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Children with chronic kidney disease (CKD) can have an inherent vulnerability to dehydration. Younger children are unable to freely access water, and CKD aetiology and stage can associate with reduced kidney concentrating capacity, which can also impact risk. This article aims to review the risk factors and consequences of mild dehydration and underhydration in CKD, with a particular focus on evidence for risk of CKD progression. We discuss that assessment of dehydration in the CKD population is more challenging than in the healthy population, thus complicating the definition of adequate hydration and clinical research in this field. We review pathophysiologic studies that suggest mild dehydration and underhydration may cause hyperfiltration injury and impact renal function, with arginine vasopressin as a key mediator. Randomised controlled trials in adults have not shown an impact of improved hydration in CKD outcomes, but more vulnerable populations with baseline low fluid intake or poor kidney concentrating capacity need to be studied. There is little published data on the frequency of dehydration, and risk of complications, acute or chronic, in children with CKD. Despite conflicting evidence and the need for more research, we propose that paediatric CKD management should routinely include an assessment of individual dehydration risk along with a treatment plan, and we provide a framework that could be used in outpatient settings. [ABSTRACT FROM AUTHOR]

In teleost fish, branchial ionocytes are important sites for osmoregulation and acid-base regulation by maintaining ionic balance in the body fluid. During the early developmental stages before the formation of the gills, teleost ionocytes are localized in the yolk-sac membrane and body skin. By comparing with teleost fish, much less is known about ionocytes in developing embryos of elasmobranch fish. The present study investigated the development of ionocytes in the embryo and larva of cloudy catshark, Scyliorhinus torazame. We first observed ionocyte distribution by immunohistochemical staining with anti-Na+/K+-ATPase (NKA) and anti-vacuolar-type H+-ATPase (V-ATPase) antibodies. The NKA- and V-ATPase-rich ionocytes appeared as single cells in the gill filaments from stage 31, the stage of pre-hatching, while the ionocytes on the body skin and yolk-sac membrane were also observed. From stage 32, in addition to single ionocytes on the gill filaments, some outstanding follicular structures of NKA-immunoreactive cells were developed to fill the inter-filament region of the gill septa. The follicular ionocytes possess NKA in the basolateral membrane and Na+/H+ exchanger 3 in the apical membrane, indicating that they are involved in acid-base regulation like single NKA-rich ionocytes. Three-dimensional analysis and whole-mount immunohistochemistry revealed that the distribution of follicular ionocytes was limited to the rostral side of gill septum. The rostral sides of gill septum might be exposed to faster water flow than caudal side because the gills of sharks gently curved backward. This dissymmetric distribution of follicular ionocytes is considered to facilitate efficient body-fluid homeostasis of catshark embryo. [ABSTRACT FROM AUTHOR]

Excessive water consumption is an extremely rare and potential asthma risk factor with very few cases reported in the literature. Common triggers of asthma include genetic factors, smoking, allergens, and viral respiratory infections. The adult patient with asthma reportedly drank too much water and was unable to get relief from his asthma while hospitalized. The patient's asthma was better controlled with the use of diuretics and control of the patient's fluid intake and output. This case explores asthma induced by excessive drinking of water. [ABSTRACT FROM AUTHOR]

During prolonged running at moderate‐to‐high intensity, running economy (RE) deteriorates and attainable maximal oxygen consumption (VO2max) decreases. Whether these changes appear similarly in trained and untrained runners exercising at the same relative intensity is not clear. We recruited 10 trained runners (TR) and 10 active adults (AA), and compared RE and attainable VO2max before and after 1 h of running at 70% of VO2max. Submaximal VO2 increased more (p = 0.019) in AA (0.20 ± 0.13 L min−1) than in TR (0.07 ± 0.05 L min−1). Attainable VO2max decreased in AA (−0.21 ± 0.15 L min−1, p = 0.002), but remained unchanged in TR (−0.05 ± 0.10 L min−1, p = 0.18). Relative intensity (i.e., VO2/attainable VO2max), increased more (p = 0.001) in AA (8.3 ± 4.4%) than in TR (2.6 ± 1.9%). These results demonstrate that the ability to resist changes in RE and VO2max following prolonged running is superior in trained versus untrained runners, when exercising at the same relative intensity. [ABSTRACT FROM AUTHOR]

Background: We assessed the incidence of and risk factors for acute kidney injury (AKI) in very low birthweight infants (VLBW) in a center with a specific neonatal management protocol focusing on avoidance of early mechanical ventilation (MV). Methods: This retrospective single center analysis includes 128 infants born in 2020 with a gestational age ≥ 22 weeks who were screened for AKI using the nKDIGO criteria. Results: AKI was identified in 25/128 patients (19.5%) with eight of them (6.3%) presenting with severe AKI. Low gestational age, birthweight and 10-minute Apgar score as well as high CRIB-1 score were all associated with incidence of AKI. Forty-five percent of the infants with MV developed AKI vs. 8.9% of those without MV (p < 0.001). Early onset of MV and administration of more than 3 dosages of NSAIDs for patent duct were identified as independent risk factors for AKI in a logistic regression analysis. Conclusions: We report a substantially lower frequency of AKI in VLBW infants as compared to previous studies, along with a very low rate of MV. A neonatal protocol focusing on avoidance of MV within the first days of life may be a key factor to decrease the risk of AKI in immature infants. [ABSTRACT FROM AUTHOR]

Aim: We examined the acute effects of a moderate alcohol dose (48 g) ingested before prolonged cycling on acute physiological responses in eight healthy males (mean ± SD; 23 ± 2 years; 1.77 ± 0.04 m; 75.8 ± 4.1 kg). Methods: In a randomized order, euhydrated participants completed two experimental sessions with the sequence of 150-min seated at rest, 90-min of cycling at 50% of the maximal rate of oxygen consumption (⁠|$\dot{\textrm V}\textrm O$| 2max), 120-min seated at rest. Participants drank 250 mL of flavored squash with or without alcohol (vodka; ~16 g) at 10, 40, and 70 min of the initial resting phase, giving a cumulative fluid intake of 750 mL with 48 g of alcohol. Heart rate, blood glucose, breath alcohol concentration, and respiratory gasses were recorded throughout the entire trial with cumulative urine volume recorded during both rest phases. Results: Total carbohydrate (control = 115 ± 19 g: alcohol = 119 ± 21 g; P  = 0.303) and lipid (control = 17 ± 4 g: alcohol = 20 ± 7 g; P  = 0.169) oxidation was similar between conditions. Average heart rate was 7% higher in the alcohol condition (control = 111 ± 12 bpm; alcohol = 119 ± 11 bpm; P  = 0.003). Blood glucose concentrations were similar between conditions during (P  = 0.782) and after exercise (P  = 0.247). Urine output was initially increased between conditions following alcohol ingestion before diminishing (P  < 0.001) with no difference in total cumulative urine output (P  = 0.331). Conclusion: Consuming an alcoholic drink containing 48 g of alcohol in the hour before moderate intensity sub-maximal aerobic exercise led to detectable increases in heart rate and rate of urine production with no effect on substrate use. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is a frequent complication of children admitted to the paediatric intensive care unit. One key management modality of AKI is the use of diuretics to reduce fluid overload. Aminophylline, a drug that is well known for its use in the treatment of bronchial asthma, is also purported to have diuretic effects on the kidneys. This retrospective cohort study assesses the effect of aminophylline in critically ill children with AKI. Methods: A retrospective chart review of children admitted to the paediatric intensive care unit of the Red Cross War Memorial Children's Hospital (RCWMCH) with AKI who received aminophylline (from 2012 to June 2018) was carried out. Data captured and analyzed included demographics, underlying disease conditions, medications, urine output, fluid balance, and kidney function. Results: Data from thirty-four children were analyzed. Urine output increased from a median of 0.4 mls/kg/hr [IQR: 0.1, 1.1] at six hours prior to aminophylline administration to 0.6 mls/kg/hr [IQR: 0.2, 1.9] at six hours and 1.6 mls/kg/hr [IQR:0.2, 4.2] at twenty-four hours post aminophylline therapy. The median urine output significantly varied across the age groups over the 24-h time period post-aminophylline, with the most response in the neonates. There was no significant change in serum creatinine levels six hours post-aminophylline administration [109(IQR: 77, 227)—125.5(IQR: 82, 200) micromole/l] P-value = 0.135. However, there were significant age-related changes in creatinine levels at six hours post-aminophylline therapy. Conclusions: Aminophylline increases urine output in critically ill children with AKI. [ABSTRACT FROM AUTHOR]

Purpose: More than 90% of patients with diabetes worldwide are type 2 diabetes (T2D), which is caused by insulin resistance or impaired producing insulin by pancreatic β cells. T2D and its complications, mainly large cardiovascular (LCV) and kidney (Ne) complications, are the major cause of death in diabetes patients. Recently, the dysregulation of peripheral T cell immune homeostasis was found in most T2D patients. However, the characteristics of T-cell receptors (TCR) remain largely unexplored in T2D patients. Patients and methods: Here we investigated the TCR repertoire using high-throughput sequencing in peripheral blood collected from T2D patient with (8 LCV and 7 Ne) or without complications. Results: Our analysis of TCR repertoires in peripheral blood samples showed that TCR profiles in T2D patients with complications tended to be single and specific compared to controls, according to the characteristics of TCR repertoire in V-J combination number, diversity, principal component analysis (PCA) and differential genes. And we identified some differentially expressed V-J gene segments and amino acid clonotypes, which had the potential to contribute to distinguishing T2D patient with or without complications. As the progression of the disease, we found that the profiling of TCR repertoire was also differential between T2D patients with LVD and Ne complications base on this pilot analysis. Conclusion: This study demonstrated the protentional unique property of TCR repertoire in peripheral blood of T2D patient with and without complications, or T2D patients with LVD and Ne complications, which provided the possibility for future improvements in immune-related diagnosis and therapy for T2D complications. [ABSTRACT FROM AUTHOR]

Lymphatic system distributes in almost all vertebrate tissues and organs, and plays important roles in the regulation of body fluid balance, lipid absorption and immune monitoring. Although CuNPs or AgNPs accumulation has been reported to be closely associated with delayed hatching and motor dysfunction in zebrafish embryos, their biological effects on lymphangiogenesis remain unknown. In this study, thoracic duct was observed to be partially absent in both CuNPs and AgNPs stressed zebrafish larvae. Specifically, CuNPs stress induced hypermethylation of E2F7/8 binding sites on CCBE1 promoters via their producing ROS, thereby leading to the reduction of binding enrichment of E2F7/8 on CCBE1 promoter and its subsequently reduced expression, then resulting in defective lymphatic vessel formation. Differently, AgNPs stress induced down-regulated CCBE1 expression via down-regulating mRNA and protein levels of E2F7/8 transcription factors, thereby resulting in defective lymphatic vessel formation. This study may be the first to demonstrate that CuNPs and AgNPs damaged lymphangiogenesis during zebrafish embryogenesis, mechanistically, CuNPs epigenetically regulated the expression of lymphangiogenesis regulator CCBE1 via hypermethylating its promoter binding sites of E2F7/8, while AgNPs via regulating E2F7/8 expression. Meanwhile, overexpression of ccbe1 mRNA effectively rescued the lymphangiogenesis defects in both AgNPs and CuNPs stressed larvae, while overexpression of e2f7/8 mRNA effectively rescued the lymphangiogenesis defects in AgNPs rather than CuNPs stressed larvae. The results in this study will shed some light on the safety assessment of nanomaterials applied in medicine and on the ecological security assessments of nanomaterials. -5JubNCLudCTXxnkfqD8au Video Abstract [ABSTRACT FROM AUTHOR]

Thirst plays a vital role in the regulation of body fluid homeostasis and if deregulated can be life-threatening. Interoceptive neurons in the subfornical organ (SFO) are intrinsically osmosensitive and their activation by hyperosmolarity is necessary and sufficient for generating thirst. However, the primary molecules sensing systemic osmolarity in these neurons remain elusive. Here we show that the mechanosensitive TMEM63B cation channel is the osmosensor required for the interoceptive neurons to drive thirst. TMEM63B channel is highly expressed in the excitatory SFO thirst neurons. TMEM63B deletion in these neurons impaired hyperosmolarity-induced drinking behavior, while re-expressing TMEM63B in SFO restored water appetite in TMEM63B-deficient mice. Remarkably, hyperosmolarity activates TMEM63B channels, leading to depolarization and increased firing rate of the interoceptive neurons, which drives drinking behavior. Furthermore, TMEM63B deletion did not affect sensitivities of the SFO neurons to angiotensin II or hypoosmolarity, suggesting that TMEM63B plays a specialized role in detecting hyperosmolarity in SFO neurons. Thus, our results reveal a critical osmosensor molecule for the generation of thirst perception. [ABSTRACT FROM AUTHOR]

Sodium is a key element for all living things, mainly animals, some plant species, and humans. In animals, sodium ions are necessary for the regulation of blood and body fluids, the transmission of nerve impulses, heart activity, and certain metabolic functions. Sodium is the chief cation in the extracellular compartment of an animal body. Sodium plays a vital role not only in the human body but also in various food types. Salt, also known as sodium chloride, is about 40% sodium and 60% chloride. It flavors food and is used as a binder and stabilizer. The sodium content in different brands of edible salts can be analyzed using flame photometry. Flame photometry, also called flame atomic emission spectrometry, is a branch of atomic spectroscopy in which the species examined in the spectrometer are in the form of atoms. The samples used for analysis are junk foods, which have become a common trend among all generations. A total of 13 brands were analyzed for iodine content. From that, two commonly used brands were selected and analyzed for estimating the sodium and potassium contents in them by flame photometry. The analysis helps in creating awareness among all generations to reduce the sodium intake in order to prevent problems like hypertension, hyponatremia, hypernatremia, and associated medical complications in the future. INSET: c. [ABSTRACT FROM AUTHOR]

Purpose: Maintaining an appropriate hydration level by ingesting fluid in a hot environment is a measure to prevent heat-related illness. Caffeine-containing beverages, including green tea (GT), have been avoided as inappropriate rehydration beverages to prevent heat-related illness because caffeine has been assumed to exert diuretic/natriuretic action. However, the influence of caffeine intake on urine output in dehydrated individuals is not well documented. The aim of the present study was to examine the effect of fluid replacement with GT on body fluid balance and renal water and electrolyte handling in mildly dehydrated individuals. Methods: Subjects were dehydrated by performing three bouts of stepping exercise for 20 min separated by 10 min of rest. They were asked to ingest an amount of water (H2O), GT, or caffeinated H2O (20 mg/100 ml; Caf-H2O) that was equal to the volume of fluid loss during the dehydration protocol; fluid balance was measured for 2 h after fluid ingestion. Results: The dehydration protocol induced hypohydration by ~ 10 g/kg body weight (~ 1% of body weight). Fluid balance 2 h after fluid ingestion was significantly less negative in all trials, and the fluid retention ratio was 52.2 ± 4.2% with H2O, 51.0 ± 5.0% with GT, and 47.9 ± 6.2% with Caf-H2O; those values did not differ among the trials. After rehydration, urine output, urine osmolality, and urinary excretions of osmotically active substances, sodium, potassium and chloride were not different among the trials. Conclusion: The data indicate that ingestion of GT or an equivalent caffeine amount does not worsen the hydration level 2 h after ingestion and can be effective in reducing the negative fluid balance for acute recovery from mild hypohydration. Trial registration: ISRCTN53057185; retrospectively registered. [ABSTRACT FROM AUTHOR]

ELABELA (ELA), also known as Toddler or Apela, is a novel endogenous ligand of the angiotensin receptor AT1-related receptor protein (APJ). ELA is highly expressed in human embryonic, cardiac, and renal tissues and involves various biological functions, such as embryonic development, blood circulation regulation, and maintaining body fluid homeostasis. ELA is also closely related to the occurrence and development of acute kidney injury, hypertensive kidney damage, diabetic nephropathy, renal tumors, and other diseases. Understanding the physiological role of ELA and its mechanism of action in kidney-related diseases would provide new targets and directions for the clinical treatment of kidney diseases. [ABSTRACT FROM AUTHOR]

Sepsis-induced acute kidney injury is associated with inflammatory dysregulations within the kidney. This study aimed to explore the renal protective effect of hispidulin on suppressing the apoptosis rate, and inhibiting reactive oxygen species production and inflammatory response after cecal puncture (CLP) operation. In order to gain a deeper understanding of the relationship between sepsis and acute kidney injury, the CLP induced kidney injury animal model was established. The automated biochemical analyzer was used to measure the kidney function related biomarkers including serum cystatin C (ScysC), blood urea nitrogen (BUN), and serum creatinine (Scr). The pathological changes of damaged kidney tissues were detected by hematoxylin and eosin (H&E) staining. The expression of inflammatory cytokines including tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6) were detected by their corresponding test kits and Real-Time Quantitative Reverse Transcription PCR (qRT-PCR). The level of reactive oxygen species production-related protein including myeloperoxidase (MPO), glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) in kidney tissue from each group were quantized using Enzyme-linked immunosorbent assay (ELISA). The protein expression was measured using western blot and the apoptotic rate of kidney tissue was measured by terminal deoxynucleotidyl transferase Deoxyuridine Triphosphate (dUTP) nick end labeling (TUNEL) assay. Our results revealed that hispidulin has the protective ability in sepsisinduced acute kidney injury. The potential mechanism of hispidulin on sepsis-induced cell apoptosis, oxidative stress and inflammatory response was also investigated. Finally, our results highlighted that hispidulin exerted a protective effects on CLP-induced acute kidney injury by suppressing the protein kinase B (AKT) and Nuclear factor kappa B (NF-κB) signaling pathways. In summary, the current study provided a piece of novel evidence, that hispidulin can be explored as a potential drug in CLP-induced acute kidney injury by examining its effects on suppressed the oxidative stress, inflammatory responses, and apoptosis in kidney tissue. [ABSTRACT FROM AUTHOR]

Aim Clinical guidelines recommend using bioelectrical impedance analysis (BIA) to assess body composition in adults with renal failure on maintenance haemodialysis. This study evaluated the feasibility, acceptability and clinical utility of using BIA with haemodialysis outpatients. Methods Patients attending the haemodialysis outpatient unit at a tertiary public hospital in Australia were consecutively recruited. Participants completed a pre- and post-dialysis BIA measure and satisfaction survey about the measurement process. Primary outcomes pertained to feasibility (recruitment and measurement completion rates). Secondary outcomes included acceptability, assessed via patient satisfaction surveys, and predictive value of BIA for identifying malnutrition according to Subjective Global Assessment (SGA). Continuous variables were presented as mean ± standard deviation (or median and interquartile range). Binomial logistic regression was performed to determine the predictive value of BIA for identifying malnutrition. Receiver operating characteristic curve analysis was used to evaluate BIA parameters for their ability to discriminate malnourished patients (determined by SGA) from well-nourished patients. Statistical significance was established at p<0.05. Results A total of 30 of 36 patients approached (83%) consented to participate, with 28 completing at least one BIA measurement and included in data analysis. BIA measurement completion rates were 93% and 87% pre- and post-dialysis, respectively. Post-dialysis BIA measures of fat mass index, fat free mass index and skeletal muscle mass most closely reflected SGA-categorised malnutrition. Patients reported high acceptability for BIA, found the process easy, and valued the results. Conclusion BIA use in an outpatient haemodialysis unit is feasible and acceptable to patients, providing valuable objective data to enhance clinical practice. [ABSTRACT FROM AUTHOR]

Background: The supraoptic nucleus (SON) of the hypothalamus contains magnocellular neurosecretory cells that secrete the hormones vasopressin and oxytocin. Sex differences in SON gene expression have been relatively unexplored. Our study used spatially resolved transcriptomics to visualize gene expression profiles in the SON of adult male (n = 4) and female (n = 4) Sprague-Dawley rats using Visium Spatial Gene Expression (10x Genomics). Methods: Briefly, 10-μm coronal sections (~ 4 × 4 mm) containing the SON were collected from each rat and processed using Visium slides and recommended protocols. Data were analyzed using 10x Genomics' Space Ranger and Loupe Browser applications and other bioinformatic tools. Two unique differential expression (DE) analysis methods, Loupe Browser and DESeq2, were used. Results: Loupe Browser DE analysis of the SON identified 116 significant differentially expressed genes (DEGs) common to both sexes (e.g., Avp and Oxt), 31 significant DEGs unique to the males, and 73 significant DEGs unique to the females. DESeq2 analysis revealed 183 significant DEGs between the two groups. Gene Ontology (GO) enrichment and pathway analyses using significant genes identified via Loupe Browser revealed GO terms and pathways related to (1) neurohypophyseal hormone activity, regulation of peptide hormone secretion, and regulation of ion transport for the significant genes common to both males and females, (2) Gi signaling/G-protein mediated events for the significant genes unique to males, and (3) potassium ion transport/voltage-gated potassium channels for the significant genes unique to females, as some examples. GO/pathway analyses using significant genes identified via DESeq2 comparing female vs. male groups revealed GO terms/pathways related to ribosomal structure/function. Ingenuity Pathway Analysis (IPA) identified additional sex differences in canonical pathways (e.g., 'Mitochondrial Dysfunction', 'Oxidative Phosphorylation') and upstream regulators (e.g., CSF3, NFKB complex, TNF, GRIN3A). Conclusion: There was little overlap in the IPA results for the two different DE methods. These results suggest sex differences in SON gene expression that are associated with cell signaling and ribosomal pathways. Highlights: Successful differentiation of nuclei from myelinated fiber tracts by gene cluster analysis and identification of SON genes that are sex-specific and common to both sexes using spatial transcriptomics. Two differential expression analysis methods: Loupe Browser and DESeq2, generated distinct lists of differentially expressed genes for the SON. GO enrichment/pathway analyses reveal terms common to both sexes relevant to SON function. Data suggest sex differences in SON gene expression may be related to cell signaling and ribosomal pathways, possibly associated with differences in upstream regulators. Plain English Summary: The brain releases the hormones oxytocin and vasopressin from the supraoptic nucleus. Oxytocin is involved in maternal behaviors, lactation, and childbirth. Vasopressin is involved in sex-based differences in social behavior and body fluid regulation. However, how the brain contributes to sex-based differences in vasopressin and oxytocin release is poorly understood. This study aimed to address this knowledge gap using spatial transcriptomics to test for sex-based differences in gene expression in the supraoptic nucleus. Spatial transcriptomics combines anatomy with gene sequencing technology, allowing us to identify groups of genes that are expressed in specific locations in the brain. We applied this approach to brain sections containing the supraoptic nucleus from four adult male and four adult female rats. Using a data analysis workflow specifically for spatial transcriptomics, we identified genes that are significantly expressed in the supraoptic nuclei of both males and females (116 genes), primarily males (31 genes), and primarily females (73 genes). Genes enriched in the supraoptic nucleus of both males and females are related to the synthesis and release of peptides like vasopressin and oxytocin. Genes specific to the male supraoptic nucleus are broadly related to cell signaling, while the female-specific genes are related to ion transporters/channels. Results from a more traditional data analysis workflow identified sex-based differences in the expression of genes related to cell metabolism and protein synthesis. Together these results may provide a mechanistic foundation that can be used to better understand how differences in gene expression related to biological sex influence brain function. [ABSTRACT FROM AUTHOR]

Bacterial infection is one of the most common and harmful medical issues following the implantation of materials and devices in the body leading to antibiotic resistance of diverse bacterial strains. In this work, a novel approach is presented combining adopted laser-based patterning method in addition to doping (Mg and Zn) metal ions to prepare calcium phosphate ceramic substrate, applicable in medicine, with enhanced surface antimicrobial characteristics. The preparation of tablets containing Mg (8.44 mol%) and Zn (2.63 mol%) β-tricalcium phosphate involved biomimetic precipitation of amorphous calcium phosphate in media of simulated body fluid enriched with Mg2+ and Zn2+ ions as well as the presence of valine as an organic additive, followed by step-wise calcination up to 1000 °C. The results from laser processing showed formation of deeper patterns with increased surface roughness (from 4.9 µm to 9.4 µm) as laser power and velocity increase, keeping constant the hatch sizes of 50 µm. The textured surfaces consist of peaks and valleys arrangement that change the morphology of Escherichia coli cells and decrease of cell viability. Our study reveals the possibilities of the application of ultra-short laser radiation as a potential alternative therapy for controlling the antimicrobial effect of the ceramic surface. [ABSTRACT FROM AUTHOR]

The environment around deep sea hydrothermal vents is characterized by an abundance of sulfur compounds, including toxic hydrogen sulfide. However, numerous communities of various invertebrates are found in it. It is suggested that invertebrates in the vicinity of hydrothermal vents detoxify sulfur compounds by biosynthesis of taurine-related compounds in the body. On the other hand, the vent endemic polychaete Alvinella pompejana has spherocrystals composed of sulfur and other metals in its digestive tract. It was considered that the spherocrystals contribute to the regulation of sulfur in body fluids. Paralvinella spp. and Polynoidae. gen. sp. live sympatrically and in areas most affected by vent fluid. In this study, we focused on the digestive tract of Paralvinella spp. and Polynoidae. gen. sp. to examine whether they have spherocrystals. We also investigated the possible involvement of bacteria in the digestive tract in spherulization. Examination with a scanning electron microscope (SEM) equipped with Energy Disperse X-ray Spectroscopy (EDS) detected spherocrystals containing sulfur and iron in the digestive tract of Paralvinella spp. In contrast, such spherocrystals were not observed in that of Polynoidae. gen. sp. although sulfur is detected there by inductively coupled plasma-optical emission spectrometry (ICP-OES). Meta-16S rRNA analysis indicated that the floras of the digestive tracts of the two species were very similar, suggesting that enteric bacteria are not responsible for spherocrystal formation. Analysis of taurine-related compounds indicated that the digestive tissues of Polynoidae. gen. sp. contain a higher amount of hypotaurine and thiotaurine than those of Paralvinella spp. Therefore, the two sympatric polychaetes use different strategies for controlling sulfur, i.e., Paralvinella spp. forms spherocrystals containing elemental sulfur and iron in the digestive tract, but Polynoidae. gen. sp. accumulates taurine-related compounds instead of spherocrystals. Such differences may be related to differences in their lifestyles, i.e., burrow-dweller or free-moving, or may have been acquired phylogenetically in the evolutionary process. [ABSTRACT FROM AUTHOR]

Thirst and water intake are regulated by the organum vasculosum of the lamina terminalis (OVLT) and subfornical organ (SFO), located around the anteroventral third ventricle, which plays a critical role in sensing dynamic changes in sodium and water balance in body fluids. Meanwhile, neural circuits involved in thirst regulation and intracellular mechanisms underlying the osmosensitive function of OVLT and SFO are reviewed. Having specific Nax channels in the glial cells and other channels (such as TRPV1 and TRPV4), the OVLT and SFO detect the increased Na+ concentration or hyperosmolality to orchestrate osmotic stimuli to the insular and cingulate cortex to evoke thirst. Meanwhile, the osmotic stimuli are relayed to the supraoptic nucleus (SON) and paraventricular nucleus of the hypothalamus (PVN) via direct neural projections or the median preoptic nucleus (MnPO) to promote the secretion of vasopressin which plays a vital role in the regulation of body fluid homeostasis. Importantly, the vital role of OVLT in sleep-arousal regulation is discussed, where vasopressin is proposed as the mediator in the regulation when OVLT senses osmotic stimuli. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate the association of postoperative day (POD) 2 weight-based fluid balance (FB-W) > 10% with outcomes after neonatal cardiac surgery. Methods: Retrospective cohort study of 22 hospitals in the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) registry from September 2015 to January 2018. Of 2240 eligible patients, 997 neonates (cardiopulmonary bypass (CPB) n = 658, non-CPB n = 339) were weighed on POD2 and included. Results: Forty-five percent (n = 444) of patients had FB-W > 10%. Patients with POD2 FB-W > 10% had higher acuity of illness and worse outcomes. Hospital mortality was 2.8% (n = 28) and not independently associated with POD2 FB-W > 10% (OR 1.04; 95% CI 0.29–3.68). POD2 FB-W > 10% was associated with all utilization outcomes, including duration of mechanical ventilation (multiplicative rate of 1.19; 95% CI 1.04–1.36), respiratory support (1.28; 95% CI 1.07–1.54), inotropic support (1.38; 95% CI 1.10–1.73), and postoperative hospital length of stay (LOS 1.15; 95% CI 1.03–1.27). In secondary analyses, POD2 FB-W as a continuous variable demonstrated association with prolonged durations of mechanical ventilation (OR 1.04; 95% CI 1.02–1.06], respiratory support (1.03; 95% CI 1.01–1.05), inotropic support (1.03; 95% CI 1.00–1.05), and postoperative hospital LOS (1.02; 95% CI 1.00–1.04). POD2 intake–output based fluid balance (FB-IO) was not associated with any outcome. Conclusions: POD2 weight-based fluid balance > 10% occurs frequently after neonatal cardiac surgery and is associated with longer cardiorespiratory support and postoperative hospital LOS. However, POD2 FB-IO was not associated with clinical outcomes. Mitigating early postoperative fluid accumulation may improve outcomes but requires safely weighing neonates in the early postoperative period. [ABSTRACT FROM AUTHOR]

Assessing the precise body water status in patients with renal disorders is crucial for their health. It has been reported that chronic fluid overload is present even in the early stages of renal insufficiency. If volume overload in a patient with chronic renal failure is not controlled, serious problems such as pulmonary oedema, cardiac remodelling, and diastolic heart failure can develop. Bioelectrical Impedance Analysis (BIA) has emerged as one of the most useful tools, although randomised clinical studies are lacking to support its universal use. Early management of hydration may improve clinical outcomes, as it allows for personalised dialysis prescriptions and nutritional support. BIA practice is utilised as non invasive health monitoring for Body Composition (BC). BIA is a practical and inexpensive method. Moreover, BIA parameters estimated for disease prognosis analysis have been found to be reasonably predictable for both patient status and healthcare. Additionally, BIA is a simple, accurate, portable, quick, easy, and low-cost method. In patients with End-stage Renal Disease (ESRD) undergoing maintenance Haemodialysis (HD) treatment, excessive fluid volume is considered a risk factor for death. Furthermore, fluid elimination to achieve Dry Weight (DW) is a crucial component of HD treatment for ESRD patients. DW is an important concept related to patients undergoing HD. Conventional methods seem to be time-consuming and operator-dependent. BIA is a new and simple method that has been reported to accurately estimate DW. Estimating the dry weight of HD patients is a challenging task. Many tools are available, but not every HD centre has access to them. Several strategies have been used to develop a more standardised method of assessing dry weight in HD patients. The Bio-impedance Spectroscopy (BIS) device has been validated against gold standard methods of volume assessment. Body composition monitoring appears to be a helpful diagnostic tool that reasonably complements existing clinical methods in assessing the DW of HD patients. BIS identifies Fluid Overload (FO) as a virtual "Over Hydration (OH)" compartment, which is calculated from the difference between the measured extracellular volume and the predicted values based on a fixed hydration of lean and adipose tissue mass. [ABSTRACT FROM AUTHOR]

Hemodynamic and intravascular volume monitoring has been utilized and significantly improved thanks to the technology revolution. Goal-Directed Therapy (GDT) derived from this advanced monitoring is beneficial for complex surgeries, and it shifted the medical approaches from static therapy to more personalized functional treatments. Conventional monitoring methods such as blood pressure, heart rate, urinary output, and central venous pressure are commonly used. However, studies have shown these routine parameters often cannot precisely estimate the quality of tissue perfusion. Tissue hypoperfusion and hypoxia play a crucial role in initiating a systemic inflammatory response after prolonged surgeries, resulting in unstable hemodynamic condition of the patients. Several studies reported the importance of GDT in non-cardiac surgeries and there are few reports on cardiac surgeries. However, tissue perfusion and fluid management are more critical in complex and prolonged cardiovascular surgeries to avoid complications such as low cardiac output syndrome and renal or pulmonary dysfunction. Different advanced hemodynamic monitorings have been utilized perioperatively in cardiac surgery to help decision-making on inotrope and fluid management. In this article we present 5 cases of usefulness hemodynamic monitoring in patients who underwent cardiovascular surgeries. [ABSTRACT FROM AUTHOR]

This study determined normative data for sweat rate (SR) and whole-body (WB) sweat sodium concentration [Na+] in athletes indigenous to a tropical climate, categorized by age, gender, and sport classification.We analyzed data from 556 athletes (386 adult and 170 young) in endurance (END), team/ball (TBA), and combat (COM) sports exercising in tropical environments (wet bulb globe temperature = 29.4 ± 2.1 °C). SR was calculated from change in body weight corrected for urine output and fluid/food intake. Sweat was collected using absorbent patches, and regional [Na+] was determined using an ion selective analyzer and normalized to WB sweat [Na+]. Data are expressed as mean ± SD. SR was higher in males compared with females in both young (24.2 ± 7.7 ml·kg-1·hr-1 vs. 16.7 ± 5.7 ml·kg-1·hr-1) and adult (22.8 ± 7.4 ml·kg-1·hr-1 vs. 18.6 ± 7.0 ml·kg-1·hr-1) athletes, in END sports in girls (END = 19.1 ± 6.0 ml·kg-1·hr-1; TBA=14.6±4.5ml·kg-1·hr-1), and in adult males (END = 25.2 ± 6.3 ml·kg-1·hr-1; TBA = 19.1 ±7.2 ml·kg-1·hr-1; COM=18.4±8.5 ml· kg-1·hr-1) and females (END = 23.5 ± 5.6 ml· kg-1·hr-1; TBA=14.2±5.2 ml·kg-1·hr-1; COM= 15.3 ± 5.2 ml·kg-1·hr-1); p < .05. WB sweat [Na+] was higher in adult athletes than in young athletes (43 ± 10 mmol/L vs. 40 ± 9 mmol/L, p < .05). These norms provide a reference range for low, low average, average high, and high SR and WB sweat [Na+], which serve as a guide for fluid replacement for athletes who live and train in the tropics. [ABSTRACT FROM AUTHOR]

Renal transplantation is considered the preferred treatment method for chronic renal failure. Early graft failure caused by transplant renal artery narrowing/stenosis is a common vascular complication after kidney transplantation. The classic symptoms include refractory hypertension, a decline in graft function, and fluid retention. Color Doppler sonography plays an important role in the diagnosis of renal artery narrowing; however, allograft artery angiography remains the gold standard. We report on a case of cadaveric donor renal transplantation, wherein the urine output markedly decreased within 7 h of transplantation due to renal arterial narrowing and the efforts that were made to salvage the kidney. [ABSTRACT FROM AUTHOR]

Background: Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduced work performance. This systematic review aimed to (1) characterise existing fluid intake measurement tools used in the workplace setting or among free‐living, healthy adults of working age and (2) report the current validation status of available assessment tools for use in a UK setting. Methods: Three electronic databases were searched for publications measuring beverage intake using a defined tool or method. Additional studies were identified by hand from trial registers, grey literature and reference lists. Eligibility was determined using predefined inclusion/exclusion criteria. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology framework. Narrative synthesis was performed. Results: The review identified 105 studies. The most frequently reported beverage assessment methods were total diet diaries/records (n = 22), fluid specific diaries/records (n = 18), food and fluid frequency questionnaires (n = 17), beverage‐specific frequency questionnaires (n = 23) and diet recalls (n = 11). General dietary measurement tools (measuring beverages as part of total diet) were used in 60 studies, and 45 studies used a beverage‐specific tool. This review identified 18 distinct dietary assessment tools, of which 6 were fluid/beverage specific. Twelve tools published relative validity for a beverage‐related variable and seven tools for total daily fluid intake (from whole diet or from beverages only). Conclusions: Several fluid intake assessment tools were identified; however, few have been fully evaluated for total beverage intake, and none in a UK working population. Key points: Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduce work performance.Existing studies that measure beverage intake in free‐living, working‐age adults tend to use whole dietary assessment tools, such as diet records or recalls, rather than beverage‐specific measurement tools.Few dietary assessment tools have been validated and reliability tested against beverage intake, and none has been evaluated in a UK working‐adult population. [ABSTRACT FROM AUTHOR]

Background: Recognizing the optimal time to discontinue continuous kidney replacement therapy (CKRT) is necessary to advance patient recovery and mitigate complications. The aim of this study was to identify predictors of successful CKRT cessation in pediatric patients. Methods: All patients requiring CKRT between January 2010 and March 2021 were evaluated. Patients on peritoneal or hemodialysis, who transferred between institutions, or who did not trial off CKRT were excluded. Successful discontinuation was defined as remaining off CKRT for at least 7 days. Demographics, admission diagnoses, PRISM III scores, and reasons for CKRT initiation were obtained. Clinical and biochemical variables were evaluated at CKRT initiation and discontinuation and in the 12-h period following discontinuation. Comparisons were conducted using Wilcoxon rank sum and Fisher's exact tests for continuous and categorical variables, respectively. A logistic regression model was fitted to identify significant factors. Results: Ninety-nine patients underwent a trial off CKRT. Admission and initiation characteristics of the success and failure groups were similar. Patients who required re-initiation (n = 26) had longer ICU lengths of stay (27.2 vs. 44.5 days, p = 0.046) and higher in-hospital mortality (15.1% vs. 46.2%, p = 0.002). Urine output greater than 0.5 mL/kg/h irrespective of diuretic administration in the 6-h period before CKRT discontinuation was a significant predictor (AUC 0.72, 95% CI 0.60–0.84, p = 0.0009). Conclusions: Determining the predictors of sustained CKRT discontinuation is critical. Urine output greater than 0.5 mL/kg/h in this pediatric cohort predicted successful discontinuation. Future studies are needed to validate this threshold in disease- and age-specific cohorts and evaluate additional biomarkers of kidney injury. [ABSTRACT FROM AUTHOR]

Introduction: Hemodialysis is life‐sustaining in kidney failure. However, proper regulation of body fluids depends on an accurate estimate of target weight. This trial aims to compare clinical endpoints between target weight estimation guided by bioimpedance spectroscopy and usual care in hemodialysis patients. Methods: This is an open‐label, parallel‐group, controlled trial that randomized, through a table of random numbers, adult patients on maintenance hemodialysis to target weight estimation based on monthly clinical evaluation alone or added to evaluation by bioimpedance twice a year. The primary outcome was survival, and the secondary outcomes were the rate of hospital admissions, change in blood pressure (BP), and antihypertensive drugs load. Participants were followed for 2 years. Survival analysis was performed using Kaplan–Meier estimator and Log‐rank test, and hospital admissions were analyzed by the incidence‐rate ratio. Findings: One hundred and ten patients were randomized to the usual care (52) or bioimpedance (58) groups, with a mean age of 57.4 (15.4) years, 64 (58%) males. There was no difference between the groups at baseline. Survival was not significantly different between groups (log‐rank test p = 0.68), but the trial was underpowered for this outcome. There was also no difference between the groups in the change in systolic or diastolic BP or in the number of antihypertensive drugs being used. The incidence rate of hospital admissions was 3.1 and 2.1 per person‐year in usual care and bioimpedance groups, respectively, with a time‐adjusted incidence rate ratio of 1.48 (95% CI: 1.20–1.82, p = 0.0001) and attributable fraction of risk among exposed individuals of 0.32 (95% CI: 0.17–0.45). Discussion: The inclusion of bioimpedance data to guide the estimation of target weight in hemodialysis patients had no detectable impact on survival or BP control, but significantly reduced the incidence rate of hospital admissions. The study was registered at ClinicalTrials.gov Identifier: NCT05272800. [ABSTRACT FROM AUTHOR]

Background/Aims: Significant weight loss during early life can be of serious concern and assessing weight is key in decisions regarding supplementation. However, supplementation is a significant risk factor for early breastfeeding cessation. Recognising differential causes of weight loss supports identification of genuinely unwell infants and targets practices that support exclusive breastfeeding appropriately. This study's aim was to identify whether maternal fluid balance/load is associated with neonatal weight loss. Methods: The databases CINAHL, MEDLINE, EMBASE, EMCARE were searched for relevant literature. Data were extracted using a structured form based on the Cochrane handbook. Meta-analysis was not possible because of the heterogeneity of all aspects of study design and outcome definitions. Results: Eight studies presented original data. Four reported an association between maternal intravenous fluid intake and neonatal weight loss, and four did not. No two studies collected the same outcome data at the same time, using the same comparator or intervention. Conclusions: Further research is required to clarify the relationship between maternal fluid intake and neonatal weight loss in a clinically useful way. [ABSTRACT FROM AUTHOR]

The renin-angiotensin system (RAS) is an important fluid regulation system in the body, and excessive activation of the circulatory or local RAS can increase blood pressure (BP). Excess fluoride can increase BP, although the underlying mechanism related to activation of the RAS remains unclear. Thus, the aim of this study was to elucidate the role of the RAS in fluoride-induced hypertension. Markers of the circulating and local RASs related to pathological changes to the kidneys, myocardium, and aorta were measured. Fluoride reduced serum levels of renin, angiotensin II (Ang II), and angiotensin (1−7) [Ang (1−7)], and dysregulated plasma levels of aldosterone and potassium levels. Excess fluoride can damage the kidneys, myocardium, and aorta, overactivate the renal angiotensin converting enzyme (ACE)-Ang II-angiotensin type 1 receptor axis, and inhibit activation of the ACE2-Ang (1−7)-Mas axis, leading to dysregulation of alpha epithelial sodium channels and significantly increased expression of Ang II in the myocardium and aorta. Hence, excess fluoride can cause low-renin hypertension via an imbalance between the circulatory and local RASs. • Excess fluoride can lead to low-renin hypertension (LRH). • Fluoride influences aldosterone secretion. • Excess fluoride can inhibit the circulating renin-angiotensin system (RAS). • Excess fluoride can activate the renal and cardiovascular RASs. • The mechanism of LRH involves an imbalance between the circulatory and local RASs. [ABSTRACT FROM AUTHOR]

Integration of native bone into orthopedic devices is a key factor in long‐term implant success. The material‐tissue interface is generally accepted to consist of a hydroxyapatite layer so bioactive materials that can spontaneously generate this hydroxyapatite layer after implantation may improve patient outcomes. Per the ISO 22317:2014 standard, "Implants for surgery – In vitro evaluation for apatite‐forming ability of implant materials," bioactivity performance statements can be assessed by soaking the material in simulated body fluid (SBF) and evaluating the surface for the formation of a hydroxyapatite layer; however, variations in test methods may alter hydroxyapatite formation and result in false‐positive assessments. The goal of this study was to identify the effect of SBF formulation on bioactivity assessment. Bioglass® (45S5 and S53P4) and non‐bioactive Ti‐6Al‐4V were exposed to SBF formulations varying in calcium ion and phosphate concentrations as well as supporting ion concentrations. Scanning electron microscopy and X‐ray powder diffraction evaluation of the resulting hydroxyapatite layers revealed that SBF enriched with double or quadruple the calcium and phosphate ion concentrations increased hydroxyapatite crystal size and quantity compared to the standard formulation and can induce hydroxyapatite crystallization on surfaces traditionally considered non‐bioactive. Altering concentrations of other ions, for example, bicarbonate, changed hydroxyapatite induction time, quantity, and morphology. For studies evaluating the apatite‐forming ability of a material to support bioactivity performance statements, test method parameters must be adequately described and controlled. It is unclear if apatite formation after exposure to any of the SBF formulations is representative of an in vivo biological response. The ISO 23317 standard test method should be further developed to provide additional guidance on apatite characterization and interpretation of the results. [ABSTRACT FROM AUTHOR]

Background: Assessment of fluid status in neonatal dialysis has largely focused on traditional tools including clinical assessment, serial weights, and blood pressure (BP) measurements. However, in infants on kidney replacement therapy, the assessment of fluid overload is problematic due to errors in weight assessment, subtlety of physical exam findings, and inaccuracy of non-invasive BP measurements. Case summary: In this presentation of a neonate with bilateral renal agenesis requiring kidney replacement therapy, the treating team assessed a number of variables in determining the ultrafiltration prescription for dialysis across 2 modalities (hemodialysis and continuous kidney replacement therapy). Complications: Fluid overload, cardiomegaly, and worsened respiratory status occurred when attempting to assess the neonate's fluid status by traditional markers (weights, blood pressures, physical exam findings). B-type natriuretic peptide (BNP) was obtained and was noted to correlate with the degree of fluid overload. Key management points: Compared to traditional tools for assessment of fluid status in pediatric dialysis, BNP assisted the medical team in optimizing the volume status of the subject and determining optimal daily ultrafiltration goals. Due to the rapid release in response to myocardial stretch and the lack of kidney clearance of the peptide, BNP may represent an objective, timely, and reliable index of volume status in the pediatric dialysis patient. [ABSTRACT FROM AUTHOR]

Background: Fluid overload associates with poor outcomes after neonatal cardiac surgery, but consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight change-based FB (FB-W) is standard in neonatal intensive care units, weighing infants after cardiac surgery may be challenging. We aimed to identify characteristics associated with obtaining weights and to understand how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population. Methods: Observational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database. Results: Forty-five percent (n = 998) of patients were weighed on postoperative day (POD) 2, varying from 2 to 98% among centers. Odds of being weighed were lower for STAT categories 4 and 5 (OR 0.72; 95% CI 0.53–0.98), cardiopulmonary bypass (0.59; 0.42–0.83), delayed sternal closure (0.27; 0.19–0.38), prophylactic peritoneal dialysis use (0.58; 0.34–0.99), and mechanical ventilation on POD 2 (0.23; 0.16–0.33). Correlation between FB-IO and FB-W was weak for every POD 1–6 and within the entire cohort (correlation coefficient 0.15; 95% CI 0.12–0.17). FB-W measured higher than paired FB-IO (mean bias 12.5%; 95% CI 11.6–13.4%) with wide 95% limits of agreement (− 15.4–40.4%). Conclusions: Weighing neonates early after cardiac surgery is uncommon, with significant practice variation among centers. Patients with increased severity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation, and further study is needed to determine which cumulative FB metric most associates with adverse outcomes. A higher resolution version of the Graphical abstract is available as Supplementary information. [ABSTRACT FROM AUTHOR]

Introduction : Acute kidney injury (AKI) is a common complication in patients undergoing coronary artery bypass graft (CABG) surgery and is associated with significant morbidity and mortality. We investigated the association of urine output (U/O) during cardiopulmonary bypass (CPB) with postoperative AKI in a cohort of patients undergoing elective CABG. Materials and Methods : This single-center retrospective study used data from patients undergoing elective CABG with CPB (March 2015 to March 2020). Demographic data and perioperative information were extracted from the Patients' records. Urine output during CPB and in the first 3 days after surgery was also recorded. Acute kidney injury was defined according to the Acute Kidney Injury Network (AKIN) classification. Spearman's correlation analysis was used to evaluate the relationship between quantitative variables and multiple logistic regression analysis was applied to determine AKI predictors. Results : A total of 532 patients with a mean age of 56.83 ± 7.99 years were analyzed. In the first 48 h after surgery, the incidence of AKI was 18%, of which, 7 (2.7%) patients developed stage II of AKI. There was no significant correlation between U/O during CPB and change in postoperative blood urea nitrogen (BUN) and creatinine. Oliguria during CPB was not observed in any of the patients. Age and duration of bypass were identified as predictors of AKI. Conclusion : In this study, the incidence of AKI was 18% and there was no significant correlation between U/O during CPB and changes in postoperative BUN and creatinine. Age and duration of bypass were independent risk factors of AKI. [ABSTRACT FROM AUTHOR]

Background: There has been a dramatic rise in the prevalence of obesity around the world, and it is now recognized as a major contributor to health problems. Secondary negative health issues, such as high blood pressure, cardiovascular disease, and type 2 diabetes, are more likely to affect those who are overweight and obese. Body fluid regulation and cardiovascular homeostasis are traditionally attributed to the renin-angiotensin-aldosterone system (RAAS), which is a hormone system. Recent studies have revealed the presence of active RAAS in many different tissues. Adipose tissue is one of these tissues where the RAAS has been found to have functional components. Objective: Assessment of renin angiotensin aldosterone possible role in obesity. Methods: PubMed, Google Scholar, and Science Direct were used to search for the terms angiotensin, obesity, and renin-angiotensin-aldosterone system. Although they only looked at the most recent or comprehensive study from July 2003 to July 2022, the authors also looked at references from relevant literature. Documents produced in languages other than English have been rendered invalid due to lack of translation-related information. Dissertations, oral presentations, unpublished publications, conference abstracts, and other items that did not deal with significant scientific research were all ignored. Conclusion: Experiments suggest that the processes that drive adipose tissue development and metabolism in peripheral organs, as well as the effects of angiotensin on appetite and metabolism, contribute to the increased activity of the reninangiotensin system in obesity. Although renin angiotensin aldosterone system antagonists are typically used to treat high blood pressure and heart failure, there is growing evidence that they may also be useful in managing obesity and other metabolic diseases. [ABSTRACT FROM AUTHOR]

A recent study published in the Journal of Clinical Endocrinology & Metabolism explores the potential of SIRT1 and miR-34a-5p as biomarkers for the early detection of cognitive impairment in patients with type 2 diabetes mellitus (T2DM). The study found that there is a notable reduction in mitochondrial function and decreased expression of SIRT1 in the peripheral blood mononuclear cells (PBMCs) of patients with Alzheimer's disease (AD) compared to healthy controls. Additionally, miR-34a-5p was found to be upregulated in the PBMCs of T2DM patients with cognitive impairment (T2DM-CI). The combination of SIRT1 mRNA and miR-34a-5p in PBMCs showed promise in accurately distinguishing T2DM-CI patients from T2DM patients without cognitive impairment. However, further research is needed to fully understand the role of miR-34a-5p in the development of cognitive impairment in T2DM. [Extracted from the article]

Increasing evidence suggests excess skin Na+ accumulation in hypertension; however, the role of skin-specific mechanisms of local Na+/water regulation remains unclear. We investigated the association between measures of sweat and trans-epidermal water loss (TEWL) with Na+ content in the skin ([Na+]skin) and clinical characteristics in consecutive hypertensive patients. We obtained an iontophoretic pilocarpine-induced sweat sample, a skin punch biopsy for chemical analysis, and measures of TEWL from the upper limbs. Serum vascular endothelial growth factor-c (VEGF-c) and a reflectance measure of haemoglobin skin content served as surrogates of skin microvasculature. In our cohort (n = 90; age 21-86 years; females = 49%), sweat composition was independent of sex and BMI. Sweat Na+ concentration ([Na+]sweat) inversely correlated with [K+]sweat and was higher in patients on ACEIs/ARBs (P < 0.05). A positive association was found between [Na+]sweat and [Na+]skin, independent of sex, BMI, estimated Na+ intake and use of ACEi/ARBs (Padjusted = 0.025); both closely correlated with age (P < 0.01). Office DBP, but not SBP, inversely correlated with [Na+]sweat independent of other confounders (Padjusted = 0.03). Total sweat volume and Na+ loss were lower in patients with uncontrolled office BP (Padjusted < 0.005 for both); sweat volume also positively correlated with serum VEGF-c and TEWL. Lower TEWL was paralleled by lower skin haemoglobin content, which increased less after vasodilatory pilocarpine stimulation when BMI was higher (P=0.010). In conclusion, measures of Na+ and water handling/regulation in the skin were associated with relevant clinical characteristics, systemic Na+ status and blood pressure values, suggesting a potential role of the skin in body-fluid homeostasis and therapeutic targeting of hypertension. [ABSTRACT FROM AUTHOR]

Background: The transfusion rate is relatively high in patients with ankylosing spondylitis (AS) undergoing total hip arthroplasty (THA). However, relevant studies focusing on the predisposing factors for transfusion with a large sample size are lacking. This study aimed to investigate the incidence of and risk factors for allogeneic blood transfusion in patients with AS undergoing primary unilateral THA. Methods: This retrospective study included 331 patients with AS who underwent primary unilateral THA between 2011 and 2021. Relevant parameters were collected through a chart review. Multivariate logistic regression analysis was conducted to identify possible factors associated with perioperative allogeneic blood transfusion. Results: A total of 113 (34.1%) patients received perioperative allogeneic blood transfusions. Factors related to receiving an allogeneic blood transfusion included prolonged operative duration (odds ratio [OR] per 10 min = 1.139, P = 0.047), increased estimated intraoperative blood loss (OR per 100 mL = 1.348, P < 0.001), and increased postoperative drainage volume (OR per 100 mL = 1.235, P = 0.024). A higher body mass index (BMI) (OR = 0.914, P = 0.012), perioperative tranexamic acid (TXA) use (OR = 0.166, P < 0.001), and a higher preoperative hemoglobin level (OR per 1 g/dL = 0.744, P = 0.004) decreased the risk of transfusion. Conclusions: In patients with AS undergoing THA, prolonged operative duration, increased estimated intraoperative blood loss, and increased postoperative drainage volume were found to be risk factors for transfusion, whereas a higher BMI, perioperative TXA use, and a higher preoperative hemoglobin level were protective factors. These results may aid in developing a better perioperative management strategy, ultimately reducing the need for transfusion. [ABSTRACT FROM AUTHOR]

Blue sac disease (BSD) in salmonids results in the abnormal accumulation of ascites fluid and can often lead to mass mortality. However, the symptoms and causes of BSD remain poorly characterized. In the winters of 2015–2017, BSD was observed in chum salmon Oncorhynchus keta alevins at Hatchery-X in Hokkaido, Japan. We conducted histological observations of the visceral organs and analyzed nutrient concentrations [glucose (GC), triglyceride (TC), and protein (PC)] in liver, muscle, plasma, and ascites fluid. Several void spaces that appeared to leak body fluid in the liver were observed. Voids between Bowman's capsules and glomeruli were wider in the kidneys of diseased alevins than in normal alevins. Liver GC was significantly lower in diseased alevins than in normal alevins, and no differences were observed in muscle TC or PC. Plasma PC, plasma TC, and hematocrit were lower in diseased alevins than in normal alevins. No differences in the nutrient concentrations of plasma and ascites fluid were observed between diseased and normal alevins. BSD in chum salmon alevins might be due to impaired body fluid regulation and imbalances in the plasma component caused by lesions in the liver and kidneys. [ABSTRACT FROM AUTHOR]

The apelinergic system comprises two peptide ligands, apelin and ELABELA, and their cognate G-protein-coupled receptor, the apelin receptor APJ. Apelin is a peptide that was isolated from bovine stomach extracts; the distribution of the four main active forms, apelin-36, -17, -13, and pyr-apelin-13 differs between tissues. The mature form of ELABELA-32 can be transformed into forms called ELABELA-11 or -21. The biological function of the apelinergic system is multifaceted, and includes the regulation of angiogenesis, body fluid homeostasis, energy metabolism, and functioning of the cardiovascular, nervous, respiratory, digestive, and reproductive systems. This review summarises the mechanism of the apelinergic system in cell apoptosis. Depending on the cell/tissue, the apelinergic system modulates cell apoptosis by activating various signalling pathways, including phosphoinositide 3-kinase (PI3K), extracellular signal-regulated protein kinase (ERK1/2), protein kinase B (AKT), 5'AMP-activated protein kinase(AMPK), and protein kinase A (PKA). Apoptosis is critically important during various developmental processes, and any dysfunction leads to pathological conditions such as cancer, autoimmune diseases, and developmental defects. The purpose of this review is to present data that suggest a significant role of the apelinergic system as a potential agent in various therapies. [ABSTRACT FROM AUTHOR]

To purpose of this work is to determine the biocompatibility of the Zr58Co21Al9Ag12 alloy; vitreous ribbons of the Zr58Co21Al9Ag12 alloy were obtained by a chill block melt spinner. They were characterized by X-ray diffraction and transmission electron microscopy. Chemical homogeneity was examined by scanning electron microscopy. Similarly, thermal analysis was performed using differential scanning calorimetry. The nanoindentation test was performed with a Berkovich nanoindenter. Subsequently, the bioactivity was evaluated by chemical immersion in simulated body fluid. After immersion, it was characterized by XRD. A cell adhesion test was performed using mesenchymal stem cells from human dental pulp. Cell viability and proliferation were evaluated with a CCK-8 assay using human lymphocytes. The ribbons have crystalline phases close to 20%. The thermal parameters, Young's modulus, and hardness were obtained. After the immersion test, Ca and P were identified. Ion release does not exceed critical levels for human cells. The alloy has a higher concentration of adhered cells compared to Ti6Al4V. The alloy remains bio-inert with respect to apatite formation; however, it exhibits excellent cell viability, proliferation, and adhesion behavior. [ABSTRACT FROM AUTHOR]

Ovarian, cervical, and endometrial cancer are the three most common gynecological malignancies that seriously threaten women's health. With the development of molecular biology technology, immunotherapy and targeted therapy for gynecologic tumors are being carried out in clinical treatment. Extracellular vesicles are nanosized; they exist in various body fluids and play an essential role in intercellular communication and in the regulation of various biological process. Several studies have shown that extracellular vesicles are important targets in gynecologic cancer treatment as they promote tumor growth, progression, angiogenesis, metastasis, chemoresistance, and immune system escape. This article reviews the progress of research into extracellular vesicles in common gynecologic tumors and discusses the role of extracellular vesicles in gynecologic tumor treatment. [ABSTRACT FROM AUTHOR]

The kidney epithelial barrier has multifaceted functions in body fluids, electrolyte homeostasis, and urine production. The renal epithelial barrier (REB) frequently faces and challenges osmotic dynamics, which gives rise to osmotic pressure (a physical force). Osmotic pressure overloading can crack epithelial integrity and damage the REB. The endurance of REB to osmotic pressure forces remains obscure. LMO7 (LIM domain only 7) is a protein associated with the cell–cell junctional complex and cortical F-actin. Its upregulation was observed in cells cultured under hypertonic conditions. LMO7 is predominantly distributed in renal tubule epithelial cells. Hypertonic stimulation leads to LMO7 and F-actin assembly in the cortical stress fibers of renal epithelial cells. Hypertonic-isotonic alternation, as a pressure force pushing the plasma membrane inward/outward, was set as osmotic disturbance and was applied to test FAK signaling and LMO7 functioning in maintaining junctional integrity. LMO7 depletion in cells resulted in junctional integrity loss in the epithelial sheet-cultured hypertonic medium or hypertonic-isotonic alternation. Conversely, FAK inhibition by PF-573228 led to failure in robust cortical F-actin assembly and LMO7 association with cortical F-actin in epithelial cells responding to hypertonic stress. Epithelial integrity against osmotic stress and LMO7 and FAK signaling are involved in assembling robust cortical F-actin and maintaining junctional integrity. LMO7 elaborately manages FAK activation in renal epithelial cells, which was demonstrated excessive FAK activation present in LMO7 depleted NRK-52E cells and epithelial integrity loss when cells with LMO7 depletion were exposed to a hypertonic environment. Our data suggests that LMO7 regulates FAK activation and is responsible for maintaining REB under osmotic disturbance. [ABSTRACT FROM AUTHOR]

Most newborns begin urinating within 24hours of life, and almost always by 48hours. Rarely, some of them are anuric beyond 24hours, thereby causing concern to parents and treating doctors. We report the case of a newborn who presented with anuria till 48hours after birth. High-resolution ultrasound examination, focusing on the renal medulla, demonstrated increased echogenicity at the tip of the pyramids. This was attributed to slow clearance of urinary sediment deposited there, which was causing obstruction to the urinary outflow. On monitoring serially over the next few days, the echogenic sludge was observed being slowly eliminated leading thereby to improvement in the urinary output. High-resolution ultrasound focusing on the renal pyramids played an important role in the observation and management of this transient event unfolding, in the urinary tract. [ABSTRACT FROM AUTHOR]

Background: Many cardiocirculatory mechanisms are involved in the adaptation to orthostatic stress. While these mechanisms may be impaired in Fontan patients. However, it is yet unclear how Fontan patients, who exhibit a critical fluid balance, respond to orthostatic stress. Angiotensin converting enzyme inhibitors are often prescribed to Fontan patients, but they may negatively influence orthostatic tolerance. Therefore, we evaluated the response to orthostatic stress in pediatric Fontan patients before and after treatment with enalapril. Methods: Thirty-five Fontan patients (aged 14 years) with moderate-good systolic ventricular function without pre-existent enalapril treatment were included. Before and after a three-month enalapril treatment period, the hemodynamic response to head-up tilt test was evaluated by various parameters including cardiac index, blood pressure, cerebral blood flow, aortic stiffness and cardiac autonomous nervous activity. Thirty-four healthy subjects (aged 13 years) served as controls. Results: Fontan patients had a decreased cerebral blood flow and increased aortic stiffness in the supine position compared to controls, while all other factors did not differ. Patients and controls showed a comparable response to head-up tilt test for most parameters. Twenty-seven patients completed the enalapril study with a mean dosage of 0.3±0.1mg/kg/day. Most parameters were unaffected by enalapril, only the percent decrease in cardiac index to tilt was higher after treatment, but the cardiac index during tilt was not lower (3.0L/min/m2 pre-enalapril versus 2.8L/min/m2 after treatment; P = 0.15). Conclusion: Pediatric Fontan patients adequately respond to orthostasis with maintenance of blood pressure and cerebral blood flow and sufficient autonomic response. Enalapril treatment did not alter the response. Clinical trial information: Scientific title: ACE inhibition in Fontan patients: its effect on body fluid regulation (sAFE-study). The Netherlands National Trial Register: Trail NL6415. Registered 2017-07-20. Trial information: https://www.trialregister.nl/trial/6415 [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. The molecular pathogenesis of HCC varies due to the different etiologies and genotoxic insults. The development of HCC is characterized by complex interactions between several etiological factors that result in genetic and epigenetic changes in proto-onco and/or tumor suppressor genes. MicroRNAs (miRNAs) are short non-coding RNAs that also can act as oncomiRs or tumor suppressors regulating the expression of cancer-associated genes post-transcriptionally. Studies revealed that several microRNAs are directly or indirectly involved in cellular signaling, and dysregulation of those miRNAs in the body fluids or tissues potentially affects key signaling pathways resulting in carcinogenesis. Therefore, in this mini-review, we discussed recent progress in microRNA-mediated regulation of crucial signaling networks during HCC development, concentrating on the most relevant ones such as PI3K/Akt/mTOR, Hippo-YAP/TAZ, and Wnt/ß-catenin, which might open new avenues in HCC management. [ABSTRACT FROM AUTHOR]

This review mainly aimed to introduce the findings of research projects comparing the responses of tropical and temperate indigenes to heat. From a questionnaire survey on thermal sensation and comfort of Indonesians and Japanese, we found that the thermal descriptor "cool" in tropical indigenes connotes a thermally comfortable feeling, suggesting that linguistic heat acclimatization exists on a cognitive level. Ten male students born and raised in Malaysia were invited to Fukuoka, Japan, and compared their responses with 10 Japanese male students with matched physical fitness and morphological characteristics. Cutaneous thermal sensitivity: The sensitivities were measured at 28 °C. The forehead warm sensitivity was significantly blunted in Malaysians. The less sensitivity to the warmth of tropical indigenes is advantageous in respect to withstanding heat stress with less discomfort and a greater ability to work in hot climates. Passive heat stress: Thermoregulatory responses, especially sweating, were investigated, during the lower leg hot bathing (42 °C for 60 min). The rectal temperature at rest was higher in Malaysians and increased smaller during immersion. There was no significant difference in the total amount of sweating between the two groups, while the local sweating on the forehead and thighs was lesser in Malaysians, suggesting distribution of sweating was different from Japanese. Exercise: Malaysian showed a significantly smaller increase in their rectal temperature during 55% maximal exercise for 60 min in heat (32 °C 70% relative humidity), even with a similar sweating and skin blood flow response in Japanese. The better heat tolerance in Malaysians could be explained by the greater convective heat transfer from the body core to the skin due to the greater core-to-skin temperature gradient. In addition, when they were hydrated, Malaysian participants showed better body fluid regulation with smaller reduction in plasma volume at the end of the exercise compared to the non-hydrated condition, whereas Japanese showed no difference between hydration conditions. We further investigated the de-acclimatization of heat adaptation by longitudinal observation on the heat tolerance of international students who had moved from tropical areas to Fukuoka for several years. [ABSTRACT FROM AUTHOR]

The direct shedding of extracellular vesicles (EVs) from the plasma membrane is a recognized fundamental method for the intercellular transfer of properties in both physiological and pathological conditions. EVs are classified according to origin, biogenesis, size, content, surface markers, and/or functional properties, and contain various bioactive molecules depending on the physiological state and the type of the cells of origin including lipids, nucleic acids, and proteins. The presence of tumor-derived EVs in body fluids such as blood, ascites, urine, and saliva, together with the important role played in the tumor microenvironment where they intervene at different levels from oncogenesis to metastasis, make EVs a priority target for cancer studies. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) can play a leading role in the analysis and characterization of EVs and their load due to its intrinsic advantages such as high throughput, low sample consumption, speed, the cost-effectiveness of the analysis, and the ease of use. This work reviews the main MALDI-TOF applications for the analysis and characterization of extracellular vesicles in the tumor field. [ABSTRACT FROM AUTHOR]