bluuebunny/crossref_metadata_2025 huggingface dataset:
Two homozygous adjacent novel missense mutations in DYSF gene caused dysferlinopathy due to splicing abnormalities
Authors: Wang Lun , Zhou Yan , Wei Tiantian , Huang Hongyao
Published: June 2024

Background: Dysferlinopathy is an autosomal recessive disorder caused by mutations in the DYSF gene. This study reported two homozygous adjacent missense mutations in the DYSF gene, presenting clinically with bilateral lower limb weakness and calf swelling. Two homozygous adjacent missense mutations in the DYSF gene may be associated with the development of dysferlinopathy, but the exact mechanism needs further investigation.

Methods: A retrospective analysis of clinical data from a dysferlinopathy-affected family was conducted. Peripheral blood samples were collected from members of this family for whole-exome sequencing (WES) and copy number variation analysis. Sanger sequencing was employed to confirm potential pathogenic variants. The Human Splicing Finder, SpliceAI, and varSEAK database were used to predict the effect of mutations on splicing function. The pathogenic mechanism of aberrant splicing in dysferlinopathy due to two homozygous adjacent missense mutations in the DYSF gene was determined by an in vivo splicing assay and an in vitro minigene assay.

Results: The proband was a 42-year-old woman who presented with weakness of the lower limbs for 2 years and edema of the lower leg. Two homozygous DYSF variants, c.5628C>A p. D1876E and c.5633A>T p. Y1878F, were identified in the proband. Bioinformatics databases suggested that the mutation c.5628C>A of DYSF had no significant impact on splicing signals. Human Splicing Finder Version 2.4.1 suggested that the c.5633A>T of DYSF mutation caused alteration of auxiliary sequences and significant alteration of the ESE/ESS motif ratio. VarSEAK and SpliceAI suggested that the c.5633A>T of DYSF mutation had no splicing effect. Both an in vivo splicing assay and an in vitro minigene assay showed two adjacent mutations: c.5628C>A p. D1876E and c.5633A>T p. Y1878F in the DYSF gene leading to an Exon50 jump that resulted in a 32-aa amino acid deletion within the protein. Point mutation c.5628C>A p. D1876E in the DYSF gene affected splicing in vitro, while point mutation c.5633A>T p. Y1878F in the DYSF gene did not affect splicing function.

Conclusion: This study confirmed for the first time that two homozygous mutations of DYSF were associated with the occurrence of dysferlinopathy. The c.5628C>A p. D1876E mutation in DYSF affected the splicing function and may be one of the contributing factors to the pathogenicity.
Association of comprehensiveness of antiretroviral care and detectable HIV viral load suppression among pregnant and postpartum women in the Democratic Republic of the Congo: a cross-sectional study
Authors: Boisson-Walsh Alix , Ravelomanana Noro L. R. , Tabala Martine , Malongo Fathy , Kawende Bienvenu , Babakazo Pélagie , Yotebieng Marcel
Published: June 2024

Introduction

Worldwide, over two-thirds of people living with HIV are on antiretroviral therapy (ART). Despite increased ART access, high virological suppression prevalence remains out of reach. Few studies consider the quality of ART services and their impact on recipients' viral suppression. We assessed the association between ART service readiness and HIV viral load suppression among pregnant and breastfeeding women living with HIV (WLH) receiving ART in maternal and child health (MCH) clinics in Kinshasa, Democratic Republic of Congo.

Methods

We performed a cross-sectional analysis leveraging data from a continuous quality improvement intervention on WLH's long-term ART outcomes. From November 2016 to May 2020, we enrolled WLH from the three largest clinics in each of Kinshasa'Łs 35 health zones. We measured clinic's readiness using three WHO-identified ART care quality indicators: relevant guidelines in ART service area, stocks of essential ART medicines, and relevant staff training in ≥24 months, scoring clinics 0-3 based on observed indicators. We defined viral load suppression as ≤1,000 cp/ml. Multilevel mixed-effect logistic models were used to estimate prevalence odds ratios (ORs) measuring the strength of the association between ART service readiness and viral suppression.

Results

Of 2,295 WLH, only 1.9% received care from a clinic with a score of 3, 24.1% received care from a 0-scoring clinic, and overall, 66.5% achieved virologically suppression. Suppression increased from 65% among WLH receiving care in 0-scoring clinics to 66.9% in 1-scoring clinics, 65.8% in 2-scoring clinics, and 76.1% in 3-scoring clinics. We did not observe a statistically significant association between ART service readiness score and increased viral suppression prevalence, however we did find associations between other factors, such as the location of the health center and pharmacist availability with suppressed viral load.

Discussion

A lack of comprehensive ART care underscores the need for enhanced structural and organizational support to improve virological suppression and overall health outcomes for women living with HIV..
Fermented mahua oil cake in the diet of Labeo rohita: effects on growth performance, digestive enzyme activity and immune response
Authors: Das Krushna Chandra , Mohanty Aradhana , Swain Priyabrat , Routray P. , Kumari Rakhi
Published: June 2024

Market instability, increased competition, escalating price and reduced availability of conventional ingredients warrants the researchers to rely on alternative feed ingredients. This approach may help in producing aqua feeds in a sustainable and cost-effective way to accomplish the global food and nutritional securities. Mahua oil cake (Bassia latifolia) is an underutilized non-conventional ingredient that holds promise for incorporation into aqua feed following nutrient enhancement by solid-state fermentation. A five-month pond feeding trial was carried out to investigate the effects of Sachharomyces cerevisiae and Bacillus subtilis fermented mahua oil cake (MOC) on the production performance, nutrient utilization, digestive capacity, and innate immunological responses of Labeo rohita fingerlings. For this, two iso-nitrogenous feed were formulated and prepared incorporating fermented MOC at different levels i.e. 0 and 40 percentage replacing soybean meal and other feed ingredients and fed to rohu fingerlings of two treatment groups in pond culture for 5 months duration. Improved growth performance, feed conversion ratio, feed intake, protein efficiency ratio and digestive capacity were observed in fish fed diets with 40 percent of fermented MOC compared to control. Innate immune responses parameters (respiratory burst activity, myeloperoxidase, lysozyme and hemaglutination activities) were significantly higher (P < 0.05) in fishes fed with fermented MOC. Therefore, we conclude incorporation of solid state fermented mahua oil cake up to 40% level in diet of L. rohita fingerlings in pond culture without any adverse effects on growth, nutrient utilization and innate immune response.
Molecular characterization and expression profile of estrogen receptor subtypes in female hilsa (Tenualosa ilisha)
Authors: Roy Arpita , Kumar Vikash , Bisai Kampan , Bhowal Pratyasha , Panda Soumya Prasad , Jana Asim Kumar , Banerjee Rajat , Das Basanta Kumar
Published: June 2024

Hilsa (Tenualosa ilisha), a highly prized edible fish, is consumed by over 250 million people worldwide. Estrogens are essential hormones required during reproduction and bind with estrogen receptors in target organs for biological activity. The two unique subtypes of the estrogen receptor found in fish are alpha (α) and beta (β) and exhibit distinctive roles in reproduction. The present study aimed to understand the breeding physiology of hilsa during the seasonal gonadal cycles through GSI seasonal variation, histological study, and molecular identification, characterization, and transcriptional modification of estrogen receptors in hilsa. Monthly GSI analysis from females showed that during September, the GSI value was maximum (22.01 ± 0.68), followed by the May GSI value (18.78 ± 0.97). Histological observation showed the formation of asynchronous gametes during the development of ovaries. The histological analysis revealed the formation of developing oocytes, nucleus, presence of primary oogonia, secondary oogonia, chromatin nucleolar oocytes, and early perinucleolar oocytes in the ovary (January–early July). Progressively, formations of the yolk vesicles, yolk granule stage, premature stage, and mature stage with post-ovulatory follicles were also identified. Linear observation was recorded during the monsoon season from July to November. Furthermore, partial length cDNAs for estrogen receptors were characterized, and their mRNA expression patterns demonstrate that ER-α expression significantly increased in September, followed by April and August in the ovary and liver tissue. Both the liver and ovary showed the highest mRNA expression of ER-β in September. The study revealed that ER-α expression was higher in the ovary as compared with liver tissue. Furthermore, we introduce three-dimensional (3D) models depicting the hilsa estrogen receptors in complex with estradiol (E2), constructed through homology modeling. This investigation contributes valuable insights into the molecular characteristics of estrogen receptors in this teleost fish. Our present work provided preliminary evidence of estrogen receptors during reproduction in hilsa.
Abundance, patterns, and taxa associations of anthropogenic marine debris on reefs in the middle Florida Keys
Authors: Payton Tokea G. , Sims Randi J. , Childress Michael J.
Published: June 2024

The Florida Keys reef tract has rapidly shifted from a structurally complex, hard coral-dominated reef to a less rugose, soft coral-dominated reef. This transition has been facilitated by persistent anthropogenic stressors including recreational and commercial fishing and increased anthropogenic marine debris. During the summers of 2020–2022, benthic censuses were conducted to identify substrate and marine debris composition for 30 reefs in the middle Florida Keys. Inshore reefs contained higher rugosity, coral cover, and marine debris abundance primarily comprised of monofilament and rope from fishing traps. Plastic items (e.g., ropes and monofilament) overall had the highest species diversity. Additionally, marine debris appears to promote turf algae growth on inshore reefs. While is it not yet possible to determine if this pattern of high debris nearshore is due to proximity to onshore debris sources, accumulation due to higher rugosity snagging debris, or increased debris removal efforts offshore, these differences in marine debris types and abundances suggest variability in potential impacts of debris on marine biota on inshore versus offshore reefs. Therefore, the differential use of marine debris by associated biota should be considered in marine debris management practices.
Design of hybrid deep learning using TSA with ANN for cost evaluation in the plastic injection industry
Authors: Kengpol Athakorn , Tabkosai Pornthip
Published: June 2024

In the plastic injection industry, plastic injection molding is one of the most extensively used mass production technologies and has been continuously increasing in recent years. Cost evaluation is essential in corporate operations to increase the market share and lead in plastic part pricing. The complexity of the plastic parts and manufacturing data resulted in a long data waiting time and inaccurate cost evaluation. Therefore, the aim of this research is to apply a cost evaluation approach that combines hybrid deep learning of a tunicate swarm algorithm (TSA) with an artificial neural network (ANN) for the cost evaluation of complicated surface products in the plastic injection industry to achieve a faster convergence rate for optimal solutions and higher accuracy. The methodology entails the ANN, which applies feature-based extraction of 3D-model complicated surface products to develop a cost evaluation model. The TSA is used to construct the initial weight into the learning model of the ANN, which can generate faster-to-convergent optimal solutions and higher accuracy. The result shows that the new hybrid deep learning TSA combined with the ANN provides more accurate cost evaluation than the ANN. The prediction accuracy of cost evaluation is approximately 96.66% for part cost and 93.75% for mold cost. The contribution of this research is the development of a new hybrid deep learning model combining the TSA with the ANN that includes the calculation of the number of hidden layers specifically for complicated surface products, which are unavailable in the literature. The cost evaluation approach can be practically applied and is accurate for complicated surface products in the plastic injection industry.
Proficiency-based progression training in robot-assisted laparoscopy for endometrial cancer: peri-operative and survival outcomes from an observational cohort study
Authors: Sickinghe Ariane , Nobbenhuis Marielle , Nelissen Ellen , Heath Owen , Ind Thomas
Published: June 2024

Introduction

Over the last decade there has been a transition from traditional laparoscopy to robotic surgery for the treatment of endometrial cancer. A number of gynecological oncology surgical fellowship programmes have adopted robot-assisted laparoscopy, but the effect of training on complications and survival has not been evaluated. Our aim was to assess the impact of a proficiency-based progression training curriculum in robot-assisted laparoscopy on peri-operative and survival outcomes for endometrial cancer.

Methods

This is an observational cohort study performed in a tertiary referral and subspecialty training center. Women with primary endometrial cancer treated with robot-assisted laparoscopic surgery between 2015 and 2022 were included. Surgery would normally include a hysterectomy and salpingo-oophorectomy with some form of pelvic lymph node dissection (sentinel lymph nodes or lymphadenectomy). Training was provided according to a training curriculum which involves step-wise progression of the trainee based on proficiency to perform a certain surgical technique. Training cases were identified pre-operatively by consultant surgeons based on clinical factors. Case complexity matched the experience of the trainee. Main outcome measures were intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theater rates and 5-year disease-free and disease-specific survival for training versus non-training cases. Mann–Witney U, Pearson’s chi-squared, multivariable regression, Kaplan-Meier and Cox proportional hazard analyses were performed to assess the effect of proficiency-based progression training on peri-operative and survival outcomes.

Results

Training cases had a lower BMI than non-training cases (30 versus 32 kg/m2, p = 0.013), but were comparable in age, performance status and comorbidities. Training had no influence on intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theater rates and median 5-year disease-free and disease-specific survival. Operating time was longer in training cases (161 versus 137 min, p = < 0.001). The range of estimated blood loss was smaller in training cases. Conversion rates, critical care unit-admissions and lymphoedema rates were comparable.

Discussion

Proficiency-based progression training can be used safely to teach robot-assisted laparoscopic surgery for women with endometrial cancer. Prospective trails are needed to further investigate the influence of distinct parts of robot-assisted laparoscopic surgery performed by a trainee on endometrial cancer outcomes.
Toxic epidermal necrolysis caused by viral hepatitis A: a case report and literature review
Authors: Ye Yun , Zhang Qian , Tan You-Wen
Published: June 2024

Toxic epidermal necrolysis (TEN) is a rare but serious immune-mediated life-threatening skin and mucous membrane reaction that is mainly caused by drugs, infections, vaccines, and malignant tumors. A 74-year-old woman presented with a moderate fever of unknown cause, which was relieved after 2 days, but with weakness and decreased appetite. Red maculopapules appeared successively on the neck, trunk, and limbs, expanding gradually, forming herpes and fusion, containing a yellow turbidous liquid and rupturing to reveal a bright red erosive surface spreading around the eyes and mouth. The affected body surface area was >90%. The severity of illness score for toxic epidermal necrolysis was 2 points. The drug eruption area and severity index score was 77. She was diagnosed with TEN caused by hepatitis A virus and treated with 160 mg/day methylprednisolone, 300 mg/day cyclosporine, and 20 g/day gammaglobulin. Her skin showed improvements after 3 days of treatment and returned to nearly normal after 1 month, and liver function was completely normal after 2 months.
Advances in biosynthesis and metabolic engineering strategies of cordycepin
Authors: Peng Ting , Guo Jinlin , Tong Xinxin
Published: June 2024

Cordyceps militaris, also called as bei-chong-cao, is an insect-pathogenic fungus from the Ascomycota phylum and the Clavicipitaceae family. It is a valuable filamentous fungus with medicinal and edible properties that has been utilized in traditional Chinese medicine (TCM) and as a nutritious food. Cordycepin is the bioactive compound firstly isolated from C. militaris and has a variety of nutraceutical and health-promoting properties, making it widely employed in nutraceutical and pharmaceutical fields. Due to the low composition and paucity of wild resources, its availability from natural sources is limited. With the elucidation of the cordycepin biosynthetic pathway and the advent of synthetic biology, a green cordycepin biosynthesis in Saccharomyces cerevisiae and Metarhizium robertsii has been developed, indicating a potential sustainable production method of cordycepin. Given that, this review primarily focused on the metabolic engineering and heterologous biosynthesis strategies of cordycepin.
Highly diverse microbial community of regenerated seedlings reveals the high capacity of the bulb in lily, Lilium brownii
Authors: Jibril Sauban Musa , Yan Wu , Wang Yi , Zhu Xishen , Yunying Zhou , Wu Jie , Wang Ling , Zhang Limin , Li Chengyun
Published: June 2024

Lily bulbs, which have both nutrient storage and reproductive functions, are a representative group of plants for studying the maintenance and transfer of plant-associated microbiomes. In this study, a comparison of the microbial composition of bulbs and their regenerated seedlings cultured under aseptic conditions, as well as subcultured seedlings that succeeded five times, was examined by amplicon sequencing. A total of 62 bacterial taxa and 56 fungal taxa were found to be transferred to the 5th generation in seedlings, which are the core microbiome of lily. After the regeneration of seedlings from bulbs, there was a significant increase in the number of detectable microbial species, and after 1, 3, and 5 successive generations, there was a decrease in the number of detectable species. Interestingly, some “new” microorganisms appeared in each generation of samples; for instance, 167 and 168 bacterial operational taxonomic units (OTUs) in the 3rd and 5th generations of seedlings that were not detected in either bulbs or seedlings of the previous two generations. These results suggest that bulbs can maintain a high diversity of microorganisms, including some with ultra-low abundance, and have a high transfer capacity to tuck shoots through continuous subculture. The diversity and maintenance of the microbiome can provide the necessary microbial reservoir support for regenerating seedlings. This habit of maintaining low abundance and high diversity may be biologically and ecologically critical for maintaining microbiome stability and function due to the sequestration nature of the plant.
Understanding the burden of antibiotic resistance: a decade of carbapenem-resistant Gram-negative bacterial infections in Italian intensive care units
Authors: Scaglione Giovanni , Perego Matilde , Colaneri Marta , Genovese Camilla , Brivio Fabio , Covizzi Alice , Viaggi Bruno , Bandera Alessandra , Gori Andrea , Finazzi Stefano , Palomba Emanuele
Published: June 2024

Introduction

In patients admitted to intensive care units (ICUs), Gram-negative bacteria (GNB) infections pose significant challenges due to their contribution to morbidity, mortality, and healthcare costs. During the SARS-CoV-2 pandemic, Italy witnessed a rise in healthcare-associated infections (HAIs), with GNBs involved in a substantial proportion of cases. Concerningly, carbapenem-resistant GNBs (CR-GNBs) have increased worldwide, posing therapeutic challenges.

Methods

Retrospective multicentre study analysing data from over 299,000 patients admitted to Italian ICUs from 2013 to 2022.

Results

The study revealed an average of 1.5 infections per patient, with HAIs peaking during the pandemic years. Ventilator associated pneumonia (VAP) emerged as the most common HAI, with Klebsiella spp. and Pseudomonas aeruginosa predominating. Alarmingly, CR-GNBs accounted for a significant proportion of infections, particularly in VAP, bloodstream infections, and intra-abdominal infections.

Discussion

Our findings underscore the pressing need for enhanced infection control measures, particularly in the ICU setting, to mitigate the rising prevalence of CR-GNBs and their impact on patient outcomes. The study provides valuable insights into the epidemiology of HAIs in Italian ICUs and highlights the challenges posed by CR-GNBs, especially in the context of the SARS-CoV-2 pandemic, which exacerbated the issue and may serve as a crucial example for the management of future viral pandemics.
Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study
Authors: Fonseca Luciana Mascarenhas , Finlay Myles G. , Chaytor Naomi S. , Morimoto Natalie G. , Buchwald Dedra , Van Dongen Hans P. A. , Quan Stuart F. , Suchy-Dicey Astrid
Published: June 2024

Background

Sleep-related disorders have been associated with cognitive decline and neurodegeneration. American Indians are at increased risk for dementia. Here, we aim to characterize, for the first time, the associations between sleep characteristics and subsequent cognitive performance in a sample of aging American Indians.

Methods

We performed analyses on data collected in two ancillary studies from the Strong Heart Study, which occurred approximately 10 years apart with an overlapping sample of 160 American Indians (mean age at follow-up 73.1, standard deviation 5.6; 69.3% female and 80% with high school completion). Sleep measures were derived by polysomnography and self-reported questionnaires, including sleep timing and duration, sleep latency, sleep stages, indices of sleep-disordered breathing, and self-report assessments of poor sleep and daytime sleepiness. Cognitive assessment included measures of general cognition, processing speed, episodic verbal learning, short and long-delay recall, recognition, and phonemic fluency. We performed correlation analyses between sleep and cognitive measures. For correlated variables, we conducted separate linear regressions. We analyzed the degree to which cognitive impairment, defined as more than 1.5 standard deviations below the average Modified Mini Mental State Test score, is predicted by sleep characteristics. All regression analyses were adjusted for age, sex, years of education, body mass index, study site, depressive symptoms score, difference in age from baseline to follow-up, alcohol use, and presence of APOE e4 allele.

Results

We found that objective sleep characteristics measured by polysomnography, but not subjective sleep characteristics, were associated with cognitive performance approximately 10 years later. Longer sleep latency was associated with worse phonemic fluency (β = −0.069, p = 0.019) and increased likelihood of being classified in the cognitive impairment group later in life (odds ratio 1.037, p = 0.004). Longer duration with oxygen saturation < 90% was associated with better immediate verbal memory, and higher oxygen saturation with worse total learning, short and long-delay recall, and processing speed.

Conclusion

In a sample of American Indians, sleep characteristics in midlife were correlated with cognitive performance a decade later. Sleep disorders may be modifiable risk factors for cognitive impairment and dementia later in life, and suitable candidates for interventions aimed at preventing neurodegenerative disease development and progression.
Early identification of Parkinson’s disease with anxiety based on combined clinical and MRI features
Authors: Jia Min , Yang Shijun , Li Shanshan , Chen Siying , Wu Lishuang , Li Jinlan , Wang Hanlin , Wang Congping , Liu Qunhui , Wu Kemei
Published: June 2024

Objective

To identify cortical and subcortical volume, thickness and cortical area features and the networks they constituted related to anxiety in Parkinson’s disease (PD) using structural magnetic resonance imaging (sMRI), and to integrate multimodal features based on machine learning to identify PD-related anxiety.

Methods

A total of 219 patients with PD were retrospectively enrolled in the study. 291 sMRI features including cortical volume, subcortical volume, cortical thickness, and cortical area, as well as 17 clinical features, were extracted. Graph theory analysis was used to explore structural networks. A support vector machine (SVM) combination model, which used both sMRI and clinical features to identify participants with PD-related anxiety, was developed and evaluated. The performance of SVM models were evaluated. The mean impact value (MIV) of the feature importance evaluation algorithm was used to rank the relative importance of sMRI features and clinical features within the model.

Results

17 significant sMRI variables associated with PD-related anxiety was used to build a brain structural network. And seven sMRI and 5 clinical features with statistically significant differences were incorporated into the SVM model. The comprehensive model achieved higher performance than clinical features or sMRI features did alone, with an accuracy of 0.88, a precision of 0.86, a sensitivity of 0.81, an F1-Score of 0.83, a macro-average of 0.85, a weighted-average of 0.92, an AUC of 0.88, and a result of 10-fold cross-validation of 0.91 in test set. The sMRI feature right medialorbitofrontal thickness had the highest impact on the prediction model.

Conclusion

We identified the brain structural features and networks related to anxiety in PD, and developed and internally validated a comprehensive model with multimodal features in identifying.
Can bacteria and carbon-based nanomaterials revolutionize nanoremediation strategies for industrial effluents?
Authors: de Carvalho Lima Elidamar Nunes , Souza Luiz Henrique Mesquita , Aguiar Eduardo Martins , Octaviano Ana Luiza Moraes , Justo João Francisco , Piqueira José Roberto Castilho
Published: June 2024

In this study, we delved into cutting-edge strategies for the effective management of wastewater, a critical issue exacerbated by industrial pollution and urban expansion. We introduce the use of carbon-based nanomaterials (CBNs), either alone or functionalized with bacteria, as a novel nanobiotechnological solution for urgent nanobioremediation needs. This technique is notable for its exceptional ability to remove various industrial pollutants, including heavy metals, pesticides, textiles, and dyes, emphasizing the pivotal role of CBNs. The development of bionanocomposites through the integration of CBNs with bacteria represents a significant advancement in enhancing bioremediation efforts. In this study, we assessed the potential health and environmental risks associated with CBN usage while offering an in-depth evaluation of the adsorption mechanisms and factors influencing bioremediation effectiveness. Furthermore, the improved efficiency in treating industrial effluents facilitated by bionanocomposites was investigated, and their alignment with circular economy principles through recyclability is discussed. We aimed to provide, a detailed overview of recent advancements, challenges, and prospects for CBNs and bacterial application in sophisticated wastewater treatment, underscoring their vital importance in promoting the environment.
Predictive factors influencing outcome of early cranioplasty after decompressive craniectomy: a outcome prediction model study
Authors: Yan Zhongnan , Li Xiaolei , Xia Bin , Xue Chaolin , Wang Yuangang , Che Hongmin , Shen Dongqing , Guo Shiwen
Published: June 2024

Objective

The timing of cranioplasty (CP) has become a widely debated topic in research, there is currently no unified standard. To this end, we established a outcome prediction model to explore the factors influencing the outcome of early CP. Our aim is to provide theoretical and practical basis for whether patients with skull defects after decompressive craniectomy (DC) are suitable for early CP.

Methods

A total of 90 patients with early CP after DC from January 2020 to December 2021 were retrospectively collected as the training group, and another 52 patients with early CP after DC from January 2022 to March 2023 were collected as the validation group. The Nomogram was established to explore the predictive factors that affect the outcome of early CP by Least absolute shrinkage analysis and selection operator (LASSO) regression and Logistic regression analysis. Receiver operating characteristic (ROC) curve was used to evaluate the discrimination of the prediction model. Calibration curve was used to evaluate the accuracy of data fitting, and decision curve analysis (DCA) diagram was used to evaluate the benefit of using the model.

Results

Age, preoperative GCS, preoperative NIHSS, defect area, and interval time from DC to CP were the predictors of the risk prediction model of early CP in patients with skull defects. The area under ROC curve (AUC) of the training group was 0.924 (95%CI: 0.867–0.980), and the AUC of the validation group was 0.918 (95%CI, 0.842–0.993). Hosmer-Lemeshow fit test showed that the mean absolute error was small, and the fit degree was good. The probability threshold of decision risk curve was wide and had practical value.

Conclusion

The prediction model that considers the age, preoperative GCS, preoperative NIHSS, defect area, and interval time from DC has good predictive ability.
Efficacy and safety of acupuncture for painful diabetic neuropathy: a systematic review and meta-analysis
Authors: Liu Jiaming , Lin Yueqi , Huang Yuheng , Yang Qingyi , Li Xiaojie , Ye Yinglan , Zheng Bohui , Song Wei
Published: June 2024

Background

Painful diabetic neuropathy (PDN) is a common chronic neurological complication of diabetes mellitus. Medications are often used to relieve pain, but with significant side effects. Acupuncture is now a component of pragmatic and integrative treatment for PDN. An increasing number of relevant randomized controlled trials have been published in recent years, but a comprehensive meta-analysis has not yet been performed. The aim of this paper is to verify the effectiveness and safety of acupuncture for PDN by meta-analysis and trial sequential analysis (TSA).

Methods

All participants in this study should have had a PDN diagnosis and the trial group was treated with acupuncture. Eight databases, including EMbase, PubMed, Web of science, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang and Chongqing VIP (CQVIP) were retrieved from inception to 5 April 2023. Meta-analysis was conducted utilizing RevMan 5.3 and Stata 15.0. TSA was performed to assess the adequacy of sample size for the outcomes.

Results

A total of 36 studies, comprising 2,739 PDN patients, were included. Among them, 1,393 patients were assigned to the trial group and 1,346 patients were treated in the control group. Outcomes covers the primary indicator Total effective rate (RR = 1.42, 95%CI [1.34, 1.52], p < 0.00001), with 21 studies reported, Pain intensity (SMD = −1.27, 95%CI [−1.58, −0.95], p < 0.00001), with 23 studies reported, and other outcomes, including motor nerve conduction velocity (MCV; MD = 3.58, 95%CI [2.77, 4.38], p < 0.00001), sensory nerve conduction velocity (SCV; MD = 3.62, 95%CI [2.75, 4.49], p < 0.00001), Depression score (SMD = −1.02, 95%CI [1.58, 0.46]), Toronto clinical scoring system (TCSS; MD = −2.41, 95%CI [−3.37, −1.45], p < 0.00001), Quality of life (SMD = 1.06, 95%CI [0.66, 1.46]), traditional Chinese medicine (TCM) syndrome score (MD = −4.99, 95%CI [−6.79, −3.18], p < 0.00001), suggesting that acupuncture have an ameliorating effect on PDN in various respect. Egger’s test revealed publication bias for four outcomes. TSA showed that as for Total effective rate, Pain Intensity, MCV and SCV, the number of included studies was sufficient to support the conclusions.

Conclusion

Acupuncture demonstrates significant effectiveness in improving PDN outcomes, including Total effective rate, Pain intensity, MCV, SCV, Depression score, TCSS, Quality of life, TCM syndrome score. But the Adverse events rate is no different in trail group and control group. The publication bias presented in Total effective rate, Pain intensity, MCV and SCV can be remedied by Trim and filling method.

Systematic review registration

Prospero, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=477295.
Nomogram to predict prognosis in patients with posterior circulation acute ischemic stroke after mechanical thrombectomy
Authors: Li Jiayang , Zhang Jin , Li Changxin , Li Jun , Wu Xupeng , Wang Shaoshuai
Published: June 2024

Purpose

This study aimed to investigate the risk factors of prognosis and hemorrhagic transformation after mechanical thrombectomy (MT) in patients with posterior circulation acute ischemic stroke (PC-AIS) caused by large vessel occlusion. We sought to develop a nomogram for predicting the risk of poor prognosis and symptomatic intracerebral hemorrhage (sICH) in patients with PC-AIS.

Methods

A retrospective analysis was conducted on 81 patients with PC-AIS who underwent MT treatment. We collected clinical information from the patients to assessed sICH and prognosis based on CT results and National Institutes of Health Stroke Scale (NIHSS) scores. Subsequently, they were followed up for 3 months, and their prognosis was assessed using the Modified Rankin Scale. We used the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression to determine the factors affecting prognosis to construct a nomogram. The nomogram’s performance was assessed through receiver operating characteristic curves, calibration curves, decision curve analysis, and clinical impact curves.

Results

Among the 81 patients with PC-AIS, 33 had a good prognosis, 48 had a poor prognosis, 19 presented with sICH, and 62 did not present with sICH. The results of the LASSO regression indicated that variables, including HPT, baseline NIHSS score, peak SBP, SBP CV, SBP SD, peak SBP, DBP CV, HbA1c, and BG SD, were predictors of patient prognosis. Variables such as AF, peak SBP, and peak DBP predicted the risk of sICH. Multivariate logistic regression revealed that baseline NIHSS score (OR = 1.115, 95% CI 1.002–1.184), peak SBP (OR = 1.060, 95% CI 1.012–1.111), SBP CV (OR = 1.296, 95% CI 1.036–1.621) and HbA1c (OR = 3.139, 95% CI 1.491–6.609) were independent risk factors for prognosis. AF (OR = 6.823, 95% CI 1.606–28.993), peak SBP (OR = 1.058, 95% CI 1.013–1.105), and peak DBP (OR = 1.160, 95% CI 1.036–1.298) were associated with the risk of sICH. In the following step, nomograms were developed, demonstrating good discrimination, calibration, and clinical applicability.

Conclusion

We constructed nomograms to predict poor prognosis and risk of sICH in patients with PC-AIS undergoing MT. The model exhibited good discrimination, calibration, and clinical applicability.
Association of bilaterally suppressed EEG amplitudes and outcomes in critically ill children
Authors: Paul Luisa , Greve Sandra , Hegemann Johanna , Gienger Sonja , Löffelhardt Verena Tamara , Della Marina Adela , Felderhoff-Müser Ursula , Dohna-Schwake Christian , Bruns Nora
Published: June 2024

Background and objectives

Amplitude-integrated EEG (aEEG) is used to assess electrocortical activity in pediatric intensive care if (continuous) full channel EEG is unavailable but evidence regarding the meaning of suppressed aEEG amplitudes in children remains limited. This retrospective cohort study investigated the association of suppressed aEEG amplitudes in critically ill children with death or decline of neurological functioning at hospital discharge.

Methods

Two hundred and thirty-five EEGs derived from individual patients <18 years in the pediatric intensive care unit at the University Hospital Essen (Germany) between 04/2014 and 07/2021, were converted into aEEGs and amplitudes analyzed with respect to age-specific percentiles. Crude and adjusted odds ratios (OR) for death, and functional decline at hospital discharge in patients with bilateral suppression of the upper or lower amplitude below the 10th percentile were calculated. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were assessed.

Results

The median time from neurological insult to EEG recording was 2 days. PICU admission occurred due to neurological reasons in 43% and patients had high overall disease severity. Thirty-three (14%) patients died and 68 (29%) had a functional decline. Amplitude suppression was observed in 48% (upper amplitude) and 57% (lower amplitude), with unilateral suppression less frequent than bilateral suppression. Multivariable regression analyses yielded crude ORs between 4.61 and 14.29 and adjusted ORs between 2.55 and 8.87 for death and functional decline if upper or lower amplitudes were bilaterally suppressed. NPVs for bilaterally non-suppressed amplitudes were above 95% for death and above 83% for pediatric cerebral performance category Scale (PCPC) decline, whereas PPVs ranged between 22 and 32% for death and 49–52% for PCPC decline.

Discussion

This study found a high prevalence of suppressed aEEG amplitudes in critically ill children. Bilaterally normal amplitudes predicted good outcomes, whereas bilateral suppression was associated with increased odds for death and functional decline. aEEG assessment may serve as an element for risk stratification of PICU patients if conventional EEG is unavailable with excellent negative predictive abilities but requires additional information to identify patients at risk for poor outcomes.
Visual light flicker stimulation: enhancing alertness in sleep-deprived rats
Authors: Wang Kun , Chen Kang , Wei Zilin , Wang Tianhui , Wei Aili , Gao Xiujie , Qin Yingkai , Zhu Yingwen , Ge Yi , Cui Bo , Zhu Mengfu
Published: June 2024

Introduction

In the evolving field of neurophysiological research, visual light flicker stimulation is recognized as a promising non-invasive intervention for cognitive enhancement, particularly in sleep-deprived conditions.

Methods

This study explored the effects of specific flicker frequencies (40 Hz and 20–30 Hz random flicker) on alertness recovery in sleep-deprived rats. We employed a multidisciplinary approach that included behavioral assessments with the Y-maze, in vivo electrophysiological recordings, and molecular analyses such as c-FOS immunohistochemistry and hormone level measurements.

Results

Both 40 Hz and 20–30 Hz flicker significantly enhanced behavioral performance in the Y-maze test, suggesting an improvement in alertness. Neurophysiological data indicated activation of neural circuits in key brain areas like the thalamus and hippocampus. Additionally, flicker exposure normalized cortisol and serotonin levels, essential for stress response and mood regulation. Notably, increased c-FOS expression in brain regions related to alertness and cognitive functions suggested heightened neural activity.

Discussion

These findings underscore the potential of light flicker stimulation not only to mitigate the effects of sleep deprivation but also to enhance cognitive functions. The results pave the way for future translational research into light-based therapies in human subjects, with possible implications for occupational health and cognitive ergonomics.
Association between spot urinary sodium-to-potassium ratio and blood pressure among Chinese adults aged 18–69 years: the SMASH study
Authors: Xu Chunxiao , Dong Jing , Liu Danru , Xu Jianwei , Zhang Bingyin , Lu Zilong , Wang Linhong , Tang Junli , Zhang Xiaochang , Ren Jie , Yu Xiaohui , Guo Rui , Guo Xiaolei , Wu Jing , Ma Jixiang
Published: June 2024

Background

Excessive sodium and low potassium intake are involved in the development of hypertension. Growing evidence showed that the sodium-to-potassium ratio (Na/K) was significantly associated with blood pressure (BP). However, studies on the dose-response relationship of spot urinary Na/K ratio with hypertension and BP in the general population are scarce, especially in the Chinese population.

Materials and methods

Data from the post-intervention survey of the Shandong Ministry of Health Action on Salt and Hypertension (SMASH) project was analyzed. Associations between Na/K molar ratio and hypertension prevalence and between Na/K molar ratio and BP indices were analyzed using multivariable logistic and linear regression, respectively, followed by subgroup analysis and interaction analysis. The restricted cubic spline model was used to explore the dose–response relationship. Informed by existing literature, we adjusted for potential confounding factors, including temperature and renal function, to assess the association and dose–response relationship.

Results

There was a non-linear positive association between Na/K and hypertension (OR:1.09, 95%CI: 1.08–1.11) and a linear positive association between Na/K and systolic BP, diastolic BP, and mean arterial pressure (β 0.53, 95%CI: 0.45–0.60; β 0.36, 95%CI: 0.31–0.41; and β 0.42, 95%CI: 0.36–0.47, respectively). The association was stronger in individuals with hypertension, female patients, those in the 50–59-year age group, and those who were obese. Environmental temperatures had little impact on associations.

Conclusion

Our findings provide further evidence that the spot urinary Na/K ratio is a simple, useful, and convenient indicator for monitoring salt reduction and potassium increase, which could be used in clinical and public health practices.
Evaluating bio-physicochemical properties of raw powder prepared from whole larvae containing liquid silk of the domestic silkworm
Authors: Hashimoto Shusuke , Yamazaki Maki , Uehara Hiroshi , Yamazaki Shinya , Kobayashi Masakazu , Yokoyama Takeshi , Yazawa Kenjiro , Shiomi Kunihiro
Published: June 2024

The domestic silkworm, Bombyx mori, has been widely used in silk production for centuries. It is also used as a bioreactor by the textile and pharmaceutical industries to mass produce recombinant bioactive proteins containing silk-based materials. Furthermore, silkworms are well-known as a source of food and have also been orally administered to prevent and treat several human disorders. In this study, we aimed to investigate the inherent bio-physicochemical properties of edible silkworms to accurately evaluate their clinical and nutritional potential. We prepared raw powder from whole larvae of silkworm. The yield rate of the powder derived from dried larvae was almost 100% (98.1–99.1% in replicates). As “percentage yield” translates to “Budomari” in Japanese, this raw powder was named “B100rw.” We further prepared B100dn that was denatured through autoclaving. Thereafter, we examined whether B100rw sustained the original bio-physicochemical properties by comparing it with B100dn. There was no significant difference in nutritional content between B100rw and B100dn. B100rw contained proteins derived from silkworm larvae and mulberry leaves, whereas the proteins of B100dn were mostly degraded. On measuring the enzymatic activity of both powders using trehalase as an indicator enzyme, B100rw was found to maintain trehalase activity. B100rw also maintained a random coil conformation, similar to that of liquid silk. This suggested that B100rw sustained the unique bio-physicochemical properties of living larvae. These findings may facilitate the development of novel food products or orally administered vaccines.
Nonlinear correlation and mediation effects between serum 25-hydroxyvitamin D levels and all-cause mortality in COPD patients
Authors: Jiang Qi , Jiang Yuewen , Ma Zheru , Huang Jingda , Li Yang
Published: June 2024

Background

Numerous studies have shown that low levels of vitamin D are linked to a higher risk of inflammatory diseases and their progression. However, how vitamin D levels affect mortality in chronic obstructive pulmonary disease (COPD) patients is still unclear. Thus, this study aimed to explore the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and the risk of death from all causes in U.S. adults with COPD.

Methods

This study analyzed 1,876 adults with COPD from the National Health and Nutrition Examination Survey (2005–2018). Mortality data up to December 31, 2019, were obtained from the National Death Index (NDI) records. Participants were categorized into three groups according to their 25(OH)D levels: Q1 (<50.0 nmol/L) for deficiency; Q2 (50.0–74.9 nmol/L) for insufficiency; and Q3 (≥75.0 nmol/L) for adequacy. A weighted Cox regression model assessed the link between 25(OH)D levels and mortality. Kaplan–Meier survival curves, subgroup, and sensitivity analyses were conducted. Additionally, the relationship between 25(OH)D and the hazard ratio (HR) was detailed through restricted cubic spline analysis. Mediation analysis revealed how 25(OH)D mediates the relationship between Dietary Inflammatory Index and mortality.

Results

There were 395 all-cause deaths during the follow-up, resulting in a mortality rate of 21.06%. After adjusting for potential confounders, higher 25(OH)D levels significantly correlated with a lower risk of all-cause mortality in COPD patients (HR = 0.52, 95% CI: 0.37–0.72, p < 0.001). Restricted cubic spline analysis indicated a non-linear relationship between 25(OH)D levels and all-cause mortality (p for nonlinear = 0.023), with levels below 63.4 nmol/L posing an independent risk for all-cause mortality in COPD patients (HR = 0.98, 95% CI: 0.97–0.99, p = 0.005). Sensitivity and subgroup analyses confirmed our results’ robustness, with mediation analysis showing 25(OH)D’s 22% mediating effect on diet-induced inflammation and all-cause mortality in COPD patients.

Conclusion

25(OH)D independently lowers the risk of all-cause mortality in COPD patients, with a non-linear L-shaped correlation, and mediates the effect of Dietary Inflammatory Index on mortality, suggesting new therapeutic possibilities.