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Background While obesity confers a survival advantage, weight loss adversely affects the survival of patients undergoing haemodialysis. However, given the limited information regarding its long‐term effects on mortality and cardiovascular events, the health benefits of weight gain remain uncertain, particularly in Asian patients undergoing haemodialysis. Methods In a prospective multicentre cohort of patients undergoing haemodialysis in South Korea, patients whose dry weight was recorded at baseline and after 1 year were analysed. Patients were stratified into five groups according to annual dry weight change: stable (−2.0% to 1.9%, n = 245), mild (2.0% to 6.9%, n = 92) and moderate (≥ 7.0%, n = 20) dry weight gain and mild (−5.0% to −2.1%, n = 91) and moderate (< −5.0%, n = 77) dry weight loss. The associations of annual dry weight change with physical function and health‐related quality of life were examined using cross‐sectional analysis. The impact of annual dry weight changes on all‐cause mortality and a composite of major adverse cardiovascular events (MACEs), defined as myocardial infarction, unstable angina, ischaemic stroke and peripheral artery disease requiring revascularization, was assessed in a longitudinal cohort of 525 individuals. Results In cross‐sectional analysis, patients with diminished physical ability had a higher frequency of dry weight fluctuations. In longitudinal analysis, the mean age of the study participants was 59.9 years, and 62.3% were men. During a median follow‐up of 3.1 years, death and MACE occurred in 105 (20.0%) and 31 (5.9%) patients, respectively. The risk of all‐cause mortality was higher in patients with moderate dry weight gain or loss than in those with stable dry weight (adjusted hazard ratio [aHR] for moderate weight gain, 2.22; 95% confidence interval [CI], 0.96–5.13; p = 0.06; and aHR for moderate weight loss, 1.78; 95% CI, 1.07–2.95; p = 0.03). The risk of MACE was significantly higher in patients with weight gain (including mild and moderate) than in those with a stable dry weight (aHR, 3.02; 95% CI, 1.32–6.88; p = 0.009). Specifically, the increased risk of all‐cause mortality attributable to moderate dry weight gain was limited to patients with obesity, whereas that for moderate dry weight loss was limited to patients with a normal body mass index. Conclusion Moderate weight gain and loss were differentially associated with lower survival among patients undergoing haemodialysis, with the former in patients with obesity and the latter in normal‐weight patients. Particularly, dry weight gain increased the risk of cardiovascular events.

The dendritic morphologies of hot-dip galvanized Zn-0.2 wt pct Al coatings on steel sheets with two different surface roughness conditions were systematically examined as functions of the inclination angle and axis of the Zn basal plane with respect to the sheet surface by using electron backscattered diffraction. When the inclination axis of the basal plane was \\[ \\langle 1\\bar{2}10 \\rangle \\], the dendrite changed its morphology by following the sequence of six-fold → eight-fold → elongated X → elongated X + C patterns with increasing inclination angle. When the inclination axis was \\[ \\langle 10\\bar{1}0 \\rangle \\], the sequence of morphological patterns on the mirror-polished steel substrate was six-fold → eight-fold → two-fold → four-fold, whereas, for the steel substrate with a rough surface, the eight-fold pattern was missing in the sequence. These sequences of morphological changes indicated the presence of a third family of preferred dendritic growth directions, in addition to the two previously known families of \\[ \\langle 10\\bar{1}0 \\rangle \\] and \\[ \\langle 0001 \\rangle \\]. The third growth direction family is proposed to be those normal to the \\[ \\left\\{ {1\\bar{2}11} \\right\\} \\] planes. The absence of the eight-fold pattern on the rough steel surface was attributed to the surface undulation that perturbed the growth in the six weakly preferred directions toward the two strongly preferred \\[ \\langle 10\\bar{1}0 \\rangle \\] directions.

The electrospray process has been extensively applied in various fields, including energy, display, sensor, and biomedical engineering owing to its ability to generate of functional micro/nanoparticles. Although the mode of the electrospray process has a significant impact on the quality of micro/nano particles, observing and discriminating the mode of electrospray during the process has not received adequate attention. This study develops a simple automated method to discriminate the mode of the electrospray process based on the current signal using a deep convolutional neural network (CNN) and class activation map (CAM). The solution flow rate and applied voltage are selected as experimental variables, and the electrospray process is classified into three modes: dripping, pulsating, and cone-jet. The current signal through the collector is measured to detect the deposition of electrospray droplets on the collector. The 1D CNN model is trained using frequency data converted from the current data. The model exhibits excellent performance with an accuracy of 96.30%. Adoption of the CAM configuration enables the model to provide a discriminative cue for each mode and elucidate the decision-making process of the CNN model.

To evaluate the relationship between urine albumin excretion (UAE) and retinal microvascular parameters assessed using swept-source optical coherence tomography angiography (SS-OCTA) in patients with diabetic retinopathy (DR). This retrospective cross-sectional study included 180 patients with diabetes and 50 age-matched controls. Patients with diabetes were grouped according to the five-stage DR severity, combined with the presence of albuminuria. All subjects underwent 12×12mm2 field SS-OCTA. The foveal avascular zone metrics, vessel density, and capillary nonperfusion area (NPA) were quantified using a semi-automatic software algorithm on three different rectangular fields (3×3 mm2, 6×6 mm2, and 10×10 mm2). The correlations between albuminuria and the four OCTA parameters were analyzed. A total of 105 subjects had normal UAE, and 75 subjects had albuminuria. Of the 102 subjects whose DR severity was higher than mild non-proliferative DR (NPDR), capillary NPA on the 3×3 mm2, 6×6 mm2, and 10×10 mm2 fields was significantly larger in the albuminuria group. None of the OCTA parameters were significantly different between the two groups in subjects with mild NPDR or without DR. Multiple logistic regression analysis showed that an increase in NPA in the 6×6 mm2 and 10×10 mm2 fields was a significant risk factor for the presence of albuminuria (odds ratio = 1.92 and 1.35). An increase in capillary NPA was independently associated with albuminuria in patients with clinically significant DR levels. SS-OCTA imaging can be a useful marker for the early detection of diabetic nephropathy.

The potential interaction between the heart and kidneys is thought to contribute to the development of renal hyperfiltration (RHF). However, the clinical implications of RHF remain unclear in patients with acute myocardial infarction (AMI). A total of 9561 AMI patients with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m 2 were enrolled from a large nationwide cohort. RHF was defined as eGFR > 90th percentile after multiple adjustments. The primary endpoint was a combination of 3 year major adverse cardiovascular events (MACEs) after AMI treatment. The cumulative event rate of MACEs was significantly higher in patients with RHF. In multivariable Cox-regression analysis, RHF increased the 1.34-fold risk of MACE (95% confidence interval [CI] 1.12–1.62) compared to those without RHF. Patients with RHF had a significantly higher risk of all-cause mortality (hazard ratio [HR] 1.64; 95% CI 1.25–2.14) and cardiac death (HR 1.78; 95% CI 1.26–2.51). There was a U-shaped association between the adjusted risk of MACEs and eGFR, with the risk increasing as eGFR exceeded approximately 100 mL/min/1.73 m 2 . The results demonstrated a consistent pattern in the 1:1 PS-matched population. Our study offers new insights into the risk stratification of AMI patients with RHF.

Introduction: A recent study showed that early renal tubular injury is ameliorated in Nod-like receptor pyrin domain-containing protein 3 (NLRP3) KO mice with rhabdomyolysis-induced acute kidney injury (RIAKI). However, the precise mechanism has not been determined. Therefore, we investigated the role of NLRP3 in renal tubular cells in RIAKI. Methods: Glycerol-mediated RIAKI was induced in NLRP3 KO and wild-type (WT) mice. The mice were euthanized 24 h after glycerol injection, and both kidneys and plasma were collected. HKC-8 cells were treated with ferrous myoglobin to mimic a rhabdomyolytic environment. Results: Glycerol injection led to increase serum creatinine, aspartate aminotransferase (AST), and renal kidney injury molecule-1 (KIM-1) level; renal tubular necrosis; and apoptosis. Renal injury was attenuated in NLRP3 KO mice, while muscle damage and renal neutrophil recruitment did not differ between NLRP3 KO mice and WT mice. Following glycerin injection, increases in cleaved caspase-3, poly (ADP-ribose) polymerase (PARP), and a decrease in the glutathione peroxidase 4 (GPX-4) level were observed in the kidneys of mice with RIAKI, and these changes were alleviated in the kidneys of NLRP3 KO mice. NLRP3 was upregulated, and cell viability was suppressed in HKC-8 cells treated with ferrous myoglobin. Myoglobin-induced apoptosis and lipid peroxidation were significantly decreased in siNLRP3-treated HKC-8 cells compared to ferrous myoglobin-treated HKC-8 cells. Myoglobin reduced the mitochondrial membrane potential and increased mitochondrial fission and reactive oxygen species (ROS) and lipid peroxidation levels, which were restored to normal levels in NLRP3-depleted HKC-8 cells. Conclusions: NLRP3 depletion ameliorated renal tubular injury in a murine glycerol-induced acute kidney injury (AKI) model. A lack of NLRP3 improved tubular cell viability via attenuation of myoglobin-induced mitochondrial injury and lipid peroxidation, which might be the critical factor in protecting the kidney.

This study aims to figure out the worldwide prevalence of anticancer therapy-associated acute kidney injury (AKI) and tubulointerstitial nephritis (TIN) and the relative risk of each cancer drug. We conducted an analysis of VigiBase, the World Health Organization pharmacovigilance database, 1967–2023 via disproportionate Bayesian reporting method. We further categorized the anticancer drugs into four groups: cytotoxic therapy, hormone therapy, immunotherapy, and targeted therapy. Reporting odds ratio (ROR) and information component (IC) compares observed and expected values to investigate the associations of each category of anticancer drugs with AKI and TIN. We identified 32,722 and 2056 reports (male, n = 17,829 and 1,293) of anticancer therapy-associated AKI and TIN, respectively, among 4,592,036 reports of all-drug caused AKI and TIN. There has been a significant increase in reports since 2010, primarily due to increased reports of targeted therapy and immunotherapy. Immunotherapy exhibited a significant association with both AKI (ROR: 8.92; IC 0.25 : 3.06) and TIN (21.74; 4.24), followed by cytotoxic therapy (7.14; 2.68), targeted therapy (5.83; 2.40), and hormone therapy (2.59; 1.24) for AKI, and by cytotoxic therapy (2.60; 1.21) and targeted therapy (1.54; 0.61) for TIN. AKI and TIN were more prevalent among individuals under 45 years of age, with a female preponderance for AKI and males for TIN. These events were reported in close temporal relationship after initiation of the respective drug (16.53 days for AKI and 27.97 days for TIN), and exhibited a high fatality rate, with 23.6% for AKI and 16.3% for TIN. These findings underscore that kidney-related adverse drug reactions are of prognostic significance and strategies to mitigate such side effects are required to optimize anticancer therapy.

Periodontitis is associated with elevated C-reactive protein (CRP) levels. Although the coexistence of periodontitis and elevated CRP levels may heighten the risk of mortality, previous studies have not confirmed their synergistic effect. Understanding this interaction is crucial for identifying potential interventions to reduce mortality risk in individuals with periodontitis. This study aimed to assess the synergistic effects of periodontitis and elevated CRP levels on mortality in 7,938 adult individuals who participated in the National Health and Nutrition Examination Study 2001–2004. The association of periodontitis status and CRP levels with mortality was assessed using a survey-weighted Cox model. The interactive effect was estimated; the synergistic effect of CRP levels and periodontitis status on mortality was assessed using the relative excess risk due to interaction (RERI). Periodontitis was diagnosed in 1,065 (13.4%) participants. Compared with the participants without periodontitis and possessing CRP levels of ≤ 0.5 mg/dL, those with periodontitis (hazard ratio [HR], 1.38) or CRP levels of > 0.5 mg/dL (HR 1.23) had higher HRs. The participants with both periodontitis and CRP levels of > 0.5 mg/dL had the highest HR of 2.01. The additive scale interactive effect of the periodontal status and CRP levels, measured using RERI 0.41 (-0.07, 0.95), was positive and nearly significant in the total population. The synergy between the periodontal status and CRP levels was more prominent in the participants aged ≥60 years than that in younger individuals. Periodontitis with high CRP levels may indicate a high mortality rate, indicating the importance of active monitoring and intensive management of periodontitis and inflammatory markers.

Little is known about the prevalence of chronic kidney disease (CKD) during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to investigate the long-term trends in CKD prevalence from South Korea including the early pandemic. We used data from 108,152 Korean adults from 2007 to 2020 obtained from a representative longitudinal serial study. We defined CKD as a condition when the participant’s estimated glomerular filtration rate was < 60 mL/min/1.73 m 2 , or one-time spot proteinuria was ≥ 1 +, and then examined the overall trends in the prevalence of CKD. Among the included adults (n = 80,010), the overall national prevalence of CKD was 6.2%. The trend slope gradually increased from 2007 to 2019, however, there was a sudden decrease in 2020 (2007–2010, 5.1% [95% confidence interval (CI) 4.7–5.5]; 2017–2019, 7.1% [95% CI 6.6–7.6]; pandemic period, 6.5% [95% CI 5.7–7.3]; and β diff , − 0.19; 95% CI − 0.24 to − 0.13). The prevalence of CKD among younger adults and those with poor medical utilization significantly decreased during the early pandemic. This study was the first large-scale study to investigate the longitudinal prevalence of CKD from 2007 to 2020. Further research is needed to fully understand the exact causes for this decline and to identify healthcare policy strategies for preventing and managing CKD.

Global evidence on the association between vaccines and renal adverse events (AEs) is inconclusive. This pharmacovigilance study analyzed a total of 120,715,116 reports from VigiBase collected between 1967 and 2022. We evaluated the global reporting of acute kidney injury (AKI), glomerulonephritis (GN), and tubulointerstitial nephritis (TIN) and assessed disproportionate signals between vaccines and renal AEs using reporting odds ratios (ROR) and the lower limit of the 95% confidence interval of the information component (IC 025 ) in comparison with the entire database. The number and proportion of reports on AKI, GN, and TIN gradually increased, with a substantial increase after 2020. Disproportionate reporting of AKI was significant for COVID-19 mRNA vaccines (ROR, 2.38; IC 025 , 1.09). Fourteen vaccines were significantly disproportionate for higher GN reporting, and the highest disproportionality for GN reporting was observed for COVID-19 mRNA (ROR, 13.41; IC 025 , 2.90) and hepatitis B vaccines (ROR, 11.35; IC 025 , 3.18). Disproportionate TIN reporting was significant for COVID-19 mRNA (ROR, 2.43; IC 025 , 0.99) and human papillomavirus (ROR, 1.75; IC 025 , 0.19) vaccines. Significant disproportionality in the reporting of AKI, GN, and TIN was observed in patients exposed to multiple vaccines, including COVID-19 mRNA vaccines, alongside increasing global reports of vaccine-associated renal AEs.