Lymphomas are highly heterogeneous tumors and different histologies are characterized by significant differences in biology. https://www.selleckchem.com/products/bso-l-buthionine-s-r-sulfoximine.html Despite the structural and molecular differences between lymphoma types, it is well recognized that the tumor microenvironment plays a critical role in the lymphoma survival and growth. Over the past few years, understanding of this notion has brought immunotherapy to the forefront of lymphoma treatment by targeting the tumor microenvironment in order to produce an effective anti-tumor response. Thus, the area of lymphoma therapy has changed dramatically within the past few years with the use of checkpoint inhibitors and more recently CAR T-cells. Remarkable results have been reported in some lymphoma types but responses vary significantly between different histologies. Future approaches will focus on combination strategies that will attack lymphoma cells in addition to activating immune responses. These strategies include combinations of different checkpoint blocking antibodies, combinations of checkpoint blocking antibodies with agonistic antibodies, immunomodulatory agents, small molecule inhibitors or CAR T-cells, and armored CAR T-cells. A number of clinical trials testing such combinations are currently under way. In this review, we discuss strategies to modulate the immune response in lymphoma. We specifically address the obstacles to effective activation of the immune system against malignant B-cells and review the current approaches that try to overcome these barriers.INTRODUCTION Despite treatment with oral antidiabetic drugs (OADs), achieving effective glycaemic control in type 2 diabetes (T2D) remains a challenge. The objective of this post hoc analysis of data from the SUSTAIN 2, 3, 4 and 10 active-controlled trials was to assess the efficacy and safety of the once-weekly glucagon-like peptide 1 receptor agonist (GLP-1RA) semaglutide in patients on background treatment with metformin (MET), with or without a sulphonylurea (SU). METHODS Data from the randomised phase 3 trials SUSTAIN 2, 3, 4 and 10 for subjects who received background MET alone or MET + SU were analysed. Change from baseline in HbA1c and body weight at the end of treatment visit (week 30 in SUSTAIN 4 and 10, week 56 in SUSTAIN 2 and 3), and rates of hypoglycaemia and adverse events leading to premature treatment discontinuation were assessed. RESULTS In total, 3411 subjects were included in the full analysis set (3410 in the safety analysis set). Across the four trials, semaglutide significantly reducedaltrials.gov NCT01930188 (SUSTAIN 2), NCT01885208 (SUSTAIN 3), NCT02128932 (SUSTAIN 4) and NCT03191396 (SUSTAIN 10).BACKGROUND As performance-based financing (PBF) is increasingly implemented across sub-Saharan Africa, some authors have suggested that it could be a 'stepping stone' for health-system strengthening and broad health-financing reforms. However, so far, few studies have looked at whether and how PBF is aligned to and integrated with national health-financing strategies, particularly in fragile and conflict-affected settings. OBJECTIVE This study attempts to address the existing research gap by exploring the role of PBF with reference to (1) user fees/exemption policies and (2) basic packages of health services and benefit packages in the Central African Republic, Democratic Republic of Congo and Nigeria. METHODS The comparative case study is based on document review, key informant interviews and focus-group discussions with stakeholders at national and subnational levels. RESULTS The findings highlight different experiences in terms of PBF's integration. Although (formal or informal) fee exemption or reduction practices exist in all settings, their implementation is not uniform and they are often introduced by external programmes, including PBF, in an uncoordinated and vertical fashion. Additionally, the degree to which PBF indicators lists are aligned to the national basic packages of health services varies across cases, and is influenced by factors such as funders' priorities and budgetary concerns. CONCLUSIONS Overall, we find that where national leadership is stronger, PBF is better integrated and more in line with the health-financing regulations and, during phases of acute crisis, can provide structure and organisation to the system. Where governmental stewardship is weaker, PBF may result in another parallel programme, potentially increasing fragmentation in health financing and inequalities between areas supported by different donors.Enzyme replacement therapy (ERT) of the Anderson-Fabry disease (AFD) has changed the outcome of patients. However, ERT has some limitations a restricted volume of distribution, requirement for intravenous access, and stimulation of the production of anti-drug antibodies. Studies of new drugs aiming to improve the clinical effectiveness and convenience of therapy have been reported. Migalastat, a pharmacological chaperone, increases available enzymate activity in patients with mutations amenable to the therapy, is now available for clinical practice. It is orally administered, and while clinical trial results are promising, long term real world follow up is awaited. PEGylated enzyme has a longer half-life and potentially reduced antigenicity, compared with standard preparations; investigation of whether a longer dosing interval is viable is under way. Moss-derived enzyme has a higher affinity for mannose receptors, and appears to have access to renal tissue. Substrate reduction therapy is based on reducing the catabolism processes of the glycosphingolipids, and is currently under investigation as monotherapy. Gene therapy has now been initiated in clinical trail of in vivo and ex vivo technologies with early results are emerging. ERT represents a certain milestone of therapy for AFD with Migalastat now a newly available option. Other agents in clinical trial prevent further potential opportunities to improve outcomes in AFD.To add new molecular and pathogenetic insights into the biological machinery associated to kidney allograft fibrosis is a major research target in nephrology and organ transplant translational medicine. Interstitial fibrosis associated to tubular atrophy (IF/TA) is, in fact, an inevitable and progressive process that occurs in almost every type of chronic allograft injury (particularly in grafts from expanded criteria donors) characterized by profound remodeling and excessive production/deposition of fibrillar extracellular matrix (ECM) with a great clinical impact. IF/TA is detectable in more than 50% of kidney allografts at 2 years. However, although well studied, the complete cellular/biological network associated with IF/TA is only partially evaluated. In the last few years, then, thanks to the introduction of new biomolecular technologies, inflammation in scarred/fibrotic parenchyma areas (recently acknowledged by the BANFF classification) has been recognized as a pivotal element able to accelerate the onset and development of the allograft chronic damage.

Polyelectrolytes currently play an increasingly important role in antivirus therapy. Antiviral activity towards influenza virus, measles virus, herpes simplex virus type 1, and cytomegalovirus was demonstrated for the 6000 Da polyelectrolyte polyallylamine. A nontoxic polyallylamine concentration of 30 µM at which the compound retains its antiviral effect towards measles and influenza viruses but lacks any toxic effect on human cells was previously determined. It is well known, at the same time, that simultaneous virus exposure to physical environmental factors and chemical substances causes a more significant decrease in virus infectivity. Temperature is among these physical factors since thermal exposure causes virus inactivation. Analysis of virus thermal inactivation parameters is of high practical importance when it comes to the development of vaccines against influenza virus and to the study of how virus particles infectivity decreases on various surfaces. In this view, the study of kinetic and thermodynamical characteristics of influenza virus thermal inactivation in the presence of the antiviral preparation polyallylanime is of particular interest. The paper reports that thermal inactivation of influenza virus in the temperature range of 38-60°C in the presence of polyallylamine follows the first-order reaction kinetics. Thermodynamic parameters of influenza virus thermal inactivation evidence that influenza virus surface proteins are involved in the inactivation process as a result of their interaction with polyallylamine. The obtained results show that polyallylamine may be used to accelerate thermal inactivation of the influenza virus.Cold atmospheric pressure plasma (CAP) has been shown to kill bacteria and remove biofilms. Here we report the development of a unique CAP array device consisting of a parallel stack of eight linear-discharge plasma elements that create a ~ 5 cm2 (2.4 cm × 2 cm) treatment area. The CAP device is fabricated from Low Temperature Co-fired Ceramic (LTCC) layers to create 24 mm long linear-discharge channels (500 μm gap) with embedded opposing silver metal electrodes. A 20 kHz AC voltage (0.5-5 kV) applied to the electrodes generates an Ar/O2 plasma between the plates, with the gas flow directing the reactive species toward the biological sample (biofilms, etc.) to affect the antimicrobial treatment. External ballast resistors were used to study discharge uniformity in the stacked array elements and internal thick film ballast resistors (≈150 kΩ) were developed to create a fully integrated device. Typical element discharge currents were 1-2.5 mA with the total array current tested at 20 mA to provide optimal device uniformity. The plasma discharge was further shown to produce reactive hydrogen peroxide and exert antimicrobial effects on Pseudomonas biofilms and Salmonella contaminated eggshell samples, with >99% of the bacterial cells killed with less than 60 seconds of plasma exposure.Internationalizing far later than other sectors, healthcare has seen trade and foreign direct investment (FDI) grow in recent years. While part of the service economy, healthcare has unique features that distinguish it from other service sectors and imprint on its globalization and spillover patterns. In this paper, we review the trends in healthcare internationalization, its drivers, and the obstacles standing in the way. We outline the special characteristics of the healthcare sector and how they affect the positive and negative spillovers from trade and FDI for home and host-countries. Implications for international business theory, research, and policy are delineated.The process in which COVID-19 vaccines are developed is sequential and continuously accumulating. On the one hand, comprehensive patent protection is a necessary means to promote research and development. It yields additional returns that pay for the occasionally substantial amounts in R&D expenses. On the other hand, patents can be harmful in a sequential development process as they monopolise knowledge that might become a basis for further research. Economic policy cannot resolve this dilemma, but the various dimensions of a patent system can provide a starting point in mitigating a trade-off.The Coronavirus crisis clearly exposed Germany's deficits in the digitalisation of the economy and society. The cooperation between established SMEs and innovative start-ups offers considerable opportunities for the respective companies and the German economy. New business models can be adopted and innovative products can be jointly developed. In particular, the digitalisation of the 'German Mittelstand' could receive a boost through collaboration with digital start-ups. https://www.selleckchem.com/products/nvp-bgt226.html This could lead to an increase in the demographically induced declining growth potential of the German economy.When it comes to digitalising healthcare, Germany lags way behind other countries. In its 2021 report, the Health System Advisory Council discusses a strategy to overcome this shortcoming, i. e. the digitalisation of the German healthcare system. The idea is to shape digitalisation in a way that healthcare provision is improved with patients' well-being in mind. Therefore, market failures in digital health markets have to be addressed as well as the chances and challenges that come with the usage of large amounts of data. Furthermore, this article highlights the potential of the electronic health record (EHR) and of the digital health app market and discusses requirements for reaching environmental and social sustainability within the context of the digitalisation of health.Even before the COVID-19 crisis, the European Monetary Union (EMU) exhibited an unsatisfactory economic development with low growth and inflation rates below the target rate of the central bank. Macroeconomic coordination among monetary and fiscal policy is necessary to fend off such large crises. Insufficient wage increases that lead to deflation need to be avoided. Last, but not least, a mechanism is needed to stabilise the financial system and quickly deal with non-performing loans. Except in the field of monetary policy, the EMU lacks institutions that support quick and sufficient economic policies. There is the danger that policy mistakes will lead to long-term stagnation in the EMU or possibly even a great recession.

We discovered that sample pH is a critical factor in LE, and increasing the buffer concentration in poorly labeled samples before relabeling resulted in the successful rescue of TMT labeling reactions. Moreover, resuspending peptides in 500 mM HEPES buffer for TMT labeling resulted in consistently higher LE and lower missing data. By better controlling the sample pH for labeling and implementing multiple methods for assessing labeling quality before combining samples, we demonstrate that robust TMT labeling for large-scale quantitative studies is achievable.The anti-HIV drug efavirenz (EFV) displays low and variable bioavailability because of its poor aqueous solubility. https://www.selleckchem.com/products/FK-506-(Tacrolimus).html Ball milling is a simple and cost-effective alternative to traditional micronization to improve the solubility and dissolution rate of EFV. A multibody dynamics model was employed to optimize the milling process parameters, while the motion of the balls in the mill jar was monitored in operando. This led to a better understanding of the milling dynamics for efficient comminution and enhancement of EFV dissolution. The variability of results for different EFV batches was also considered. Depending on the EFV batch, there were intrinsic differences in how the milling affected the dissolution behavior and inhibition of HIV-1 infection. High-energy grinding is more effective on EFV materials containing an amorphous fraction; it helps to remove agglomeration and enhances dissolution. Polyvinylpyrrolidone (PVP) addition improves the dissolution by forming a hydrophilic layer on the EFV surface, thereby increasing the drug wettability. Polymorphism also affects the quality, dosage, and effectiveness of the drug. The mechanical stress effect and PVP addition on the EFV polymorphic transformation were monitored by X-ray powder diffraction, while the residual of ground EFV was collected after dissolution, analyzed by scanning electron microscopy, and provided insights into the morphological changes.DDX3X is a human DEAD-box RNA helicase implicated in many important cellular processes. In addition to the RecA-like catalytic core, DDX3X contains N- and C-terminal domains. The ancillary domains of DEAD-box RNA helicases have been shown to modulate their interactions with RNA and nucleotide substrates. Here, with the goal of understanding the role of N- and C-terminal domains of DDX3X on the DDX3X catalytic activity, we examined the interactions of RNA substrates and nucleotides with a DDX3X construct possessing the entire N-terminal domain and the catalytic core but lacking 80 residues from its C-terminal domain. Next, we compared our results with previously investigated DDX3X constructs. Our data show that the C-terminal truncated DDX3X does not bind to a blunt-ended double-helix RNA. This conclusion agrees with the data obtained on the wild-type LAF-1 protein, the DDX3X ortholog in Caenorhabditis elegans, and disagrees with the data obtained on the minimally active DDX3X construct, which misses 131 residues from its N-terminal domain and 80 residues from its C-terminal domain. The minimally active DDX3X construct was able to bind to the blunt-ended RNA construct. Combined, the previous studies and our results indicate that the N-terminal of DDX3X modulates the choice of DDX3X-RNA substrates. Furthermore, a previous study showed that the wild-type DDX3X construct hydrolyzes all four nucleotides and deoxynucleotides, both in the presence and absence of RNA. The C-terminal truncated DDX3X investigated here hydrolyzes only cytidine triphosphate (CTP) in the absence of RNA and CTP, adenosine triphosphate (ATP), and deoxyribose adenosine triphosphate (dATP) in the presence of RNA. Hence, the C-terminal truncated DDX3X has a more stringent nucleotide specificity than wild-type DDX3X.In this research, a heterostructure of the CuO-ZnO-based solar cells has been fabricated using low-cost, earth-abundant, non-toxic metal oxides by a low-cost, low-temperature spin coating technique. The device based on CuO-ZnO without a hole transport layer (HTL) suffers from poor power conversion efficiency due to carrier recombination on the surface of CuO and bad ohmic contact between the metal electrode and the CuO absorber layer. The main focus of this research is to minimize the mentioned shortcomings by a novel idea of introducing a solution-processed vanadium pentoxide (V2O5) HTL in the heterostructure of the CuO-ZnO-based solar cells. A simple and low-cost spin coating technique has been investigated to deposit V2O5 onto the absorber layer of the solar cell. The influence of the V2O5 HTL on the performance of CuO-ZnO-based solar cells has been investigated. The photovoltaic parameters of the CuO-ZnO-based solar cells were dramatically enhanced after insertion of the V2O5 HTL. V2O5 was found to enhance the open-circuit voltage of the CuO-ZnO-based solar cells up to 231 mV. A detailed study on the effect of defect properties of the CuO absorber layer on the device performance was theoretically accomplished to provide future guidelines for the performance enhancement of the CuO-ZnO-based solar cells. The experimental results indicate that solution-processed V2O5 could be a promising HTL for the low-cost, environment-friendly CuO-ZnO-based solar cells.The organic and eco-friendly materials are extended to prevail over the worldwide energy crisis where bio-inspired carbonaceous electrode materials are being prepared from biogenic items and wastes. Here, coconut water is sprayed over three-dimensional (3D) nickel foam for obtaining a carbonaceous electrode material, i.e., C@Ni-F. The as-prepared C@Ni-F electrode has been used for structural elucidation and morphology evolution studies. Field emission scanning electron microscopy analysis confirms the vertically grown nanosheets of the C@Ni-F electrode, which is further employed in the oxygen evolution reaction (OER) and hydrogen evolution reaction (HER), where excellent OER and HER performances with small overpotentials of 219 and 122 mV and with stumpy Tafel slopes, i.e., 27 and 53 mV dec-1, are respectively obtained, suggesting a bifunctional potential of the sprayed electrode material. Moreover, sustainable bifunctional performance of C@Ni-F proves considerable chemical stability and moderate mechanical robustness against long-term operation, suggesting that, in addition to being a healthy drink to mankind, coconut water can also be used for water splitting applications.

Substantial research on natural products and herbal medicines and their potential in novel antiviral drugs are discussed. Furthermore, to control contagious viral infections, i.e., to reduce the viral load on surfaces, current strategies focusing on biomimetic anti-adhesive surfaces through nanostructured topography and hydrophobic surface modification techniques are introduced. Biomaterial surfaces functionalized with antimicrobial polymers and nanoparticles against viral infections are also discussed. We recognize the importance of research on antiviral biomaterials and present potential strategies for future directions in applying these biomaterial-based approaches to control viral infections and SARS-CoV-2.
Multimodal treatment is recognized as the optimal paradigm for the management of chronic pain (CP). Careful balance between pharmacological and physical/psychological approaches is thus desirable but can be easily disrupted.

This study aimed at exploring the impact of the COVID-19 pandemic on pharmacological and physical/psychological treatments of CP.

A Pan-Canadian cross-sectional web-based study was conducted between April 16th and May 31st 2020 among adults living with CP when the country was in the ascending slope of the first COVID-19 pandemic wave.

A total of 2864 participants shared their treatment experience (mean age 49.7 years and women 83.5%). Among medication users (n = 2533), 38.3% reported changes in their pharmacological pain treatment. The main reasons were as follows (1) changes in pain symptoms, (2) lack of access to prescribers/cancellation of medical appointments, and (3) increased medication intake in compensation for stopping physical/psychological treatments because of the pandemic. Among participants who used physical/psychological pain management approaches before the pandemic (n = 2467), 68.3% had to modify their treatments or self-management strategies. Common reasons were lack of access to clinics/exercise facilities and the need to compensate for having to stop another type of physical/psychological treatment because of the pandemic-related public health safety measures.

Our study underlines the negative impact of the COVID-19 pandemic on access to pain relief, which is considered a fundamental human right. Results will help to justify resource allocation and inform the development of interventions to be better prepared for waves to come and future health crises.
Our study underlines the negative impact of the COVID-19 pandemic on access to pain relief, which is considered a fundamental human right. Results will help to justify resource allocation and inform the development of interventions to be better prepared for waves to come and future health crises.Rodent models are an invaluable tool for studying the pathophysiological mechanisms underlying stress and depressive disorders. However, the widely used behavioral assays to measure depressive-like states in rodents have serious limitations. In this commentary, we suggest that learning tasks, particularly those that can be analyzed with the framework of reinforcement learning, are ideal for assaying reward processing deficits relevant to depression. The key advantages of these tasks are their repeatable, quantifiable nature and the link to clinical studies. By optimizing the behavioral readout of stress-induced phenotypes in rodents, a reinforcement learning-based approach may help bridge the translational gap and advance antidepressant discovery.
This study sought to assess the magnitude of and factors associated with mental health outcomes among frontline health care workers (FHCWs) providing care during the Spring 2020 COVID-19 pandemic surge in New York City.

A cross-sectional, survey-based study over 4 weeks during the Spring 2020 pandemic surge was used to assess symptoms of COVID-19-related posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in 2,579 FHCWs at the Mount Sinai Hospital. Participants were additionally asked about their occupational and personal exposures to COVID-19. Multivariable logistic regression and relative importance analyses were conducted to identify factors associated with these outcomes.

A total of 3,360 of 6,026 individuals completed the survey (55.8% participation), with 2,579 (76.8%) analyzed based on endorsing frontline responsibilities and providing information related to the three outcomes. 1,005 (39.0%) met criteria for symptoms of COVID-19-related PTis large sample of FHCWs providing care during the 2020 NYC pandemic surge, 39% experienced symptoms of COVID-19-related PTSD, MDD, and/or GAD and pre-pandemic burnout as well as leadership support were identified as the most highly associated factors. These findings suggest that interventions aimed at reducing burnout and augmenting support from hospital leadership may be appropriate targets to mitigate the risk for developing further psychopathology in this population and others working in the midst of crisis.
The aim of this study was to compare smoking behavior in out-patients in terms of psychological factors with a view to supporting cessation treatment.

We conducted a cross-sectional and analytical study through face-to-face interviews by the primary care physician with 765 volunteer participants who applied to our hospital for any reason between March and July 2019. The questionnaire administered had two parts questions about sociodemographic characteristics and usage of tobacco and tobacco products, and questions of the UCLA Loneliness Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMBS), and Fagerström Test for Nicotine Dependence (FTND).

The study was completed with 765 participants of which 53.1% (n=406) were female and 46.9% (n=359) male. Multidimensional perceived social support scale mean score of the participants was 69.9±15.2 (min=12, max=84). https://www.selleckchem.com/products/Adriamycin.html There was a significant relation between mean MPSS and mean WEMBS (p<0.05). As nicotine scores increased, the mean scores both in MPSS and WEMBS decreased (p<0.05).

We suggest that the results of the psychometric preliminary evaluations should be customized for individuals applying to smoking cessation clinics and that including the individual's close social connections in the process can facilitate the decision to quit, thus increase smoking cessation rates.
We suggest that the results of the psychometric preliminary evaluations should be customized for individuals applying to smoking cessation clinics and that including the individual's close social connections in the process can facilitate the decision to quit, thus increase smoking cessation rates.

New technologies in medicine, even if they are promising medically, are often expensive and logistically difficult to implement at the hospital level. Transcatheter aortic valve replacement (TAVR) is a model technology that is revolutionary in treating aortic stenosis, but has been plagued with significant challenges with financial sustainability. In this article, a margin analysis at the hospital level was performed using literature data. A TAVR industry analysis was performed using Porter's Five Forces framework. The data indicate that TAVR is more expensive than surgical aortic valve replacement, although the cost of TAVR is declining with the use of an optimized minimalist protocol. The overall industry is growing as its clinical indications expand, and it will likely undergo significant reduction of costs when new valves enter the US market. As such, TAVR is a growing industry, with financial sustainability currently dependent on operational efficiency. A concluding list of specific program interventions is provided to help TAVR programs improve operational efficiency and clinical outcomes, as well as help decide whether to create, expand, or redirect funding for TAVR programs. Importantly, the frameworks used to analyze this rapidly evolving technology can be applied to other new technologies to determine financial sustainability.Evaluation of endocrine issues is a sometimes overlooked yet important component of the preoperative medical evaluation. Patients with diabetes, thyroid disease, and hypothalamic-pituitary-adrenal axis suppression are commonly encountered in the surgical setting and require unique consideration to optimize perioperative risk. For patients with diabetes, perioperative glycemic control has the strongest association with postsurgical outcomes. The preoperative evaluation should include recommendations for adjustment of insulin and noninsulin diabetic medications before surgery. Recommendations differ based on the type of diabetes, the type of insulin, and the patient's predisposition to hyperglycemia or hypoglycemia. Generally, patients with thyroid dysfunction can safely undergo operations unless they have untreated hyperthyroidism or severe hypothyroidism. Patients with known primary or secondary adrenal insufficiency require supplemental glucocorticoids to prevent adrenal crisis in the perioperative setting. Evidence supporting the use of high-dose supplemental corticosteroids for patients undergoing long-term glucocorticoid therapy is sparse. We discuss an approach to these patients based on the dose and duration of ongoing or recent corticosteroid therapy. As with other components of the preoperative medical evaluation, the primary objective is identification and assessment of the severity of endocrine issues before surgery so that the surgeons, anesthesiologists, and internal medicine professionals can optimize management accordingly.
Studies evaluating the role of adjuvant chemotherapy (ACT) in Adrenocortical Carcinoma (ACC) are limited due to its rarity. The objective of this study was to evaluate if ACT provides a survival benefit in patients who underwent curative-intent resection of localized ACC and to determine factors associated with receipt of ACT.

The National Cancer Data Base was queried to identify patients (2010-2016) with curative-intent resection of localized ACC (T1-T3, N0, M0).

Of 577 patients with adrenalectomy, 389 (67%) had adrenalectomy alone, and 188 (33%) received ACT. Private insurance, lymphovascular invasion, stage II, and radiotherapy were predictors of ACT (P<0.05). Advanced (T3) stage lymphovascular invasion, and being uninsured were associated with decreased OS (P<0.05). There was no association between ACT and OS.

For patient who underwent curative-intent resection of localized ACC, there was no association between ACT and OS. https://www.selleckchem.com/products/ldc203974-imt1b.html Private insurance, lymphovascular invasion, stage II disease, and radiotherapy were associated with receipt of ACT.
For patient who underwent curative-intent resection of localized ACC, there was no association between ACT and OS. Private insurance, lymphovascular invasion, stage II disease, and radiotherapy were associated with receipt of ACT.Acromegaly is a chronic disease due to growth hormone (GH) and insulin-like growth factor 1 (IGF-1) excess. It is associated with various systemic complications including cardiovascular disease. Arterial hypertension occurs in about 20% to 30% of patients. Its pathogenesis is mainly related to the increase in plasma volume secondary to a sodium retaining actions of GH and IGF-1 in the kidney, but abnormalities in vessel architecture and reactivity participate. Left ventricular hypertrophy and diastolic dysfunctions were frequently reported in echo-based studies and are mostly mild and without clinical consequences. Recent cardiac MRI studies described a much lower frequency of myocardial hypertrophy than echo-based assessments. Progression to systolic dysfunction with congestive heart failure is nowadays very rare. Risk of coronary heart disease and of clinically significant arrythmias does not seem to be increased. Acromegaly-related cardiac valve abnormalities may be related to fibrotic changes and seem to persist after effective treatment of acromegaly. Advances in acromegaly treatment over the last decades significantly diminished the cardiovascular burden of the disease, with the cardiovascular disease anymore being the leading cause of death.Many ecological and evolutionary processes are affected by urbanization, but cities vary by orders of magnitude in their human population size and areal extent. To quantify and manage urban biodiversity, one must understand both how biodiversity scales with city size, and how ecological, evolutionary, and socioeconomic drivers of biodiversity scale with city size. We show how environmental abiotic and biotic drivers, as well as human cultural and socioeconomic drivers, may act through ecological and evolutionary processes differently, at different scales, to influence patterns in urban biodiversity. Because relationships likely take linear and nonlinear forms, the need to describe the specific scaling relationships is highlighted, including deviations and potential inflection points, where different management strategies may successfully conserve urban biodiversity.