic (85.7% vs. 43.8%, p = 0.005). Overall survival (OS) and relapse-free survival (RFS) at 5 and 3 years, respectively, showed no significant differences between ATG-T and ATG-G (32.0% vs. 40.3%, p = 0.423; 66.7% vs. 60.4%, p = 0.544). Despite notable advancements in immunotherapy in the past decades, allogeneic hematopoietic stem cell transplantation (allo-HCT) remains a promising, potentially curative treatment modality. Only a limited number of studies have performed a direct comparison of two prevalent rabbit anti-thymocyte globulin (r-ATG) formulations—specifically, Thymoglobuline (ATG-T, formerly Genzyme) and Grafalon (ATG-G, formerly Fresenius). The primary objective of our retrospective analysis was to compare the outcomes of adult patients undergoing matched or mismatched unrelated donor (MUD/MMUD) allo-HCT, with a graft-versus-host disease (GvHD) prophylaxis based on either ATG-T or ATG-G. A total of 87 patients who had undergone allo-HCT between 2012 and 2022 were included. We observed no significant differences between ATG-T and ATG-G concerning the occurrence of acute graft-versus-host disease (aGvHD), regardless of its severity. Conversely, chronic graft-versus-host disease (cGvHD) occurred less frequently in the ATG-T group compared to the ATG-G group (7.5% vs. 38.3%, p = 0.001). The negative impact of ATG-G on cGvHD was confirmed by multivariate analysis (HR 8.12, 95% CI 2.06–32.0, p = 0.003). Patients treated with ATG-T manifested a higher incidence of cytomegalovirus (CMV) reactivations (70% vs. 31.9%, p < 0.001), with a shorter time between transplant and CMV (<61 days, 77.8% vs. 33.3%, p = 0.008) and a higher median CMV copy number (1000 vs. 0, p = 0.004). Notably, despite a higher occurrence of CMV reactivations in the ATG-T cohort, most patients were asymptomatic compared to ATG-G (85.7% vs. 43.8%, p = 0.005). By multivariate analysis, only aGvHD had an influence on CMV reactivations (HR 0.18, 95% CI 0.04–0.75, p = 0.019). Finally, we observed no significant differences in terms of 5-year overall survival (OS) and 3-year relapse-free survival (RFS) while comparing ATG-T and ATG-G (32.0% vs. 40.3%, p = 0.423; 66.7% vs. 60.4%, p = 0.544, respectively). [ABSTRACT FROM AUTHOR]

This study intended to investigate the impact of long‐term tenofovir fumarate (TDF) antiviral regimen on renal function in human immunodeficiency virus (HIV)‐infected patients with low‐risk of kidney injury. The observational study involving 100 HIV‐infected patients without underlying diseases who achieved virological suppression and immunological recovery after sustained antiviral regimen of TDF+ lamivudine+ efavirenz (TLE) for 3.19 years. Renal function, including estimated glomerular filtration rate (eGFR), blood and urine β2 microglobulin, and other parameters, was assessed every 3 months over a period of 2.5 years. The eGFR showed a slight increasement from 116.0 at month 0 to 119.7 at month 30. Blood β2 microglobulin increased from 2.02 mg/L at month 0 to 2.77 mg/L at month 30. Compared to month 0, the difference in blood β2 microglobulin was statistically significant at month 6 and months 12‐30 (P <.05). The incidence of proximal renal tubular dysfunction fluctuated from 2% at month 0 to 2.5% at month 30. The urine β2 microglobulin fluctuated from 0.5 (0.3‐1.1) to 0.8 (0.5‐1.35) mg/L at months 18‐30, which was higher than 0.41 (0.18‐1.1) mg/L at month 0 (P <.05). The abnormal concentration proportion of urine β2 microglobulin fluctuated from 72.7% to 81.3% at months 18‐30, which was higher than the proportion of 57.0% at month 0. The abnormal proportion of blood β2 microglobulin, urine β2 microglobulin, and proximal renal tubular dysfunction were not correlated with eGFR (r1 = 0.119, r2 = −0.008, r3 = −0.165, P >.05). Long‐term TDF antiviral regimen in low‐risk of kidney injury HIV‐infected patients may lead to damage in the proximal renal tubules and glomeruli. Blood and urine β2 microglobulin levels may be helpful in screening for renal dysfunction. [ABSTRACT FROM AUTHOR]

Background: Tubular dysfunction can cause electrolyte disturbances with potentially serious consequences. We studied the epidemiology and outcomes of electrolyte disturbances and tubular dysfunction among critically ill children and evaluated their relationships with acute kidney injury (AKI). Methods: We conducted a prospective cohort study recruiting children aged 1 month to ≤ 18 years old admitted to the pediatric intensive care unit (PICU) from 6/2020 to 6/2021. The serum levels of sodium, potassium, calcium, phosphate, and magnesium were reviewed and simultaneous urinary investigations for tubular function were performed among children with electrolyte disturbances. Results: Altogether there were 253 episodes of admission. The median (interquartile) age was 4.9 (1.3–11.0) years and 58.1% were male. The median number of electrolyte disorders was 3 (2–4) types. Hypophosphatemia (74.2%), hypocalcemia (70.3%) and hypermagnesemia (52.9%) were the three commonest types of disturbances. Urinary electrolyte wasting was commonly observed among children with hypomagnesemia (70.6%), hypophosphatemia (67.4%) and hypokalemia (28.6%). Tubular dysfunction was detected in 82.6% of patients and urinary β2-microglobulin level significantly correlated with the severity of tubular dysfunction (p < 0.001). The development of tubular dysfunction was independent of AKI status. Tubular dysfunction was associated with mortality (p < 0.001) and was an independent predictor of PICU length of stay (LOS) (p < 0.001). The incorporation of the tubular dysfunction severity into the AKI staging system improved the prediction of PICU LOS. Conclusions: Tubular dysfunction was associated with both morbidity and mortality in critically ill children and its assessment may help to capture a more comprehensive picture of acute kidney insult. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the efficacy and safety of basiliximab (BAS) versus a single dose of anti‐thymocyte globulin (r‐ATG) induction therapy in pediatric kidney transplant recipients (KTRs). Methods: This single‐center retrospective comparative cohort study included all pediatric KTRs from May 2013 to April 2018 and followed up to 12 months. In the first period, all recipients received BAS, while from May 2016, a single 3 mg/kg dose of r‐ATG was instituted. Maintenance therapy consisted of a calcineurin inhibitor plus prednisone plus azathioprine or mycophenolate. Results: A total of 227 patients were included (BAS, n = 113; r‐ATG, n = 114). The main combination of immunosuppressive drugs was tacrolimus, prednisone, and azathioprine in both groups (87% vs. 88%, p =.718). Patients receiving r‐ATG showed superior survival‐free of the composite endpoint (acute rejection, graft loss, or death; 76% vs. 61%, p =.003; HR 2.08, 1.29–3.34, p =.003) and lower incidence of biopsy‐proven acute rejection (10% vs. 21%, p =.015). There was no difference in the overall incidence of CMV infection (33% vs. 37%, p =.457), PTLD (1% vs. 3%, p =.309), 30‐day hospital readmissions (24% vs. 23%, p =.847), and kidney function at 12 months (86 ± 29 vs. 84 ± 30 mL/min/1.73m2, p =.614). Conclusions: These data suggest that induction therapy with a single 3 mg/kg dose of r‐ATG is associated with higher efficacy for preventing acute rejection and similar safety profile compared to BAS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Breast cancer is the most frequent malignancy among women all over the globe. The albumin/globulin ratio (AGR) is a simple and cost-effective inflammatory measure that is strongly related with cancer patient prognosis and treatment response. Aim: To evaluate the prognostic impact of albumin to globulin ratio on the outcome of women with metastatic breast cancer. METHODS: This study is a retrospective analysis of data obtained from sixty female patients diagnosed with metastatic breast cancer and treated in Medical Oncology Department, Zagazig University from January 2015 to December 2017. Several variables were extracted anonymously from patients' medical records, then were analyzed by applying receiver operating curve (ROC) analysis. RESULTS: Kaplan Meier survival curves disclosed a 5-year overall survival rate which differed significantly in patients as regard the AGR (p < 0.001), with AGR cut-off value (≤1.1). The 5-year overall survival rate was 35%. On the other side, there were no statistically significant differences between neither AGR and PFS (p = 0.297), nor clinical or pathologic criteria of our studied patients. CONCLUSIONS: Statistically significant correlation was found between AGR and OS; high AGR was associated with prolonged OS. Nevertheless, according to follow-up, a long-term follow-up should be done to assess its prognostic significance for disease-free survival. [ABSTRACT FROM AUTHOR]

The underlying etiology of schizophrenia is still not fully understood, and recent studies have pointed to a potential link between hormonal factors and the risk of developing this condition. Sex Hormone-Binding Globulin (SHBG) is a protein that regulates the bioavailability of sex hormones. However, the causal relationship between SHBG levels and schizophrenia remains unclear, this study aimed to investigate the causal relationship based on two-sample Mendelian randomization (MR) analysis. This study was based on the summary data of genome-wide association studies (GWAS) of schizophrenia and SHBG in European populations. Two-sample MR was applied, and genetic factors were used as instrumental variables, and the causal relationship between schizophrenia and SHBG was assessed. We selected 79 single nucleotide polymorphisms with genome-wide significance from the schizophrenia GWAS as instrumental variables. The inverse variance weighting (IVW) method results showed that there is a causal relationship and a positive correlation between schizophrenia and female SHBG, with an odds ratio (OR) of 1.024 (95%CI: 1.007–1.042, P = 0.005), and this result was further confirmed by the Weighted median odds ratio (OR) of 1.032 (95%CI: 1.016–1.048, P = 5.58E-05) and the Weighted mode of 1.035 (95%CI: 1.004–1.067, P = 0.028). Schizophrenia and male SHBG also have a causal relationship and a positive correlation, with an odds ratio (OR) of 1.027 (95%CI: 1.007–1.047, P = 0.008). This study found a positive correlation between schizophrenia and SHBG in both men and women through MR analysis, indicating that the level of SHBG may be elevated in patients with schizophrenia, regardless of gender. [ABSTRACT FROM AUTHOR]

Background: Current Association for the Advancement of Blood & Biotherapies (AABB) standards require transfusion services to have a policy on Rh immune globulin (RhIG) immunoprophylaxis for when RhD‐negative patients are exposed to RhD‐positive red cells. This is a survey of AABB‐accredited transfusion services in the United States (US) regarding institutional policies and practices on RhIG immunoprophylaxis after RhD‐negative patients receive RhD‐positive (i.e., RhD‐incompatible) packed red blood cell (pRBC) and platelet transfusions. Results: Approximately half of the respondents (50.4%, 116/230) have policies on RhIG administration after RhD‐incompatible pRBC and platelet transfusions, while others had policies for only pRBC (13.5%, 31/230) or only platelet (17.8%, 41/230) transfusions, but not both. In contrast, 18.3% (42/230) report that their institution has no written policies on RhIG immunoprophylaxis after RhD‐incompatible transfusions. Most institutions (70.2%, 99/141) do not have policies addressing safety parameters to mitigate the risk of hemolysis associated with the high dose of RhIG required to prevent RhD alloimmunization after RhD‐incompatible pRBC transfusions. Discussion: With approximately half of US AABB‐accredited institutions report having policies on RhIG immunoprophylaxis after both RhD‐incompatible pRBC and platelet transfusions, some institutions may not be in compliance with AABB standards. Further, most with policies on RhIG immunoprophylaxis after RhD‐incompatible pRBC transfusion do not have written safeguards to mitigate the risk of hemolysis associated with the high dose of RhIG required. Conclusion: This survey underscores the diverse and inadequate institutional policies on RhIG immunoprophylaxis after RhD exposure in Rh‐negative patients via transfusion. This observation identifies an opportunity to improve transfusion safety. [ABSTRACT FROM AUTHOR]

This study explores the genetic diversity of soybean (Glycine max) genotypes using polyacrylamide gel electrophoresis (A-PAGE) to analyze globulin reserve proteins. The research utilized 51 soybean genotypes from various origins, including Canada, Turkey, Uzbekistan and others. The APAGE method was employed to extract and analyze the globulin storage proteins in the grains of soybean samples. The proteins were categorized into ω, γ, β and α zones, revealing distinct electrophoretic patterns among the genotypes. A total of 22 spectra and 107 patterns were identified, demonstrating polymorphism based on the frequency of occurrence. The genetic diversity index, calculated using Nei’s formula, indicated varying levels of genetic diversity across the different zones. [ABSTRACT FROM AUTHOR]