Calorie Restriction with or without Time-Restricted Eating in Weight Loss.

BACKGROUND: The long-term efficacy and safety of time-restricted eating for weight loss are not clear. METHODS: We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with calorie restriction or daily calorie restriction alone. For 12 months, all the participants were instructed to follow a calorie-restricted diet that consisted of 1500 to 1800 kcal per day for men and 1200 to 1500 kcal per day for women. The primary outcome was the difference between the two groups in the change from baseline in body weight; secondary outcomes included changes in waist circumference, body-mass index (BMI), amount of body fat, and measures of metabolic risk factors. RESULTS: Of the total 139 participants who underwent randomization, 118 (84.9%) completed the 12-month follow-up visit. The mean weight loss from baseline at 12 months was -8.0 kg (95% confidence interval [CI], -9.6 to -6.4) in the time-restriction group and -6.3 kg (95% CI, -7.8 to -4.7) in the daily-calorie-restriction group. Changes in weight were not significantly different in the two groups at the 12-month assessment (net difference, -1.8 kg; 95% CI, -4.0 to 0.4; P = 0.11). Results of analyses of waist circumferences, BMI, body fat, body lean mass, blood pressure, and metabolic risk factors were consistent with the results of the primary outcome. In addition, there were no substantial differences between the groups in the numbers of adverse events. CONCLUSIONS: Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily calorie restriction. (Funded by the National Key Research and Development Project [No. 2018YFA0800404] and others; ClinicalTrials.gov number, NCT03745612.).

Reference-frame-independent measurement-device-independent quantum key distribution with mismatched-basis statistics.

The source flaw associated with the basis vector in the reference-frame-independent measurement-device-independent quantum key distribution (RFI-MDI-QKD) has not been systematically studied. As a result, it is often assumed that bit error is equal to phase error, which is not theoretically rigorous. Here, we propose a postprocessing method to estimate the phase error rate from the discarded mismatched-basis statistics, where the qubit source does not need to be characterized in detail. The source flaw in the basis vector of the RFI-MDI-QKD protocol can thus be corrected using this method. The numerical simulation results clearly demonstrate that the RFI-MDI-QKD protocol with uncharacterized sources is also insensitive to the misalignment of the reference frame.

Impact of some social and clinical factors on the development of postpartum depression in Chinese women.

BACKGROUND: Postpartum depression (PPD) is prevalent and may present major adverse impacts on mother and child health. According to previous studies, mostly from the western society, PPD may have complicated etiologies, such as genetic, social and psychological factors. The aim of this study was to explore the associations of some social and clinical factors, particularly those unique in Chinese, with significant PPD symptoms. METHODS: A sample of 556 pregnant women in their 36th to 40th gestational week were randomly recruited in a cross-sectional study using a self-reported questionnaire, which collected maternal sociodemographic and clinical information. During their 2nd to 4th postpartum months, 522 participants responded to our screening of significant PPD symptoms, based on a score of Edinburgh Postnatal Depression Scale ≥9. RESULTS: A total of 90 (17.3%) participants were identified with significant PPD symptoms, and the following factors were observed more frequently in women with significant PPD symptoms (PPD+) than with fewer symptoms (PPD-): intensive involvement of parents-in-law in a participant's life (living together with her, taking care of her, or discriminating against a female baby), lack of support from husband, cesarean delivery, and breast milk insufficiency (supplemented with formula). After multiple logistic regression analysis, parents-in-law's preference to baby boy while devaluing baby girl, dissatisfaction with husband's support, cesarean delivery, and mixed feeding were strongly associated with significant PPD symptoms. CONCLUSION: The potential risk factors for significant PPD symptoms, i.e., "son preference" custom, cesarean delivery and mixed feeding, deserve confirmation in continued, especially clinical diagnosis-based longitudinal studies.

Effect of time-restricted eating regimen on weight loss is mediated by gut microbiome.

Time-restricted eating (TRE) is a promising obesity management strategy, but weight-loss efficacy varies among participants, and the underlying mechanism is unclear. The study aimed to investigate the role of gut microbiota in weight-loss response during long-term TRE intervention. We analyzed data from 51 obese adults in a 12-month TRE program, categorizing them into distinct weight loss groups (DG) and moderate weight loss groups (MG) based on their TRE responses. Shotgun metagenomic sequencing analysis revealed a significant increase in species closely associated with weight loss effectiveness and metabolic parameter changes in the DG group. Pathways related to fatty acid biosynthesis, glycogen biosynthesis, and nucleotide metabolism were reduced in the DG group and enhanced in the MG group. Next, we identified nine specific species at baseline that contributed better responses to TRE intervention and significant weight loss. Collectively, gut microbiota contributes to responsiveness heterogeneity in TRE and can predict weight-loss effectiveness.

Effects of Time-Restricted Eating on Nonalcoholic Fatty Liver Disease: The TREATY-FLD Randomized Clinical Trial.

Importance: The efficacy and safety of time-restricted eating (TRE) on nonalcoholic fatty liver disease (NAFLD) remain uncertain. Objective: To compare the effects of TRE vs daily calorie restriction (DCR) on intrahepatic triglyceride (IHTG) content and metabolic risk factors among patients with obesity and NAFLD. Design, Setting, and Participants: This 12-month randomized clinical trial including participants with obesity and NAFLD was conducted at the Nanfang Hospital in Guangzhou, China, between April 9, 2019, and August 28, 2021. Interventions: Participants with obesity and NAFLD were randomly assigned to TRE (eating only between 8:00 am and 4:00 pm) or DCR (habitual meal timing). All participants were instructed to maintain a diet of 1500 to 1800 kcal/d for men and 1200 to 1500 kcal/d for women for 12 months. Main Outcomes and Measures: The primary outcome was change in IHTG content measured by magnetic resonance imaging; secondary outcomes were changes in body weight, waist circumference, body fat, and metabolic risk factors. Intention-to-treat analysis was used. Results: A total of 88 eligible patients with obesity and NAFLD (mean [SD] age, 32.0 [9.5] years; 49 men [56%]; and mean [SD] body mass index, 32.2 [3.3]) were randomly assigned to the TRE (n = 45) or DCR (n = 43) group. The IHTG content was reduced by 8.3% (95% CI, -10.0% to -6.6%) in the TRE group and 8.1% (95% CI, -9.8% to -6.4%) in the DCR group at the 6-month assessment. The IHTG content was reduced by 6.9% (95% CI, -8.8% to -5.1%) in the TRE group and 7.9% (95% CI, -9.7% to -6.2%) in the DCR group at the 12-month assessment. Changes in IHTG content were comparable between the 2 groups at 6 months (percentage point difference: -0.2; 95% CI, -2.7 to 2.2; P = .86) and 12 months (percentage point difference: 1.0; 95% CI, -1.6 to 3.5; P = .45). In addition, liver stiffness, body weight, and metabolic risk factors were significantly and comparably reduced in both groups. Conclusions and Relevance: Among adults with obesity and NAFLD, TRE did not produce additional benefits for reducing IHTG content, body fat, and metabolic risk factors compared with DCR. These findings support the importance of caloric intake restriction when adhering to a regimen of TRE for the management of NAFLD. Trial Registration: ClinicalTrials.gov Identifiers: NCT03786523 and NCT04988230.

Time-Dependent Endovascular Treatment Effect According to Collateral Status in Basilar Artery Occlusion.

Prior studies on anterior circulation stroke have demonstrated that the benefits of endovascular treatment (EVT) may be absent in patients with poor collaterals. Our study focused on patients with basilar artery occlusion (BAO) to investigate time-dependent EVT effects according to the posterior circulation collateral score (PC-CS). The BASILAR study was a nationwide prospective Chinese registry of consecutive BAO patients. Patients were divided into groups receiving standard medical therapy alone (SMT group) or SMT plus EVT (EVT group). Restricted cubic spline analyses (RCSA) were performed to explore the nonlinear and linear relationships between EVT time and outcomes for different PC-CS. We included 828 patients with acute BAO. Compared with the poor collateral (PC-CS 0-3), the adjusted odds ratio of favorable outcome was 1.311 in patients with moderate (PC-CS 4-5) (95% CI, 0.781-2.201) and 1.899 with good (PC-CS 6-10) collateral (1.125-3.207) for EVT. RCSA revealed that in patients with PC-CS 0-3, the favorable outcome probability after EVT significantly decreased to 10% within 6 h and stabilized thereafter (Pnonlinearity = 0.035), while in patients with moderate and good collateral, the probability was maintained at approximately 30% and 40% respectively, even beyond 6 h (all Pnonlinearity > 0.05). Among patients with BAO, good collateral circulation was independently associated with improved outcomes along with the usage of thrombectomy. Patients with poor collaterals should receive EVT as early as possible, especially within 6 h of symptom onset, while the time window may be extended in patients with moderate and good collaterals. Unique identifier: ChiCTR1800014759.

Case report: Autoimmune nodopathy with concurrent serum and CSF IgG4 anti-neurofascin 155 antibodies.

Objective: To report a case of autoimmune nodopathy (AN) with concurrent serum and CSF immunoglobulin (Ig)G4 anti-neurofascin 155 (NF155) and anti-GD1b antibodies. Methods: A 20-year-old male presented distal weakness of the 4 limbs, hypoesthesia, absent tendon reflexes and sensory ataxia. Nerve conduction studies (NCS), MRI, and autoantibody tests were performed. Results: NCS revealed a diffuse demyelinating neuropathy in the peripheral nerve with motor and sensory involvement. MRI of the cervical and lumbar plexus showed diffuse enlargement. IgG4 anti-NF155 antibodies in both serum and CSF and IgG anti-GD1b antibodies in serum were positive. After treatment with IVIg, rituximab, and plasma exchange, the titer of the patient's anti-NF155 antibodies decreased, but symptoms did not significantly improve. Discussion: This patient presented a typical clinical feature of AN with serum and CSF anti-NF155 antibodies and serum anti-GD1b antibodies coexistent but poor response to IVIg, rituximab and plasma exchange. Early detection of antibodies may be helpful in both diagnosis and therapy of the disease. And prospective studies are necessary to demonstrate the potential role of anti-NF155 antibodies in CSF and help further understand this complex and heterogeneous disease.

DDX56 inhibits PRV replication through regulation of IFN-ß signaling pathway by targeting cGAS.

Pseudorabies virus (PRV) is an agent of Aujeszky's disease, and causes great economic losses to pig farming. Re-outburst of pseudorabies implies that new control measures are urgently needed. We show here that DDX56 possesses the ability to inhibit PRV replication in vitro, which may be an important factor for PRV infection. Overexpression of DDX56 inhibited PRV genomic DNA transcription and lower titers of PRV infection in PK15 cells, whereas down-regulation of the DDX56 expression had a promotion role on virus replication. Further study demonstrated that DDX56 exerted its proliferation-inhibitory effects of PRV through up-regulating cGAS-STING-induced IFN-ß expression. Moreover, we found that DDX56 could promote cGAS expression and direct interaction also existed between DDX56 and cGAS. Based on this, DDX56-regulated IFN-ß pathway may be targeted at cGAS. To verify this, down-regulated cGAS expression in DDX56 over-expression cells was performed. Results indicated that knockdown of cGAS expression could abrogate the inhibition role of DDX56 on PRV proliferation and weaken the effect of DDX56 on IFN-ß expression. In addition, DDX56 played a promotion role in IRF3 phosphorylation and nucleus translocation. Altogether, our results highlight DDX56's antiviral role in PRV infection, and our findings contribute to a better understanding of host factors controlling PRV replication.

The Relationship Between Admission Blood Pressure and Clinical Outcomes for Acute Basilar Artery Occlusion.

Background and Purpose: Optimal blood pressure management of patients with basilar artery occlusion (BAO) remains uncertain. This study aimed to investigate the relationship between admission blood pressure and clinical outcomes following acute BAO. Materials and Methods: We analyzed data from a prospective, nationwide cohort study of 829 patients with acute BAO and posterior circulation stroke. Baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded on admission. The primary outcome was neurological functional disability based on the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included successful reperfusion, mortality within 90 days, and National Institutes of Health Stroke Scale (NIHSS) score change. Multivariable logistic regression was used to assess the associations of SBP and DBP with outcomes. Results: We include 829 patients with posterior circulation stroke and BAO between January 2014 and May 2019. Multivariate logistic regression showed high SBP and DBP correlated with unfavorable outcomes. The favorable prognosis (mRS ≤ 3) rates of the low-to-normal and the hypertension groups were 34.8 and 23.9%, respectively. After adjusting for covariates, multivariate regression analysis demonstrated that an SBP > 140 mm Hg was associated with a poor functional outcome [adjusted OR (aOR), 1.509; 95% CI, 1.130-2.015] and mortality at 90 days (aOR, 1.447; 95% CI, 1.055-1.985), and predicted a lower probability of successful reperfusion (aOR, 0.550; 95% CI, 0.389-0.778). The risk of symptomatic intracranial hemorrhage and the NIHSS score at 24 h were not significantly different between the high SBP group and the low-to-normal blood pressure group. And the results for DBP were similar. Conclusion: Among patients with acute BAO, higher systolic or DBP at admission was associated with poor stroke outcomes and had a lower probability of successful reperfusion, with an increased risk of mortality. Trail Registration: [http://www.chictr.org.cn], [ChiCTR1800014759].

Association of Serum 25-Hydroxyvitamin D With Cardiovascular Outcomes and All-Cause Mortality in Individuals With Prediabetes and Diabetes: Results From the UK Biobank Prospective Cohort Study.

OBJECTIVE: To examine the associations of circulating 25-hydroxyvitamin D (25[OH]D) concentrations with cardiovascular disease (CVD) and all-cause mortality in individuals with prediabetes and diabetes from the large population-based UK Biobank cohort study. RESEARCH DESIGN AND METHODS: A total of 67,789 individuals diagnosed with prediabetes and 24,311 with diabetes who had no CVD or cancer at baseline were included in the current study. Serum 25(OH)D concentrations were measured at baseline. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% CIs for cardiovascular outcomes and mortality after 10-14 years. RESULTS: After multivariable adjustment, higher serum 25(OH)D levels were significantly and nonlinearly associated with lower risk of cardiovascular outcomes and all-cause mortality among participants with prediabetes and diabetes (all P nonlinearity < 0.05). Compared with those in the lowest category of 25(OH)D levels (<25 nmol/L), participants with prediabetes in the highest category of 25(OH)D levels (≥75 nmol/L) had a significant association with lower risk of cardiovascular events (HR 0.78; 95% CI 0.71-0.86), coronary heart disease (CHD) (HR 0.79; 95% CI 0.71-0.89), heart failure (HR 0.66; 95% CI 0.54-0.81), stroke (HR 0.75; 95% CI 0.61-0.93), CVD mortality (HR 0.43; 95% CI 0.32-0.59), and all-cause mortality (HR 0.66; 95% CI 0.58-0.75). Likewise, these associations with cardiovascular events, CHD, heart failure, CVD mortality, and all-cause mortality were observed among participants with diabetes, except for stroke. CONCLUSIONS: These findings highlight the importance of monitoring and correcting vitamin D deficiency in the prevention of CVD and mortality among adults with prediabetes and diabetes.

Endovascular treatment in patients with coma that developed secondary to acute basilar artery occlusion.

OBJECTIVE: This study aimed to evaluate the efficacy of endovascular treatment (EVT) in patients with secondary coma following acute basilar artery occlusion (comatose patients) and to identify the impact of the Glasgow Coma Scale (GCS) score on medical decisions. METHODS: Patients from the Endovascular Treatment for Acute Basilar Artery Occlusion study were divided into comatose and noncomatose cohorts. The primary outcome was favorable functional independence (modified Rankin Scale [mRS] scores 0-3). The safety outcome was 90-day mortality. Subgroup analysis was performed to identify populations best suited for EVT. Multivariate logistic regression was used to identify independent predictive factors of clinical outcomes. RESULTS: Comatose patients who underwent EVT had more favorable functional outcomes and lower mortality compared with those who underwent standard medical treatment (functional outcomes: 15.98% vs 4.17%; mortality: 62.72% vs 82.29%). Moreover, EVT was associated with better outcomes in the cohort with GCS scores of 6-8 (mRS scores 0-3, 25.33% and mortality, 41.33%) than in the cohort with GCS scores of 3-5. Multivariate analysis indicated that EVT was an independent factor for favorable functional outcomes (adjusted OR 8.921, 95% CI 2.330-34.158) and mortality (adjusted OR 0.189, 95% CI 0.092-0.411) in comatose patients. The initial GCS score was an independent factor for favorable functional outcomes (adjusted OR 1.402, 95% CI 1.115-1.763) and mortality (adjusted OR 0.613, 95% CI 0.499-0.752) in comatose patients with EVT. CONCLUSIONS: EVT significantly improved the prognosis of comatose patients, and patients with GCS scores of 6-8 were found to benefit more from EVT than those with GCS scores of 3-5. The initial GCS score was an independent predictive factor for prognosis in comatose patients.

Twenty-four-hour National Institute of Health Stroke Scale predicts short- and long-term outcomes of basilar artery occlusion after endovascular treatment.

Background: The present study aimed to evaluate the prognostic value of the 24-h National Institute of Health Stroke Scale (NIHSS) for short- and long-term outcomes of patients with basilar artery occlusion (BAO) after endovascular treatment (EVT) in daily clinical routine. Methods: Patients with EVT for acute basilar artery occlusion study registry with the 24-h NIHSS, and clinical outcomes documented at 90 days and 1 year were included. The NIHSS admission, 24-h NIHSS, NIHSS delta, and NIHSS percentage change, binary definitions of early neurological improvement [ENI; improvement of 4/(common ENI)/8 (major ENI)/10 (dramatic ENI)] NIHSS points were compared to predict the favorable outcomes and mortality at 90 days and 1 year. The primary outcome was defined as favorable if the modified Rankin Scale (mRS) score was 0-3 at 90 days. Results: Of the 644 patients treated with EVT, the 24-h NIHSS had the highest discriminative ability for favorable outcome prediction [receiver operator characteristic (ROC)NIHSS 24 h area under the curve (AUC): 0.92 (0.90-0.94)] at 90 days and 1 year [(ROCNIHSS 24 h AUC: 0.91 (0.89-0.94)] in comparison to the NIHSS score at admission [ROCNIHSS admission AUC at 90 days: 0.73 (0.69-0.77); 1 year: 0.74 (0.70-0.78)], NIHSS delta [ROCΔ NIHSS AUC at 90 days: 0.84 (0.81-0.87); 1 year: 0.81 (0.77-0.84)], and NIHSS percentage change [ROC%change AUC at 90 days: 0.85 (0.82-0.89); 1 year: 0.82 (0.78-0.86)]. Conclusion: The 24-h NIHSS with a threshold of ≤23 points was the best surrogate for short- and long-term outcomes after EVT for BAO in the clinical routine.

Endovascular treatment for distal basilar artery occlusion stroke.

Background: This study aimed to investigate the clinical outcomes of endovascular treatment (EVT) for distal basilar artery occlusion (BAO) and compare them with the outcomes of standard medical treatment (SMT) in daily clinical practice. Methods: Patients with distal BAO enrolled in the BASILAR study from January 2014 to May 2019 were included. Differences in clinical outcomes were analyzed using Pearson's chi-square test and multivariable logistic regression. Clinical outcomes were evaluated using the modified Rankin Scale (mRS) score at 90 days, the mortality at 90 days, and the occurrence of symptomatic intracranial hemorrhage within 48 h. Results: Among the 267 patients with distal BAO (222 patients in the EVT group and 45 patients in the SMT group), compared with the SMT group, the EVT group was associated with a favorable outcome (mRS 0-3; 40.1 vs. 15.6%; aOR 5.44; 95% CI, 1.68-17.66; P = 0.005) and decreased mortality (44.6 vs. 71.1%, aOR 0.32, 95% CI, 0.13-0.77; P = 0.012). In the EVT group, multivariable analysis showed that the initial National Institutes of Health Stroke Scale (NIHSS) score and posterior circulation-Alberta Stroke Program Early CT Score (pc-ASPECTS) were associated with favorable functional outcomes and mortality. Conclusion: Our study suggests that, compared with SMT, EVT is technically feasible and safe for patients with distal BAO.

Impact of Body Temperature in Patients With Acute Basilar Artery Occlusion: Analysis of the BASILAR Database.

Background: A link between body temperature and stroke outcomes has been established but not for acute basilar artery occlusion. We aimed to determine the association between body temperature and clinical outcomes in patients with acute basilar artery occlusion and temperature management range. Methods: We included patients from the Endovascular Treatment for Acute Basilar Artery Occlusion Study (BASILAR) database with records of both admission body temperature (ABT) and peak body temperature (PBT). ABT was defined as the body temperature first measured at the hospital visit, PBT was defined as the highest temperature within 24 h of treatment, and minus body temperature (MBT) was defined as PBT-ABT. The primary clinical outcome was favorable functional outcome, defined as the proportion of patients with a modified Rankin Scale score of 0-3 at 3 months. Secondary outcomes included 3-month mortality, in-hospital mortality, and symptomatic cerebral hemorrhage. Results: A total of 664 patients were enrolled in the study; 74.7% were men, with a median age of 65 (interquartile range, 57.25-74) years. In all patients, multivariate analysis indicated that PBT and MBT were independent predictors of favorable functional outcome [odds ratio (OR), 0.57 (95% CI, 0.43-0.77); OR, 0.68 (95% CI, 0.52-0.88), respectively], and higher ABT, PBT, and MBT were associated with an increased 3-month mortality [OR, 1.47 (95% CI, 1.03-2.10), OR, 1.58 (95% CI, 1.28-1.96), OR, 1.35 (95% CI, 1.11-1.65), respectively]. Proportional odds models demonstrated that when ABT, PBT, MBT were in the range of <37.5, <38.9, and -0.6-2.7°C, respectively, the benefit of the endovascular treatment is clearly greater than that of standard medical treatment in terms of favorable functional outcome. Conclusions: Body temperature is an independent predictor of clinical outcome in patients with acute basilar artery occlusion. It is necessary to control the patient body temperature within the appropriate range in clinical settings. Trial Registration: Chinese Clinical Trial Registry ChiCTR1800014759. Registered 03 February 2018. Retrospectively registered.

[Association of dietary habits with gestational diabetes mellitus among Cantonese women].

OBJECTIVE: To evaluate the relationship between dietary habits and the risk of gestational diabetes mellitus (GDM) in Cantonese women. METHDS: This a cross-sectional study included 571 pregnant women who underwent a 75-g oral glucose challenge test at the 24th to 28th gestational week. Food frequency questionnaire (FFQ) was used by three dieticians to evaluate all the subjects' dietary habits. RESULTS: 13% of the investigated subjects were identified to have GDM (GDM⁺). No significant differences were found between the GDM⁺ and GDM⁻ groups in the intake of energy, macronutrients, fibers, or cholesterol. The amount of low- and middle-GI fruits consumed daily in the two groups was not statistically different, but the GDM⁺ subjects reported a significantly greater amount of high-GI fruit intake as well as energy-dense foods than the GDM⁻ subjects (P<0.05). Multiple logistic regression analysis revealed that increased consumption of energy-dense snack foods and high glycemic-index fruits were strongly associated with the risk of GDM. CONCLUSION: Local dietary composition (high-GI fruit and energy-dense foods) is closely related to the risk of GDM in Cantonese women, for whom intensive health education of dietary behavior is needed to control GDM.