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Prognostic implications of iron deficiency in patients with atrial fibrillation, with and without chronic heart failure

Background Iron deficiency (ID) is common in patients with atrial fibrillation/flutter (AF), but its prognostic implications and optimal diagnostic criteria, particularly in those with and without heart failure (HF), remain unclear. This study assessed the associations between different ID definitions and clinical outcomes in patients with AF.

Methods This Danish nationwide cohort study included 10 834 patients with AF who underwent iron studies between 2008 and 2019, stratified by HF status. ID was defined using four criteria: European Society of Cardiology (ESC) guidelines, ferritin 100 ng/mL, transferrin saturation (TSAT) 20% and serum iron ≤13 µmol/L. Associations between ID definitions and all-cause mortality, cardiovascular mortality and all-cause hospitalisation were evaluated using Cox regression models, adjusted for confounders.

Results Prevalence of ID varied substantially across definitions, ranging from 36.2% to 62.7%. Over a median follow-up of 31 months, TSAT 20% was associated with increased all-cause and cardiovascular mortality in both HF (HR 1.25, 95% CI 1.14 to 1.37 and HR 1.31, 95% CI 1.14 to 1.49, respectively) and patients without HF (HR 1.39, 95% CI 1.18 to 1.64 and HR 1.54, 95% CI 1.18 to 2.00, respectively). Similarly, serum iron ≤13 µmol/L was associated with higher all-cause and cardiovascular mortality in HF (HR 1.44, 95% CI 1.31 to 1.58 and HR 1.42, 95% CI 1.24 to 1.63, respectively) and patients without HF (HR 1.67, 95% CI 1.41 to 1.97 and HR 1.46, 95% CI 1.13 to 1.89, respectively). ID defined by ESC guidelines or ferritin 100 ng/mL was not associated with mortality in either group but was linked to higher all-cause hospitalisation in patients with HF (HR 1.15, 95% CI 1.08 to 1.23 and HR 1.16, 95% CI 1.09 to 1.23, respectively).

Medaka: a novel model for analyzing genome–environment interactions

Analyzing genome– environment interactions using medaka model.

As a temperate fish species, medaka tolerates fluctuating environments (e.g., seasonal changes and different water salinity levels).

Medaka are highly tolerant to inbreeding; a near-isogenic inbred panel named Medaka Inbred Kiyosu-Karlsruhe panel and several wild-derived inbred strains of medaka have been established.

These panels and strains allow the analysis of phenotype–genotype interactions under different environmental conditions and the modeling of human populations.

Advanced epigenomic approaches, including assay for transposase-accessible chromatin using sequencing, highthroughput chromosome conformation capture (Hi-C), and analysis of histone modifications and DNA methylation, extend genomic approaches in our understanding of gene–environment interactions. sciencenewshighlights ScienceMission https://sciencemission.com/Medaka

Medaka is an established vertebrate model system for biological and biomedical research. It possesses unique features that make it particularly suitable for studying genome–environment interactions. Endemic to habitats spanning from 4 to 40°C and varying salinities, it combines broad ecological adaptability with experimental tractability. Its exceptional tolerance to inbreeding enabled the creation of the Medaka Inbred Kiyosu-Karlsruhe panel—80 near-isogenic, fully sequenced lines derived from a single wild population. More than 100 wild-derived, fully sequenced strains, collected throughout East Asia for more than 40 years, show relatively low intra-strain variation (inbreeding coefficient of 0.75) but high inter-strain variability (SNP rates 4%). Advanced quantification methods facilitate genome-wide association studies and quantitative trait locus mapping.

Continue reading “Medaka: a novel model for analyzing genome–environment interactions” | >

Scientists discover a hidden force that helps wire the brain

Growing neurons rely on chemical cues to find their targets, but new research shows that the brain’s physical properties help shape those signals. Scientists discovered that tissue stiffness can trigger the production of guidance molecules through a force-sensing protein called Piezo1. This protein not only detects mechanical forces but also helps maintain the structure of brain tissue. The discovery reveals a powerful link between the brain’s physical environment and how its wiring is built.

Progression Independent of Relapse Activity in Aquaporin-4-IgG–Positive NMOSDA Decade-Long Cohort Study

This study assessed the frequency of PIRA in a well-characterized cohort of patients with AQP4-IgG–positive NMOSD with over a decade of follow-up.

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The Multifaceted Paradigm of Rectal Cancer

“In a world where trimodality therapy has been the standard of care for so long, it’s remarkable to think that some of these cancers can be cured with a single systemic agent alone.”

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The world of cancer treatment is a rapidly evolving creature, and rectal cancer is no exception. In particular, locally advanced rectal cancer has a number of valid treatment options. While it’s traditionally a surgical disease, in some cases we now have evidence for watch-and-wait approaches that spare patients the morbidity and toxicity associated with oncologic resections. But even when the goal is to get the patient to a total mesorectal excision (TME), several nuances can influence decision making. Suddenly, talking to a patient about rectal cancer has become as lengthy a discussion as those we have with intermediate-risk prostate cancer patients.

We currently have good evidence to suggest that total neoadjuvant therapy (TNT) should be standard of care for locally advanced rectal cancers. But even within this algorithm of chemotherapy and chemoradiation followed by surgery, questions abound. Which treatment should we start with? Which chemotherapy should be used? What radiation fractionation should we employ? And which concurrent chemotherapy should be paired with radiation? While the 5-year follow-up of the RAPIDO trial demonstrated a statistically significant increase in the locoregional recurrence rate (10% vs 6%) with short course radiation,1 this must be viewed through a critical lens, given that the two arms did not directly compare short-and long-course radiation. Perhaps it was the addition of neoadjuvant chemotherapy, delaying surgery, that resulted in a detriment to the locoregional control. Thus, short-course radiation is still indicated as a reasonable treatment option per NCCN guidelines.

Survival and Risk Profile of Patients With Significant Tricuspid Regurgitation by Etiology

Does the cause of tricuspid regurgitation (TR) affect survival?

A new analysis of nearly 13K patients finds that survival in Primary TR is better than in Secondary or Lead-associated TR. @JabbarMMS

BackgroundTricuspid regurgitation (TR) is a common valvular disorder that can affect patients’ quality of life and survival. The impact of TR etiology on overall survival and the associated risk factors in each subgroup are not well studied.

Incorporating Intensity Modulated Total Body Irradiation (IMRT-TBI) into Future Cooperative Group Clinical Trials: An NRG Hematologic Malignancies Working Group-Led Report from the National Clinical Trials Network

Read it in the RedJournal: @NRGOnc

: Intensity-modulated radiation therapy (IMRT) is increasingly used for total body irradiation (TBI) due to its ability to deliver myeloablative doses while sparing radiosensitive organs. To enable consistent evaluation in future National Clinical Trials Network (NCTN) studies, the xxx Hematologic Malignancies Working Group (HMWG) convened IMRT-TBI experts and NCTN leaders to develop consensus recommendations for standardized multi-institutional implementation.

Group Vs Individual Grief-Focused Cognitive Behavioral Therapy for Older Adults

In a randomized clinical trial including older bereaved adults, group-format grief-focused cognitive behavioral therapy (ProlongedGriefDisorder) was noninferior to individual therapy for reducing symptoms of prolonged grief, posttraumatic stress disorder, depression, and anxiety at 6 months.

Both formats produced large reductions in symptom burden, suggesting either delivery method is effective for older adults seeking treatment after loss.

This study examines whether cognitive behavioral therapy delivered in a group format is noninferior to cognitive behavioral therapy delivered in an individual format in reducing prolonged grief disorder symptoms in older adults.

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