Citations

INTRODUCTION: This study used the novel C-reactive protein-albumin-lymphocyte (CALLY) index to explore its relationship with the risk of developing gallstones. METHODS: This study conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey data from 2017 to 2020; multivariable logistic regression examined the CALLY-gallstone association. Restricted cubic splines tested nonlinearity. Subgroup and mediation analyses explored population variations and mediating effects (Conicity, lipid accumulation product, and a body shape index). Receiver operating characteristic curves compared CALLY, systemic immune inflammation index, systemic inflammatory response index, and aggregate index of systemic inflammation predictive performance. RESULTS: After comprehensive adjustments, the highest CALLY quartile had significantly lower gallstone risk vs the lowest (odds ratio 0.56, 95% confidence interval 0.34–0.94). Restricted cubic splines revealed a linear inverse correlation. Subgroup analyses generally supported this inverse relationship. Mediation analysis identified the Conicity index as the strongest mediator (21.47%, P < 0.001), followed by lipid accumulation product and a body shape index (10.72% each, P < 0.001). Receiver operating characteristic analysis showed CALLY (area under the curve = 0.604) outperformed systemic immune inflammation index (0.540), systemic inflammatory response index (0.550), and aggregate index of systemic inflammation (0.546). DISCUSSION: A significant inverse association exists between the CALLY index and gallstone prevalence. The CALLY index demonstrates superior predictive ability compared with other indices, suggesting its potential utility as an objective biomarker for early gallstone risk identification.

Abstract Studies on human and animal models have demonstrated a complex molecular regulatory network between the dental mesenchyme and epithelium governing tooth development. However, epigenetic regulation of tooth development is largely unexplored. This study aimed to elucidate the relationship between epigenetic modifiers and dental root development using mice deficient in histone deacetylase 3 (Hdac3) under the control of the osterix promoter (Osx-Cre/Hdac3fl/fl or Hdac3-CKOosx). We observed tooth root size and histology in Hdac3-CKOosx mice. Dental pulp progenitor cells (DPCs) were isolated from lower incisors, and calcification and gene expression were assessed. Hdac3 depletion in osterix-expressing dental pulp stem cells, including odontoblasts, caused a progressive postnatal obstruction, resulting in relatively short roots and small root apices of the first molar. Mild degeneration was observed during the development of dentin and cementum structures. Dentin and cementum had uneven borders and showed disordered H&E staining in Hdac3-CKOosx mice that had a thin cementum compared to that of WT mice. Hdac3 inhibition/deletion in dental pulp stem cells probably influenced Msh homeobox 1 (Msx1) and Col1a1 expression in the early developmental stage, thereby driving differentiation in DPCs. Subsequently, Msx1, Col1a1, and osteocalcin expression were remarkably downregulated during calcification. Deletion or inhibition of Hdac3 in conditional KO dental pulp stem cells cultured in mineralization medium resulted in aberrant cell cycle control, and the early stages of maturation of DPCs and odontoblasts were inhibited. Inhibition of Hdac3 in cementocytes also restricted their proliferation and calcification. These results suggested that the deletion or inhibition of Hdac3 in the dental mesenchyme may cause development and maturation deficiency of tooth root.

Background: Ibrutinib, a potent Bruton’s tyrosine kinase inhibitor with marked efficacy against hematological malignancies, is associated with the heightened risk of atrial fibrillation (AF). Although ibrutinib-induced AF is linked to enhanced oxidative stress, the underlying mechanisms remain unclear. Objective: This research aimed to explore the molecular mechanism and regulatory target in ibrutinib-induced AF. Methods: We performed in vivo electrophysiology studies using ibrutinib-treated mice, and then employed proteomic and single-cell transcriptomic analyses to identify the underlying targets and mechanisms. The effects of A-kinase anchoring protein 1 (AKAP1) depletion on mitochondrial quality surveillance (MQS) were evaluated using both in vivo and ex vivo AKAP1 overexpression models. Results: Atrial AKAP1 expression was significantly reduced in ibrutinib-treated mice, leading to inducible AF, atrial fibrosis, and mitochondrial fragmentation. These pathological changes were effectively mitigated in an overexpression model of ibrutinib-treated mice injected with an adeno-associated virus carrying Akap1. In ibrutinib-treated atrial myocytes, AKAP1 down-regulation promoted dynamin-related protein 1 (DRP1) translocation into mitochondria by facilitating DRP1 dephosphorylation at Ser637, thereby mediating excessive mitochondrial fission. Impaired MQS was also suggested by defective mitochondrial respiration, mitochondrial metabolic reprogramming, and suppressed mitochondrial biogenesis, accompanied by excessive oxidative stress and inflammatory activation. The ibrutinib-mediated MQS disturbance can be markedly improved with the inducible expression of the AKAP1 lentiviral system. Conclusions: Our findings emphasize the key role of AKAP1-mediated MQS disruption in ibrutinib-induced AF, which explains the previously observed reactive oxygen species overproduction. Hence, AKAP1 activation can be employed to prevent and treat ibrutinib-induced AF.

Objective: This study aims to appraise recommendations from an expert panel of surgical educators on optimizing surgical education and training in the setting of contemporary challenges. Background: The Blue Ribbon Committee (BRC II), a group of surgical educators, was convened to make recommendations to optimize surgical training, considering the current changes in the landscape of surgical education. Surgical trainees were recruited to assess their impressions of the recommendations. Methods: A mixed-methods study design was employed, with a survey, followed by focus group interviews. Participating residents and fellows were recruited through a purposeful sampling approach. Descriptive statistics were applied to analyze the survey data, and a thematic data analysis on interview transcripts was employed. Results: The majority of trainee respondents (n=16) thought that all of the subcommittee recommendations should be included in the final BRC II recommendations and paper. According to the interviews, overall, the feedback from the trainees was positive, with particular excitement around work-life integration, education support and faculty development, and funding pitfalls. Some themes about concerns included a lack of clarity about the recommendations, concern about some recommendations being in conflict with one another, and a disconnect between the initial BRC II survey and the subsequent recommendations. Conclusions: The residents gathered for this focus group were encouraged by the thought, effort, and intention that gathered the surgical leaders across the country to make the recommendations. While the trainees wanted clarity on some areas, the overall opinion was in agreement with the recommendations.

Evidence from our laboratory has established a role for the G0/G1 Switch Gene 2 (G0S2) as the primary inhibitor of adipose lipolysis through inhibition of adipose triglyceride lipase (ATGL), the rate‐limiting enzyme in triglyceride hydrolysis. We have demonstrated that differential expression of G0S2 plays a crucial role in regulating hepatic lipid content during fasting and feeding. Hepatic G0S2 expression is also significantly increased in a pathological condition in mice with obesity‐induced hepatic steatosis or non‐alcoholic fatty liver disease (NAFLD), major metabolic health issues in today's society. Based on preliminary evidence we hypothesized there is a dynamic relationship between adipose lipolysis and hepatic G0S2 expression during physiological fasting, a relationship that has not been previously described. To better understand this relationship we evaluated the effect of free fatty acids (FFA) on G0S2 expression in liver. Interestingly, hepatic G0S2 expression during fasting results from increased free fatty acid (FFA) delivery to the liver from adipose tissue. Moreover, we identified that increases in hepatic FFA lead to increased G0S2 expression in a bi‐mechanistic manner. We investigated and subsequently determined that both transcriptional activation of G0S2 and inhibition of protein degradation are occurring in response to increased hepatic FFA levels. Utilizing a luciferase based reporter system and in vivo chromatin immunoprecipitation we found transcriptional activation of G0S2 in liver occurs in response to activation of liver‐X‐receptor α (LXRα). LXRα is a known regulator of pro‐lipogenic signaling in liver and plays a major role in cholesterol homeostasis. It has also been shown that LXRα can be activated in response to FAs most likely through its dimerization partner RXRα that is a known FA responsive transcription factor. We demonstrate G0S2 is a direct downstream target gene for LXRα. Additionally, the direct repeat 4 (DR4) LXR response element (LXRE) found 2kb upstream of the transcriptional start site in the G0S2 promoter is required for G0S2/ LXRα binding. This DR4 binding site is conserved between the human and mouse isoforms of G0S2 and is required in each for LXRα binding. Furthermore, we found that G0S2 is subject to ubiquitin modification and is degraded in a proteasome dependent pathway. Mutation analysis of the six‐lysine residues found in G0S2 provided key evidence that the lysine at position 25 is the prominent site for ubiquitylation. The G0S2 K25 mutant is more stable than wild‐type G0S2, which is consistent with the accompanying decrease in ubiquitylation. Additionally, fatty acids were able to abrogate G0S2 degradation and increase protein stability. These findings indicate that two mechanisms of expression regulation in combination with adipose lipolysis are functioning concomitantly to regulate hepatic G0S2 expression under physiological conditions. Additionally, aberrant G0S2 expression may contribute to the pathological setting with metabolically linked diseases including NAFLD. Support or Funding Information This work was supported by NIDDK grants DK089178 and 2R56DK089178 from the National Institutes of Health. Pre‐doctoral funding support for B.H. was generously provided by the Mayo Graduate School and Mayo Foundation for Medical Education & Research.

Gastric cancer (GC) is one of the most malignant neoplasms worldwide, accounting for about 770,000 deaths in 2020. The incidence of gastric cancer bone metastasis (GC-BM) is low, about 0.9–13.4%, and GC patients develop GC-BM because of a suitable bone microenvironment. Osteoblasts, osteoclasts, and tumor cells interact with each other, secreting cytokines such as PTHrP, RANK-L, IL-6, and other growth factors that disrupt the normal bone balance and promote tumor growth. The functions and numbers of immune cells in the bone microenvironment are continuously inhibited, resulting in bone balance disorder due to the cytokines released from destroyed bone and growing tumor cells. Patients with GC-BM are generally younger than 65 years old and they often present with a later stage of the disease, as well as more aggressive tumors. They usually have shorter overall survival (OS) because of the occurrence of skeletal-related events (SREs) and undetected bone destruction due to the untimely bone inspection. Current treatments of GC-BM focus mainly on gastric cancer and SRE-related treatment. This article reviews the clinical features, possible molecular pathogeneses, and the most commonly used diagnostic methods and treatments of bone metastasis in gastric cancer.

AbstractBackgroundChildren with diffuse intrinsic pontine gliomas (DIPG) have a dismal prognosis. Adavosertib (AZD1775) is an orally available, blood-brain barrier penetrant, Wee1 kinase inhibitor. Preclinical efficacy against DIPG is heightened by radiation induced replication stress.MethodsUsing a rolling six design, 7 adavosertib dose levels (DLs) (50 mg/m2 alternating weeks, 50 mg/m2 alternating with weeks of every other day, 50 mg/m2, then 95, 130, 160, 200 mg/m2) were assessed. Adavosertib was only given on days of cranial radiation therapy (CRT).The duration of CRT (54 Gy over 30 fractions; 6 weeks) constituted the dose limiting toxicity (DLT) period. Endpoints included tolerability, pharmacokinetics, overall survival (OS) and peripheral blood γH2AX levels as a marker of DNA damage.ResultsA total of 46 eligible patients with newly diagnosed DIPG [median (range) age 6 (3–21) years; 52% female] were enrolled. The recommend phase 2 dose (RP2D) of adavosertib was 200 mg/m2/d during days of CRT. Dose limiting toxicity included ALT elevation (n = 1, DL4) and neutropenia (n = 1, DL7). The mean Tmax, T1/2 and Clp on Day 1 were 2 h, 4.4 h, and 45.2 L/hr/m2, respectively. Modest accumulation of adavosertib was observed comparing day 5 versus day 1 AUC0-8h (accumulation ratio = 1.6). OS was 11.1 months (95% CI: 9.4, 12.5) and did not differ from historical control.ConclusionAdavosertib in combination with CRT is well tolerated in children with newly diagnosed DIPG, however, compared to historical controls, did not improve OS. These results can inform future trial design in children with high-risk cancer.