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preterm and term neonates to be differentiated. T1 and T2 relaxation time metrics of the midbrain allow differentiation between the different stages of prematurity. SyMRI allows for a quantitative assessment of incomplete brain maturation by providing tissue-specific properties while not exceeding a clinically acceptable imaging time.Visual summary. Coronary interventional trials in 2020.Of the 800 G protein-coupled receptors (GPCRs) in humans, only three (GPR4, GPR65, and GPR68) regulate signaling in acidified microenvironments by sensing protons (H+). How these receptors have uniquely obtained this ability is unknown. Here, we show these receptors evolved the capability to sense H+ signals by acquiring buried acidic residues. Using our informatics platform pHinder, we identified a triad of buried acidic residues shared by all three receptors, a feature distinct from all other human GPCRs. Phylogenetic analysis shows the triad emerged in GPR65, the immediate ancestor of GPR4 and GPR68. To understand the evolutionary and mechanistic importance of these triad residues, we developed deep variant profiling, a yeast-based technology that utilizes high-throughput CRISPR to build and profile large libraries of GPCR variants. Using deep variant profiling and GPCR assays in HEK293 cells, we assessed the pH-sensing contributions of each triad residue in all three receptors. As predicted by our calculations, most triad mutations had profound effects consistent with direct regulation of receptor pH sensing. In addition, we found that an allosteric modulator of many class A GPCRs, Na+, synergistically regulated pH sensing by maintaining the pKa values of triad residues within the physiologically relevant pH range. As such, we show that all three receptors function as coincidence detectors of H+ and Na+. Taken together, these findings elucidate the molecular evolution and long-sought mechanism of GPR4, GPR65, and GPR68 pH sensing and provide pH-insensitive variants that should be valuable for assessing the therapeutic potential and (patho)physiological importance of GPCR pH sensing.ATP-binding cassette subfamily A member 13 (ABCA13) is predicted to be the largest ABC protein, consisting of 5058 amino acids and a long N-terminal region. Mutations in the ABCA13 gene were reported to increase the susceptibility to schizophrenia, bipolar disorder, and major depression. However, little is known about the molecular functions of ABCA13 or how they associate with psychiatric disorders. Here, we examined the biochemical activity of ABCA13 using HEK293 cells transfected with mouse ABCA13. The expression of ABCA13 induced the internalization of cholesterol and gangliosides from the plasma membrane to intracellular vesicles. Cholesterol internalization by ABCA13 required the long N-terminal region and ATP hydrolysis. To examine the physiological roles of ABCA13, we generated Abca13 KO mice using CRISPR/Cas and found that these mice exhibited deficits of prepulse inhibition. Vesicular cholesterol accumulation and synaptic vesicle endocytosis were impaired in primary cultures of Abca13 KO cortical neurons. Furthermore, mutations in ABCA13 gene associated with psychiatric disorders disrupted the protein's subcellular localization and impaired cholesterol trafficking. These findings suggest that ABCA13 accelerates cholesterol internalization by endocytic retrograde transport in neurons and that loss of this function is associated with the pathophysiology of psychiatric disorders.

Magnetic resonance imaging (MRI)-targeted biopsies have changed the dogma in prostate cancer diagnosis. Biopsies can be performed either transrectally (MRI-guided and transrectal ultrasound fusion transrectal biopsy [MRI-TRUSB]) or transperineally (MRI-guided and transrectal ultrasound fusion transperineal biopsy [MRI-TPB]).

To evaluate the detection and complication rates of MRI-TRUSB and MRI-TPB.

We performed a literature search in PubMed, Scopus, EMBASE, and CENTRAL, and selected randomized controlled trials (RCTs) and observational studies comparing MRI-TRUSB versus MRI-TPB.

Our search identified 3608 studies; we included five in the qualitative and two in the quantitative synthesis. On per-patient pooled analysis for clinically significant prostate cancer (csPCa), MRI-TPB detection rates were significantly higher (relative risk 1.28 [95% confidence interval CI 1.03-1.60], p =  0.03). On a per-lesion analysis, MRI-TPB anterior csPCa detection rates were statistically significantly higher (relatiPB approach, and comparing these data with historical MRI-TRUSB cohorts.

We looked at the outcomes by comparing magnetic resonance imaging (MRI)-guided and transrectal ultrasound fusion transrectal biopsy with MRI-guided and transrectal ultrasound fusion transperineal biopsy (TPB). The analysis suggests, based on very low certainty evidence, that MRI-TPB has better detection for clinically significant prostate cancer, anterior tumors, and lower complications.

We looked at the outcomes by comparing magnetic resonance imaging (MRI)-guided and transrectal ultrasound fusion transrectal biopsy with MRI-guided and transrectal ultrasound fusion transperineal biopsy (TPB). The analysis suggests, based on very low certainty evidence, that MRI-TPB has better detection for clinically significant prostate cancer, anterior tumors, and lower complications.

Dyslipidemia has been associated with endothelial dysfunction in childhood. Impairment of renal function has been demonstrated in dyslipidemic adults.

The aim of this study was to assess markers of early endothelial and renal dysfunction in dyslipidemic children.

This was a cross-sectional study of 100 children with dyslipidemia and 100 age- and sex-matched control subjects without dyslipidemia aged 7-16 years. Renal dysfunction was assessed by measurement of serum creatinine and cystatin C levels, urinary beta 2-microglobulin levels, urinary albumin to creatinine (AlbCr) ratio, and by the estimated glomerular filtration rate (eGFR), based on serum creatinine or cystatin C. Endothelial dysfunction and early vascular changes were evaluated by ultrasound assessment of flow mediated dilation (FMD) of the brachial artery, and carotid intima-media thickness (cIMT), respectively.

The markers of early renal dysfunction showed no difference between the dyslipidemic children and control subjects except for the urinary AlbCr ratio that was higher in the dyslipidemic children (median, 0.007mg/mg vs 0.005mg/mg, p=0.004). The urinary AlbCr ratio was positively correlated with the triglyceride to high-density lipoprotein cholesterol ratio (r=0.28, p=0.013). FMD values were lower in the dyslipidemic children than in the control subjects (8.504±4.73% vs 10.535±4.35%, p=0.004), but cIMT did not differ between groups. This decrease in FMD values was evident in children aged ≥10 years. FMD was independently associated with the level of lipoprotein (a) (beta=-0.29, p=0.01).

Among markers of endothelial and renal dysfunction investigated, FMD was found to be lower and the urinary AlbCr ratio higher in children with dyslipidemia.

Among markers of endothelial and renal dysfunction investigated, FMD was found to be lower and the urinary AlbCr ratio higher in children with dyslipidemia.

Current guidelines for the treatment of patients with necrotizing acute pancreatitis (NAP) recommend that invasive intervention for pancreatic necrosis should be deferred to 4 or more weeks from disease onset to allow necrotic collections becoming "walled-off". However, for patients showing signs of clinical deterioration, especially those with persistent organ failure (POF), it is controversial whether this delayed approach should always be adopted. In this study, we aimed to assess the impact of differently timed intervention on clinical outcomes in a group of NAP patients complicated by POF.

All NAP patients admitted to our hospital from January 2013 to December 2017 were screened for potential inclusion. They were divided into two groups based on the timing of initial intervention (within 4 weeks and beyond 4 weeks). All the data were extracted from a prospectively collected database.

Overall, 131 patients were included for analysis. Among them, 100 (76.3%) patients were intervened within 4 weeks and 31 (23.7%) underwent delayed interventions. As for organ failure prior to intervention, the incidences of respiratory failure, renal failure and cardiovascular failure were not significantly different between the two groups (P>0.05). The mortality was not significantly different between the two groups (35.0% vs. 32.3%, P=0.83). AZD4547 The incidences of new-onset multiple organ failure (8.0% vs. 6.5%, P=1.00), gastrointestinal fistula (29.0% vs. 12.9%, P=0.10) and bleeding (35.0% vs. 35.5%, P=1.00), length of ICU (30.0 vs. 22.0 days, P=0.61) and hospital stay (42.5 vs. 40.0 days, P=0.96) were comparable between the two groups.

Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients complicated by POF.

Intervention within 4 weeks did not worsen the clinical outcomes in NAP patients complicated by POF.

This cross-sectional comparative study investigated the effects of qat chewing habit on the radiographic bone density (RBD) and trabecular microstructure of temporomandibular joint condyles using cone beam computed tomography (CBCT).

In total, 85 systemically healthy Yemeni males were included and divided into qat chewers (QCs; n=41); and non-qat chewers (NQCs; n=44). The participants responded to a structured questionnaire and underwent standardized clinical examination and CBCT scanning of the temporomandibular joint. Measurements of RBD and trabecular microstructure (trabecular thickness, trabecular separation, bone volume fraction, and fractal dimension) were performed. Statistical significance was established at P ≤ .05.

No statistically significant differences were found between QCs and NQCs in RBD or trabecular microstructure. The mean standard deviations and maximum values of trabecular separation on the nonchewing side for QCs were significantly lower compared to the corresponding values for NQCs (0.60 and 2.68 for QCs vs 0.72 and 3.05 for NQCs; P=.025 and .05, respectively). A comparison between chewing and nonchewing sides in QCs revealed no significant differences.

Qat chewing habit induces insignificant changes in condylar RBD and trabecular microstructure as detected by CBCT. Further studies using advanced radiographic techniques are warranted.

Qat chewing habit induces insignificant changes in condylar RBD and trabecular microstructure as detected by CBCT. Further studies using advanced radiographic techniques are warranted.

The aim of this study was to identify computed tomography (CT) features that differentiate basal cell adenoma (BCA) from Warthin tumor (WT).

Histopathologically confirmed parotid gland tumors (57 BCAs and 83 WTs) were retrospectively reviewed. CT images were evaluated to determine location, distribution, cyst formation, size, the new vessel facing sign (VFS), and enhancement behavior including the CT attenuation of solid portions of the tumor (AST), the vessel near the tumor (AVT), and maxillary artery (AMA) on early stage 2-phase contrast CT. Tumor CT attenuation ratios (AST/AVT and AST/AMA) were calculated. Chi-square tests, independent t-tests, and receiver operating characteristic curve analysis were conducted.

Malefemale ratio, patient age, posteroinferior location, tumor size, and presence of VFS were significantly lower for BCA than WT. The average AST/AVT was significantly higher for BCA than WT. The threshold value for AST/AVT on early stage 2-phase contrast CT was 0.72 between BCA and WT, and sensitivity and specificity were 94.

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