Understanding the molecular crossroads in acute liver failure: A pathway to new therapies.

In this editorial we comment on the article published in a recent issue of the World Journal of Gastroenterology. Acute liver failure (ALF) is a critical condition characterized by rapid hepatocellular injury and organ dysfunction, and it often necessitates liver transplant to ensure patient survival. Recent research has elucidated the involvement of distinct cell death pathways, namely ferroptosis and pyroptosis, in the pathogenesis of ALF. Ferroptosis is driven by iron-dependent lipid peroxidation, whereas pyroptosis is an inflammatory form of cell death; both pathways contribute to hepatocyte death and exacerbate tissue damage. This comprehensive review explores the interplay between ferroptosis and pyroptosis in ALF, highlighting the role of key regulators such as silent information regulator sirtuin 1. Insights from clinical and preclinical studies provide valuable perspectives on the dysregulation of cell death pathways in ALF and the therapeutic potential of targeting these pathways. Collaboration across multiple disciplines is essential for translating the experimental insights into effective treatments for this life-threatening condition.

Sex differences in clinical characteristics and long-term clinical outcomes in Asian hospitalized heart failure patients.

AIMS: Sex differences in long-term post-discharge clinical outcomes in Asian patients hospitalized for acute decompensated heart failure (HF) persist despite the world-wide implementation of guideline-directed medical therapy for decades. The present study aims to elucidate the puzzling dilemma and to depict the directions of solution. METHODS AND RESULTS: Between 2011 and 2020, a total of 12 428 patients (6518 men and 5910 women, mean age 73.50 ± 14.85) hospitalized for acute decompensated HF were retrospectively enrolled from a university HF cohort. Compared with men, women hospitalized for acute decompensated HF were older in age (76.40 ± 13.43 vs. 71.20 ± 15.67 years old, P < 0.0001) with more coexisting hypertension, diabetes, hyperlipidaemia and moderate to severe chronic kidney disease, but less with ischaemic heart disease, cerebrovascular disease and chronic obstructive pulmonary disease (P < 0.0001). In echocardiography measurement parameters, women had smaller left ventricular and left atrial dimensions, higher left ventricular mass index, higher left ventricular ejection fraction (LVEF) and more in HF with preserved ejection fraction (EF) category (LVEF > 50%) than men (P < 0.0001). In HF therapy, women compared with men received more guideline-directed medical HF therapies including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor-neprilysin inhibitors and sodium-glucose cotransporter-2 inhibitors, but similar beta-blockers and mineralocorticoid receptor antagonists (P < 0.0001). Post-discharge long-term clinical outcomes after multivariate-adjusted analysis revealed that women compared with men had lower all-cause mortality [adjusted hazard ratio (aHR): 0.89, 95% confidence interval (CI): 0.84-0.93], lower cardiovascular mortality (aHR: 0.89, 95% CI: 0.80-0.99) and lower 1 year mortality (aHR: 0.91, 95% CI: 0.84-0.99) but similar HF rehospitalization rate (aHR: 1.02, 95% CI: 0.95-1.09) over 8 years of follow-up. The superiority of women over men in all-cause mortality was shown in HF with preserved EF (>50%) and HF with mildly reduced EF (40%-50%), but not in HF with reduced EF (<40%) category. Subgroup forest plot analysis showed body mass index, coexisting hypertension and chronic obstructive pulmonary disease as significant interacting factors. CONCLUSIONS: With more coronary risk factors and medical comorbidities, less cardiac remodelling and better adherence to guideline-directed HF therapy, women hospitalized for acute decompensated HF demonstrated superiority over men in long-term post-discharge clinical outcomes, including all-cause mortality, cardiovascular mortality and 1 year mortality, and mainly in HF with preserved and mid-range EF categories, in the Asian HF cohort.

Emergence of non-trivial solutions from trivial solutions in reaction-diffusion equations for pattern formation.

Reaction-diffusion equations serve as fundamental tools in describing pattern formation in biology. In these models, nonuniform steady states often represent stationary spatial patterns. Notably, these steady states are not unique, and unveiling them mathematically presents challenges. In this paper, we introduce a framework based on bifurcation theory to address pattern formation problems, specifically examining whether nonuniform steady states can bifurcate from trivial ones. Furthermore, we employ linear stability analysis to investigate the stability of the trivial steady-state solutions. We apply the method to two classic reaction-diffusion models: the Schnakenberg model and the Gray-Scott model. For both models, our approach effectively reveals many nonuniform steady states and assesses the stability of the trivial solution. Numerical computations are also presented to validate the solution structures for these models.

The Association between Cafestol and Cardiovascular Diseases: A Comprehensive Review.

Cafestol, a bioactive compound found in coffee, has attracted considerable attention due to its potential impact on cardiovascular health. This review aims to comprehensively explore the association between cafestol and cardiovascular diseases. We delve into the mechanisms through which cafestol influences lipid metabolism, inflammation, and endothelial function, all of which are pivotal in cardiovascular pathophysiology. Moreover, we meticulously analyze epidemiological studies and clinical trials to elucidate the relationship between cafestol and cardiovascular outcomes. Through a critical examination of existing literature, we aim to provide insights into the potential benefits and risks associated with cafestol concerning cardiovascular health.

Preparation of PEG/P(U-AM-ChCl) composite hydrogels using ternary DES light polymerization and their properties.

Deep eutectic solvents (DES) were prepared using urea (U) and acrylamide (AM) as hydrogen bond donors (HBD) and choline chloride (ChCl) as hydrogen bond acceptor (HBA), and polyethylene glycol (PEG) was selected as a filler and uniformly dispersed in DES to prepare PEG/P(U-AM-ChCl) composite hydrogels by light polymerization. The composite hydrogels were characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The effects of the content of PEG on the swelling properties, mechanical properties and fatigue resistance of the composite hydrogels were investigated. The results showed that the compressive strength and fatigue strength of the composite hydrogels were gradually enhanced with the increase of the PEG content in the composite hydrogels, in which the maximum compressive strength of the hydrogels with 1 wt% PEG added was increased by 1.86 times. The composite hydrogel had excellent swelling properties, and the equilibrium swelling degree of the hydrogel with 1 wt% PEG added reached 10.15. Meanwhile, the PEG/P(U-AM-ChCl) composite hydrogel had excellent self-healing properties, and the self-healing rate of the composite hydrogel with a PFG content of 1 wt% could reach 91.93% after 48 hours of healing. This study provides a convenient and efficient method to prepare composite hydrogels with superior swelling properties and self-healing properties.

HomPINNs: homotopy physics-informed neural networks for solving the inverse problems of nonlinear differential equations with multiple solutions.

Due to the complex behavior arising from non-uniqueness, symmetry, and bifurcations in the solution space, solving inverse problems of nonlinear differential equations (DEs) with multiple solutions is a challenging task. To address this, we propose homotopy physics-informed neural networks (HomPINNs), a novel framework that leverages homotopy continuation and neural networks (NNs) to solve inverse problems. The proposed framework begins with the use of NNs to simultaneously approximate unlabeled observations across diverse solutions while adhering to DE constraints. Through homotopy continuation, the proposed method solves the inverse problem by tracing the observations and identifying multiple solutions. The experiments involve testing the performance of the proposed method on one-dimensional DEs and applying it to solve a two-dimensional Gray-Scott simulation. Our findings demonstrate that the proposed method is scalable and adaptable, providing an effective solution for solving DEs with multiple solutions and unknown parameters. Moreover, it has significant potential for various applications in scientific computing, such as modeling complex systems and solving inverse problems in physics, chemistry, biology, etc.

The Effects of Different Types of Sleep Disorder on Colorectal Cancer: A Nationwide Population-Based Cohort Study.

The impact of sleep disorders (SDs), particularly sleep apnea (SA), on the development of colorectal cancer (CRC) has been the subject of significant research. However, the potential contribution of other SDs to the incidence of CRC remains unexplored. The objective of this study was to examine the effects of SDs on the risk of developing CRC. This study assessed CRC risk among individuals diagnosed with SDs compared with age- and sex-matched unaffected individuals. A longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database (NHIRD) encompassing 177,707 individuals diagnosed with SDs and 177,707 matched controls. Cox proportional hazard regression analysis was used to determine the relative increased risk of CRC in individuals with SDs and specific subgroups of SDs. The CRC incidences were 1.32-fold higher (95% CI 1.23-1.42) in the overall SD cohort, 1.17-fold higher (95% CI 0.82-1.68) in the SA cohort, 1.42-fold higher (95% CI 1.31-1.55) in the insomnia cohort, 1.27-fold higher (95% CI 1.17-1.38) in the sleep disturbance cohort, and 1.00-fold higher (95% CI 0.77-1.29) in the other SD cohort, after adjusting for age, sex, and comorbidities.

Effect of Annual Influenza Vaccination on the Risk of Lung Cancer Among Patients With Hypertension: A Population-Based Cohort Study in Taiwan.

Objectives: Lung cancer is a main contributor to all newly diagnosed cancers worldwide. The chemoprotective effect of the influenza vaccine among patients with hypertension remains unclear. Methods: A total of 37,022 patients with hypertension were retrospectively enrolled from the Taiwan National Health Insurance Research Database. These patients were further divided into a vaccinated group (n = 15,697) and an unvaccinated group (n = 21,325). Results: After adjusting for sex, age, comorbidities, medications, level of urbanization and monthly income, vaccinated patients had a significantly lower risk of lung cancer occurrence than unvaccinated patients (adjusted hazard ratio [aHR]: 0.56, 95% confidence interval [CI]: 0.47-0.67). A potential protective effect was observed for both sexes and in the elderly age group. With a greater total number of vaccinations, a potentially greater protective effect was observed (aHR: 0.75, 95% CI 0.60-0.95; aHR: 0.66, 95% CI: 0.53-0.82; aHR: 0.26, 95% CI: 0.19-0.36, after receiving 1, 2-3 and ≥4 vaccinations, respectively). Conclusion: Influenza vaccination was associated with a lower risk of lung cancer among patients with hypertension. The potentially chemoprotective effect appeared to be dose dependent.

Preparation and characterization of PA/P(AA-co-AM) composite hydrogels via photopolymerization.

The present study synthesized a deep eutectic solvent (DES) using acrylic acid (AA), acrylamide (AM), and choline chloride (ChCl), and added phytic acid (PA) as a filler. Subsequently, the PA/P(AA-co-AM) composite hydrogel was prepared under ultraviolet irradiation and used a photoinitiator. Characterization of the hydrogels was conducted using Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The study aimed to investigate the impact of PA on the mechanical properties, fatigue resistance, and electrical conductivity of the composite hydrogel. The findings demonstrated that as the mass fraction of PA increased, the compressive strength of the composite hydrogel gradually decreased, yet the fatigue resistance of the composite hydrogel increased. Specifically, after 10 cycles of compression, the resilience recovery rate of FP0 dropped from 86.9% to 70.4%, the maximum stress recovery rate of FP1 dropped from 97.9% to 89.4%, the maximum stress recovery rate of FP2 dropped from 94.4% to 86.6%, and the maximum stress recovery rate of FP3 dropped from 97.3% to 93%. Overall, this study offers a straightforward and efficient method for producing composite hydrogels with both fatigue resistance and electrical conductivity.

The Association between Statins and Liver Cancer Risk in Patients with Heart Failure: A Nationwide Population-Based Cohort Study.

Heart failure (HF) and cancer have similar risk factors. HMG-CoA reductase inhibitors, also known as statins, are chemoprotective agents against carcinogenesis. We aimed to evaluate the chemoprotective effects of statins against liver cancer in patients with HF. This cohort study enrolled patients with HF aged ≥20 years between 1 January 2001 and 31 December 2012 from the National Health Insurance Research Database in Taiwan. Each patient was followed to assess liver cancer risk. A total of 25,853 patients with HF were followed for a 12-year period; 7364 patients used statins and 18,489 did not. The liver cancer risk decreased in statin users versus non-users (adjusted hazard ratio (aHR) = 0.26, 95% confidence interval (CI): 0.20-0.33) in the entire cohort in the multivariate regression analysis. In addition, both lipophilic and hydrophilic statins reduced the liver cancer risk in patients with HF (aHR 0.34, 95% CI: 0.26-0.44 and aHR 0.42, 95% CI: 0.28-0.54, respectively). In the sensitivity analysis, statin users in all dose-stratified subgroups had a reduced liver cancer risk regardless of age, sex, comorbidity, or other concomitant drug use. In conclusion, statins may decrease liver cancer risk in patients with HF.

The Association between Influenza Vaccine and Risk of Chronic Kidney Disease/Dialysis in Patients with Hypertension.

BACKGROUNDS: Influenza vaccination could decrease the risk of major cardiac events in patients with hypertension. However, the vaccine's effects on decreasing the risk of chronic kidney disease (CKD) development in such patients remain unclear. METHODS: We retrospectively analysed the data of 37,117 patients with hypertension (≥55 years old) from the National Health Insurance Research Database during 1 January 2001 to 31 December 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated (n = 15,961) and unvaccinated groups (n = 21,156). RESULTS: In vaccinated group, significantly higher prevalence of comorbidities such as diabetes, cerebrovascular disease, dyslipidemia, heart and liver disease were observed compared with unvaccinated group. After adjusting age, sex, comorbidities, medications (anti-hypertensive agents, metformin, aspirin and statin), level of urbanization and monthly incomes, significantly lower risk of CKD occurrence was observed among vaccinated patients in influenza season, non-influenza season and all season (Adjusted hazard ratio [aHR]: 0.39, 95% confidence level [C.I.]: 0.33-0.46; 0.38, 95% C.I.: 0.31-0.45; 0.38, 95% C.I.: 0.34-0.44, respectively). The risk of hemodialysis significantly decreased after vaccination (aHR: 0.40, 95% C.I.: 0.30-0.53; 0.42, 95% C.I.: 0.31-0.57; 0.41, 95% C.I.: 0.33-0.51, during influenza season, non-influenza season and all season). In sensitivity analysis, patients with different sex, elder and non-elder age, with or without comorbidities and with or without medications had significant decreased risk of CKD occurrence and underwent hemodialysis after vaccination. Moreover, the potential protective effect appeared to be dose-dependent. CONCLUSIONS: Influenza vaccination decreases the risk of CKD among patients with hypertension and also decrease the risk of receiving renal replacement therapy. Its potential protective effects are dose-dependent and persist during both influenza and noninfluenza seasons.

Protective Effects of Influenza Vaccine against Colorectal Cancer in Populations with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study.

Chronic kidney disease (CKD) is associated with malignancy, including colorectal cancer, via the potential mechanism of chronic inflammation status. This study aimed to determine whether influenza vaccines can reduce the risk of colorectal cancer in patients with CKD. Our cohort study enrolled 12,985 patients older than 55 years with a diagnosis of CKD in Taiwan from the National Health Insurance Research Database at any time from 1 January 2001 to 31 December 2012. Patients enrolled in the study were divided into a vaccinated and an unvaccinated group. In this study, 7490 and 5495 patients were unvaccinated and vaccinated, respectively. A propensity score was utilized to reduce bias and adjust the results. Cox proportional hazards regression was used to estimate the correlation between the influenza vaccine and colorectal cancer in patients with CKD. The results showed that the influenza vaccine exerted a protective effect against colorectal cancer in populations with CKD. The incidence rate of colon cancer in the vaccinated group was significantly lower than in the unvaccinated group, with an adjusted hazard rate (HR) of 0.38 (95% CI: 0.30-0.48, p < 0.05). After the propensity score was adjusted for Charlson comorbidity index, age, sex, dyslipidemia, hypertension, diabetes, monthly income, and level of urbanization, the dose-dependent effect was found, and it revealed adjusted HRs of 0.74 (95% CI: 0.54-1.00, p < 0.05), 0.41 (95% CI: 0.30-0.57, p < 0.001), 0.16 (95% CI: 0.11-0.25, p < 0.001) for one, two to three, and four or more vaccinations, respectively. In summary, the influenza vaccine was found to be associated with a reduced risk of colorectal cancer in CKD patients. This study highlights the potential chemopreventive effect of influenza vaccination among patients with CKD. Future studies are required to determine whether the aforementioned relationship is a causal one.

Investigating the spatial interaction of immune cells in colon cancer.

The intricate network of interactions between cells and molecules in the tumor microenvironment creates a heterogeneous ecosystem. The proximity of the cells and molecules to their activators and inhibitors is essential in the progression of tumors. Here, we develop a system of partial differential equations coupled with linear elasticity to investigate the effects of spatial interactions on the tumor microenvironment. We observe interesting cell and cytokine distribution patterns, which are heavily affected by macrophages. We also see that cytotoxic T cells get recruited and suppressed at the site of macrophages. Moreover, we observe that anti-tumor macrophages reorganize the patterns in favor of a more spatially restricted cancer and necrotic core. Furthermore, the adjoint-based sensitivity analysis indicates that the most sensitive model's parameters are directly related to macrophages. The results emphasize the widely acknowledged effect of macrophages in controlling cancer cells population and spatially arranging cells in the tumor microenvironment.

Preparation of SA/P(U-AM-ChCl) composite hydrogels by frontal polymerization and its performance study.

Deep eutectic solvent (DES) was synthesized from urea (U), acrylamide (AM) and choline chloride (ChCl), sodium alginate (SA) was selected as filler, and SA/P(U-AM-ChCl) composite hydrogel was prepared by thermal initiation frontal polymerization (FP). The hydrogels were characterised by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The effects of SA on the swelling properties, mechanical properties and self-healing properties of the composite hydrogels were investigated. The results show that the swelling properties of the composite hydrogel with the addition of SA are greatly enhanced due to the large number of hydroxyl groups contained in the SA chain. The tensile strength of the hydrogel gradually increased with increasing SA content, with the maximum tensile strength increasing by a factor of 2.89. The self-healing efficiency of the composite hydrogel gradually increased with the increase of SA, and the healing rate of FP5 reached 94.4% after 48 h of healing. This study provides a simple and rapid method for the preparation of composite hydrogels with good mechanical properties and self-healing properties.

Preparation of novel ß-CD/P(AA-co-AM) hydrogels by frontal polymerization.

In this paper, betaine (Bet) was used as a hydrogen bond acceptor (HBA), and acrylic acid (AA) and acrylamide (AM) were used as hydrogen bond donors (HBD) and mixed to form a deep eutectic solvent (DES). Different concentrations of ß-cyclodextrin (ß-CD) were dispersed in the DES, and a novel ß-CD/P(AA-co-AM) hydrogel was prepared by frontal polymerization (FP). The characteristic structure and morphology of the hydrogels were analyzed using Fourier transform infrared (FTIR) spectroscopy and scanning electron microscopy (SEM), and the properties of the hydrogels were investigated. The results show that the mechanical properties of the hydrogel were improved by ß-CD acting as a second cross-linking agent in the polymerization process, thus increasing the cross-link density of the hydrogel. Because the carboxyl groups contained in the acrylic acid dissociate under alkaline conditions, the composite hydrogel shows excellent pH responsiveness under alkaline conditions. Tetracycline hydrochloride was used as a drug model to test the drug loading and drug release performance of the hydrogels. With the increase of ß-CD content, the loading capacity of the hydrogels for tetracycline hydrochloride gradually increased. The data of drug release indicated that the hydrogel has good drug delivery performance and has promising applications in drug delivery systems and other areas.

Bifurcation analysis of a free boundary model of vascular tumor growth with a necrotic core and chemotaxis.

A considerable number of research works has been devoted to the study of tumor models. Several biophysical factors, such as cell proliferation, apoptosis, chemotaxis, angiogenesis and necrosis, have been discovered to have an impact on the complicated biological system of tumors. An indicator of the aggressiveness of tumor development is the instability of the shape of the tumor boundary. Complex patterns of tumor morphology have been explored in Lu et al. (J Comput Phys 459:111153, 2022). In this paper, we continue to carry out a bifurcation analysis on such a vascular tumor model with a controlled necrotic core and chemotaxis. This bifurcation analysis, to the parameter of cell proliferation, is built on the explicit formulas of radially symmetric steady-state solutions. By perturbing the tumor free boundary and establishing rigorous estimates of the free boundary system, we prove the existence of the bifurcation branches with Crandall-Rabinowitz theorem. The parameter of chemotaxis is found to influence the monotonicity of the bifurcation point as the mode l increases both theoretically and numerically.

The phase 1/2 trial of indomethacin in chronic pancreatitis (The PAIR trial): Protocol for a parallel multi-center randomized controlled trial.

BACKGROUND/OBJECTIVES: Current treatments for chronic pancreatitis focus on symptom management and therapeutics targeting disease reversal are lacking. Given the role of the cyclooxygenase-2 (COX-2) enzyme in producing prostaglandin E2 (PGE2), a key component in the inflammatory pathway of chronic pancreatitis, this study evaluates the physiologic effect of oral indomethacin, a COX-2 inhibitor, on PGE2 levels in pancreatic fluid. METHODS: This pilot two-center randomized controlled trial seeks to examine 32 subjects with chronic pancreatitis who have no contraindications to indomethacin. Subjects will be randomized to either oral indomethacin 50 mg twice a day or placebo twice a day for a total of 28 days. Baseline (pre-treatment) assessment of pain and quality of life will be performed using the Brief Pain Inventory and the PROMIS-10 questionnaires, respectively. Biological specimens including blood, urine, and saliva will be collected at pre-treatment and post-treatment(day 28). Endoscopic pancreatic function testing with concomitant pancreatic fluid collection will also be performed pre- and post-treatment to assess the change in pancreatic fluid PGE2 levels. The relationship between pancreatic fluid PGE2 levels with blood and saliva PGE2 levels will be examined. CONCLUSIONS: This study will elucidate the effect of oral indomethacin on PGE2 levels in the pancreas to assess its role in the inflammatory pathway of chronic pancreatitis. Should indomethacin significantly reduce PGE2 levels, this may represent a potential disease-altering treatment for chronic pancreatitis.

Influenza Vaccination Reduces the Risk of Liver Cancer in Patients with Chronic Kidney Disease: A Nationwide Population-Based Cohort Study.

Previous studies have indicated that influenza vaccination reduces the development of lung cancer. However, the protective effects of influenza vaccination on primary liver cancer in patients with chronic kidney disease (CKD) are unclear. This cohort study identified 12,985 patients aged at least 55 years who had received a diagnosis of CKD between 1 January 2001 and 31 December 2012 from the National Health Insurance Research Database of Taiwan. The patients were classified according to vaccination status. Propensity score matching was used to reduce selection bias. Cox proportional hazards regression analysis was used to evaluate the correlation between influenza vaccination and primary liver cancer in patients with CKD. The prevalence of primary liver cancer was lower in patients with CKD who had received an influenza vaccine (adjusted hazard ratio: 0.45, 95% confidence interval [CI]: 0.35−0.58, p < 0.001). The protective effects were observed regardless of sex, age, and comorbidities. Moreover, dose-dependent protective effects were observed. In the subgroup analysis, where the patients were classified by the number of vaccinations received, the adjusted hazard ratios for 1, 2−3, and ≥4 vaccinations were 0.86 (95% CI: 0.63−1.17), 0.45 (95% CI: 0.31−0.63), and 0.21 (95% CI: 0.14−0.33), respectively. In conclusion, influenza vaccination was associated with a lower incidence of liver cancer in patients with CKD.

Preparation and properties of CS/P(AM-co-AA) composite hydrogels by frontal polymerization of ternary DES.

A deep eutectic solvent (DES) was prepared from choline chloride (ChCl), acrylamide (AM) and acrylic acid (AA); chitosan (CS) was used as a filler, and CS/P(AM-co-AA) composite hydrogels were prepared by frontal polymerization (FP). The hydrogels were characterized by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The mechanical properties, pH responsiveness and conductivity of the hydrogel were studied. The results showed that the mechanical properties of the hydrogel were significantly improved by adding CS, and the tensile strength and compressive strength were increased by 11.61 and 1.65 times respectively due to the increase in number of hydrogen bonds. At the same time, due to the presence of AA, the composite hydrogel has excellent pH response and super high swelling performance under alkaline conditions. The introduction of CS enhanced the conductivity of the hydrogel and gradually increased with the increase of CS content. The conductivity of the hydrogel with CS content of 10 wt% was nearly 160 times that of the hydrogel without CS. In this study, a more convenient and rapid method was proposed to prepare conductive composite hydrogels with excellent mechanical properties and pH responsiveness.

Influenza vaccination and risk of atrial fibrillation in patients with gout: A nationwide population-based cohort study.

Objective: Although influenza vaccination reduces the risk of atrial fibrillation (AF), its protective effect in patients with gout remains unclear. The present study aimed to evaluate the protective effect of influenza vaccination in patients with gout. Methods: A total of 26,243 patients with gout, aged 55 and older, were enrolled from the National Health Insurance Research Database (NHIRD) between 1 January 2001, and 31 December 2012. The patients were divided into vaccinated (n = 13,201) and unvaccinated groups (n = 13,042). After adjusting comorbidities, medications, sociodemographic characteristics, the risk of AF during follow-up period was analyzed. Results: In influenza, non-influenza seasons and all seasons, the risk of AF was significantly lower in vaccinated than in unvaccinated patients (Adjust hazard ratio [aHR]: 0.59, 95% confidence interval [CI]: 0.50-0.68; aHR: 0.50, 95% CI: 0.42-0.63; aHR: 0.55, 95% CI: 0.49-0.62, respectively). In addition, the risk of AF significantly decreased with increased influenza vaccination (aHR: 0.85, 95% CI: 0.69-1.04; aHR: 0.72, 95% CI: 0.60-0.87; aHR: 0.40, 95% CI: 0.33-0.49, after first, 2-3 times, and ≥4 times of vaccination, respectively). Furthermore, sensitivity analysis indicated that the risk of AF significantly decreased after influenza vaccination for patients with different sexes, medication histories, and comorbidities. Conclusions: Influenza vaccination is associated with a lower risk of AF in patients with gout. This potentially protective effect seems to depend on the dose administered.