Differences in ambulatory versus home blood pressure levels by ethnicity: data from the United Kingdom and Japan
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Constructing future behavior in the hippocampal formation through composition and replay
The hippocampus is critical for memory, imagination and constructive reasoning. Recent models have suggested that its neuronal responses can be well explained by state spaces that model the transitions between experiences. Here we use simulations and hippocampal recordings to reconcile these views. We show that if state spaces are constructed compositionally from existing building blocks, or primitives, hippocampal responses can be interpreted as compositional memories, binding these primitives together. Critically, this enables agents to behave optimally in new environments with no new learning, inferring behavior directly from the composition. We predict a role for hippocampal replay in building and consolidating these compositional memories. We test these predictions in two datasets by showing that replay events from newly discovered landmarks induce and strengthen new remote firing fields. When the landmark is moved, replay builds a new firing field at the same vector to the new location. Together, these findings provide a framework for reasoning about compositional memories and demonstrate that such memories are formed in hippocampal replay.
Blood pressure elevations post-lenvatinib treatment in hepatocellular carcinoma: a potential marker for better prognosis
Lenvatinib is a tyrosine kinase inhibitor that effectively inhibits vascular endothelial growth factor signaling and is used for treating hepatocellular carcinoma. However, angiogenesis inhibitors often cause hypertension. Although lenvatinib-induced hypertension has been proposed as a potential surrogate marker for better prognosis, studies on blood pressure elevations and outcomes following lenvatinib initiation are limited. This study included 67 patients who underwent lenvatinib therapy at the Department of Gastroenterology, Kagoshima University Hospital, between May 2018 and December 2023. The median age of the cohort was 71 years, and 82.1% of the patients were male. The median blood pressure at admission was 128/73 mmHg, which significantly increased to 136/76 mmHg the day after lenvatinib administration. Grade 3 hypertension (≥160/100 mmHg) occurred in 37.3% of patients during hospitalization. The median increase in systolic blood pressure from admission to its peak during hospitalization was 26 mmHg. Patients who experienced an increase in blood pressure of ≥26 mmHg were classified into the blood pressure elevation group, which showed a significantly lower mortality rate than that of the blood pressure non-elevation group (35.3% vs. 81.8%, log-rank p = 0.007), even after adjusting for age, sex, disease stage, performance status, and liver reserve function. This study demonstrated that patients who experienced earlier blood pressure elevation after lenvatinib administration had lower overall mortality rates. These findings suggest that blood pressure elevations after lenvatinib initiation may serve as valuable prognostic indicators in patients with cancer undergoing lenvatinib therapy.
Socially vulnerable communities face disproportionate exposure and susceptibility to U.S. wildfire and prescribed burn smoke
While air pollution from most U.S. sources has decreased, emissions from wildland fires have risen. Here, we use an integrated assessment model to estimate that wildfire and prescribed burn smoke caused $200 billion in health damages in 2017, associated with 20,000 premature deaths. Nearly half of this damage came from wildfires, predominantly in the West, with the remainder from prescribed burns, mostly in the Southeast. Our analysis reveals positive correlations between smoke exposure and various social vulnerability measures; however, when also considering smoke susceptibility, these disparities are systematically influenced by age. Senior citizens, who are disproportionately White, represented 16% of the population but incurred 75% of the damages. Nonetheless, within most age groups, Native American and Black communities experienced the greatest damages per capita. Our work highlights the extraordinary and disproportionate effects of the growing threat of fire smoke and calls for targeted, equitable policy solutions for a healthier future.
Bicomponent nano- and microfiber aerogels for effective management of junctional hemorrhage
Managing junctional hemorrhage is challenging due to ineffective existing techniques, with the groin being the most common site, accounting for approximately 19.2% of potentially survivable field deaths. Here, we report a bicomponent nano- and microfiber aerogel (NMA) for injection into deep, narrow junctional wounds to effectively halt bleeding. The aerogel comprises intertwined poly(lactic acid) nanofibers and poly(ε-caprolactone) microfibers, with mechanical properties tunable through crosslinking. Optimized aerogels demonstrate improved resilience, toughness, and elasticity, enabling rapid re-expansion upon blood contact. They demonstrate superior blood absorption and clotting efficacy compared to commercial products (i.e., QuikClot® Combat Gauze and XStat®). Most importantly, in a lethal swine junctional wound model (Yorkshire swine, both male and female, n = 5), aerogel treatment achieved immediate hemostasis, a 100% survival rate, no rebleeding, hemodynamic stability, and stable coagulation, hematologic, and arterial blood gas testing.
Office and home blood pressure and their difference according to frailty status among community-dwelling older adults: the NOSE study
The relationship between frailty and blood pressure (BP) is inconsistent, and limited research has compared BP by frailty status using long-term home BP measurements. We aimed to identify office and home BP and determine differences according to frailty status, stratified by taking antihypertensives in community-dwelling older adults. This cross-sectional study was part of the ongoing non-randomized intervention NOSE study. Participants were aged ≥ 64 years. Frailty was categorized robust, pre-frailty, or frailty using the revised Japanese version of the Cardiovascular Health Study criteria. Office BP was measured in survey settings, and each participant was instructed to take home BP. We used the average home BP for 4 weeks post-survey. An analysis of covariance analyzed the relationship between frailty and office and home BP, and their differences stratified by antihypertensive use. We included 418 older participants (mean age: 72.8 years); 39.5% were male, 40.4% were taking antihypertensives, and 6.7% had frailty. Individuals with frailty taking antihypertensives had higher home morning systolic BP (SBP) than those with robust (134.2 vs. 145.7 mmHg, P = 0.018) and pre-frailty (135.6 vs. 145.7 mmHg, P = 0.024). The difference between office and morning home SBP in treated participants was 7.1 mmHg (robust), 4.7 mmHg (pre-frailty), and −5.1 mmHg (frailty), showing significant differences (robust vs. frailty: P = 0.005, pre-frailty vs. frailty: P = 0.016). Home morning SBP was higher in individuals with frailty taking antihypertensives compared to those without frailty, and it may be higher than office BP. Individuals with frailty should measure home BP for good BP control.
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