Developmental transcriptional programs are increasingly recognized as key drivers of paediatric gliomagenesis. Here, we unexpectedly find that the forebrain-specific doublesex- and mab-3-related transcription factor a2 (DMRTA2), despite being highly expressed in H3G34-mutant diffuse hemispheric glioma (DHG-H3G34) and implicated in tumour initiation, is not required for the maintenance of established patient-derived tumour cells. These findings support a stage-specific framework in which transcriptional dependencies are dynamically rewired during tumour progression in paediatric brain tumours.

The COVID-19 pandemic and the restrictive measures introduced during this period had a significant impact on the health status of older adults. In this regard, particular interest is focused on assessing changes in geriatric status, especially the transition from prefrailty to established frailty syndrome under conditions of prolonged physical inactivity and social isolation. The aim of the study was to analyze the dynamics of geriatric status in older patients during prolonged exposure to reduced mobility conditions during lockdown. The study included 525 patients aged 65-74 years residing in residential social care institutions. All participants underwent comprehensive geriatric assessment, including monitoring of somatic parameters (blood pressure, heart rate, and body mass index), handgrip dynamometry, and the six-minute walk test. Examinations were performed at baseline and repeated after 1 and 6 months of follow-up. It was established that marked unfavorable changes in the structure of geriatric status occurred over the six-month observation period. The prevalence of prefrailty decreased from 35,8 to 14,1%, which was associated with the transition of a substantial proportion of patients to the frailty category. At the same time, the prevalence of frailty syndrome increased from 49,5 to 72%. In addition, the number of patients with mild, moderate, and severe frailty increased by 11,6; 6,1 and 4,4%, respectively. The obtained results indicate that prolonged mobility restriction and social isolation are significant factors contributing to deterioration of geriatric status and acceleration of frailty progression. These findings confirm the importance of early identification of prefrailty and timely implementation of preventive and corrective interventions aimed at preserving functional independence in older patients.

Transient tachypnea of the neonate (TTN) is the most common cause of respiratory distress in newborns. While often self-limiting, the severity of TTN varies significantly, ranging from mild tachypnea to severe respiratory failure requiring non-invasive ventilation. Early and objective grading of TTN severity remains difficult in routine practice. Clinical scores are subjective, and chest radiography is insensitive to the extent of lung fluid. This study evaluated a semi-quantitative lung ultrasound (LUS) B-line score as a predictor of oxygen requirement in neonates with TTN.

In a prospective cohort at a tertiary neonatal intensive care unit (NICU), we enrolled 267 neonates (gestational age ≥ 33 weeks) with a clinical diagnosis of TTN. Within 6 hours of admission, we recorded a standardized twelve-zone LUS score, respiratory rate, and arterial blood gas values. The primary outcome was the highest level of respiratory support within 72 hours, classified as no oxygen support, low-flow oxygen support, or escalated respiratory support. Analyses included Spearman correlation, receiver-operating-characteristic (ROC) curves, and multivariable ordinal logistic regression.

The LUS score correlated inversely with arterial oxygen (PaO₂) (ρ = -0.705, P < 0.001) and positively with partial pressure of arterial carbon dioxide (PaCO₂) (ρ = 0.399, P < 0.001). Mean scores rose with increasing support (0.5 ± 2.1, 15.0 ± 6.4, and 27.0 ± 4.8 for room air, low-flow, and high-flow groups; P < 0.001). For predicting any oxygen use, the area under the curve (AUC) was 0.982 (95% CI [0.968-0.997]) with an optimal cutoff of 5.5. A cutoff of 22.5 identified infants needing high-flow support (AUC 0.965). In multivariable analysis, the LUS score was the strongest independent predictor of respiratory support level (adjusted odds ratio per point, 1.70; 95% CI [1.41-2.05]; P < 0.001).

A semi-quantitative LUS score provides a non-invasive and physiologically coherent measure of disease severity in TTN and can help stratify early oxygen and respiratory support requirements at the bedside. These findings suggest that incorporating LUS scoring into early NICU assessment may help standardize decisions about initiation and escalation of respiratory support in infants with TTN.

Respiratory depression remains a major safety concern during propofol-based sedation for surgical abortion. Ciprofol is a novel intravenous sedative-hypnotic agent with pharmacological properties similar to propofol and a potentially improved safety profile. This randomized controlled trial aimed to compare the incidence of respiratory depression of ciprofol versus propofol, both combined with alfentanil, for procedural sedation in patients undergoing surgical abortion.

In this single-center, assessor-blinded, randomized controlled trial, 234 patients scheduled for surgical abortion under intravenous anesthesia were assessed for eligibility, and 226 were randomly assigned to receive either ciprofol (0.4 mg/kg; n=113) or propofol (2.0 mg/kg; n=113). Alfentanil (7.5 μg/kg) was administered intravenously as part of anesthesia induction in all patients. The primary outcome was the incidence of respiratory depression (SpO₂ <90% requiring airway intervention) throughout the anesthesia and surgical procedure. Secondary outcomes included the overall incidence of perioperative adverse events as a composite safety endpoint defined as the occurrence of at least one prespecified adverse event from induction to discharge. Additional anesthesia-related variables, including induction characteristics, hemodynamic changes, depth of sedation, post-procedure pain scores, and patient satisfaction, were evaluated as exploratory outcomes.

Under the same anesthesia depth, respiratory depression occurred less frequently with ciprofol than with propofol (9.7% vs 20.4%, P=0.026). The overall incidence of perioperative adverse events was lower in the ciprofol group (28.3% vs 64.6%, P < 0.001). Injection pain was observed in 34.5% of patients receiving propofol and in none receiving ciprofol. PONV, hemodynamic instability, procedure time, time to discharge, post-procedure pain scores and patient satisfaction were comparable between groups. No serious adverse events occurred.

Ciprofol combined with alfentanil was associated with a lower incidence of respiratory depression and perioperative adverse events than propofol, while providing comparable procedural sedation efficacy in patients undergoing surgical abortion.

Generally, people who acquire infection with the COVID-19 virus exhibit a fever and respiratory illness. However, certain individuals also exhibit gastrointestinal (GIT) symptoms, involving anorexia, diarrhea, abdominal pain, nausea, and vomiting. This study aimed to quantify and assess serum interleukin 6 (IL-6) and fecal calprotectin (FC) in COVID-19-positive individuals who exhibit diarrhea and other GIT symptoms as indicators of inflammation in the intestinal tract. The investigation included 80 cases with diarrhea and other GIT symptoms. They were divided into two groups: group A (cases) consisted of 40 COVID-19 patients with GIT symptoms and group B (controls) consisted of 40 COVID-19 patients without GIT symptoms. Serum IL-6 and FC were assessed in both groups. The most effective cut-off value for predicting intestinal inflammation was >63, with a sensitivity of 67.5% and a specificity of 65%. The most effective cut-off value for predicting intestinal inflammation was >194, with a sensitivity of 87.6% and a specificity of 77.3%. Although the FC was more significant than serum IL-6, the difference in the area under curve (AUC) was insignificant (0.075; z-test= 1.632, p>0.05). In COVID-19 cases with experienced intestinal symptoms, serum IL-6 and FC were increased.

The purpose of this review is to summarize and critically analyze data on markers of metabolic and mitochondrial stress in atherosclerosis in older and oldest-old patients, highlighting differences between circulating clinical biomarkers, metabolic-epigenetic indicators, and intracellular regulators of mitochondrial quality control, as well as the limitations of age-specific interpretation. An analytical narrative review of the literature was performed using PubMed, Scopus, and Web of Science for 2010-2025; the last control search was conducted on April 27, 2026. The keywords used were signaling molecules, FGF21, GDF15, endothelial dysfunction, mitochondrial dysfunction, lactate, endothelial aging, and cellular senescence. The analysis included 38 sources with a focus on clinical cohorts, age-stratified data, experimental studies on vascular aging, and publications with translational potential. The selection of markers was based on their representation of different levels of the pathological process: systemic stress response, metabolic-epigenetic remodeling, and intracellular mitochondrial quality control. The most clinically relevant circulating candidates are FGF21 (fibroblast growth factor 21) and GDF15 (growth differentiation factor 15). FGF21 is associated with atherosclerotic lesions and cardiovascular risk, but its increase should be interpreted as a reflection of an activated stress response rather than as an independent diagnostic criterion. GDF15 is associated with age, functional decline, comorbidity, and poor prognosis, but it is not a specific marker of atherosclerosis. Lactate and lactylation represent a promising metabolic-epigenetic mechanism linking glycolytic shift, cellular senescence, and vascular inflammation, but evidence of correspondence between circulating and tissue levels is still required. AMPK, PGC-1α, and PINK1/Parkin have predominantly mechanistic significance and should currently be considered intracellular regulators and therapeutic targets rather than clinically validated biomarkers. In atherosclerosis in older and oldest-old patients, markers of metabolic and mitochondrial stress should be assessed within a hierarchical evidence model and with mandatory consideration of age, comorbidity, and treatment-related confounders. FGF21 and GDF15 are the closest to clinical validation; lactate and lactylation represent a promising direction for translational research; AMPK, PGC-1α, and PINK1/Parkin form the pathogenic basis of mitochondrial quality control but require clinically reproducible assessment methods.

This review analyzes the efficacy and safety of total arterial revascularization (TAR) in elderly patients. Given the global demographic aging and the high prevalence of coronary artery disease in individuals over 60, selecting the optimal coronary artery bypass grafting strategy is of paramount importance. The traditional use of autologous vein grafts is limited by their high susceptibility to atherosclerosis and occlusion in the long term. The TAR strategy, which utilizes only arterial bypasses (bilateral internal thoracic arteries, radial artery), aims to overcome this drawback.

Long-lived individuals are systematically excluded from large studies, creating a gap in the evidence base for managing myocardial infarction (MI) in this age group. Aim - to research the features of MI course and outcomes in long-lived patients depending on treatment strategies. Retrospective analysis of 32 medical records of long-lived patients (≥90 years) with MI. Clinical, laboratory, instrumental data, and treatment outcomes were evaluated. The mortality rate was 37,5%. Characteristic features included high comorbidity (100% - hypertension, 50% - atrial fibrillation). The most unfavorable prognostic factors were acute heart failure, atrial fibrillation, as well as elevated creatinine and leukocyte levels. Mortality in the percutaneous coronary intervention group was lower than in the conservative treatment group (27% vs. 43%). MI in long-lived patients occurs against a background of high comorbidity. Percutaneous coronary intervention is associated with lower mortality; however, this issue requires further prospective studies.

A single-center, retrospective study included 41 patients over 90 years of age who underwent primary percutaneous coronary intervention for the treatment of acute coronary syndrome in the period from 01.2019 to 01.2023. Based on electrocardiography data, patients were divided into 2 groups: Group 1 (n=21) with ST-segment elevation acute coronary syndrome (ST-ACS), Group 2 (n=20) with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Multivessel coronary artery disease was detected in 71% of cases in STE-ACS versus 65% of cases in the NSTE-ACS group (p=0,658). Moreover, simultaneous complete revascularization was predominantly performed in NSTE-ACS (p=0,043). The length of stay in the intensive care unit was comparable (p=0,575), as was the overall length of hospital stay (p=0,463). In-hospital mortality was 35% for NSTE-ACS and 38,1% for STE-ACS (p=0,837). The incidence of hospital-acquired pneumonia, stroke, and bleeding did not differ significantly between the comparison groups. According to the data obtained, patients over 90 years of age with acute coronary syndrome with and without ST-segment elevation can successfully and safely undergo percutaneous coronary intervention.

Myocardial infarction is a life-threatening condition with high mortality, which is especially important for patients over 75 years of age who have an increased risk of complications and death. Objective - to assess the incidence of in-hospital mortality and adverse cardiovascular events in patients aged over 75 years with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) who underwent percutaneous coronary intervention. An analysis of data from a prospective registry of patients with ACS hospitalized in the vascular center based on the Alexandrovskaya City Hospital from January 2016 to November 2024 was performed. The initial sample included 14 420 cases of hospitalization, including 10 126 patients with NSTE-ACS. For the analysis, patients were stratified into four groups: 1st - up to 60 years old; 2nd - 60-74 years old; 3rd - 75-89 years old; 4th - 90 years and older. Data processing was performed using Excel, Jamovi, IBM SPSS Statistic 24, R statistical programs. Values of p<0,05 were considered statistically significant. Coronary angiography was performed in 98,6 % of patients. With increasing age, the following are noted: an increase in the proportion of women, an increase in the number of comorbidities, the Charlson comorbidity index, the number of points on the Killip, CRUSADE, GRACE scales, an increase in the number of complications and fatal outcomes. Among patients over 75 years of age, the PCI group had a higher incidence of adverse events, total complications, and mortality compared to the conservative management group. The strongest predictors of mortality in this group were patient age, elevated CPK-MB levels at admission, and total complications. Predictors of the composite endpoint were elevated CPK-MB levels, AIM Score, and systolic blood pressure at admission. Elderly patients and long-term survivors with MI represent a high-risk group, necessitating an individualized and balanced approach at all stages of treatment. Further research is needed to determine optimal treatment strategies for non-ST-elevation ACS in older age groups.