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Circadian rhythms are essential regulators of a multitude of physiological and behavioral processes, such as the metabolism and function of the liver. Circadian rhythms are crucial to liver homeostasis, as the liver is a key metabolic organ accountable for the systemic equilibrium of the body. Circadian rhythm disruption alone is sufficient to cause liver cancer through the maintenance of hepatic metabolic disorder. Although there is evidence linking CRD to hepatocarcinogenesis, the precise cellular and molecular mechanisms that underlie the circadian crosstalk that leads to hepatocellular carcinoma remain unknown. The expression of CRD-related genes in HCC was investigated in this study via bulk RNA transcriptomic analysis and single-cell sequencing. Dysregulated CRD-related genes are predominantly found in hepatocytes and fibroblasts, according to the findings. By using a combination of single-cell RNA sequencing and bulk RNA sequencing analyses, the dysregulated CRD-related genes ADAMTS13, BIRC5, IGFBP3, MARCO, MT2A, NNMT, and PGLYRP2 were identified. The survival analysis using the Kaplan-Meier method revealed a significant correlation between the expression levels of BIRC5 and IGFBP3 and the survival of patients diagnosed with HCC.
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Carcinoma Hepatocelular , Ritmo Circadiano , Regulación Neoplásica de la Expresión Génica , Neoplasias Hepáticas , Análisis de Secuencia de ARN , Análisis de la Célula Individual , Survivin , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/metabolismo , Humanos , Ritmo Circadiano/genética , Survivin/genética , Survivin/metabolismo , Perfilación de la Expresión Génica , Transcriptoma , Proteína 3 de Unión a Factor de Crecimiento Similar a la InsulinaRESUMEN
Hepatocellular carcinoma (HCC) is associated with high rates of metastasis and recurrence, and is one of the most common causes of cancer-associated death worldwide. This study examined the protein changes within circulating exosomes in patients with HCC against those in healthy people using isobaric tags for a relative or absolute quantitation (iTRAQ)-based quantitative proteomics analysis. The protein levels of von Willebrand factor (VWF), cathelicidin antimicrobial peptide (CAMP), and proteasome subunit beta type-2 (PSMB2) were altered in HCC. The increased levels of VWF and PSMB2 but decreased CAMP levels in the serum of patients with HCC were validated by enzyme-linked immunosorbent assays. The level of CAMP (the only cathelicidin found in humans) also decreased in the circulating exosomes and buffy coat of the HCC patients. The serum with reduced levels of CAMP protein in the HCC patients increased the cell proliferation of Huh-7 cells; this effect was reduced following the addition of CAMP protein. The depletion of CAMP proteins in the serum of healthy people enhances the cell proliferation of Huh-7 cells. In addition, supplementation with synthetic CAMP reduces cell proliferation in a dose-dependent manner and significantly delays G1-S transition in Huh-7 cells. This implies that CAMP may act as a tumor suppressor in HCC.
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Carcinoma Hepatocelular , Catelicidinas , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/metabolismo , Catelicidinas/metabolismo , Línea Celular Tumoral , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Neoplasias Hepáticas/metabolismo , Factor de von Willebrand/metabolismoRESUMEN
Combined mutagenesis is widely applied for the breeding of robust Yarrowia lipolytica used in the production of erythritol. However, the changes of genome after mutagenesis remains unclear. This study aimed to unravel the mechanism involved in the improved erythritol synthesis of CA20 and the evolutionary relationship between different Y. lipolytica by comparative genomics analysis. The results showed that the genome size of Y. lipolytica CA20 was 20,420,510 bp, with a GC content of 48.97%. There were 6330 CDS and 649 ncRNA (non-coding RNA) in CA20 genome. Average nucleotide identity (ANI) analysis showed that CA20 genome possessed high similarity (ANI > 99.50%) with other Y. lipolytica strains, while phylogenetic analysis displayed that CA20 was classified together with Y. lipolytica IBT 446 and Y. lipolytica H222. CA20 shared 5342 core orthologous genes with the 8 strains while harbored 65 specific genes that mainly participated in the substrate and protein transport processes. CA20 contained 166 genes coding for carbohydrate-active enzymes (CAZymes), which was more than that found in other strains (108ï¼137). Notably, 4, 2, and 13 different enzymes belonging to glycoside hydrolases (GHs), glycosyltransferases (GTs), and carbohydrate esterases (CEs), respectively, were only found in CA20. The enzymes involved in the metabolic pathway of erythritol were highly conserved in Y. lipolytica, except for transaldolase (TAL1). In addition, the titer and productivity of erythritol by CA20 were 190.97 g/L and 1.33 g/L/h, respectively, which were significantly higher than that of WT5 wherein 128.61 g/L and 0.92 g/L/h were obtained (P< 0.001). Five frameshift mutation genes and 15 genes harboring nonsynonymous mutation were found in CA20 compared with that of WT5. Most of these genes were involved in the cell division, cell wall synthesis, protein synthesis, and protein homeostasis maintenance. These findings suggested that the genome of Y. lipolytica is conserved during evolution, and the variance of living environment is one important factor leading to genome divergence. The varied number of CAZymes existed in Y. lipolytica is one factor that contributes to the performance difference. The increased synthesis of erythritol by Y. lipolytica CA20 is correlated with the improvement of the stability of cell structure and internal environment. The results of this study provide a basis for the directional breeding of robust strains used in erythritol production.
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Yarrowia , Yarrowia/genética , Yarrowia/metabolismo , Eritritol/metabolismo , Filogenia , Glicerol/metabolismo , Fitomejoramiento , GenómicaRESUMEN
Many applications require a photodetector (PD) with multiple functional modes. This study demonstrates a dual functional PD with a simple structure that uses a nanostructured p-Cu2O/n-Si heterojunction. This device features a self-powering characteristic for an open-circuit voltage (V oc) of 0.5 V and exhibits an external quantum efficiency (EQE) of 3780% at a reverse bias of -5 V. There is a high EQE at low reverse-bias because trapped holes cause charge to be injected from the electrode. The nanostructured p-Cu2O/n-Si heterojunction also has a high response speed (<10 ms) in the self-powered mode because there is a built-in potential within p-n junction. This study shows that a nanostructured p-Cu2O/n-Si heterojunction acts as a self-powered PD for reducing power consumption and as a photomultiplication (PM)-type PD with high internal gain.
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Exosomes secreted by adipose-derived stem cells (ADSCs) enhance angiogenesis and wound healing. However, in clinical settings, wounds may be infected by various bacteria or pathogens. We investigated whether human ADSCs stimulated with lipopolysaccharide (LPS) secrete exosomes (ADSC-LPS-exo) that augment the angiogenesis of human umbilical vein endothelial cells (HUVECs). ExoQuick-TC exosome precipitation solution was used to purify exosomes from human ADSC culture media in the presence or absence of 1 µg/mL LPS treatment for 24 h. The uptake of ADSC-LPS-exo significantly induced the activation of cAMP response element binding protein (CREB), activating protein 1 (AP-1), and nuclear factor-κB (NF-κB) signaling pathways and increased the migration of and tube formation in HUVECs. RNA interference with CREB, AP-1, or NF-κB1 significantly reduced the migration of and tube formation in HUVECs treated with ADSC-LPS-exo. An experiment with an antibody array for 25 angiogenesis-related proteins revealed that only interleukin-8 expression was significantly upregulated in HUVECs treated with ADSC-LPS-exo. In addition, proteomic analysis revealed that eukaryotic translation initiation factor 4E, amyloid beta A4 protein, integrin beta-1, and ras-related C3 botulinum toxin substrate 1 may be potential candidates involved in ADSC-LPS-exo-mediated enhanced angiogenesis.
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Movimiento Celular , Exosomas/fisiología , Células Endoteliales de la Vena Umbilical Humana/fisiología , Lipopolisacáridos/farmacología , Células Madre Mesenquimatosas/fisiología , Neovascularización Fisiológica , Proliferación Celular , Células Cultivadas , Células Endoteliales de la Vena Umbilical Humana/citología , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Humanos , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/efectos de los fármacos , Transducción de SeñalRESUMEN
Dinuclear Pt(III) complexes were commonly reported to have short-lived lowest-lying triplet states, resulting in extremely weak or no photoluminescence. To overcome this obstacle, a new series of dinuclear Pt(III) complexes, named Pt2a-Pt2c, were strategically designed and synthesized using donor (D)-acceptor (A)-type oxadiazole-thiol chelates as bridging ligands. These dinuclear Pt(III) complexes possess a d7-d7 electronic configuration and exhibit intense phosphorescence under ambient conditions. Among them, Pt2a exhibits orange phosphorescence maximized at 618 nm in degassed dichloromethane solution (Φp ≈ 8.2%, τp ≈ 0.10 µs) and near-infrared (NIR) emission at 749 nm (Φp ≈ 10.1% τp ≈ 0.66 µs) in the crystalline powder and at 704 nm (Φp ≈ 33.1%, τp ≈ 0.34 µs) in the spin-coated neat film. An emission blue-shifted by more than 3343 cm-1 is observed under mechanically ground crystalline Pt2a, affirming intermolecular interactions in the solid states. Time-dependent density functional theory (TD-DFT) discloses the lowest-lying electronic transition of Pt2a-Pt2c complexes to be a bridging ligand-metal-metal charge transfer (LMMCT) transition. The long-lived triplet states of these dinuclear platinum(III) complexes may find potential use in lighting. Employing Pt2a as an emitter, high-performance organic light-emitting diodes (OLEDs) were fabricated with NIR emission at 716 nm (η = 5.1%), red emission at 614 nm (η = 8.7%), and white-light emission (η = 11.6%) in nondoped, doped (in mCP), and hybrid (in CzACSF) devices, respectively.
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A series of novel anthranilic acid derivatives I-IV, of which COOH-NH2 (I) and COOH-NHMe (IV) are endowed with acid and base bifunctionality, were designed and synthesized for matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry applications in dual polarity molecular imaging of biological samples, particularly for lipids. The heat of protonation, deprotonation, and proton transfer reaction as well as the capability of analyzing biomolecules in both positive and negative ion modes for I-IV were systematically investigated under standard 355 nm laser excitation. The results indicate correlation between dual polarity and acid-base property. Further, COOH-NHMe (IV) showed a unique performance and was successfully applied as the matrix for MALDI-TOF mass spectrometry imaging (MSI) for studying the mouse brain. Our results demonstrate the superiority of COOH-NHMe (IV) in detecting more lipid and protein species compared to commercially available matrices. Moreover, MALDI-TOF MSI results were obtained for lipid distributions, making COOH-NHMe (IV) a potential next generation universal matrix.
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Hearing loss is the most prevalent hereditary sensory disorder in children. Approximately 2 in 1000 infants are affected by genetic hearing loss. The PJVK gene, which encodes the pejvakin protein, has been linked to autosomal recessive non-syndromic hearing loss DFNB59. Previous clinical studies have revealed that PJVK mutations might be associated with a wide spectrum of auditory manifestations, ranging from hearing loss of pure cochlear origin to that involving the retrocochlear central auditory pathway. The phenotypic variety makes the pathogenesis of this disease difficult to determine. Similarly, mouse models carrying different Pjvk defects show phenotypic variability and inconsistency. In this study, we generated a knockin mouse model carrying the c.874G > A (p.G292R) variant to model and investigate the auditory and vestibular phenotypes of DFNB59.
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Modelos Animales de Enfermedad , Pérdida Auditiva Sensorineural/genética , Proteínas/genética , Animales , Sistemas CRISPR-Cas , Técnicas de Sustitución del Gen , Células Ciliadas Auditivas/patología , Pérdida Auditiva Sensorineural/patología , Pérdida Auditiva Sensorineural/fisiopatología , Ratones Endogámicos C57BL , Ratones Transgénicos , Mutación Missense , Ganglio Espiral de la Cóclea/patología , Vestíbulo del Laberinto/fisiopatologíaRESUMEN
Solution processing of amorphous oxide semiconductors (AOS) is used for electronic and optoelectronic applications. However, the device performance is much lower than that for a device that is fabricated using vacuum processing. This study uses acetylacetone (acac) as an additive in the precursor solution to reduce the nanocluster size in a ZnSnO (ZTO) film. A metal-semiconductor-metal (MSM)-type UV photodetector (PD) is fabricated using as-prepared ZTO film. ZTO film that features a smaller nanocluster size, so more oxygen vacancies are induced, which produces more electrons and the photocurrent is increased. The surface at the metal/semiconductor interface is smoother so there is greater contact with fewer interface states and the dark current is decreased. An extremely high photo-to-dark current ratio (PDCR) of 1314 is achieved for a solution-processed ZTO MSM-type PD.
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With the aim of generalizing the structure-properties relationship of bending heterocyclic molecules that undergo prominent photoinduced structural planarization (PISP), a series of new dihydrodibenzo[ac]phenazine derivatives in which one nitrogen atom is replaced by oxygen (PNO), sulfur (PNS), selenium (PNSe), or dimethylmethanediyl (PNC) was strategically designed and synthesized. Compounds PNO, PNS, and PNSe have significantly nonplanar geometries in the ground state, which undergo PISP to give a planarlike conformer and hence a large emission Stokes shift. A combination of femtosecond early relaxation dynamics and computational approaches established an R*âI* (intermediate)âP* sequential kinetic pattern for PNS and PNSe, whereas PNO undergoes R*âP* one-step kinetics. The polarization ability of the substituted heteroatoms, which is in the order O
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Phenothiazine derivatives based on the 10-phenyl-10H-phenothiazine (NAS) chromophore, namely 7-phenyl-7H-benzo[c]phenothiazine (NAS-1) and 12-phenyl-12H-benzo[a]phenothiazine (NAS-2), were designed and synthesized. NAS-1 and NAS-2 are constitutional isomers with different steric strains imposed on the phenothiazine core moiety. In solution, the more-strained NAS-2 possesses a bent structure and undergoes photoinduced structural planarization (PISP). In the crystal, despite the absence of PISP, bent NAS-2 exhibits prominent excimer emission as well as emission mechanochromism, which is not observed in the planar-like NAS and NAS-1. This unconventional observation results from the bent core structure facilitating π-π stacking of the peripheral naphthalene moieties. Two-photon-coupled depth-dependent emission shows spectral differences between the surface and kernel of the NAS-2 crystal, and is believed to be a general phenomenon, at least in part, for materials exhibiting emission mechanochromism.
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This study demonstrates dual functional hybrid heterojunction photodiodes (PDs) that comprise an amorphous indium gallium zinc oxide (a-IGZO) thin film blended with graphene nanoflakes and a SiO2 (5 nm)/Si substrate. The PDs exhibit a photo-responsivity of approximately 0.15-0.27 A W-1 under 633 nm illumination, which is much higher than that for a-IGZO based phototransistor in the visible region. The device also gives a long-lasting persistent photocurrent (PPC) when the UV light is extinguished. This results show that the hybrid heterojunction acts as a high performance photodetector for the detection of visible light and provides a universal scenario for development of PPC.
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ZnO-based heterojunctions have found applications as self-powered ultraviolet photodetectors (PDs). However, high doping levels are not compatible with high mobility for metallic doped ZnO-based PDs so further development has been inhibited. This study demonstrates a method to increase the open-circuit voltage (V oc) that allows keeping a sufficiently high level of mobility of ZnO, using a ZnO nanorod/GaN heterojunction that incorporates graphene nanosheets as the active layer. These hybrid PDs have triple the value for V oc of PDs that have only pure ZnO and better exhibit photo-response characteristics. The results of surface Kelvin probe microscopy and x-ray photoelectron spectrometer show that the complex defects that occur because Zn interstitials form a shallow donor in ZnO are mainly responsible for the increase in the value of V oc. Using this functional nanostructure as an active layer represents a new method for the manufacture of high-performance self-powered PDs.
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Recently, all-inorganic perovskites such as CsPbBr3 and CsPbI3, have emerged as promising materials for light-emitting applications. While encouraging performance has been demonstrated, the stability issue of the red-emitting CsPbI3 is still a major concern due to its small tolerance factor. Here we report a highly stable CsPbI3 quantum dot (QD) light-emitting diode (LED) with red emission fabricated using an improved purification approach. The device achieved decent external quantum efficiency (EQE) of 0.21% at a bias of 6 V and outstanding operational stability, with a L 70 lifetime (EL intensity decreases to 70% of starting value) of 16 h and 1.5 h under a constant driving voltage of 5 V and 6 V (maximum EQE operation) respectively. Furthermore, the device can work under a higher voltage of 7 V (maximum luminance operation) and retain 50% of its initial EL intensity after 500 s. These findings demonstrate the promise of CsPbI3 QDs for stable red LEDs, and suggest the feasibility for electrically pumped perovskite lasers with further device optimizations.
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Medicamentos Herbarios Chinos , Farmacias , Farmacia , Humanos , Medicina Tradicional China , TaiwánRESUMEN
BACKGROUND: Polyunsaturated fatty acids (PUFAs) are nutrients necessary for life. The liver is the essential metabolic center, which aids in maintaining health via diverse biological actions. In the present work, a proteomics study was conducted with an aim to provide new insights into PUFA-regulated hepatic protein expression in apoE-knockout mice. Additionally, we investigated how n-3 PUFAs influence cytokine-challenge by using HepG2 cells as a model. RESULTS: Through the proteomic analysis using 2-dimensional electrophoresis and mass spectrometry, we found that 28, 23, 14, and 28 hepatic proteins were up-regulated at least a two-fold difference in intensity compared with the control group in mice treated with the docosahexaenoic acid, eicosapentaenoic acid, arachidonic acid, and linoleic acid, respectively. In contrast, 12 hepatic proteins were down-regulated with a ratio value of less than 0.5 compared to their control counterparts by these four fatty acids. All of the altered proteins were then sorted according to their biochemical properties related to metabolism, redox stress/inflammation, enzymatic reactions, and miscellaneous functions. The results provide evidence that PUFAs may act as either pro-inflammatory or anti-inflammatory agents. Cytokine-challenged HepG2 cells were used to reveal the anti-inflammatory function of n-3 PUFAs. The results showed that interleukin (IL)-1ß combined with IL-6 induced C-reactive protein (CRP) mRNA expression and its protein secretion by HepG2 cells. The CRP promoter activity was significantly increased in the IL-6-treated cells, whereas IL-1ß alone had no effect. However, IL-1ß and IL-6 acted synergistically to further enhance CRP promoter activities. Furthermore, n-3 PUFAs inhibited nuclear factor-κB (NF-κB) activation and the phosphorylation of the nuclear signal transducer and activator of transcription 3 (STAT3) during cytokine-induced CRP production. CONCLUSION: This study indicates that PUFAs induced changes in the hepatic protein profile in vivo. Furthermore, n-3 PUFAs exert their anti-inflammatory properties through differential molecular mechanisms in hepatic cells. These results provide novel information regarding the roles of PUFAs in the liver at the tissue and cellular levels.
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Ácidos Grasos Insaturados/metabolismo , Regulación de la Expresión Génica , Hígado/metabolismo , Transducción de Señal , Animales , Proteína C-Reactiva/metabolismo , Células Hep G2 , Humanos , Masculino , Ratones , Ratones Noqueados , ARN Mensajero/metabolismoRESUMEN
In this work p-ZnO/n-GaN heterojunction diodes were directly formed on the Si substrate by a combination of cost-effective solgel spin-coating and thermal annealing treatment. Spin-coated n-ZnO films on InN/GaN/Si wafers were converted to p-type polarity after thermal treatment of proper annealing durations. X-ray diffraction (XRD) analysis reveals that InN-codoped ZnO films have grown as the standard hexagonal wurtzite structure with a preferential orientation in the (002) direction. The intensity of the (002) peak decreases for a further extended annealing duration, indicating the greater incorporation of dopants, also confirmed by x-ray photoelectron spectroscopy and low-temperature photoluminescence. Hall and resistivity measurements validate that our p-type ZnO film has a high carrier concentration of 3.73×10¹7 cm⻳, a high mobility of 210 cm²/Vs, and a low resistivity of 0.079 Ωcm. As a result, the proposed p-ZnO/n-GaN heterojunction diode displays a well-behaving current rectification of a typical p-n junction, and the measured current versus voltage (I-V) characteristic is hence well described by the modified Shockley equation. The research on the fabrication of p-ZnO/n-GaN heterojunctions shown here generates useful advances in the production of cost-effective ZnO-based optoelectronic devices.
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Galio/química , Indio/química , Semiconductores , Óxido de Zinc/química , Análisis Costo-Beneficio , Estudios de Factibilidad , Semiconductores/economía , TemperaturaRESUMEN
In this work, local nanotip arrays on GaN-based light-emitting (LED) structures were fabricated through nano-oxidation using an atomic force microscope (AFM). The photoluminescence (PL) intensity of the InGaN/GaN multiple quantum wells (MQWs) active layer and the light extraction efficiency of the LED structure were enhanced by forming this nanotips structure to serve as a graded-refractive index layer, which is further validated by the finite-difference time-domain analysis. The PL emission peak of the MQWs active layer has a blue-shift phenomenon that is caused by a partial reduction of the strain on the InGaN well. It is expected that our approach opens a promising route for simultaneously enhancing both the internal quantum efficiency and the light extraction efficiency of GaN-based LEDs. The proposed AFM-based method will be of importance for local patterning the light emitting components for optoelectronic applications.
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BACKGROUND: Traumatic femoral fractures, often resulting from high-energy impacts such as traffic accidents, necessitate immediate management to avoid severe complications. The Stress Index (SI), defined as the glucose-to-potassium ratio, serves as a predictor of mortality and adverse outcomes in various trauma contexts. This study aims to evaluate the prognostic value of the SI in patients with traumatic femoral fractures. METHODS: This retrospective cohort study included adult trauma patients aged 20 or above with traumatic femoral fractures from the Trauma Registry System at a level 1 trauma center in southern Taiwan between 1 January 2009 and 31 December 2022. At the emergency room, serum electrolyte levels were assessed using baseline laboratory testing. By dividing blood glucose (mg/dL) by potassium (mEq/L), the SI was calculated. The best cut-off value of the SI for predicting mortality was determined using the Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC). RESULTS: A total of 3717 patients made up the final group, of which 3653 survived and 64 died. In comparison to survivors, deceased patients had substantially higher blood glucose levels (199.3 vs. 159.0 mg/dL, p < 0.001) and SIs (53.1 vs. 41.6, p < 0.001). The optimal SI cut-off value for predicting mortality was 49.7, with a sensitivity of 53.1% and a specificity of 78.7% (AUC = 0.609). High SI was associated with increased mortality (4.2% vs. 1.0%, p < 0.001) and longer hospital stays (12.8 vs. 9.5 days, p < 0.001). The adjusted odds ratios of mortality, controlled by comorbidities, the Glasgow Coma Scale, and the Injury Severity Score, were significantly higher in patients with a higher SI (AOR 2.05, p = 0.016) than those with a lower SI. CONCLUSIONS: Elevated SI upon admission correlates with higher mortality and extended hospital stay in patients with traumatic femoral fractures. Although the SI has a moderate predictive value, it remains a useful early risk assessment tool, necessitating further prospective, multi-center studies for validation and standardization.
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BACKGROUND: The Stress Index (SI), calculated as the ratio of blood glucose to serum potassium levels, is a promising prognostic marker in various acute care settings. This study aimed to evaluate the utility of the SI for predicting mortality in patients with isolated moderate-to-severe traumatic brain injury (TBI). METHODS: This retrospective cohort study included adult trauma patients (aged ≥ 20 years) with isolated moderate to severe TBI (Abbreviated Injury Scale ≥ 3 for only head region) treated from 2009-2022. The SI was computed from the initial glucose and potassium levels upon arrival at the emergency department. Logistic regression models were used to assess the association between the SI and mortality after adjusting for relevant covariates. The most effective threshold value of the SI for predicting mortality was identified using receiver operating characteristic (ROC) analysis. RESULTS: Among the 4357 patients with isolated moderate and severe TBI, 463 (10.6%) died. Deceased patients had a significantly higher SI (61.7 vs. 44.1, p < 0.001). In multivariate analysis, higher SI independently predicted greater mortality risk (odds ratio (OR) 6.70, 95% confidence interval (CI) 1.66-26.99, p = 0.007). The optimal SI cutoff for predicting mortality was 48.50 (sensitivity 62.0%, specificity 71.4%, area under the curve 0.724). Patients with SI ≥ 48.5 had nearly two-fold higher adjusted mortality odds compared to those below the threshold (adjusted OR 1.94, 95% CI 1.51-2.50, p < 0.001). CONCLUSIONS: SI is a useful predictor of mortality in patients with isolated moderate-to-severe TBI. Incorporating SI with standard clinical assessments could enhance risk stratification and management approaches for this patient population.