Long-term outcomes of subthalamic nucleus deep brain stimulation for Parkinson's disease in Singapore.

Introduction: Subthalamic nucleus deep brain stimulation (STN-DBS) is a proven treatment modality for Parkinson's disease (PD), reducing dyskinesia and time spent in the "OFF" state. This study evaluates the long-term outcomes of STN-DBS in PD patients up to 10 years post-surgery in Singapore. Method: We conducted a retrospective review of Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores, activities of daily living (ADLs), disease milestones, dopaminergic drug prescriptions, and adverse events in patients before and after STN-DBS surgery. Results: A total of 94 PD patients who underwent bilateral STN-DBS were included. STN-DBS reduced time in the "OFF" state by 36.9% at 1 year (P=0.034) and 40.9% at 5 years (P=0.006). Time with dyskinesia did not significantly change. Levodopa equivalent daily dose was reduced by 35.1% by 5 years (P<0.001). MDS-UPDRS-II and III scores increased from 5 years post-DBS by 40.5% and 35.4%, respectively. Independence in ADLs decreased, though not significantly. The prevalence of frequent falls increased at 5 years. Surgery- and device-related adverse events were uncommon and generally mild. Conclusion: STN-DBS provides sustained relief from motor complications and reduced medication requirements in PD patients in Singapore. This study highlights STN-DBS as an effective treatment option, significantly enhancing the quality of life for those with PD.

Research Note: Synergistic effect of isopropoxy benzene guanidine and colistin against mcr-1-positive Escherichia coli in vitro and in duck intestine infection models.

Colistin (CST) is considered as "agent of last resort" against gram-negative bacteria as feed additive. Its clinical effectiveness has reduced since the emergence of mcr-1 gene in ducks. Isopropoxy benzene guanidine (IBG), a new guanidine derivative, showed positive effects on improving animal weights and alleviating intestinal pathogens, therefore, the objective of this study was to evaluate the effect of this compound supplement with CST in ducks and explore the possibilities in feed additive. A total of fifteen duck-origin Escherichia coli carrying the mcr-1 gene were included in this study. A checkerboard microdilution assay was used to evaluate the in vitro antibacterial activity of IBG combined with CST against mcr-1-positive E. coli. A 3-by-2 time-kill array of IBG (16, 32, and 64 µg/mL) and CST (1/2 MIC and 1/4 MIC) over 24 hours was utilized to characterize the activity of the agents alone and in combination against E. coli strain 1 in vitro. The intestinal colonization model was used to evaluate the in vivo effect of IBG combined with CST. These results indicated that the combination of IBG plus CST showed a synergistic effect against all clinical isolates (FICI < 0.5). The bacterial burden was reduced by more than 2 log10 CFU/mL when E. coli strain 1 was tested with 1/2 MIC CST plus 64 µg/mL IBG for 24 h. Further experiments in vivo demonstrated that the CST combined with IBG was able to increase duck weights, reduced intestinal pathogenic E. coli and showed a synergistic antibacterial effect. Combination of CST (4 mg/kg b.w.) plus IBG (32 or 64 mg/kg b.w.) achieved 1.84 to 3.29 log10 CFU/g killing after 7 d of therapy, which was significantly different from that in the challenge control group (p<0.05). In summary, our study demonstrated the potential use of IBG as feed additive for veterinary purposes in ducks and provided new insights into overcoming resistance in the future.

Awake versus Asleep Anesthesia in Deep Brain Stimulation Surgery for Parkinson's Disease: A Systematic Review and Meta-Analysis.

INTRODUCTION: Deep brain stimulation (DBS) is a well-established surgical therapy for patients with Parkinsons' Disease (PD). Traditionally, DBS surgery for PD is performed under local anesthesia, whereby the patient is awake to facilitate intraoperative neurophysiological confirmation of the intended target using microelectrode recordings. General anesthesia allows for improved patient comfort without sacrificing anatomic precision and clinical outcomes. METHODS: We performed a systemic review and meta-analysis on patients undergoing DBS for PD. Published randomized controlled trials, prospective and retrospective studies, and case series which compared asleep and awake techniques for patients undergoing DBS for PD were included. A total of 19 studies and 1,900 patients were included in the analysis. RESULTS: We analyzed the (i) clinical effectiveness - postoperative UPDRS III score, levodopa equivalent daily doses and DBS stimulation requirements. (ii) Surgical and anesthesia related complications, number of lead insertions and operative time (iii) patient's quality of life, mood and cognitive measures using PDQ-39, MDRS, and MMSE scores. There was no significant difference in results between the awake and asleep groups, other than for operative time, for which there was significant heterogeneity. CONCLUSION: With the advent of newer technology, there is likely to have narrowing differences in outcomes between awake or asleep DBS. What would therefore be more important would be to consider the patient's comfort and clinical status as well as the operative team's familiarity with the procedure to ensure seamless transition and care.

Lobectomy versus gross total resection for glioblastoma multiforme: A systematic review and individual-participant data meta-analysis.

Overall survival (OS)for glioblastoma multiforme (GBM) has a known association with the extent of tumor resection with gross total resection (GTR) typically considered as the upper limit. In certain regions such as the anterior temporal lobe, more extensive resection by means of a lobectomy may be feasible. In our systematic review and meta-analysis, we aimed to compare the outcomes of lobectomy and GTR for GBM. PubMed and Embase were queriedfor studies that compared the outcomes after lobectomy or GTR for GBM. The primary outcomes were OS, progression-free survival (PFS), and Karnofksy Performance Status (KPS) score at the latest follow-up. The secondary outcomes were seizure control at the latest follow-up and complication rates. Meta-analysis for OS and PFS was performed using individual-participant data reconstructed from published Kaplan-Meier curves. Random-effect meta-analysis was performed for KPS. The secondary outcomes were pooled using descriptive statistics. Of the 795 records screened, 6 were included in our study. Meta-analysis revealed that anterior temporal, frontal, or occipital lobectomy was associated with significantly better OS (p < 0.001) and PFS (p < 0.001) than GTR, but not KPS (MD = 6.37; 95% CI=(-13.80, 26.54); p = 0.536). Anterior temporal lobectomy was associated with significantly better seizure control rates than GTR for temporal GBM (OR = 27; 95% CI=(1.4, 515.9); p = 0.002). There was no statistically significant difference in complication rates between anterior temporal, frontal, or occipital lobectomy and GTR. In conclusion, lobectomy was associated with significantly better OS, PFS, and seizure control than GTR for GBM.

[Active components and mechanism of Jinwugutong Capsules in treatment of osteoporosis: a study based on UPLC-Q-Exactive-MS/MS combined with network pharmacology].

UPLC-Q-Exactive-MS/MS and network pharmacology were employed to preliminarily study the active components and mechanism of Jinwugutong Capsules in the treatment of osteoporosis. Firstly, UPLC-Q-Exactive-MS/MS was employed to characterize the chemical components of Jinwugutong Capsules, and network pharmacology was employed to establish the "drug-component-target-pathway-disease" network. The key targets and main active components were thus obtained. Secondly, AutoDock was used for the molecular docking between the main active components and key targets. Finally, the animal model of osteoporosis was established, and the effect of Jinwugutong Capsules on the expression of key targets including RAC-alpha serine/threonine-protein kinase(AKT1), albumin(ALB), and tumor necrosis factor-alpha(TNF-α) was determined by enzyme-linked immunosorbent assay(ELISA). A total of 59 chemical components were identified from Jinwugutong Capsules, among which coryfolin, 8-prenylnaringenin, demethoxycurcumin, isobavachin, and genistein may be the main active components of Jinwugutong Capsules in treating osteoporosis. The topological analysis of the protein-protein interaction(PPI) network revealed 10 core targets such as AKT1, ALB, catenin beta 1(CTNNB1), TNF, and epidermal growth factor receptor(EGFR). The Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment showed that Jinwugutong Capsules mainly exerted the therapeutic effect by regulating the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT) signaling pathway, neuroactive ligand-receptor interaction, mitogen-activated protein kinase(MAPK) signaling pathway, Rap1 signaling pathway and so on. Molecular docking showed that the main active components of Jinwugutong Capsules well bound to the key targets. ELISA results showed that Jinwugutong Capsules down-regulated the protein levels of AKT1 and TNF-α and up-regulated the protein level of ALB, which preliminarily verified the reliability of network pharmacology. This study indicates that Jinwugutong Capsules may play a role in the treatment of osteoporosis through multiple components, targets, and pathways, which can provide reference for the further research.

Novel third-generation tyrosine kinase inhibitor for newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia: a case study.

Although Philadelphia chromosome-positive acute leukemia (Ph + -ALL) has been revolutionized with tyrosine kinase inhibitors (TKIs), resistance and mutation are universal events during treatment with first-generation and second-generation TKIs. The present third-generation TKI has a dose-dependent, increased risk of serious cardiovascular events and the sensitivity is poor for patients with ≥2 mutations accompanied by the T315I mutation. Thus, novel and well-tolerated TKIs should be explored. This study analyzes the efficacy and advert effects of olverembatinib, a novel third TKI, in the treatment of newly diagnosed adult Ph + -ALL in induction therapy. Four adult patients with newly diagnosed Ph + -ALL were treated with olverembatinib as the first-line treatment. For induction therapy, these patients received 40 mg of oral olverembatinib quaque omni die for 28 days, 1 mg/kg/d of prednisone for 14 days, then tapered and stopped at 28 days and vindesine 4 mg/d at days 1, 8 and 15. After induction therapy, these patients received median or high-dose of cytarabine and methotrexate combined with oral olverembatinib as consolidation therapy. Then the allogeneic hematopoietic stem cell transplantation (allo-HSCT) was performed. All patients reached complete remission with a complete cytogenetic response after induction therapy. Two patients reached major molecular remission and one with complete molecular remission. Before allo-HSCT, all the patients achieved complete molecular remission. All the patients have survived disease-free for 3-6 months. No severe advert effects were observed. It is well-tolerated and effective for olverembatinib in the treatment of newly diagnosed adult patients with Ph + -ALL. A prospective study should be performed to further testify the role.

Clinical Application of a Stereotactic Frame-Specific 3D-Printed Attachment for Deep Brain Stimulation Surgery.

BACKGROUND: Mispositioning of microelectrodes during deep brain stimulation surgery can incur serious complications for patients. Current practice of creating a burr hole for introduction of the microelectrode is done freehand and can cause trajectory misalignment. We aimed to create a sterilizable surgical adjunct to minimize error from burr hole placement. METHODS: We designed and demonstrated clinical use of a 3D-printed surgical jig that can be mounted to the current Cosman-Roberts-Wells stereotactic frame. The jig allowed accurate placement of the perforating burr for creation of the burr hole. RESULTS: Intraoperative usage of the jig in 11 patients who underwent bilateral deep brain stimulation microelectrode placement for Parkinson disease demonstrated high accuracy of microelectrode placement, with an average 1.18 mm deviation (range, 0-2.7 mm) from intended trajectories. No intraoperative complications were encountered. CONCLUSIONS: This proof-of-concept study highlights the utility of 3D-printed surgical adjuncts that are fully customizable and rapidly produced to improve current surgical practice. The jig reduced surgery duration, need for multiple trajectories, and risk of potentially devastating neurological complications. As demonstrated, 3D-printed devices are useful as surgical adjuncts to optimize safety and efficacy in deep brain stimulation surgeries.

An antibiotic envelope to reduce infections in deep brain stimulation surgery.

The therapeutic benefits of Deep Brain Stimulation (DBS) surgery in patients with movement disorderssuch as Parkinson's Diseaseare life-altering. Surgical site infections (SSI), however, can result in increasedhospitalisations, prolonged antibiotics and neurological sequelae. We performed aretrospective review to evaluate the effectiveness of an antibiotic envelope to reduce SSI in DBS surgeries.This study includedall DBS surgeries performed between August 2020 to May 2022 using a single-use, multifilament, antibiotic-coated mesh envelope wrapped around the DBS implantable pulse generator (IPG)(TYRX™ Absorbable Antibacterial Envelope,Medtronic Fridley, MN, USA). Standardised infection-prevention measures were applied and various patient-specific and surgery-specific factors were analysed.44 patients were analysed with 26 (59.1 %) primary implantations and 18 (40.9 %) revision surgeries.The median age was 65 years old with an average follow-up of 13.5 months (range 3-24 months). The mean Body Mass Indexwas 24.0 (range 16.7-35.6). 8 (18.2 %) patients had underlying diabetes mellitus. There were only 2 (4.5 %) SSIs reported with neither involvingthe subcutaneous IPG and antibiotic envelope. 1 superficial-incisional SSI (2.3 %) was from a prior retro-auricular abscess around a lead-wirerequiring antibiotics and subcutaneous implanttransposition. The other was a deep-incisional SSI (2.3 %) from repetitive trauma causingdelayed scalp wound dehiscence and lead-wire extrusion, requiring antibiotics and wound revision. Both subjects were discharged well with no implants removed. Theantibioticenvelope therefore appears to be a safe and well-tolerated adjunct that may reduce SSIs in DBS surgery. Further prospective work withlarger sample sizes in a multi-institution setting is required.

Saving the Exposed Deep Brain Stimulation Implant: A Comprehensive Review of Implant Extrusion and Reconstructive Options.

INTRODUCTION: Deep brain stimulation (DBS) for the treatment of Parkinson disease is susceptible to complications, such as hardware extrusion, most commonly at the scalp and chest. The authors describe their experience with the management of hardware extrusion and reconstruction with one of the largest single-institution experience and suggest an evidence-based treatment algorithm for the management of such cases. METHODS: A retrospective review of hospital records was performed to identify patients who underwent DBS-related surgery and reconstruction from January 2015 to April 2020. Management of these patients involved culture-directed antibiotics, local wound debridement, various forms of reconstruction, and hardware removal when indicated. RESULTS: Ninety-four patients with 131 DBS-related procedures were included. Twelve patients (12.8%) had hardware extrusion, of which 6 occurred primarily at the scalp and 6 occurred primarily at the chest. Primary closure of scalp wounds (odds ratio, 0.05 [0.004-0.71], P = 0.035) was negatively associated with treatment success. The type of reconstruction of chest wounds did not affect its success ( P = 0.58); however, none of them involved a new surgical bed, such as contralateral or hypochondrial placement. CONCLUSIONS: Hardware extrusion is a significant complication of DBS-related surgery. Management of extrusion at the scalp should involve the use of tension-free, well-vascularized locoregional flaps as opposed to primary closure. Implantable pulse generator extrusions at the chest can be managed with both primary closure and repositioning in a new surgical bed. Extruded DBS implants may be salvaged with appropriate reconstructive considerations, and the authors suggest an evidence-based treatment algorithm.

[Chiral separation of new chiral insecticide pyraquinil isomers and establishment of analytical methods in vegetables].

Pyraquinil (Pyr), with a new skeleton of pyrazolo[1,5-a]quinazoline fused heterocycle, is a new chiral insecticide independently developed by South China Agricultural University in 2017. In previous studies, we found that pyraquinil can effectively control the lepidopteran pest population on cruciferous crops. Remarkably, the insecticidal activity of pyraquinil was 64-fold better than that of fipronil against the fipronil-resistant Plutella xylostella field population. Pesticides with new active mechanisms should be developed in the future to cope with the development of resistance to Plutella xylostella. Therefore, pyraquinil with new active sites has the potential to be the main rotation variety for the control of Plutella xylostella. Thus, pyraquinil has a broad prospect for application in the future. However, a chiral separation and analysis method for pyraquinil and oxidation products using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) has not been established yet. Based on the physical and chemical properties of the new chiral pesticide pyraquinil, we screened chiral chromatographic columns and optimized the mobile phase ratio in this study. The separation and analysis methods for pyraquinil were developed based on the QuEChERS (quick, easy, cheap, effective, rugged, safe) system. Simultaneously, we also established oxidation metabolites. These methods were used for the simultaneous determination of the chiral isomers of pyraquinil and oxidation products in pakchoi (Brassica rapa ssp. chinensis L.) and water spinach (Ipomoea aquatica Forsk) via HPLC-MS/MS. The Chiral INC column (250 mm×4.6 mm, 5 µm) was used for separation. Ammonium formate aqueous solution (2 mmol/L) and acetonitrile were used as the mobile phases. The column temperature was 28 ℃. The injection volume was 1 µL, and the flow rate was 0.5 mL/min. MS analysis was performed using an electrospray ionization source in the negative and multiple reaction monitoring modes. We found that under the optimized conditions, the resolution of the four isomers of pyraquinil were 1.63, 2.83, and 1.74, respectively, and the resolution of the isomers of the pyraquinil oxidation product was 5.82, which achieved baseline separation. Then, the absolute configuration and peak order of pyraquinil and oxidation product isomers were determined by derivatization. The order of the peaks was RS-Pyr, SS-Pyr, RR-Pyr, SR-Pyr, S-Pyr+O, and R-Pyr+O. The purification conditions of sample pretreatment were optimized; 1 g (0.835 g MgSO4+0.150 g PSA+0.015 g GCB) was determined to be the optimal purification agent; and the average recoveries ranged from 80% to 110%. The chiral isomers of pyraquinil and oxidation products showed good linearity in the concentration range of 1.25 to 1250 µg/L and 2.5 to 2500 µg/L respectively. The square of the regression coefficient of the linear equation (R2) was greater than 0.99. The matrix effects of the pyraquinil and oxidation product isomers in pakchoi ranged from 6.1 to 30.6. In the water spinach, the matrix effect of the pyraquinil and oxidation product isomers were in the range of 0.7-26.8. The average recoveries of pyraquinil isomer at three spiked levels of 0.25, 5, 100 µg/kg in samples (pakchoi and water spinach) ranged from 90.2% to 110.6%. The oxidation product isomer average recoveries in samples (pakchoi and water spinach) spiked with 0.5, 10, 200 µg/kg ranged from 72.6% to 100.1%. Further, the relative standard deviations (RSDs) were 0.5%-9.4%. In water spinach, the intra-day and inter-day repeatability RSDs ranged from 0.5% to 8.7% and 1.0%to 8.6%, respectively. In pakchoi, the intra-day and inter-day repeatability RSDs ranged from 0.6% to 9.4% and 1.0% to 7.6%, respectively. These results indicate that the proposed method has satisfactory sensitivity, accuracy, and precision. This study can provide analytic technology for a novel chiral pesticide for environmental behavior studies, quality control, and pharmacodynamics evaluation, as well as significant technical support for the development and application of new pesticides.

Modulating p-Orbital of Bismuth Nanosheet by Nickel Doping for Electrocatalytic Carbon Dioxide Reduction Reaction.

Electrochemical reduction of CO2 (CO2 RR) to value-added chemicals is an effective way to harvest renewable energy and utilize carbon dioxide. However, the electrocatalysts for CO2 RR suffer from insufficient activity and selectivity due to the limitation of CO2 activation. In this work, a Ni-doped Bi nanosheet (Ni@Bi-NS) electrocatalyst is synthesized for the electrochemical reduction of CO2 to HCOOH. Physicochemical characterization methods are extensively used to investigate the composition and structure of the materials. Electrochemical results reveal that for the production of HCOOH, the obtained Ni@Bi-NS exhibits an equivalent current density of 51.12 mA cm-2 at -1.10 V, which is much higher than the pure Bi-NS (18.00 mA cm-2 at -1.10 V). A high Faradaic efficiency over 92.0 % for HCOOH is achieved in a wide potential range from -0.80 to -1.10 V, and particularly, the highest efficiency of 98.4 % is achieved at -0.90 V. Both experimental and theoretical results reveal that the superior activity and selectivity are attributed to the doping effect of Ni on the Bi nanosheet. The density functional theory calculation reveals that upon doping, the charge is transferred from Ni to the adjacent Bi atoms, which shifts the p-orbital electronic density states towards the Fermi level. The resultant strong orbital hybridization between Bi and the π* orbitals of CO2 facilitates the formation of *OCHO intermediates and favors its activation. This work provides an effective strategy to develop active and selective electrocatalysts for CO2 RR by modulating the electronic density state.

Photo-Cross-Linkable Human Albumin Colloidal Gels Facilitate In Vivo Vascular Integration for Regenerative Medicine.

Biodegradable cellular and acellular scaffolds have great potential to regenerate damaged tissues or organs by creating a proper extracellular matrix (ECM) capable of recruiting endogenous cells to support cellular ingrowth. However, since hydrogel-based scaffolds normally degrade through surface erosion, cell migration and ingrowth into scaffolds might be inhibited early in the implantation. This could result in insufficient de novo tissue formation in the injured area. To address these challenges, continuous and microsized strand-like networks could be incorporated into scaffolds to guide and recruit endogenous cells in rapid manner. Fabrication of such microarchitectures in scaffolds is often a laborious and time-consuming process and could compromise the structural integrity of the scaffold or impact cell viability. Here, we have developed a fast single-step approach to fabricate colloidal hydrogels, which are made up of randomly packed human serum albumin-based photo-cross-linkable microparticles with continuous internal networks of microscale voids. The human serum albumin conjugated with methacrylic groups were assembled to microsized aggregates for achieving unique porous structures inside the colloidal gels. The albumin hydrogels showed tunable mechanical properties such as elastic modulus, porosity, and biodegradability, providing a suitable ECM for various cells such as cardiomyoblasts and endothelial cells. In addition, the encapsulated cells within the hydrogel showed improved cell retention and increased survivability in vitro. Microporous structures of the colloidal gels can serve as a guide for the infiltration of host cells upon implantation, achieving rapid recruitment of hematopoietic cells and, ultimately, enhancing the tissue regeneration capacity of implanted scaffolds.

An open label randomized trial to assess the efficacy of tranexamic acid in reducing post-operative recurrence of chronic subdural haemorrhage.

Chronic subdural haemorrhage (CSDH) is a common neurosurgical entity with complex pathophysiological pathways. The generally favourable surgical outcome may be affected by its associated risks including recurrence rates. We performed a prospective randomized multi-center clinical trial comparing the addition of tranexamic acid (TXA) to standard neurosurgical procedures for patients with symptomatic CSDH. The primary endpoint was CSDH requiring repeat surgery within 6-month post-operatively. Secondary endpoints were comparison of post-operative volumes between the treatment arms and safety evaluation of the dosing regime. 90 patients were analyzed with 49 patients in the observation arm and 41 patients in the TXA arm. The observation arm had five (10.2%) recurrences compared to two (4.8%, p = 0.221) in the TXA arm. Patients in the TXA arm demonstrated a greater reduction of their CSDH volume at 6 weeks follow up (36.6%) compared to the observation arm (23.3%, p = 0.6648). There were no reportable serious adverse events recorded in the observation arm, compared to 4 (9.8%) patients in the TXA arm. The addition of TXA treatment to standard surgical drainage of CSH did not significantly reduce symptomatic post-operative recurrence. Patients in the TXA arm had a delay in the CSDH recurrence with a comparative reduction of residual hematoma volume at the 6-week follow up although the effect was unsustained. Larger randomized trials with dose adjustments should be considered to investigate subgroups of patients that may benefit from this medical adjunct.

Automated detection of subthalamic nucleus in deep brain stimulation surgery for Parkinson's disease using microelectrode recordings and wavelet packet features.

BACKGROUND: Deep brain stimulation (DBS) to the subthalamic nucleus (STN) is an effective neurosurgery that overcomes the motor system alternations of patients with advanced Parkinson's disease. The most challenging aspect of DBS surgery is the accurate identification of STN and its borders. In general, it is performed manually by a neurophysiologist using the microelectrode recordings (MERs). This process is subjective, and tedious and further, interpretation of MERs is difficult because of its inherent nonstationary variations. NEW METHODS: In this work, the wavelet-packet based features are proposed to automatically localize the STN and its subcortical structures using microelectrode recorded signals during DBS surgery. The study analyses 2904 MERs of 26 PD patients who underwent DBS implantation. The low and high order statistical parameters are extracted from the wavelet packet coefficients of MERs and used in the classifications, namely, non-STN vs. STN, pre-STN vs. STN and STN vs. post-STN. RESULTS: Most of the features are significantly different in STN and its subcortical regions, namely, pre-STN and post-STN. The proposed features achieve an average accuracy of 85 % in non-STN vs. STN, 87.2 % in pre-STN vs. STN and 77.7 % in STN vs. post-STN. The accuracy is improved by around 10 % in non-STN vs. STN and STN vs. post-STN when the transition error is 1 mm. COMPARISON WITH EXISTING METHODS: The proposed features are found to be better than the wavelet features. CONCLUSIONS: The proposed approach could be a potential useful adjunct for the real-time rapid intraoperative identification of STN and its anatomical borders.

Miniaturized Paper-Supported 3D Cell-Based Electrochemical Sensor for Bacterial Lipopolysaccharide Detection.

Sensitive detection of lipopolysaccharides (LPSs), which are present on the outer wall of Gram-negative bacteria, is important to reflect the degree of bacterial contamination in food. For indirect assessment of the LPS content, a miniaturized electrochemical cell sensor consisting of a screen-printed paper electrode, a three-dimensional cells-in-gels-in-paper culture system, and a conductive jacket device was developed for in situ detection of nitric oxide released from LPS-treated mouse macrophage cells (Raw264.7). Nafion/polypyrrole/graphene oxide with excellent selectivity, high conductivity, and good biocompatibility functionalized on the working electrode via electrochemical polymerization could enhance sensing. Raw264.7 cells encapsulated in the alginate hydrogel were immobilized on a Nafion/polypyrrole/graphene oxide/screen-printed carbon electrode in paper fibers as a biorecognition element. Differential impulse voltammetry was employed to record the current signal as-influenced by LPS. Results indicated that LPS from Salmonella enterica serotype Enteritidis caused a significant increase in peak current, varying from 1 × 10-2 to 1 × 104 ng/mL, dose-dependently. This assay had a detection limit of 3.5 × 10-3 ng/mL with a linear detection range of 1 × 10-2 to 3 ng/mL. These results were confirmed by analysis of nitric oxide released from Raw264.7 via the Griess method. The miniaturized sensor was ultimately applied to detect LPSs in fruit juice samples. The results indicated that the method exhibited high recovery and relative standard deviation lower than 2.65% and LPSs in samples contaminated with 102-105 CFU/mL bacteria could be detected, which proved the practical value of the sensor. Thus, a novel, low-cost, and highly sensitive approach for LPS detection was developed, providing a method to assess Gram-negative bacteria contamination in food.

Detection of Subthalamic Nucleus using Time-Frequency Features of Microelectrode recordings and Random Forest Classifier.

Accurate localization of subthalamic nucleus (STN) is a key prior in deep brain stimulation (DBS) surgery for the patients with advanced Parkinson's disease (PD). Microelectrode recordings (MERs) along with preplanned trajectories are often employed for the STN localization and it remains challenging task. These MER signals are nonstationary and multicomponent in nature. In this study, we propose a system based on time-frequency features of MERs to differentiate the STN and non-STN regions. We assessed the system with 50 MER trajectories from 26 PD patients who have undergone DBS surgery. The signals are pre-processed and subjected to six-level wavelet decomposition. Then, the entropy is computed from the detailed and approximate coefficients. These features are fed to the random forest classifier and the model is evaluated by leave one patient out cross-validation. The results show that entropy associated with detailed wavelet coefficients (D1and D2) are higher in STN where as it is lower in other wavelet scales. All extracted features except entropy from approximate coefficients are found to have significant difference between non-STN and STN (p<; 0.05). The random forest classifier achieves about 83% accuracy and 87% precision in differentiating the STN and non-STN regions.

A review on microelectrode recording selection of features for machine learning in deep brain stimulation surgery for Parkinson's disease.

OBJECTIVE: This study seeks to systematically review the selection of features and algorithms for machine learning and automation in deep brain stimulation surgery (DBS) for Parkinson's disease. This will assist in consolidating current knowledge and accuracy levels to allow greater understanding and research to be performed in automating this process, which could lead to improved clinical outcomes. METHODS: A systematic literature review search was conducted for all studies that utilized machine learning and DBS in Parkinson's disease. RESULTS: Ten studies were identified from 2006 utilizing machine learning in DBS surgery for Parkinson's disease. Different combinations of both spike independent and spike dependent features have been utilized with different machine learning algorithms to attempt to delineate the subthalamic nucleus (STN) and its surrounding structures. CONCLUSION: The state-of-the-art algorithms achieve good accuracy and error rates with relatively short computing time, however, the currently achievable accuracy is not sufficiently robust enough for clinical practice. Moreover, further research is required for identifying subterritories of the STN. SIGNIFICANCE: This is a comprehensive summary of current machine learning algorithms that discriminate the STN and its adjacent structures for DBS surgery in Parkinson's disease.

Plasma inflammatory factors in older people predict acute kidney injury: a case-control study.

PURPOSE: To investigate whether inflammatory factors are predictors of acute kidney injury (AKI) in older people in the intensive care unit (ICU). METHODS: We performed a case-control study that included 98 older people (≥ 65 years) who were admitted to ICU from 2013 to 2017. The contents of plasma pro-inflammatory factors [interleukin (IL)-1b, IL-6, IL-8, tumor necrosis factor-a (TNF-α)] and the anti-inflammatory factor IL-10 were determined at the first day of admission. Patients were assessed based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria and were divided into AKI and non-AKI (control) groups (n = 49 for each). T test was applied for differences comparisons in the levels of inflammatory factors between the two groups. Logistic regression was used to identify independent predictors of AKI. RESULTS: AKI patients had significantly elevated plasma contents of IL-6, IL-8 and IL-10, relative to the control group. A strong correlation was observed between IL-6 and IL-8 with AKI (OR 36.4 and 18.2, respectively). For each increase in the natural log unit in the levels of IL-6 and IL-8, the risk of developing AKI augmented by 36.4% and 18.2%, respectively. Moreover, the higher the tertile value of IL-6 and IL-8, the higher the risk of developing AKI. The area under the receiver operating characteristic curve for IL-6 and IL-8 was, respectively, 87% and 83% for predicting AKI. CONCLUSION: Plasma inflammatory contents of IL-6 and IL-8 can predict AKI in older people. Management of inflammatory factors should take into consideration the age of AKI patients.

Prolyl hydroxylase domain 3 influences the radiotherapy efficacy of pancreatic cancer cells by targeting hypoxia-inducible factor-1α.

PURPOSE: Pancreatic cancer is characterized by a hypoxic microenvironment and resistance to most currently available treatment modalities. Prolyl hydroxylase domain 3 (PHD3) is a rate-limiting enzyme that regulates the degradation of hypoxia-inducible factors (HIFs) and is deregulated in pancreatic cancer cells. Whether such alteration of PHD3 expression contributes to the sustained growth and radioresistance of pancreatic cancer cells remains largely unknown. MATERIALS AND METHODS: PHD3 was overexpressed in pancreatic cancer Mia-paca2 cells via lentiviral expression. Cell cycle progression and apoptosis were assayed by flow cytometry. HIF-1α, EGFR, and PHD3 protein expression was assessed by Western blotting. Cell survival was determined in a colony formation assay. RESULTS: PHD3 overexpression suppressed HIF-1α protein expression and EGFR phosphorylation and enhanced the 2 Gy irradiation-mediated reductions in HIF-1α and phosphorylated (p)-EGFR under either normoxic or hypoxic conditions. PHD3 overexpression inhibited the growth and colony formation of Mia-paca2 cells in response to irradiation under either normoxic or hypoxic conditions. PHD3 overexpression exacerbated irradiation-induced apoptosis, with a greater effect under hypoxia than normoxia. Cell cycle distribution analysis demonstrated that PHD3 overexpression resulted in further shortened S phase and lengthened G2/M phase in response to irradiation. CONCLUSION: PHD3 expression may contribute to the radiotherapy efficacy of pancreatic cancer cells and serve as a novel biomarker for improving radiotherapy efficacy in pancreatic cancer.

Cytotoxic triterpenoid saponins from the defatted seeds of Camellia oleifera Abel.

Five new oleanane-type triterpenoid saponins, oleiferasaponins D1-D5 (1-5), were isolated from the defatted seeds of Camellia oleifera Abel. Their structures were elucidated by spectroscopic and chemical methods. The cytotoxic activities of compounds 1-5 were evaluated against five human tumor cell lines (HCT-116, HepG2, BGC-823, NCI-H1650, and A2780). Compounds 1-2 exhibited cytotoxic activity against five human cancer cell lines, with IC50 values ranging from 3.31 to 10.23 µM. Compounds 3-5 showed moderate cytotoxic activities toward the tested cell lines.