Risk factors for hemorrhagic cystitis in children undergoing hematopoietic stem cell transplantation: a systematic review and meta-analysis.

BACKGROUND: The risk factors for hemorrhagic cystitis (HC) in children undergoing hematopoietic stem cell transplantation (HSCT) are unclear. Therefore, we conducted this systematic review and meta-analysis to investigate the risk factors for HC in children undergoing HSCT. METHODS: We performed this meta-analysis by retrieving studies from PubMed, EMBASE, and the Cochrane Library up to October 10, 2023, and analyzing those that met the inclusion criteria. I2 statistics were used to evaluate heterogeneity. RESULTS: Twelve studies, including 2,764 patients, were analyzed. Male sex (odds ratio [OR] = 1.52; 95% confidence interval [CI], 1.16-2.00; p = 0.003, I2 = 0%), allogeneic donor (OR = 5.28; 95% CI, 2.60-10.74; p < 0.00001, I2 = 0%), human leukocyte antigen (HLA) mismatched donor (OR = 1.86; 95% CI, 1.00-3.44; p = 0.05, I2 = 31%), unrelated donor (OR = 1.58; 95% CI, 1.10-2.28; p = 0.01, I2 = 1%), myeloablative conditioning (MAC) (OR = 3.17; 95% CI, 1.26-7.97; p = 0.01, I2 = 0%), busulfan (OR = 2.18; 95% CI, 1.33-3.58; p = 0.002, I2 = 0%) or anti-thymoglobulin (OR = 1.65; 95% CI, 1.07-2.54; p = 0.02, I2 = 16%) use, and cytomegalovirus (CMV) reactivation (OR = 2.64; 95% CI, 1.44-4.82; p = 0.002, I2 = 0%) were risk factors for HC in children undergoing HSCT. CONCLUSIONS: Male sex, allogeneic donor, HLA-mismatched, unrelated donor, MAC, use of busulfan or anti-thymoglobulin, and CMV reactivation are risk factors for HC in children undergoing HSCT.

The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis.

BACKGROUND: Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent. OBJECTIVE: Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis. METHODS: From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis. RESULTS: There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096). CONCLUSIONS: General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.

Tissue-specific knockout in Drosophila neuromuscular system reveals ESCRT's role in formation of synapse-derived extracellular vesicles.

Tissue-specific gene knockout by CRISPR/Cas9 is a powerful approach for characterizing gene functions in animal development. However, this approach has been successfully applied in only a small number of Drosophila tissues. The Drosophila motor nervous system is an excellent model system for studying the biology of neuromuscular junction (NMJ). To expand tissue-specific CRISPR to the Drosophila motor system, here we present a CRISPR-mediated tissue-restricted mutagenesis (CRISPR-TRiM) toolkit for knocking out genes in motoneurons, muscles, and glial cells. We validated the efficacy of this toolkit by knocking out known genes in each tissue, demonstrated its orthogonal use with the Gal4/UAS binary expression system, and showed simultaneous knockout of multiple redundant genes. Using these tools, we discovered an essential role for SNARE pathways in NMJ maintenance. Furthermore, we demonstrate that the canonical ESCRT pathway suppresses NMJ bouton growth by downregulating the retrograde Gbb signaling. Lastly, we found that axon termini of motoneurons rely on ESCRT-mediated intra-axonal membrane trafficking to lease extracellular vesicles at the NMJ.

The Weight-loss Effect of GLP-1RAs Glucagon-Like Peptide-1 Receptor Agonists in Non-diabetic Individuals with Overweight or Obesity: A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are new drugs for the treatment of obesity. OBJECTIVE: To assess the weight-loss effects of GLP-1RAs in the treatment of patients with overweight or obesity without diabetes. METHODS: This is a systematic review with meta-analysis and trial sequential analysis. PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from their inception to January 1, 2022. Eligible trials report on outcomes including body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), or total body fat (TBF). Mean differences (MDs) and standardized mean differences (SMDs) were summarized using random-effects models. RESULTS: Forty-one trials involving 15,135 participants were included. Compared with controls, GLP-1RAs significantly reduced BW (MD -5.319 kg, 95% CI: -6.465, -4.174), BMI (MD -2.373 kg/m2, 95% CI: -2.821, -1.924), WC (MD -4.302 cm, CI:-5.185 to -3.419), WHR (MD -0.011, CI -0.015 to -0.007), but not TBF (MD -0.320%, CI -1.420 to -0.780). Trial sequential analysis (TSA) supported conclusive evidence of the effects of GLP-1RAs on BW, BMI, and WC for weight loss. GLP-1RAs had nonlinear dose-response relationships with weight loss. Extensive sensitivity analyses demonstrated the robustness of the results, though the GRADE certainty of the evidence ranged from high to very low. High to moderate GRADE certainty of evidence suggested semaglutide as the most effective GLP-1RA agent, with the best efficacy and low to moderate risk of adverse effects. CONCLUSIONS: The present study provides conclusive evidence for the effect of GLP-1RAs on weight loss in a nonlinear dose-response manner in patients with obesity or overweight without diabetes. In terms of changes in BW, BMI, and WC, there is firm evidence for the overall weight-loss effects of GLP-1RAs. Of the GLP-1RAs, semaglutide might be the most effective agent.

The Effects of Pressure Gradient on Papilledema Improvement After Venous Sinus Stenting in Idiopathic Intracranial Hypertension.

PURPOSE: This study aimed to evaluate the impact of the pressure gradient on papilledema after stenting in patients with idiopathic intracranial hypertension (IIH) patients and venous sinus stenosis (VSS). MATERIALS AND METHODS: In this prospective cohort study, we examined 121 patients with IIH and VSS who underwent stenting. The papilledema Frisen grade at the 1-month follow-up was used as a grouping factor (favorable outcome: 0-1; unfavorable outcome: 2-5). We used multivariable logistic regression modeling to determine independent predictors of favorable outcome. The performance of the prediction model was evaluated using a receiver operating characteristic (ROC) analysis. RESULTS: A total of 96 patients had papilledema grades 0 to 1, and 25 patients had papilledema grades 2 to 5. Patients with the first group had significantly lower gradient pressures preoperatively (15.2 mmHg vs. 21.4 mmHg, p=0.001) and postoperatively (2 mmHg vs. 3.3 mmHg, p=0.002) relative to those in the second group. Multivariate analysis indicated that preoperative pressure gradient (odds ratio [OR] = 1.119; 95% confidence interval [CI] = 1.034-1.211]) and postoperative pressure gradient (OR = 1.498; 95% CI = 1.147-1.957) were independent predictors of favorable outcome. In the ROC analysis, the cut-off pressure gradient for the highest sensitivity (0.44) and specificity (0.874) was 22.75 mmHg, with a Youden's index of 0.314. Survival analysis demonstrated that patients with a preoperative pressure gradient <22.75 mmHg had more rapid improvement of papilledema than did those with a pressure gradient >22.75 mmHg (mean+SD: 2.639+0.382 [95% CI: 1.890-3.388] versus mean+SD: 3.882+0.884 [95% CI: 2.149-5.616]; p=0.004). CONCLUSION: A significant reduction in the pressure gradient appears to be strongly correlated with the success of VSS in patients with IIH. A higher preoperative pressure gradient may reduce stenting efficacy in patients with IIH. CLINICAL IMPACT: Venous sinus stenting has the potential to yield substantial clinical advantages in individuals diagnosed with idiopathic intracranial hypertension with venous sinus stenosis. Nevertheless, a heightened preoperative pressure gradient could lead to less favorable results. Thus, the early adoption of venous sinus stenting is advised to avert additional irreversible clinical deterioration among idiopathic intracranial hypertension patients with venous sinus stenosis.

Integrating clinical access limitations into iPDT treatment planning with PDT-SPACE.

PDT-SPACE is an open-source software tool that automates interstitial photodynamic therapy treatment planning by providing patient-specific placement of light sources to destroy a tumor while minimizing healthy tissue damage. This work extends PDT-SPACE in two ways. The first enhancement allows specification of clinical access constraints on light source insertion to avoid penetrating critical structures and to minimize surgical complexity. Constraining fiber access to a single burr hole of adequate size increases healthy tissue damage by 10%. The second enhancement generates an initial placement of light sources as a starting point for refinement, rather than requiring entry of a starting solution by the clinician. This feature improves productivity and also leads to solutions with 4.5% less healthy tissue damage. The two features are used in concert to perform simulations of various surgery options of virtual glioblastoma multiforme brain tumors.

Predicting the Rapid Improvement of Papilledema After Stenting in Idiopathic Intracranial Hypertension.

PURPOSE: This study aimed to identify predictors of rapid improvement of papilledema after stenting and develop a simple preintervention scale. METHODS: A prospective cohort of idiopathic intracranial hypertension (IIH) with venous sinus stenosis (VSS) treated with stenting in a tertiary hospital from January 2014 to December 2019 was reviewed. We categorized papilledema improvement into favorable (grades 0-1) and unfavorable (grades 2-5). We employed logistic regression analysis to find the predictive factors and develop the predictive scale. We then estimated the performance of the scale using the ROC curve and Hosmer-Lemeshow test. RESULTS: There were 110 patients who underwent venous sinus stenting, with a mean age of 37.1 years and a predominance of females (77.3%). A total of 85 patients had a favorable outcome following stenting, while 25 patients had an unfavorable outcome. The results of the multivariate analysis indicate that lower preoperative pressure gradients (odds ratio, OR: 4.01; 95% confidence interval, CI: 1.27-12.68), stenosis rates (OR: 4.16; 95% CI: 1.11-15.56), and preoperative papilledema grades (OR: 2.92; 95% CI: 1.44-5.91) were independently associated with rapid improvement of papilledema following stenting treatment. The 3­item scale exhibited good discrimination with an area under the curve (AOC) of 0.81 (95% CI 0.72-0.89, p < 0.001), as well as acceptable calibration determined by the Hosmer-Lemeshow test (P = 0.42). The optimal cut-off value of the scale (range 0-6 points) was ≥ 4 points, with a sensitivity of 72%, specificity of 73%, and accuracy of 78%. CONCLUSION: The presence of lower preoperative pressure gradients, stenosis severity, and preoperative status of papilledema were identified as positive predictors of rapid improvement of the papilledema following stenting in IIH patients. The 3­item scale provides a promising preintervention predictive model for predicting rapid response following stenting treatment in IIH patients with VSS.

Determination of Vascular Endothelial Growth Factor-B Concentrations in Aqueous Humor and Plasma of Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy Patients Before and After Anti-VEGF Therapy.

INTRODUCTION: Anti-vascular endothelial growth factor (anti-VEGF) injection was widely used in patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV); however, the systemic and local levels of vascular endothelial growth factor (VEGF)-B were seldom detected before. This study was conducted to detect and compare the aqueous humor and plasma VEGF-B levels in nAMD and PCV before and after anti-VEGF therapy. METHODS: Concentrations of VEGF-B in aqueous humor and plasma of individuals with nAMD (n = 10), PCV (n = 22), and age-related cataract controls (n = 12) were measured by enzyme-linked immunosorbent assay. Ranibizumab was injected intravitreally in patients monthly for three consecutive months. Before each injection in patients and at the baseline of controls, blood and aqueous humor samples were collected. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were collected before each injection in patient groups. The differences of BCVA, CRT, and VEGF-B levels in aqueous humor and plasma between groups before and after anti-VEGF therapy were compared. RESULTS: VEGF-B was overexpressed in aqueous humor and plasma of nAMD and PCV groups compared with control group (P < 0.05), but no statistically significant difference existed across nAMD and PCV groups (P > 0.05). Moreover, there were no obvious difference in levels of VEGF-B in aqueous humor and plasma within the treatment groups after anti-VEGF treatment (P > 0.05). The mean CRT in the nAMD group was thinner than that in the PCV group at baseline (P < 0.01). After injections, the CRT obviously declined in both groups (P < 0.05). There was no correlation between CRT reduction and high VEGF-B expression in aqueous humor and plasma of treatment groups. CONCLUSION: Overexpression of VEGF-B locally and systemically in patients with nAMD and PCV indicated that elevated VEGF-B concentrations were relevant to the disease processes. Ranibizumab did not influence the levels of VEGF-B in the real world. CRT might help to distinguish PCV from nAMD.

Stenting versus medical treatment for idiopathic intracranial hypertension: a matched-control study.

BACKGROUND: This prospective cohort study compared the outcomes of stenting and medical treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). METHODS: In this single-center cohort study, patients with IIH and VSS were evaluated between January 2014 and December 2019 with follow-up periods of 1, 3, and 6 months. The patients received either stenting or medical treatment. The two groups underwent 1:1 matching using propensity score analysis, and the clinical outcomes were compared. RESULTS: Following 1:1 matching, 36 patients who underwent stenting and 36 who underwent medical treatment were matched. The median improvements in the papilledema Frisén grade were greater in the stenting group at 1 month (-2 vs 0), 3 months (-3 vs -1), and 6 months (-3 vs -1) than in the medical treatment group. Patients who received stenting treatment had a significantly higher prevalence of complete resolution of their respective symptoms (headache, tinnitus, or visual disturbances) at 3 months (58.3% vs 13.9%, OR 8.68, 95% CI 2.74 to 27.52) and 6 months (80.6% vs 22.2%, OR 14.50, 95% CI 4.64 to 45.32) than those receiving medical treatment. CONCLUSIONS: This matched-control study shows that stenting has a greater efficacy rate and rapid resolution of papilledema and its respective symptoms compared with medical treatment.

The effect of calcium supplementation in people under 35 years old: A systematic review and meta-analysis of randomized controlled trials.

Background: The effect of calcium supplementation on bone mineral accretion in people under 35 years old is inconclusive. To comprehensively summarize the evidence for the effect of calcium supplementation on bone mineral accretion in young populations (≤35 years). Methods: This is a systematic review and meta-analysis. The Pubmed, Embase, ProQuest, CENTRAL, WHO Global Index Medicus, Clinical Trials.gov, WHO ICTRP, China National Knowledge Infrastructure (CNKI), and Wanfang Data databases were systematically searched from database inception to April 25, 2021. Randomized clinical trials assessing the effects of calcium supplementation on bone mineral density (BMD) or bone mineral content (BMC) in people under 35 years old. Results: This systematic review and meta-analysis identified 43 studies involving 7,382 subjects. Moderate certainty of evidence showed that calcium supplementation was associated with the accretion of BMD and BMC, especially on femoral neck (standardized mean difference [SMD] 0.627, 95% confidence interval [CI] 0.338-0.915; SMD 0.364, 95% CI 0.134-0.595; respectively) and total body (SMD 0.330, 95% CI 0.163-0.496; SMD 0.149, 95% CI 0.006-0.291), also with a slight improvement effect on lumbar spine BMC (SMD 0.163, 95% CI 0.008-0.317), no effects on total hip BMD and BMC and lumbar spine BMD were observed. Very interestingly, subgroup analyses suggested that the improvement of bone at femoral neck was more pronounced in the peripeak bone mass (PBM) population (20-35 years) than the pre-PBM population (<20 years). Conclusions: Our findings provided novel insights and evidence in calcium supplementation, which showed that calcium supplementation significantly improves bone mass, implying that preventive calcium supplementation before or around achieving PBM may be a shift in the window of intervention for osteoporosis. Funding: This work was supported by Wenzhou Medical University grant [89219029].

Osteoporosis and bone fractures are common problems among older people, particularly older women. These conditions cause disability and reduce quality of life. Progressive loss of bone mineral density is usually the culprit. So far, strategies to prevent bone weakening with age have produced disappointing results. For example, taking calcium supplements in later life only slightly reduces the risk of osteoporosis or fracture. New approaches are needed. Bone mass increases gradually early in life and peaks and plateaus around 20-35 years of age. After that period, bone mass slowly declines. Some scientists suspect that increasing calcium intake during this period of peak bone mass may reduce osteoporosis or fracture risk later in life. A meta-analysis by Liu, Le et al. shows that boosting calcium intake in young adulthood strengthens bones. The researchers analyzed data from 43 randomized controlled trials that enrolled 7,382 participants. About half the studies looked at the effects of taking calcium supplements and the other half analyzed the effects of a high calcium diet. Boosting calcium intake in people younger than age 35 improved bone mineral density throughout the body. It also increased bone mineral density at the femoral neck, where most hip fractures occur. Calcium supplementation produced larger effects in individuals between the ages of 20 and 35 than in people younger than 20. Both high calcium diets and calcium supplements with doses less than 1000 mg/d boosted bone strength. Higher dose calcium supplements did not provide any extra benefits. The analysis suggests people should pay more attention to bone health during early adulthood. Large randomized clinical trials are needed to confirm the long-term benefits of boosting calcium intake during early adulthood. But if the results are validated, taking calcium supplements, or eating more calcium-rich foods between the ages of 20 and 35 may help individuals build healthier bones and prevent fractures and osteoporosis later in life.

Effect of high-protein vs. high-fat snacks before lunch on glycemic variability in prediabetes: A study protocol for a randomized controlled trial.

Background: China has the largest number of patients with Type 2 Diabetes Mellitus (T2DM), and it tends to increasingly grow in the future, putting an enormous burden on disease control and prevention in China. While glycemic variability (GV) came to be an important indicator of blood glucose control in diabetic patients, studies suggested that premeal snacks may help blood glucose control, but there are still some problems to be researched. Therefore, we designed this trial to evaluate which kind of premeal snacks would lead to better effects on GV under two diet patterns in pre-diabetes subjects and to evaluate assessments of acceptability and compliance, behavior, and metabolism changes in individuals will be described. Methods and analysis: The study is a single-center, open-label, multiparallel group, randomized controlled trial. A total of 32 male and female volunteers will be randomized into 4 groups in a single allocated ratio of soy milk (powder) snack, milk (powder) snack, almonds snack, and placebo control with 250 ml of water taken 30 min before lunch, respectively. The study consists of two intervention periods over 11 days. The first intervention period under habitual diet conditions from D3 to D6 (4 days), during which all subjects are asked to maintain their habitual eating and daily activities similar to the run-in period. The second intervention consists of prelunch snacks with standard meals. We will examine both the effect of GV and various metabolic and behavioral outcomes potentially associated with the interventions. At the end of this study, we will assess the acceptability and maintainability of the intervention through interviews. Clinical trial registration: Chinese Clinical Trial Registry, identifier ChiCTR2200058935.

Selection of the Reference Gene for Expression Normalization in Salsola ferganica under Abiotic Stress.

Salsola ferganica is a natural desert herbaceous plant in the arid area of western and northwestern China. Because of its salt tolerance and drought resistance, it is of great significance in desert afforestation and sand-fixing capacity. There has been much research on the genes involved in plants under desert stresses in recent years. The application of the best internal reference genes for standardization was a critical procedure in analyzing the gene expression under different types. Even so, the reference gene has not been reported in the application of gene expression normalization of S. ferganica. In this study, nine reference genes (TUA-1726, TUA-1760, TUB, GAPDH, ACT, 50S, HSC70, APT, and U-box) in S. ferganica were adopted and analyzed under six different treatments (ABA, heat, cold, NaCl, methyl viologen (MV), and PEG). The applicability of candidate genes was evaluated by statistical software, including geNorm, NormFinder, BestKeeper, and RefFinder, based on their stability values in all the treatments. These results indicated that the simultaneous selection of two stable reference genes would fully standardize the optimization of the normalization research. To verify the feasibility of the above internal reference genes, the CT values of AP2/ERF transcription factor family genes were standardized using the most (ACT) and least (GAPDH) stable reference genes in S. ferganica seedlings under six abiotic stresses. The research showed that HSC70 and U-box were the most appropriate reference genes in ABA stressed samples, and ACT and U-box genes were the optimal references for heat-stressed samples. TUA-1726 and U-box showed the smallest value in gene expression levels of cold treatment. The internal reference groups of the best applicability for the other samples were U-box and ACT under NaCl treatment, ACT and TUA-1726 under MV stress, HSC70 and TUB under PEG treatment, and ACT in all samples. ACT and U-box showed higher stability than the other genes based on the comprehensive stability ranking of RefFinder, as determined by the geometric mean in this study. These results will contribute to later gene expression studies in other closely related species and provide an important foundation for gene expression analysis in S. ferganica.

Scalable and accessible personalized photodynamic therapy optimization with FullMonte and PDT-SPACE.

SIGNIFICANCE: Open-source software packages have been extensively used in the past three decades in medical imaging and diagnostics, aiming to study the feasibility of the application ex vivo. Unfortunately, most of the existing open-source tools require some software engineering background to install the prerequisite libraries, choose a suitable computational platform, and combine several software tools to address different applications. AIM: To facilitate the use of open-source software in medical applications, enabling computational studies of treatment outcomes prior to the complex in-vivo setting. APPROACH: FullMonteWeb, an open-source, user-friendly web-based software with a graphical user interface for interstitial photodynamic therapy (iPDT) modeling, visualization, and optimization, is introduced. The software can perform Monte Carlo simulations of light propagation in biological tissues, along with iPDT plan optimization. FullMonteWeb installs and runs the required software and libraries on Amazon Web Services (AWS), allowing scalable computing without complex set up. RESULTS: FullMonteWeb allows simulation of large and small problems on the most appropriate compute hardware, enabling cost improvements of 10 × versus always running on a single platform. Case studies in optical property estimation and diffuser placement optimization highlight FullMonteWeb's versatility. CONCLUSION: The FullMonte open source suite enables easier and more cost-effective in-silico studies for iPDT.

Characteristics and Outcomes of the Idiopathic Intracranial Hypertension Treatment in Intrinsic and Extrinsic Stenosis: A Single-Center Experience in China.

INTRODUCTION: This study aimed to explore the precipitating factors and evaluate the impact of different stenosis types on treatment outcomes in patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). METHODS: We recruited patients with IIH who presented with VSS, either intrinsic or extrinsic. We observed the clinical and laboratory findings, and we then compared the outcomes of stenting and medical treatment in different stenosis types. RESULTS: Among 145 patients with IIH and VSS, 59 were of the intrinsic type and 86 were of the extrinsic type. Patients in the intrinsic group were older (42 vs. 34 years old, P < 0.001) and presented with higher pre-op gradient pressure (15 mmHg vs. 12 mmHg, P < 0.001). There was no significant difference between groups regarding other precipitating factors (P > 0.05). Stenting was significantly associated with complete resolution of the headache and impaired vision both in intrinsic (adjusted OR 0.017, 95% CI 0.001-0.35, P = 0.011; adjusted OR 0.056, 95% CI 0.004-0.697, P = 0.025, respectively) and extrinsic types of stenosis (adjusted OR 0.072, 95% CI 0.015-0.343, P = 0.001; adjusted OR 0.241, 95% CI 0.062-0.931, P = 0.039, respectively). Meanwhile, stenting was significantly associated with improvement of the papilledema in extrinsic-type stenosis compared with medical treatment (adjusted OR 0.017, 95% CI 0.002-0.135, P < 0.001). CONCLUSION: Stenting may provide substantial clinical improvement in patients with IIH regardless of intrinsic or extrinsic stenosis type in our patient population, as noted in other series. TRIAL REGISTRATION: Clinical trial registration number ChiCTR-ONN-17010421.

Disentangling effects of multiple stressors on matter flow in a lake food web.

Understanding the relative importance of multiple stressors is valuable to prioritize conservation and restoration measures. Yet, the effects of multiple stressors on ecosystem functioning remain largely unknown in many fresh waters. Here, we provided a methodology combining ecosystem modeling with linear regression to disentangle the effects of multiple stressors on matter flow, an important ecosystem function. Treating a shallow lake as the model ecosystem, we simulated matter flow dynamics during 1950s-2010s with different combinations of stressors by Ecopath with Ecosim (EwE) modeling and determined the relative importance of each stressor by generalized linear mixed models. We found that matter flow of the lake food web was highly dynamic, attributing to effects of multiple anthropogenic stressors. Biological invasion played the strongest role in driving the matter flow dynamics, followed by eutrophication, while biomanipulation (i.e., phytoplankton control by planktivorous fish stocking) was of little importance. Eutrophication had a stronger role on primary producers, pelagic food chain, and top predators, while biological invasion on consumers in the middle of food chains. The former was more important in driving the quantity of matter flow, while the latter on trophic transfer efficiencies. Scenario forecasting showed that reducing nutrients contents could largely shape the matter flow pattern, while biomanipulation had little effect. Our findings provided new insights into understanding the mechanistic links between anthropogenic stressors and ecosystem functioning by combining ecosystem modeling with linear regression.

The F-Box Protein CG5003 Regulates Axon Pruning and the Integrity of the Drosophila Mushroom Body.

Protein homeostasis serves as an important step in regulating diverse cellular processes underlying the function and development of the nervous system. In particular, the ubiquitination proteasome system (UPS), a universal pathway mediating protein degradation, contributes to the development of numerous synaptic structures, including the Drosophila olfactory-associative learning center mushroom body (MB), thereby affecting associated function. Here, we describe the function of a newly characterized Drosophila F-box protein CG5003, an adaptor for the RING-domain type E3 ligase (SCF complex), in MB development. Lacking CG5003 ubiquitously causes MB γ axon pruning defects and selective CG5003 expression in pan-neurons leads to both γ axon and α/ß lobe abnormalities. Interestingly, change in CG5003 expression in MB neurons does not cause any abnormalities in axons, suggesting that CG5003 functions in cells extrinsic to MB to regulate its development. Mass spectrum analysis indicates that silencing CG5003 expression in all neurons affects expression levels of proteins in the cell and structural morphogenesis, transcription regulator activity, and catalytic activity. Our findings reinforce the importance of UPS and identify a new factor in regulating neuronal development as exemplified by the synaptic structure MB.

Ginsenoside Rd Ameliorates High Fat Diet-Induced Obesity by Enhancing Adaptive Thermogenesis in a cAMP-Dependent Manner.

OBJECTIVE: With the discovery of thermogenic adipocytes in humans, it has been hypothesized that enhancing adaptive thermogenesis may improve obesity. Although many studies have found that ginseng can improve obesity, the beneficial effects of ginsenoside Rd on obesity and its mechanisms have not been studied. METHODS: High-fat diet-induced obese mice were used as the study subjects, with intraperitoneal injection of Rd daily at a dose of 15 mg/kg. Body weight and energy metabolism were observed. The effects of Rd on glucose tolerance, insulin sensitivity, and cold tolerance were tested. The expression of genes associated with thermogenesis was analyzed. Finally, the mechanisms by which Rd regulates adaptive thermogenesis were studied. RESULTS: Rd ameliorated obesity and insulin resistance. Rd increased cold tolerance through enhancing thermogenic gene expression in brown adipose tissue and increased the browning of white adipose tissue induced by cold stress. Rd increased intracellular cyclic adenosine monophosphate (cAMP) content. Decreasing intracellular cAMP levels by an inhibitor of adenylyl cyclase SQ22536 abolished the promoting effects of Rd on the expression of thermogenic genes. CONCLUSIONS: Rd improves obesity and insulin resistance. The upregulation of thermogenesis by Rd is dependent on the cAMP/protein kinase A signaling pathway.

Hot melt extrusion technology for improved dissolution, solubility and "spring-parachute" processes of amorphous self-micellizing solid dispersions containing BCS II drugs indomethacin and fenofibrate: Profiles and mechanisms.

Many strategies have been employed to improve oral drug delivery. One such approach involves the use of supersaturable delivery systems such as amorphous self-micellizing solid dispersions (SmSDs). SmSDs have attracted more attention recently, but little is known regarding the impact of production methods on profiles and internal mechanisms of final SmSDs in spite of its importance. In this study, amorphous SmSDs containing self-micellizing Soluplus® and BCS II drug (either indomethacin (IND) or fenofibrate (FEN)) were generated using various methods: solvent evaporation (SOL), freeze-drying (FD), microwave radiation-quench cooling (MQC), and hot melt extrusion (HME). Microscopic morphology, amorphous state, thermal behavior, dissolution/solubility, and "spring-parachute" data were used to assemble physicochemical profiles for SmSD systems prepared using each method. Analysis of intermolecular interactions, solubilization, and crystallization inhibition further uncovered internal mechanisms explaining observed physicochemical properties. Generally, SmSD/IND and SmSD/FEN systems generated using HME exhibited superior dissolution, solubility, and spring-parachute profiles. The superior advantages of HME-generated SmSD/IND systems were attributed to relatively stronger intermolecular interactions than observed in SmSD/IND systems fabricated using other methods. Moreover, self-micellizing Soluplus® carrier was able to solubilize IND or FEN and suppress drug crystallization from a supersaturated state, which seemed to be an important mechanism for the properties enhancement caused by SmSD/FENHME. This knowledge should be useful for guiding further development of self-micellizing solid dispersions and for gaining deeper understanding of how HME technology can improve supersaturable drug delivery based on SmSDs strategy.

Untargeted metabolomics approach (UPLC-Q-TOF-MS) explores the biomarkers of serum and urine in overweight/obese young men.

BACKGROUND AND OBJECTIVES: Obesity is linked to metabolic diseases characterized by insulin resistance, such as diabetes and cardiovascular disease. In this study, we investigated the metabolic disorders of uncomplicated obesity to identify early alterations in biological systems. METHODS AND STUDY DESIGN: Metabolic differences between overweight/obese (n=36) and normal-weight (n=35) young Chinese men without known metabolic disorders were assessed. Metabolic profiling of the serum and urine was performed using ultra-performance liquidchromatography quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS). Partial least squares discriminant analysis (PLS-DA) was undertaken to reveal and classify the differences between the two groups. RESULTS: Compared to normal-weight men, obese men had higher levels of the serum metabolites phenylalanine, Phe-Phe, and L-tryptophan, whereas those of p-cresol sulfate and p-cresol were less in obesity. Urinary metabolites phenylacetamide, L-glutamine, phenylacetylglutamine, indoxyl sulfate, p-cresol, and p-cresol sulfate were greater in obese men. CONCLUSIONS: These findings indicate that disorders involving aromatic amino acids and the tricarboxylic acid cycle (TCA) have microbiomic involvement in the uncomplicated phase of obesity.

Differences in phytoaccumulation of organic pollutants in freshwater submerged and emergent plants.

Plants play an important role as sinks for or indicators of semivolatile organic pollutants, however most studies have focused on terrestrial plants and insufficient information has been obtained on aquatic plants to clarify the accumulation of organic pollutants via air-to-leaf vs. water-to-leaf pathways. The presence of p, p'-dichlorodiphenyldichloroethylene (p, p'-DDE), hexachlorobenzene (HCB), 15 polycyclic aromatic hydrocarbons (PAHs), and 9 substituted PAHs (s-PAHs), including oxy-PAHs and sulfur-PAHs, in 10 submerged and emergent plants collected from Lake Dianchi was analyzed in this study. Relatively low concentrations of p, p'-DDE (ND to 2.22 ng/g wet weight [ww]) and HCB (0.24-0.84 ng/g ww) and high levels of PAHs (46-244 ng/g ww) and s-PAHs (6.0-46.8 ng/g ww) were observed in the aquatic plants. Significantly higher concentrations of most of the compounds were detected in the leaves of the submerged plants than in those of the emergent plants. The percentages of concentration difference relative to the concentrations in the submerged plants were estimated at 55%, 40%, 10%-69% and 0.5%-79% for p, p'-DDE, HCB, PAHs, and s-PAHs, respectively. The percentages were found to increase significantly with an increase in log Kow, suggesting that the high level of phytoaccumulation of pollutants in aquatic plants is due to hydrophobicity-dependent diffusion via the water-to-leaf pathway and the mesophyll morphology of submerged plants.