Lupus nephritis (LN) is the most common and significant complication of systemic lupus erythematosus (SLE) due to its poor prognosis and mortality rates in SLE patients. There is a critical need for new drugs as the pathogenesis of LN remains to be elucidated and immunosuppressive therapy comes with many deficiencies. In this study, 23 hub genes (IFI6, PLSCR1, XAF1, IFI16, IFI44, MX1, IFI44L, IFIT3, IFIT2, IFI27, DDX58, EIF2AK2, IFITM1, RTP4, IFITM3, TRIM22, PARP12, IFIH1, OAS1, HERC6, RSAD2, DDX60, and MX2) were identified through bioinformatics and network analysis and are closely related to interferon production and function. Interestingly, immune cell infiltration analysis and correlation analysis demonstrate a positive correlation between the expression of 23 hub genes and monocyte infiltration in glomeruli and M2 macrophage infiltration in the tubulointerstitium of LN patients. Additionally, the CTD database, DsigDB database, and DREIMT database were used to explore the bridging role of genes in chemicals and LN as well as the potential influence of these chemicals on immune cells. After comparison and discussion, six small molecules (Acetohexamide, Suloctidil, Terfenadine, Prochlorperazine, Mefloquine, and Triprolidine) were selected for their potential ability in treating lupus nephritis.

Hepatitis C infection is a leading etiology of hepatic dysfunction and a major indication for liver transplantation due to the development of fibrosis, cirrhosis, and hepatocellular carcinoma. Nonalcoholic fatty liver disease (NAFLD) and, specifically, its subtype nonalcoholic steatohepatitis (NASH) is a rising cause of liver disease. It is predicted to surpass hepatitis C as a leading indication for transplant. The introduction of direct-acting antivirals (DAAs) decreased the prevalence of chronic hepatitis C infections, but the obesity epidemic and metabolic syndrome have increased the prevalence of NASH. Weight loss and dietary modifications are recommended NASH therapies, but unlike for hepatitis C, federally approved agents are lacking and currently under investigation. Clinical trials face many barriers in NASH treatment because of the difficulty of diagnosis and a lack of standardized and accurate clinical and histologic responses. Mortality and morbidity in NASH are heightened because of the presence of multiple comorbidities including cardiovascular disease, diabetes, and renal dysfunction. A liver transplant may be indicated, but a thorough screening of candidates, including a comprehensive cardiovascular assessment, is essential to ensuring successful outcomes pre- and post-transplant. Therapeutic agents for NASH are warranted before it becomes a significant and leading cause of morbidity and mortality worldwide.

Background/Aims: Procedural duration has been proposed as a marker of esophagogastroduodenoscopy (EGD) quality; however, formal benchmarks remain undefined. This study examined the association between EGD duration and clinically significant findings (CSFs), as well as procedural behaviors contributing to diagnostic yield.Methods: We conducted a retrospective analysis of 120 first-time diagnostic EGDs performed at a single academic center and categorized procedures as lasting 6 minutes. Logistic regression models were used to assess associations among procedure time, quality metrics (photographs, landmarks, biopsies), clinical indications, and CSF detection.Results: Longer procedures were independently associated with a high rate of CSF detection. Compared with procedures lasting 6 minutes had 17.5-fold greater odds of detecting a CSF (p=0.02). Procedures performed for bleeding or “other” indications were independently associated with a high diagnostic yield (p=0.02 and 0.03, respectively). Although increased photo count and landmark documentation correlated with time, neither was independently predictive of CSFs after adjustment. Procedural duration also showed a stepwise increase in the number of biopsies obtained, photographs taken, and landmarks identified.Conclusions: Longer EGD duration was independently associated with increased CSF detection in a stepwise manner. Procedural time may serve as a practical, unifying measure correlated with multiple performance behaviors reflective of comprehensiveness in diagnostic EGD.

Background and aims: Colorectal cancer is the second leading cause of cancer death in the United States, yet ∼25% of patients undergoing colonoscopy have suboptimal bowel preparation. Bowel preparation is cited as the leading deterrent to an elective colonoscopy. Methods: This randomized, controlled, single-blinded noninferiority trial assessed the efficacy, safety, and patient tolerability of oral sulfate tablets (OST) compared with polyethylene glycol (PEG) based bowel preparation formulations, with explicit consideration of patient satisfaction and adverse events. Between March and August 2024, adult outpatients at Albany Medical Center requiring routine colonoscopies were consented and enrolled. Endoscopists were blinded to preparation assignments and graded the cleansing of the colon based on the US FDA Bowel Prep Scoring Scale. Patients completed a preparation satisfaction questionnaire. Results: This study assessed 177 patients (n=94 OST/n=83 PEG). Overall cleansing scores favored OST with 67.0% “excellent” preparations versus 57.8% for PEG. Although differences were not statistically significant in segmental analyses, trends favored OST. Generally, bowel preparation cleansing scores for the proximal, mid, and distal colon were numerically better for OST. Polyp identification was higher for OST (60.6%) versus PEG (54.2%). Tolerability favored OST, with 18.1% of patients in the OST group reporting adverse events (AE) versus 65.1% of patients in the PEG group. The most common AE for both groups was nausea. OST was “tolerable” to “very easy” to consume in 88.3% of patients compared with 78.6% for patients in the PEG group. OST was again requested by 92.6% of patients, compared with 60.7% of patients in the PEG group. Conclusions: This real-world study demonstrates the noninferior efficacy and safety of OST compared with conventional PEG-based formulations while highlighting improved patient tolerability, palatability, and potential preference bias due to free-of-charge provision.