Neonatal Severe Anemia Caused by Fetomaternal

A document by Douni Roger. Click on the document to view its contents.

A document by Rupert Dwyer. Click on the document to view its contents.

Title:Heart Failure Progression in the Setting of Persistent Atrial Fibrillation, High Premature Ventricular Complex Burden, and Malignancy-Related Limitations to Guideline-Directed Medical TherapyAuthors:1Douni Roger, MD; 1Waleed Shaker, MD; 1Majid Yavari, MD; 1Mark Castellani, MD; 1Zan Siddiqi, MD;2Maurice Tiotsop, PhDAffiliations:1University of Michigan/Sparrow Hospital;2University of Louisville School of MedicineCorresponding Author:rogerdou@msu.edu

A document by Xavier Bosch-Capblanch. Click on the document to view its contents.

Objective: Evidence on the stress–fecundability relationship is mixed, and both the population heterogeneity and the effects of moderate stress remain understudied. We aimed to investigate the association of stress with fecundability in women planning pregnancy, and to explore whether this association varied by gravidity, health status, or lifestyle factors. Design: Perspective cohort study. Setting: National Free Pre-conception Check-up Project (NFPCP), China Population: 512,735 reproductive-aged women who participated in the NFPCP between 2012 and 2018. Methods: Perceived psychological stress was assessed at enrollment using a two-item questionnaire rated on a 5-point Likert scale. Associations between perceived stress levels and fecundability were estimated using Cox proportional hazards regression models, adjusting for potential confounders. Main outcome measures: Participants were followed every three months for one year or until pregnancy was confirmed by gynecologic ultrasonography, whichever came first. The primary outcome was time to pregnancy. Results: Compared with the no-stress group, fecundability was 2% higher in the moderate-stress group (HR, 1.02; 95% CI, 1.01, 1.03) and 15% lower in the high-stress group (HR, 0.85; 95% CI, 0.81, 0.90). The beneficial effect was specific to moderate stress arising from life and work, whereas financial strain showed no such reproductive advantage. Subgroup analyses revealed that the positive association was more pronounced among women without tobacco exposure or with hyperglycemia (impaired glucose tolerance or diabetes), and the adverse impact of high stress was significantly exacerbated in women with obesity or a history of prior pregnancies. Conclusions: In this large-scale cohort, we identified an inverse U-shaped association where moderate stress from life or work enhanced fecundability. These findings challenge the view that all stress is harmful, offering reassurance that moderate life or work stress is compatible with conception. Nevertheless, high stress levels warrant careful attention, particularly among women with obesity or those with a history of prior pregnancies.

Urbanisation and urban heat frequently co-occur, and climate change is expected to amplify these effects, yet their consequences on population dynamics and life-history traits remain unclear. Using the common woodlouse Armadillidium vulgare, a widespread decomposer and urban indicator species, we combined fine-scale field surveys with climatic chamber experiments on field animals’ offspring to disentangle these effects. Field surveys revealed consistently higher abundances and occurrences in Urban Heat Islands (UHIs) compared to Urban Cool Islands (UCIs), but with lower reproductive success and elevated senescence, as measured by β-galactosidase activity, pointing to a trade-off between density and individual fitness. For field animals’ offspring following in chambers, growth remained unaffected, but survival and reproduction declined under future (2050) climate conditions relative to present (2024), suggesting only limited acclimatisation. Offspring of individuals from Urban Heat Islands (UHI) showed earlier reproductive timing under future climate conditions, suggesting a potential adaptive response. Moreover, β-galactosidase activity was lower in UHI offspring exposed to 2050 conditions, pointing to acclimatisation in stress physiology. Together, these results highlight that even highly opportunistic urban generalists may experience fitness costs when urban heat and urbanisation interact with climate change, with potential consequences for decomposer-driven ecosystem functioning in cities.

Non-healing spontaneous coronary artery dissection in a young woman managed with coronary artery bypass grafting: A case report with literature reviewGashaw Solela1*, Desalew Mekonnen1, Nish Patel2, Jim Kauten3, Chala Fekadu Oljira1, Adane Petros1, Siraj Kemal Mussa1, Gashayeneh Genetu Tiruneh1, Getu Kusa Wakoya1, Tesfamariam Aklilu Betemariam1, Dagmawit Mesfin Tasew4, Clifford J Kavinsky5, Tesfaye Telila3, Obsinet Merid61Deparment of Cardiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia2Miami Cardiac and Vascular Institute, Miami, Florida, United States3Piedmont Heart Institute, Atlanta, Georgia, United States3Division of Cardiology, Northwestern University, Atlanta, Georgia, United States4Department of Internal Medicine, Myungsung Medical College, Addis Ababa, Ethiopia5Division of Cardiology, Loyola University Medical Centre, Maywood, Illinois, United States6Morehouse School of Medicine, Atlanta, Georgia, United States*Corresponding author: gashawsol@gmail.com, ORCID ID: 0000-0002-2233-9270

TitleA diagnostic pitfall of the reversed halo sign: pulmonary infarction mistaken for pneumonia

IntroductionCardiac implantable electronic devices (CIEDs), including permanent pacemakers and implantable cardioverter-defibrillators (ICDs), are widely used in the management of bradyarrhythmias, tachyarrhythmias, and conduction disorders. Although implantation techniques and device technology have advanced substantially, mechanical complications remain clinically relevant. Lead displacement continues to represent an important cause of device malfunction and may present with a broad spectrum of clinical manifestations.¹Twiddler syndrome is a well-recognized but uncommon mechanical complication first described by Bayliss and colleagues in 1968, in which rotation of the pulse generator within its subcutaneous pocket results in lead coiling, retraction, and eventual loss of effective myocardial contact.² Variants such as Reel and Ratchet syndromes have since been described, differing primarily in the direction and mechanism of generator manipulation.³⁻⁴ Although the overall incidence is low, reported between 0.07% and 7%,⁵ presentations range from asymptomatic loss of capture to inappropriate ICD shocks and rare cases of sudden cardiac death.⁶⁻⁷When lead migration occurs proximally into the superior vena cava (SVC) or right atrium, pacing impulses may stimulate adjacent extracardiac structures, most notably the phrenic nerve, resulting in rhythmic diaphragmatic or abdominal wall contractions. These symptoms may be misinterpreted as arrhythmia, neuromuscular disease, or anxiety, leading to diagnostic delay.⁸ We report an early post-implantation presentation of right hemidiaphragmatic twitching due to ventricular lead migration into the SVC and highlight diagnostic and management considerations.

Long non-coding RNAs (lncRNAs), is a broad class of non-protein-coding RNAs characterised as new regulators of gene expression at the epigenetic, transcriptional, and post-transcriptional level. Thus, lncRNAs are involved in the regulation of physiological processes and the development of human diseases and cancer by modulating proinflammatory, oncogenic and proangiogenic pathways. Inflammation, cancer and angiogenesis are interlinked through a network of signals and pathways which reinforces itself through feedback loops. Inflammation triggers vessel formation to transfer immune cells and nutrients, and the new vessels then supply more inflammatory cells and factors. Chronic inflammation induces oncogenic transformation and angiogenesis induced by tumour-derived signals support tumour growth and provide the route for distal metastasis. Here we review the implication of lncRNAs in these processes and interactions in the gastrointestinal (GI) tract with a special focus on inflammation and cancer angiogenesis. LncRNAs due to their highly cell-, tissue- and disease-specific expression are attractive targets for the development of novel therapeutics with limited off-target effects and toxicity. We discuss new discoveries which highlight the value of lncRNA targeting as therapeutic applications in GI inflammation and cancer angiogenesis and identify gaps in our current knowledge and understanding. We illustrate advancing approaches, their advantages and challenges for the pharmacological targeting of lncRNAs.

Sialorrhea Following Rhytidectomy: A Case Report and Comprehensive Review of Management StrategiesAuthors: Malihe Kadkhodaei1, Ali-Mohammad Fallah Tafti2*, Mohammad Mehdi Mehrabi3,Seyyed Mohammad Hosseini Marvast4

This study manipulated self-disclosure in a series of real-world speed-dating events and monitored the moment-by-moment evolution of participants' skin conductance responses throughout 505 five-minute first-time encounters. Both disclosure condition and mutual attractiveness separately affected emotional arousal and physiological synchrony with attractiveness impacting arousal primarily at the beginning of the date, and disclosure taking effect later in the encounter. Specifically, for the highly attracted couples, we observed increases in arousal during the first three minutes of the date, and increased synchrony during the first minute. Both effects of attractiveness faded away as the romantic date progressed. In contrast, self-disclosure followed a distinct temporal pattern with increased arousal becoming evident halfway through the encounter, and physiological synchrony forming in the final minute of high- versus low disclosure dates. These findings suggest that mutual attraction initially drives excitement and emotional alignment, while reciprocal self-disclosure gradually takes over and becomes the main factor determining arousal and synchrony. Our results are a step forward in understanding the complexity and dynamics of initial romantic interactions and highlight the value of incorporating physiological measures in survey-dominant relationship research.

A document by Iftekhar Ahmed Sakib. Click on the document to view its contents.

Green canopy cover dynamics extracted from high-throughput RGB imagery via automated labeled segmentation enabled nonlinear modeling that accounted for short-term weather variation, explaining up to 56% of protein yield variation in 150 soybean genotypes across ten seasons and enabling prediction in new environments as well as identification of tolerant genotypes.

Background: Asthma and obesity frequently coexist in childhood, yet whether asthma predisposes to later adiposity remains underexplored, particularly using measures beyond body mass index (BMI). Considering this, we aimed to examine the association between asthma in early childhood and subsequent adiposity through adolescence, assessed using BMI and body fat percentage, and to evaluate sex-specific effects. Methods: This prospective study included 4717 participants from the Portuguese population-based Generation XXI birth cohort. Physician-diagnosed asthma at age 4 years was the exposure. Incident obesity and overweight/obesity were assessed at ages 7-, 10-, and 13-years using BMI and body fat percentage estimated by bioelectrical impedance analysis and classified according to age- and sex-specific percentiles. Children who were already overweight or obese at age 4 were excluded from the respective analysis. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for confounders. Effect modification by sex was tested, and sex-stratified analyses were performed. Results: Asthma was associated with a higher risk of incident obesity defined by body fat percentage in adjusted analyses (aHR=1.91, 95%CI:1.16-3.16), whereas associations with BMI-defined obesity were not statistically significant. Sex-stratified analyses showed that these associations were confined to girls, who had increased risk of obesity (aHR=1.97, 95%CI:1.19-3.26) and overweight/obesity (aHR=1.75, 95%CI:1.02-3.01) defined by body fat percentage. No significant associations were observed among boys. Conclusions: Asthma in early childhood was associated with increased adiposity in adolescence assessed by body fat percentage, particularly among girls. These findings suggest that children with asthma may develop excess fat accumulation not fully captured by BMI and support the integration of body composition and metabolic risk assessment into paediatric asthma care.

Increasing research efforts in recent years and new approaches in clinical studies provided significant insights into the pathophysiology of freezing of gait (FOG). However, the study of causative mechanisms for complex gait disorders typically needs refined in-vivo models, which are still lacking for FOG. The characteristics of FOG pose major difficulties not only for reproduction in animals with different types of gaits, but also for assessment of such episodic behavior in the animal environment. In this review, we examine the currently available animal models of FOG and FOG-like phenomena for their validity and applicability and present a prospective view of modeling based on novel technologies to manipulate integrated mechanisms.

Purpose: Social media has propagated several “challenges” that engage primarily adolescents in life-threatening behaviors such as the “Benadryl Challenge,” where participants filmed themselves ingesting large doses of diphenhydramine. Once shared online, these activities have the potential to propagate, leading to an increase in those seeking emergency healthcare. Methods: This study correlated call volume from poison centers with online mentions of the Benadryl Challenge. Data was collected from the National Poison Data System (NPDS) and the RADARS® Web Monitoring Program across July 1 to December 31, 2020. The NPDS provided diphenhydramine-related call volume across poison centers and the RADARS® Web Monitoring Program estimated the total number of online mentions related to the Benadryl Challenge across online platforms, blogs, forums, and news websites. Analysis utilized cross-correlation statistics, identifying lead-lag relationships between the datasets. Results: Cross-correlation analysis revealed a reciprocal relationship with an increase in all diphenhydramine-related calls predicting a consistent but not statistically significant increase in web mentions. Following the first spike in web mentions was a statistically significant increase in adolescent-only related calls. The increase in poison center calls was consistently elevated over baseline for over 25 days following the spike in web mentions. Conclusions: Poison center call volume and web mentions demonstrate a reciprocal relationship and poison center call volume remained elevated for over 25 days after the spike in web mentions. Emergency services/departments and public health efforts can be informed real-time by these relationships as an early warning to healthcare facilities and professionals and may justify integration within these spaces to educate and prevent harm.