The ICF2 gene Zbtb24 specifically regulates the differentiation of B1 cells via promoting heme synthesis.

BACKGROUND: Loss-of-function mutations of ZBTB24 cause immunodeficiency, centromeric instability, and facial anomalies syndrome 2 (ICF2). ICF2 is a rare autosomal recessive disorder with immunological defects in serum antibodies and circulating memory B cells, resulting in recurrent and sometimes fatal respiratory and gastrointestinal infections. The genotype-phenotype correlation in patients with ICF2 indicates an essential role of ZBTB24 in the terminal differentiation of B cells. METHODS: We used the clustered regularly interspaced short palindromic repeats (CRISPER)/Cas9 technology to generate B cell specific Zbtb24-deficient mice and verified the deletion specificity and efficiency by quantitative polymerase chain reaction (Q-PCR) and western blotting analyses in fluorescence-activated cell sorting (FACS)-sorted cells. The development, phenotype of B cells and in vivo responses to T cell dependent or independent antigens post immunization were analyzed by flow cytometry and enzyme-linked immunosorbent assay (ELISA). Adoptive transfer experiment in combination with in vitro cultures of FACS-purified B cells and RNA-Seq analysis were utilized to specifically determine the impact of Zbtb24 on B cell biology as well as the underlying mechanisms. RESULTS: Zbtb24 is dispensable for B cell development and maintenance in naive mice. Surprisingly, B cell specific deletion of Zbtb24 does not evidently compromise germinal center reactions and the resulting primary and secondary antibody responses induced by T cell dependent antigens (TD-Ags), but significantly inhibits T cell independent antigen-elicited antibody productions in vivo. At the cellular level, Zbtb24-deficiency specifically impedes the plasma cell differentiation of B1 cells without impairing their survival, activation and proliferation in vitro. Mechanistically, Zbtb24-ablation attenuates heme biosynthesis partially through mTORC1 in B1 cells, and addition of exogenous hemin abrogates the differentiation defects of Zbtb24-null B1 cells. CONCLUSIONS: Zbtb24 seems to regulate antibody responses against TD-Ags B cell extrinsically, but it specifically promotes the plasma cell differentiation of B1 cells via heme synthesis in mice. Our study also suggests that defected B1 functions contribute to recurrent infections in patients with ICF2.

Early Burst Suppression Similarity Association with Structural Brain Injury Severity on MRI After Cardiac Arrest.

BACKGROUND: Identical bursts on electroencephalography (EEG) are considered a specific predictor of poor outcomes in cardiac arrest, but its relationship with structural brain injury severity on magnetic resonance imaging (MRI) is not known. METHODS: This was a retrospective analysis of clinical, EEG, and MRI data from adult comatose patients after cardiac arrest. Burst similarity in first 72 h from the time of return of spontaneous circulation were calculated using dynamic time-warping (DTW) for bursts of equal (i.e., 500 ms) and varying (i.e., 100-500 ms) lengths and cross-correlation for bursts of equal lengths. Structural brain injury severity was measured using whole brain mean apparent diffusion coefficient (ADC) on MRI. Pearson's correlation coefficients were calculated between mean burst similarity across consecutive 12-24-h time blocks and mean whole brain ADC values. Good outcome was defined as Cerebral Performance Category of 1-2 (i.e., independence for activities of daily living) at the time of hospital discharge. RESULTS: Of 113 patients with cardiac arrest, 45 patients had burst suppression (mean cardiac arrest to MRI time 4.3 days). Three study participants with burst suppression had a good outcome. Burst similarity calculated using DTW with bursts of varying lengths was correlated with mean ADC value in the first 36 h after cardiac arrest: Pearson's r: 0-12 h: - 0.69 (p = 0.039), 12-24 h: - 0.54 (p = 0.002), 24-36 h: - 0.41 (p = 0.049). Burst similarity measured with bursts of equal lengths was not associated with mean ADC value with cross-correlation or DTW, except for DTW at 60-72 h (- 0.96, p = 0.04). CONCLUSIONS: Burst similarity on EEG after cardiac arrest may be associated with acute brain injury severity on MRI. This association was time dependent when measured using DTW.

The International Cardiac Arrest Research Consortium Electroencephalography Database.

OBJECTIVES: To develop the International Cardiac Arrest Research (I-CARE), a harmonized multicenter clinical and electroencephalography database for acute hypoxic-ischemic brain injury research involving patients with cardiac arrest. DESIGN: Multicenter cohort, partly prospective and partly retrospective. SETTING: Seven academic or teaching hospitals from the United States and Europe. PATIENTS: Individuals 16 years old or older who were comatose after return of spontaneous circulation following a cardiac arrest who had continuous electroencephalography monitoring were included. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Clinical and electroencephalography data were harmonized and stored in a common Waveform Database-compatible format. Automated spike frequency, background continuity, and artifact detection on electroencephalography were calculated with 10-second resolution and summarized hourly. Neurologic outcome was determined at 3-6 months using the best Cerebral Performance Category (CPC) scale. This database includes clinical data and 56,676 hours (3.9 terabytes) of continuous electroencephalography data for 1,020 patients. Most patients died ( n = 603, 59%), 48 (5%) had severe neurologic disability (CPC 3 or 4), and 369 (36%) had good functional recovery (CPC 1-2). There is significant variability in mean electroencephalography recording duration depending on the neurologic outcome (range, 53-102 hr for CPC 1 and CPC 4, respectively). Epileptiform activity averaging 1 Hz or more in frequency for at least 1 hour was seen in 258 patients (25%) (19% for CPC 1-2 and 29% for CPC 3-5). Burst suppression was observed for at least 1 hour in 207 (56%) and 635 (97%) patients with CPC 1-2 and CPC 3-5, respectively. CONCLUSIONS: The I-CARE consortium electroencephalography database provides a comprehensive real-world clinical and electroencephalography dataset for neurophysiology research of comatose patients after cardiac arrest. This dataset covers the spectrum of abnormal electroencephalography patterns after cardiac arrest, including epileptiform patterns and those in the ictal-interictal continuum.

Development of a Strategy for L-Lactic Acid Production by Rhizopus oryzae Using Zizania latifolia Waste and Cane Molasses as Carbon Sources.

As a biodegradable and renewable material, polylactic acid is considered a major environmentally friendly alternative to petrochemical plastics. Microbial fermentation is the traditional method for lactic acid production, but it is still too expensive to compete with the petrochemical industry. Agro-industrial wastes are generated from the food and agricultural industries and agricultural practices. The utilization of agro-industrial wastes is an important way to reduce costs, save energy and achieve sustainable development. The present study aimed to develop a method for the valorization of Zizania latifolia waste and cane molasses as carbon sources for L-lactic acid fermentation using Rhizopus oryzae LA-UN-1. The results showed that xylose derived from the acid hydrolysis of Z. latifolia waste was beneficial for cell growth, while glucose from the acid hydrolysis of Z. latifolia waste and mixed sugars (glucose and fructose) from the acid hydrolysis of cane molasses were suitable for the accumulation of lactic acid. Thus, a three-stage carbon source utilization strategy was developed, which markedly improved lactic acid production and productivity, respectively reaching 129.47 g/L and 1.51 g/L·h after 86 h of fermentation. This work demonstrates that inexpensive Z. latifolia waste and cane molasses can be suitable carbon sources for lactic acid production, offering an efficient utilization strategy for agro-industrial wastes.

Rapid context inference in a thalamocortical model using recurrent neural networks.

Cognitive flexibility is a fundamental ability that enables humans and animals to exhibit appropriate behaviors in various contexts. The thalamocortical interactions between the prefrontal cortex (PFC) and the mediodorsal thalamus (MD) have been identified as crucial for inferring temporal context, a critical component of cognitive flexibility. However, the neural mechanism responsible for context inference remains unknown. To address this issue, we propose a PFC-MD neural circuit model that utilizes a Hebbian plasticity rule to support rapid, online context inference. Specifically, the model MD thalamus can infer temporal contexts from prefrontal inputs within a few trials. This is achieved through the use of PFC-to-MD synaptic plasticity with pre-synaptic traces and adaptive thresholding, along with winner-take-all normalization in the MD. Furthermore, our model thalamus gates context-irrelevant neurons in the PFC, thus facilitating continual learning. We evaluate our model performance by having it sequentially learn various cognitive tasks. Incorporating an MD-like component alleviates catastrophic forgetting of previously learned contexts and demonstrates the transfer of knowledge to future contexts. Our work provides insight into how biological properties of thalamocortical circuits can be leveraged to achieve rapid context inference and continual learning.

Objective Depression Detection Using EEG and Eye Movement Signals Induced by Oil Paintings.

Depression is a mental disorder characterized by persistent sadness and loss of interest, which has become one of the leading causes of disability worldwide. There are currently no objective diagnostic standards for depression in clinical practice. Previous studies have shown that depression causes both brain abnormalities and behavioral disorders. In this study, both electroencephalography (EEG) and eye movement signals were used to objectively detect depression. By presenting 40 carefully selected oil paintings-20 positive and 20 negative-as stimuli, we were able to successfully evoke emotions in 48 depressed patients (DPs) and 40 healthy controls (HCs) from three centers. We then used Transformer, a deep learning model, to conduct emotion recognition and depression detection. The experimental results demonstrate that: a) Transformer achieves the best accuracies of 89.21% and 92.19% in emotion recognition and depression detection, respectively; b) The HC group has higher accuracies than the DP group in emotion recognition for both subject-dependent and subject-independent experiments; c) The neural pattern differences do exist between DPs and HCs, and we find the consistent asymmetry of the neural patterns in DPs; d) For depression detection, using single oil painting achieves the best accuracies, and using negative oil paintings has higher accuracies than using positive oil paintings. These findings suggest that EEG and eye movement signals induced by oil paintings can be used to objectively identify depression.

Tagging Continuous Labels for EEG-based Emotion Classification.

EEG-based emotion classification has long been a critical task in the field of affective brain-computer interface (aBCI). The majority of leading researches construct supervised learning models based on labeled datasets. Several datasets have been released, including different kinds of emotions while utilizing various forms of stimulus materials. However, they adopt discrete labeling methods, in which the EEG data collected during the same stimulus material are given a same label. These methods neglect the fact that emotion changes continuously, and mislabeled data possibly exist. The imprecision of discrete labels may hinder the progress of emotion classification in concerned works. Therefore, we develop an efficient system in this paper to support continuous labeling by giving each sample a unique label, and construct a continuously labeled EEG emotion dataset. Using our dataset with continuous labels, we demonstrate the superiority of continuous labeling in emotion classification through experiments on several classification models. We further utilize the continuous labels to identify the EEG features under induced and non-induced emotions in both our dataset and a public dataset. Our experimental results reveal the learnability and generality of the relation between the EEG features and their continuous labels.

Effects of biochar application and nutrient fluctuation on the growth, and cadmium and nutrient uptake of Trifolium repens with different planting densities in Cd-contaminated soils.

Biochar has been used to remediate contaminated-soil with heavy metals, however, less is known on how biochar interacts with planting density and nutrient fluctuation to affect the remediation. A pot experiment was conducted in the greenhouse to investigate the effects of biochar application (without vs. with 1% biochar, g/g substrate), nutrient fluctuation (constant vs. pulsed) and planting density (1-, 3- and 6-individuals per pot) on the growth, and cadmium (Cd) and nutrient uptake of Trifolium repens population. Our results found that the growth of T. repens population increased significantly with increasing planting density, and the increment decreased with increasing planting density. Both the Cd and nutrient uptake were higher at higher planting density (e.g., 3- and 6-individuals) than at lower planting density (e.g., 1-individual). Biochar application increased the biomass and shoot Cd uptake, but decreased the ratio of root to shoot and root Cd uptake of T. repens population, the effects of which were significantly influenced by planting density. Although nutrient fluctuation had no effect on the growth of T. repens population, but its interaction with planting density had significant effects on Cd uptake in tissues. Overall, the effects of biochar application and nutrient fluctuation on the growth and Cd uptake were both influenced by planting density in the present study. Our findings highlight that biochar application and constant nutrient supply at an appropriate planting density, such as planting density of 3-individuals per pot in the present study, could promote the growth, and Cd and nutrient uptake of T. repens population.

Deep Depression Detection with Resting-State and Cognitive-Task EEG.

Depression is a common mental disorder that negatively affects physical health and personal, social and occupational functioning. Currently, accurate and objective diagnosis of depression remains challenging, and electroencephalography (EEG) provides promising clinical practice or home use due to considerable performance and low cost. This work investigates the capabilities of deep neural networks with EEG-based neural patterns from both resting states and cognitive tasks for depression detection. We collect EEG signals from 33 depressed patients and 40 healthy controls using wearable dry electrodes and build Attentive Simple Graph Convolutional network and Transformer neural network for objective depression detection. Four experiment stages, including two resting states and two cognitive tasks, are designed to characterize the alteration of relevant neural patterns in the depressed patients, in terms of decreased energy and impaired performance in sustained attention and response inhibition. The Transformer model achieves an AUC of 0.94 on the Continuous Performance Test-Identical Pairs version (sensitivity: 0.87, specificity: 0.91) and the Stroop Color Word Test (sensitivity: 0.93, specificity: 0.88), and an AUC of 0.89 on the two resting states (sensitivity: 0.85 and 0.87, specificity: 0.88 and 0.90, respectively), indicating the potential of EEG-based neural patterns in identifying depression. These findings provide new insights into the research of depression mechanisms and EEG-based depression biomarkers.

Investigating Emotion EEG Patterns for Depression Detection with Attentive Simple Graph Convolutional Network.

Depression severely limits daily functioning, diminishes quality of life and possibly leads to self-harm and suicide. Noninvasive electroencephalography (EEG) has been shown effective as biomarkers for objective depression diagnose and treatment response prediction, and dry EEG electrodes further extend its availability for clinical use. Even though many efforts have been made to identify depression biomarkers, searching reliable EEG biomarkers for depression detection remains challenging. This work presents a systematic investigation of capabilities of emotion EEG patterns for depression detection using a dry EEG electrode system. We design an emotion elicitation paradigm with happy, neutral and sad emotions and collect EEG signals during film watching from 33 depressed patients and 40 healthy controls. The mean activation levels at frontal and temporal sites in the alpha, beta and gamma bands of the depressed group are different to those of the healthy group, indicating the impacts of depressive symptoms on the emotion experiences. To leverage the topology information among EEG channels for emotion recognition and depression detection, an Attentive Simple Graph Convolutional network is built. The deep depression-health classifier achieves a sensitivity of 81.93% and a specificity of 91.69% on the happy emotions, suggesting the promising use of the emotion neural patterns for distinguishing the depressed patients from the healthy controls.

Identifying sex differences in EEG-based emotion recognition using graph convolutional network with attention mechanism.

OBJECTIVE: Sex differences in emotions have been widely perceived via self-reports, peripheral physiological signals and brain imaging techniques. However, how sex differences are reflected in the EEG neural patterns of emotions remains unresolved. In this paper, we detect sex differences in emotional EEG patterns, investigate the consistency of such differences in various emotion datasets across cultures, and study how sex as a factor affects the performance of EEG-based emotion recognition models. APPROACH: We thoroughly assess sex differences in emotional EEG patterns on five public datasets, including SEED, SEED-IV, SEED-V, DEAP and DREAMER, systematically examine the sex-specific EEG patterns for happy, sad, fearful, disgusted and neutral emotions, and implement deep learning models for sex-specific emotion recognition. MAIN RESULTS: (1) Sex differences exist in various emotion types and both Western and Eastern cultures; (2) The emotion patterns of females are more stable than those of males, and the patterns of happiness from females are in sharp contrast with the patterns of sadness, fear and disgust, while the energy levels are more balanced for males; (3) The key features for emotion recognition are mainly located at the frontal and temporal sites for females and distributed more evenly over the whole brain for males, and (4) The same-sex emotion recognition models outperform the corresponding cross-sex models. SIGNIFICANCE: These findings extend efforts to characterize sex differences in emotional brain activation, provide new physiological evidence for sex-specific emotion processing, and reinforce the message that sex differences should be carefully considered in affective research and precision medicine.

Efficient Co-production of Docosahexaenoic Acid Oil and Carotenoids in Aurantiochytrium sp. Using a Light Intensity Gradient Strategy.

Aurantiochytrium is a promising source of docosahexaenoic acid (DHA) and carotenoids, but their synthesis is influenced by environmental stress factors. In this study, the effect of different light intensities on the fermentation of DHA oil and carotenoids using Aurantiochytrium sp. TZ209 was investigated. The results showed that dark culture and low light intensity conditions did not affect the normal growth of cells, but were not conducive to the accumulation of carotenoids. High light intensity promoted the synthesis of DHA and carotenoids, but caused cell damage, resulting in a decrease of oil yield. To solve this issue, a light intensity gradient strategy was developed, which markedly improved the DHA and carotenoid content without reducing the oil yield. This strategy produced 30.16 g/L of microalgal oil with 15.11 g/L DHA, 221 µg/g astaxanthin, and 386 µg/g ß-carotene. This work demonstrates that strain TZ209 is a promising DHA producer and provides an efficient strategy for the co-production of DHA oil together with carotenoids.

Neurophysiology State Dynamics Underlying Acute Neurologic Recovery After Cardiac Arrest.

BACKGROUND AND OBJECTIVES: Epileptiform activity and burst suppression are neurophysiology signatures reflective of severe brain injury after cardiac arrest. We aimed to delineate the evolution of coma neurophysiology feature ensembles associated with recovery from coma after cardiac arrest. METHODS: Adults in acute coma after cardiac arrest were included in a retrospective database involving 7 hospitals. The combination of 3 quantitative EEG features (burst suppression ratio [BSup], spike frequency [SpF], and Shannon entropy [En]) was used to define 5 distinct neurophysiology states: epileptiform high entropy (EHE: SpF ≥4 per minute and En ≥5); epileptiform low entropy (ELE: SpF ≥4 per minute and <5 En); nonepileptiform high entropy (NEHE: SpF <4 per minute and ≥5 En); nonepileptiform low entropy (NELE: SpF <4 per minute and <5 En), and burst suppression (BSup ≥50% and SpF <4 per minute). State transitions were measured at consecutive 6-hour blocks between 6 and 84 hours after return of spontaneous circulation. Good neurologic outcome was defined as best cerebral performance category 1-2 at 3-6 months. RESULTS: One thousand thirty-eight individuals were included (50,224 hours of EEG), and 373 (36%) had good outcome. Individuals with EHE state had a 29% rate of good outcome, while those with ELE had 11%. Transitions out of an EHE or BSup state to an NEHE state were associated with good outcome (45% and 20%, respectively). No individuals with ELE state lasting >15 hours had good recovery. DISCUSSION: Transition to high entropy states is associated with an increased likelihood of good outcome despite preceding epileptiform or burst suppression states. High entropy may reflect mechanisms of resilience to hypoxic-ischemic brain injury.

The International Cardiac Arrest Research (I-CARE) Consortium Electroencephalography Database.

Objective: To develop a harmonized multicenter clinical and electroencephalography (EEG) database for acute hypoxic-ischemic brain injury research involving patients with cardiac arrest. Design: Multicenter cohort, partly prospective and partly retrospective. Setting: Seven academic or teaching hospitals from the U.S. and Europe. Patients: Individuals aged 16 or older who were comatose after return of spontaneous circulation following a cardiac arrest who had continuous EEG monitoring were included. Interventions: not applicable. Measurements and Main Results: Clinical and EEG data were harmonized and stored in a common Waveform Database (WFDB)-compatible format. Automated spike frequency, background continuity, and artifact detection on EEG were calculated with 10 second resolution and summarized hourly. Neurological outcome was determined at 3-6 months using the best Cerebral Performance Category (CPC) scale. This database includes clinical and 56,676 hours (3.9 TB) of continuous EEG data for 1,020 patients. Most patients died (N=603, 59%), 48 (5%) had severe neurological disability (CPC 3 or 4), and 369 (36%) had good functional recovery (CPC 1-2). There is significant variability in mean EEG recording duration depending on the neurological outcome (range 53-102h for CPC 1 and CPC 4, respectively). Epileptiform activity averaging 1 Hz or more in frequency for at least one hour was seen in 258 (25%) patients (19% for CPC 1-2 and 29% for CPC 3-5). Burst suppression was observed for at least one hour in 207 (56%) and 635 (97%) patients with CPC 1-2 and CPC 3-5, respectively. Conclusions: The International Cardiac Arrest Research (I-CARE) consortium database provides a comprehensive real-world clinical and EEG dataset for neurophysiology research of comatose patients after cardiac arrest. This dataset covers the spectrum of abnormal EEG patterns after cardiac arrest, including epileptiform patterns and those in the ictal-interictal continuum.

Investigating EEG-based functional connectivity patterns for multimodal emotion recognition.

Objective.Previous studies on emotion recognition from electroencephalography (EEG) mainly rely on single-channel-based feature extraction methods, which ignore the functional connectivity between brain regions. Hence, in this paper, we propose a novel emotion-relevant critical subnetwork selection algorithm and investigate three EEG functional connectivity network features: strength, clustering coefficient, and eigenvector centrality.Approach.After constructing the brain networks by the correlations between pairs of EEG signals, we calculated critical subnetworks through the average of brain network matrices with the same emotion label to eliminate the weak associations. Then, three network features were conveyed to a multimodal emotion recognition model using deep canonical correlation analysis along with eye movement features. The discrimination ability of the EEG connectivity features in emotion recognition is evaluated on three public datasets: SEED, SEED-V, and DEAP.Main results. The experimental results reveal that the strength feature outperforms the state-of-the-art features based on single-channel analysis. The classification accuracies of multimodal emotion recognition are95.08±6.42%on the SEED dataset,84.51±5.11%on the SEED-V dataset, and85.34±2.90%and86.61±3.76%for arousal and valence on the DEAP dataset, respectively, which all achieved the best performance. In addition, the brain networks constructed with 18 channels achieve comparable performance with that of the 62-channel network and enable easier setups in real scenarios.Significance.The EEG functional connectivity networks combined with emotion-relevant critical subnetworks selection algorithm we proposed is a successful exploration to excavate the information between channels.

Multimodal Emotion Recognition in Response to Oil Paintings.

Most previous affective studies use facial expression pictures, music or movie clips as emotional stimuli, which are either too simplified without contexts or too dynamic for emotion annotations. In this work, we evaluate the effectiveness of oil paintings as stimuli. We develop an emotion stimuli dataset with 114 oil paintings selected from subject ratings to evoke three emotional states (i.e., negative, neutral and positive), and acquire both EEG and eye tracking data from 20 subjects while watching the oil paintings. Furthermore, we propose a novel affective model for multimodal emotion recognition by 1) extracting informative features of EEG signals from both the time domain and the frequency domain, 2) exploring topological information embedded in EEG channels with graph neural networks (GNNs), and 3) combining EEG and eye tracking data with a deep autoencoder neural network. From the exper-iments, our model obtains an averaged classification accuracy of 94.72 % ± 1.47 %, which demonstrates the feasibility of using oil paintings as emotion elicitation material.

Identifying similarities and differences in emotion recognition with EEG and eye movements among Chinese, German, and French People.

Objective.Cultures have essential influences on emotions. However, most studies on cultural influences on emotions are in the areas of psychology and neuroscience, while the existing affective models are mostly built with data from the same culture. In this paper, we identify the similarities and differences among Chinese, German, and French individuals in emotion recognition with electroencephalogram (EEG) and eye movements from an affective computing perspective.Approach.Three experimental settings were designed: intraculture subject dependent, intraculture subject independent, and cross-culture subject independent. EEG and eye movements are acquired simultaneously from Chinese, German, and French subjects while watching positive, neutral, and negative movie clips. The affective models for Chinese, German, and French subjects are constructed by using machine learning algorithms. A systematic analysis is performed from four aspects: affective model performance, neural patterns, complementary information from different modalities, and cross-cultural emotion recognition.Main results.From emotion recognition accuracies, we find that EEG and eye movements can adapt to Chinese, German, and French cultural diversities and that a cultural in-group advantage phenomenon does exist in emotion recognition with EEG. From the topomaps of EEG, we find that theγandßbands exhibit decreasing activities for Chinese, while for German and French,θandαbands exhibit increasing activities. From confusion matrices and attentional weights, we find that EEG and eye movements have complementary characteristics. From a cross-cultural emotion recognition perspective, we observe that German and French people share more similarities in topographical patterns and attentional weight distributions than Chinese people while the data from Chinese are a good fit for test data but not suitable for training data for the other two cultures.Significance.Our experimental results provide concrete evidence of the in-group advantage phenomenon, cultural influences on emotion recognition, and different neural patterns among Chinese, German, and French individuals.

High incidence of epileptiform activity in adults undergoing extracorporeal membrane oxygenation.

OBJECTIVE: The prevalence of seizures and other types of epileptiform brain activity in patients undergoing extracorporeal membrane oxygenation (ECMO) is unknown. We aimed to estimate the prevalence of seizures and ictal-interictal continuum patterns in patients undergoing electroencephalography (EEG) during ECMO. METHODS: Retrospective review of a prospective ECMO registry from 2011-2018 in a university-affiliated academic hospital. Adult subjects who had decreased level of consciousness and underwent EEG monitoring for seizure screening were included. EEG classification followed the American Clinical Neurophysiology Society criteria. Poor neurological outcome was defined as a Cerebral Performance Category of 3-5 at hospital discharge. RESULTS: Three hundred and ninety-five subjects had ECMO, and one hundred and thirteen (28.6%) had EEG monitoring. Ninety-two (23.3%) subjects had EEG performed during ECMO and were included in the study (average EEG duration 54 h). Veno-arterial ECMO was the most common cannulation strategy (83%) and 26 (28%) subjects had extracorporeal cardiopulmonary resuscitation. Fifty-eight subjects (63%) had epileptiform activity or ictal-interictal continuum patterns on EEG, including three (3%) subjects with nonconvulsive status epilepticus, 33 (36%) generalized periodic discharges, and 4 (5%) lateralized periodic discharges. Comparison between subjects with or without epileptiform activity showed comparable in-hospital mortality (57% vs. 47%, p = 0.38) and poor neurological outcome (and 56% and 36%, p = 0.23). Twenty-seven subjects (33%) had acute neuroimaging abnormalities (stroke N = 21). CONCLUSIONS: Seizures and ictal-interictal continuum patterns are commonly observed in patients managed with ECMO. Further studies are needed to evaluate whether epileptiform activity is an actionable target for interventions. SIGNIFICANCE: Epileptiform and ictal-interictal continuum abnormalities are frequently observed in patients supported with ECMO undergoing EEG monitoring.

SLC25A25-AS1 over-expression could be predicted the dismal prognosis and was related to the immune microenvironment in prostate cancer.

It has been established that long-chain coding RNA (lncRNA) SLC25A25-AS1 is associated with cancer progression. However, the roles and mechanisms of SLC25A25-AS1 in prostate cancer (PC) have not been reported in the literature. The present study explored the relationship between SLC25A25-AS1 expression and PC progression via comprehensive analysis. The pan-cancer expression of SLC25A25-AS1 was identified using data from The Cancer Genome Atlas (TCGA) database and tissue specimens from our hospital. The expression levels of SLC25A25-AS1 in various subgroups based on the clinical features were identified. The prognostic value of SLC25A25-AS1 and SLC25A25-AS1 co-expressed lncRNAs in PC patients was assessed by survival analysis and ROC analysis, and prognosis-related risk models of SLC25A25-AS1 were constructed. The relationship between SLC25A25-AS1 and the PC immune microenvironment was investigated using correlation analysis. SLC25A25-AS1 expression in PC was significantly increased and correlated with the T stage, clinical stage, Gleason score (GS), and dismal prognosis. SLC25A25-AS1 overexpression exhibited good performance in evaluating the prognosis of PC patients. The area under the curves (AUCs) of the 1-, 3-, and 5-year overall survival (OS) for SLC25A25-AS1 was 1, 0.876, and 0.749. Moreover, the AUCs for the 1-, 3-, and 5-year progress free interval (PFI) for SLC25A25-AS1 were 0.731, 0.701, and 0.718. SLC25A25-AS1 overexpression correlated with the infiltration of CD8 T cells, interstitial dendritic cells (IDC), macrophages and other cells. AC020558.2, ZNF32-AS2, AP4B1-AS1, AL355488.1, AC109460.3, SNHG1, C3orf35, LMNTD2-AS1, and AL365330.1 were significantly associated with SLC25A25-AS1 expression, and short OS and PFI in PC patients. The risk models of the SLC25A25-AS1-related lncRNAs were associated with a dismal prognosis in PC. Overall, SLC25A25-AS1 expression was increased in PC and related to the prognosis and PC immune microenvironment. The risk model of SLC25A25-AS1 have huge prospect for application as prognostic tools in PC.

Automated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage.

OBJECTIVE: Delayed cerebral ischemia (DCI) is a leading complication of aneurysmal subarachnoid hemorrhage (SAH) and electroencephalography (EEG) is increasingly used to evaluate DCI risk. Our goal is to develop an automated DCI prediction algorithm integrating multiple EEG features over time. METHODS: We assess 113 moderate to severe grade SAH patients to develop a machine learning model that predicts DCI risk using multiple EEG features. RESULTS: Multiple EEG features discriminate between DCI and non-DCI patients when aligned either to SAH time or to DCI onset. DCI and non-DCI patients have significant differences in alpha-delta ratio (0.08 vs 0.05, p < 0.05) and percent alpha variability (0.06 vs 0.04, p < 0.05), Shannon entropy (p < 0.05) and epileptiform discharge burden (205 vs 91 discharges per hour, p < 0.05) based on whole brain and vascular territory averaging. Our model improves predictions by emphasizing the most informative features at a given time with an area under the receiver-operator curve of 0.73, by day 5 after SAH and good calibration between 48-72 hours (calibration error 0.13). CONCLUSIONS: Our proposed model obtains good performance in DCI prediction. SIGNIFICANCE: We leverage machine learning to enable rapid, automated, multi-featured EEG assessment and has the potential to increase the utility of EEG for DCI prediction.