Nomogram for predicting surgical site infections in elderly patients after open lumbar spine surgery: A retrospective study.

The aim of this study is to develop a nomogram to assess the risk of surgical site infection in elderly patients undergoing open lumbar spine surgery and explore related risk factors. We reviewed the records of 578 elderly patients who had undergone open lumbar spine surgery. The clinical parameters were subjected to lasso regression and logistic regression analyses. Subsequently, a nomogram was constructed to predict the risk of postoperative surgical site infection and validated using bootstrap resampling. A total of 578 patients were included in the analysis, of which 17 were diagnosed as postoperative surgical site infection. Following the final logistic regression analysis, obesity, hypoalbuminemia and drinking history were identified as independent risk factors and subsequently incorporated into the nomogram. The nomogram demonstrated excellent discrimination, with an area under the receiver-operating characteristic curve of 0.879 (95% CI 0.769 ~ 0.989) after internal validation. The calibration curve exhibited a high level of consistency. Decision curve analysis revealed that this nomogram had greater clinical value when the risk threshold for surgical site infection occurrence was >1% and <89%. We had developed a nomogram for predicting the risk of postoperative surgical site infection in elderly patients who had undergone open lumbar spine surgery. Validation using bootstrap resampling demonstrated excellent discrimination and calibration, indicating that the nomogram may hold potential clinical utility as a simple predictive tool for healthcare professionals.

Executive function and attentional bias as serial mediators in the relationship between frailty and depressive symptoms among older inpatients: A cross-sectional study.

AIMS AND OBJECTIVES: To examine the serial mediating effect of executive function and attentional bias in the relationship between frailty and depressive symptoms. BACKGROUND: Although the role of frailty in predicting depression has been well documented, the underlying mechanisms remain unclear. DESIGN: A cross-sectional study was conducted with 667 older inpatients aged 60-90 years in the internal medicine wards of a hospital in China. METHODS: Attentional bias, frailty and depressive symptoms were assessed using the Attention to Positive and Negative Information Scale, the Physical Frailty Phenotype and the 5-item Geriatric Depression Scale. Executive function was measured using 3 tests, including digital backward, category Verbal Fluency Test and Trail Making Test. The study followed the STROBE guideline. RESULTS: The latent profile analysis (LPA) identified four patterns of attentional bias, namely "no positive bias & no negative bias" (class 1, 9.3%), "minor positive bias & no negative bias" (class 2, 48.0%), "major positive bias & minor negative bias" (class 3, 25.6%) and "major positive bias & no negative bias" (class 4, 17.1%). Regression analysis found that frailty was associated with depressive symptoms. Frailty was also negatively associated with executive function, which was a protective factor for attentional bias class 1, 2 and 3 with reference to class 4. Attentional bias class 1 and 2 but not class 3 was associated with depressive symptoms with reference to class 4. The joint significance test confirmed executive function and attentional bias as serial mediators linking frailty to depressive symptoms. DISCUSSION: Unlike robust older adults who have the age-related positivity effect, frail older adults have attentional bias deficits due to executive dysfunction, and consequently experience clinically relevant depressive symptoms. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should take executive function training and attentional bias regulation into consideration to reduce the detrimental effects of frailty on emotional well-being.

Genome-wide analysis of zinc finger-homeodomain (ZF-HD) transcription factors in diploid and tetraploid cotton.

ZF-HD (zinc finger-homeodomain) gene family plays important roles in plant growth, development, and various stress responses. In the present study, 49, 50, 22, and 32 ZF-HD genes were identified in Gossypium hirsutum, Gossypium barbadense, Gossypium arboretum, and Gossypium raimondii genomes, respectively. According to their phylogenetic features, the ZF-HD genes were classified into six groups. Segmental duplication, whole genome duplication, and transposable elements provides major forces for the expansion of cotton ZF-HD gene family during the divergence of Gossypium species and the divergence between monocots and dicots. The Ka/Ks ratios of the ZF-HD segmental duplication pairs were mainly distributed around 0.12, which indicated that they have experienced strong purifying selective pressure during evolution. Transcriptome analysis showed that 6 Gossypium hirsutum and 4 Gossypium barbadense ZF-HD genes were expressed in all tested tissues. Further, expression profiles under abiotic stress exhibited that the ZF-HD genes were differentially regulated in response to various stresses. Taken together, our findings provide a valuable information on the characterization of ZF-HD gene family and lay foundation for their further function investigations in cotton.

Expressive suppression and rumination mediate the relationship between frailty and depression among older medical inpatients.

OBJECTIVE: Frailty is common among older medical inpatients and has been found to be an independent risk factor for depression. However, few studies have explored the underlying mechanisms of the frailty-depression relationship. The present study was aimed to examine emotional regulation strategies as mediators in the frailty-depression relationship based on the process model of emotional regulation. METHODS: Older medical inpatients (N=684) completed questionnaires and tests on frailty, emotional regulation strategies, and depressive symptoms. RESULTS: Structural equation models showed that expressive suppression and rumination, but not cognitive reappraisal, mediated the relationship between frailty and depressive symptoms (RMSEA = 0.059, CFI = 0.963, TLI = 0.957). CONCLUSIONS: Frail older medical inpatients habitually use expressive suppression and rumination in their daily lives, which may lead to more psychological disturbance. Interventions targeting expressive suppression and rumination might be effective in reducing the detrimental effect of frailty on psychological well-being among older medical inpatients.

Critical Role of p38 in Spinal Cord Injury by Regulating Inflammation and Apoptosis in a Rat Model.

STUDY DESIGN: To evaluate the effect of p38 pathway on spinal cord injury (SCI), a rat model of SCI was performed. OBJECTIVE: We determined the effect of p38 on SCI and SCI related inflammation, apoptosis, and autophagy. SUMMARY OF BACKGROUND DATA: SCI is a severe clinical problem worldwide. It is difficult to prevent cell necroptosis and promote the survival of residual neurons after SCI. p38, a class of mitogen-activated protein kinases, its effect on SCI and SCI related inflammation, apoptosis, and autophagy have not been studied very well. METHODS: The rats were randomly divided into the following four groups: the sham-operated (sham) group, the SCI group, the SCI + vehicle group, and the SCI + SB203580 (10 mg/kg) group. The p38 inhibitor SB203580 was administered by oral (10 mg/kg/d) gavage once per day for 14 days. Neurological recovery was assessed using the Basso, Beattie, and Bresnahan locomotion rating scale. Apoptosis, autophagy, and inflammation related proteins were measured by enzyme-linked immunosorbent assay kits or western blotting. RESULTS: Our results showed that p38 was upregulated after SCI from day 3, which was paralleled with the levels of its proteins ATF-2, suggesting an increase in p38 activity. Our results showed administration of SB203580 attenuated histopathology and promoted locomotion recovery in rats after SCI. SB203580 administration significantly inhibited inflammatory cytokines levels as well as the inflammation signaling pathway. SB203580 administration also modulated the apoptosis and autophagy signaling pathway. CONCLUSION: Our findings suggest that p38 inhibitor SB203580 treatment alleviates secondary SCI by inhibiting inflammation and apoptosis, thereby promoting neurological and locomoter functional recovery, thus suggest the important role of p38 in neuronal protection after SCI. LEVEL OF EVIDENCE: N/A.

[Effect of simvastatin on atherosclerosis and central aortic pressure in ApoE gene knockout mice].

OBJECTIVE: To investigate the effects of simvastatin on atherosclerosis and central aortic pressure in ApoE-knockout (ApoE-/-) mice. METHODS: Ten 5-week-old male ApoE-/- mice and 5 C57 mice were fed with high-lipid diet for 3 weeks, and then C57 mice (WT group) and 5 ApoE-/- mice (ApoE-/- group) were given 1% carboxymethyl cellulose solution (8 ml·kg-1·d-1), and another 5 ApoE-/- mice (ApoE-/-/S group) were given simvastatin solution (50 mg·kg-1·d-1) by gavege for 3 weeks. The areas of atherosclerotic lesion in aortic root, central aortic pressure and serum lipid levels were examined. RESULTS: No atherosclerotic plaques were observed in WT group. Compared with ApoE-/- group, simvastatin significantly decreased atherosclerotic lesion area in aortic root (89 818.05±16 980.93 µm2 vs 34 937.01±13 280.65 µm2, P<0.05). The systolic pressure (SP), mean arterial pressure (MAP), pulse pressure (PP) and diastolic pressure (DP) of central aortic pressure were significantly increased in ApoE-/- group compared with those in WT group (P<0.05). Compared to ApoE-/- group, the SP, MAP and PP of central aortic pressure were significantly reduced in ApoE-/-/S group (P<0.05). SP and MAP of central aortic pressure were positively correlated with atherosclerotic lesion area (SP: r=0.7152, P=0.0461; PP: r=0.7594， P=0.0288). Compared with WT group, serum triglyceride, total cholesterol and low-density lipoprotein levels were markedly increased in ApoE-/- group (P<0.05). Serum high-density lipoprotein level was decreased in ApoE-/- group compared with WT group. No differences in serum triglyceride, total cholesterol, low-density lipoprotein and high-density lipoprotein levels were found between ApoE-/- group and ApoE-/-/S group. CONCLUSION: Simvastatin can attenuate atherosclerosis of aorta in ApoE-/- mice, which is associated with the reduced central aortic systolic pressure but not with the serum lipids levels.