Clinical Application of Extracorporeal Membrane Oxygenation in the Treatment of Fulminant Myocarditis.

Fulminant myocarditis (FM) is a rare but serious clinical syndrome which can be characterized by the rapid deterioration of cardiac function, with cardiogenic shock (CS) and arrhythmic electrical storms being common presentations, often requiring adjunctive support with mechanical circulatory devices. With the development of mechanical circulatory support (MCS) devices, there are now more and more studies investigating the application of MCS in FM patients, and the use of extracorporeal membrane oxygenation (ECMO) to treat FM has shown good survival rates. This review elucidates the treatment of FM, and the application and clinical outcomes associated with ECMO intervention.

The causal association between peripheral blood eosinophils and nasal polyps: a Mendelian randomization study.

OBJECTIVE: Observational studies suggested that peripheral blood eosinophils were associated with the risk of nasal polyps. However, these studies did not confirm the causality. This study aims to apply Mendelian randomization (MR) method to comprehensively assess the potential causal association between peripheral blood eosinophils and nasal polyps. METHODS: Genetic instrumental variables were extracted from the largest available genome-wide association study (GWAS) of European participants, which were used to investigate the relationship between peripheral blood eosinophils and nasal polyps. The inverse variance weighted method, the MR Egger method, and the weighted median method were applied for this analysis. MR-Egger intercept tests, leave-one-out analyses, and funnel plots were performed for the sensitivity analysis. RESULTS: With the inverse variance weighted method, the MR analysis suggested that there was a significant difference between peripheral blood eosinophils and the risk of nasal polyps (ukb-a-97, OR 1.004, 95% CI 1.003-1.005, p < 0.001; ukb-a-541, OR 1.005, 95% CI 1.004-1.006, p < 0.001; ukb-b-7211, OR 1.004, 95% CI 1.003-1.005, p < 0.001; ukb-b-8425, OR 1.004, 95% CI 1.003-1.005, p < 0.001; finn-b-J10_NASALPOLYP, OR 3.089, 95% CI 2.537-3.761, p < 0.001). Consistent results were also proved by using the weighted median method and the MR Egger method. CONCLUSIONS: Our findings reveal the causal effect of peripheral blood eosinophils on the increased risk of nasal polyps.

Esterified Soy Proteins with Enhanced Antibacterial Properties for the Stabilization of Nano-Emulsions under Acidic Conditions.

Soy protein isolate (SPI), including ß-conglycinin (7S) and glycinin (11S), generally have low solubility under weakly acidic conditions due to the pH closed to their isoelectric points (pIs), which has limited their application in acidic emulsions. Changing protein pI through modification by esterification could be a feasible way to solve this problem. This study aimed to obtain stable nano-emulsion with antibacterial properties under weakly acidic conditions by changing the pI of soy protein emulsifiers. Herein, the esterified soy protein isolate (MSPI), esterified ß-conglycinin (M7S), and esterified glycinin (M11S) proteins were prepared. Then, pI, turbidimetric titration, Fourier transform infrared (FTIR) spectra, intrinsic fluorescence spectra, and emulsifying capacity of esterified protein were discussed. The droplet size, the ζ-potential, the stability, and the antibacterial properties of the esterified protein nano-emulsion were analyzed. The results revealed that the esterified proteins MSPI, M7S, and M11S had pIs, which were measured by ζ-potentials, as pH 10.4, 10.3, and 9.0, respectively, as compared to native proteins. All esterified-protein nano-emulsion samples showed a small mean particle size and good stability under weakly acidic conditions (pH 5.0), which was near the original pI of the soy protein. Moreover, the antibacterial experiments showed that the esterified protein-based nano-emulsion had an inhibitory effect on bacteria at pH 5.0.

Effects of parasternal intercostal block on surgical site wound infection and pain in patients undergoing cardiac surgery: A meta-analysis.

This study aimed to assess the effect of parasternal intercostal block on postoperative wound infection, pain, and length of hospital stay in patients undergoing cardiac surgery. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were extensively queried using a computer, and randomised controlled studies (RCTs) from the inception of each database to July 2023 were sought using keywords in English and Chinese language. Literature quality was assessed using Cochrane-recommended tools, and the included data were collated and analysed using Stata 17.0 software for meta-analysis. Ultimately, eight RCTs were included. Meta-analysis revealed that utilising parasternal intercostal block during cardiac surgery significantly reduced postoperative wound pain (standardised mean difference [SMD] = -1.01, 95% confidence intervals [CI]: -1.70 to -0.31, p = 0.005) and significantly shortened hospital stay (SMD = -0.40, 95% CI: -0.77 to -0.04, p = 0.029), though it may increase the risk of wound infection (OR = 5.03, 95% CI:0.58-44.02, p = 0.144); however, the difference was not statistically significant. The application of parasternal intercostal block during cardiac surgery can significantly reduce postoperative pain and shorten hospital stay. This approach is worth considering for clinical implementation. Decisions regarding its adoption should be made in conjunction with the relevant clinical indices and surgeon's experience.

Gel Property of Soy Protein Emulsion Gel: Impact of Combined Microwave Pretreatment and Covalent Binding of Polyphenols by Alkaline Method.

This study investigated the effects of microwave modification, alkali polyphenol (ferulic acid) covalently combined modification, and microwave-alkali polyphenol covalently combined modification on the gel properties of soy protein emulsions. The results showed that the properties of soy protein emulsions were improved significantly by the three modification methods. After three kinds of modification, the viscoelasticity of soy protein emulsion gel increased, and a gel system with stronger elasticity was formed. The texture, water-holding, and hydration properties of the emulsion gel increased significantly. The SEM and ClSM results showed that the modified soy protein emulsion gel had a more compact and uniform porous structure, and the oil droplets could be better embedded in the network structure of the gel. Among the three modification methods, the microwave-alkali method polyphenol covalently combining the compound modification effect was best, and the microwave modification effect was least effective compared to the other two methods. Our obtained results suggested that for gel property modification of soy protein emulsion gels, microwave pretreatment combined with the covalent binding of polyphenols by an alkaline method is an effective method.

Systematic analysis of the molecular mechanisms of methotrexate therapy for rheumatoid arthritis using text mining.

OBJECTIVES: The purpose of this study was to determine the expression of related genes in patients with rheumatoid arthritis (RA) treated with methotrexate (MTX), to identify hub genes, and to systematically analyse the functions, pathways, and networks of these genes. METHODS: The PubMed identifiers (PMIDs) of relevant publications were obtained from the PubMed database, and gene data were extracted from these documents using the text mining software PubTator. The Database for Annotation, Visualization and Integrated Discovery (DAVID) was used to obtain enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway information. In addition, the STRING database was used to construct a protein-protein interaction (PPI) network. Genes with which at least 10 other genes interacted were identified as hub genes. RESULTS: A total of 216 genes were identified as being associated with treatment efficacy for MTX, of which 14 pathways exhibited significant correlation (p<0.05, FDR<0.05). In addition, the constructed MTX treatment-related network consisted of 267 interactions. Fourteen genes were found to interact with at least 10 other genes (p<0.05, FDR<0.05) and identified as hub genes in the PPI network. These genes were JAK1, MAPK1, JUN, AKT1, MAPK14, MAPK8, FGB, FN1, ALB, B2M, IL2RB, GGH, IL2RA, and TP53. CONCLUSIONS: This study will assist in elucidating the molecular mechanisms associated with the treatment efficacy of MTX for RA and provide a scientific rationale for guiding patient medication. However, the relationship between particular genes and the efficacy of MTX treatment for RA patients requires additional investigation.

Effect of Virtual Reality Upper Limb Rehabilitation Training on Older Adults.

Virtual reality has gained more attention in the physical training field, but few studies focus on the effects of VR on older adults. Based on existing study we suggest that VR-based upper limb training might be more effective for older adults and used functional near inferred spectrum and movement analysis to evaluate the effects of VR-based training on older adults. 20 older and 20 youth adults were recruited to perform VR training by extending their upper limb to reaching the objects, and non-VR training as a contrast. Both age-related and task-related differences were found in cortical activation, showing that the VR training has aroused more cortical activation. The older groups have more intensive movement but perform worse in terms of task completion. Both groups performed better in VR, and the difference in the older group was higher.

The application of extracorporeal membrane oxygenation in emergent airway management - a single-center retrospective study.

BACKGROUND: Emergent airway occurrences pose a significant threat to patient life. Extracorporeal membrane oxygenation (ECMO) has been proven to be an effective method for managing emergent airways. METHODS: A retrospective analysis was conducted on all patients receiving ECMO as an adjunct for emergent airway management from January 2018 to December 2022 at the People's Hospital of Zhongshan City. We collected the basic information of the patients, their blood gas data before and after ECMO, the related parameters of ECMO, and the outcome and then analyzed and summarized these data. RESULTS: Six patients, with an average age of 51.0(28-66) years, received veno-venous (VV)- ECMO as an adjunct due to emergent airway issues. The average ECMO support duration was 30.5(11-48) hours. All six patients were successfully weaned off ECMO support, with five (83.3%) being successfully discharged after a hospital stay of 15.5(7-55) days. All six patients underwent VV-ECMO through femoral-internal jugular vein cannulation. Among these, five patients, whose airway obstruction was due to hemorrhage, underwent a non-anticoagulant ECMO strategy with no recorded thrombotic events. CONCLUSIONS: The rapid establishment of ECMO support is aided by the establishment of a standardized ECMO initiation protocol and the formation of a multidisciplinary rapid-response ECMO team, which is particularly crucial for emergent airway management. When airway obstruction results from hemorrhagic factors, the early adoption of a non-anticoagulant ECMO strategy can be considered when implementing VV-ECMO.

Application of postoperative adjuvant radiotherapy in limited-stage small cell lung cancer: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: One of the most important treatments for small cell lung cancer (SCLC) is radiation therapy. Currently, the criteria for administering postoperative adjuvant radiotherapy (PORT) in SCLC remain uncertain. Therefore, we conducted a meta-analysis to investigate the influence of PORT on the prognosis of limited-stage SCLC (LS-SCLC). METHODS: We conducted a comprehensive search across three databases, PubMed, Embase, and the Cochrane Library. Data analysis involved utilizing both random-effects and fixed-effects models for pooling the results. A comparative analysis was performed to assess the prognostic outcomes of patients with LS-SCLC who did and did not undergo PORT. The primary outcome assessed was overall survival (OS), while the secondary outcome was disease-free survival (DFS). RESULTS: This analysis included 11 retrospective studies comprising 7694 eligible participants. Among the entire population of LS-SCLC patients, the OS was superior in those receiving PORT than in those not receiving it (hazard ratio [HR]: 0.79, 95 % confidence interval [CI]: 0.71-0.87; P < 0.0001). In pN0 stage LS-SCLC patients, PORT was associated with a detrimental effect on OS (HR: 1.22, 95 % CI: 1.04-1.43; P = 0.01). In pN1 stage LS-SCLC patients, additionally administering PORT did not provide a significant OS advantage as compared to not administering it (HR: 0.82, 95 % CI: 0.60-1.12; P = 0.21). In pN2 stage LS-SCLC patients, those receiving PORT demonstrated a significant improvement in OS (HR: 0.59; 95 % CI: 0.50-0.70; P < 0.0001) as compared to those not receiving it. Regarding DFS in LS-SCLC patients, the difference in the protective effect with and without the administration of PORT was less pronounced (HR: 0.76, 95 % CI: 0.58-1.00; P = 0.053). CONCLUSIONS: With respect to OS, PORT is not advisable in patients with pN0 or pN1 stage LS-SCLC but is highly recommended in pN2 stage LS-SCLC. Further research is warranted to confirm these findings.

Soy proteins modified using cavitation jet technology.

Soy proteins are seen as a promising alternative food source for meat with environmentally friendly properties. The problem is that the functional properties of soy proteins do not meet the needs of the food industry, and some existing modification technologies have adverse effects. Recently, cavitation jet technology (CJT) has been studied because it generates high heat, high pressure, strong shear and strong shock waves. This review summarizes the history and mechanism of cavitation jets. The energy generated during the cavitation jet process can open molecular structures, and the shock waves and microjets generated can pulverize the materials by erosion. The impact of the CJT on the morphology, structure, and functionality of soy proteins is discussed. The impact of combining CJT with other techniques on the production of soy proteins was also reviewed. The modification of proteins using two or more methods with complementary strengths, avoiding the disadvantages of certain techniques, makes the modification of proteins more effective. One of the most prominent effects is the combined treatment of cavitation jets with physical techniques. Finally, the review provides a comprehensive analysis of the application of modified soy proteins in the food industry and highlights promising avenues for future research.

Dosimetric comparison of gamma knife and linear accelerator (VMAT and IMRT) plans of SBRT of Lung tumours.

This study evaluates dosimetric differences in Stereotactic Body Radiation Therapy (SBRT) for lung tumors using plans of Gamma Knife, and Volumetric Modulated Arc Therapy (VMAT), Intensity-Modulated Radiation Therapy (IMRT) plans based on Linear Accelerator, aiming to inform the reader of appropriate treatment strategy selection. Ten patients with 23 lung tumor lesions treated with SBRT at Zhongshan Hospital of Dalian University were analyzed. Plans of Gamma Knife, and VMAT, IMRT plans based on Linear Accelerator were created for each lesion, totaling 18 plans per type. Lesions were treated with 30-50 Gy in 5-10 fractions. Dosimetric parameters, including gradient index (GI), heterogeneity index (HI), conformity index (CI), and doses to the plan target volumes (PTVs), the gross tumor volumes (GTVs) and organs at risk (OARs) were compared. Plans of Gamma Knife showed superior HI and GI, higher PTV and GTV doses, and reduced doses to the ipsilateral and contralateral lungs, esophagus, spinal cord, and heart compared to VMAT and IMRT plans (p < 0.05). However, Plans of Gamma Knife required longer delivery times. When comparing VMAT and IMRT plans, VMAT plans had shorter delivery times than IMRT plans, but required more monitor units (MUs). Additionally, IMRT plans delivered a lower mean dose to the ipsilateral lung compared to VMAT plans. Gamma Knife SBRT plans achieves steeper dose falloff and minimizes radiation to normal lung tissue compared to VMAT and IMRT plans, but with longer delivery times. VMAT and IMRT plans displayed similar dose distributions for lung SBRT.

The influence of target layout and target graphic type on searching performance based on eye-tracking technology.

With the development of various intelligent technologies, the application of interactive interfaces is becoming more and more widespread, and the related researches conducted for interactive interfaces are also increasing. The purpose of this study was to explore the influence of icon layout location, icon graphic type, and icon layout method on users' searching performance in interactive interfaces through eye-tracking technology. Participants were asked to perform search tasks for the search target (facet icon or linear icon) on each image. Thus, each trial consisted of a search task on a given image. In total, each participant had 36 trials to complete. Searching time, fixation duration, and fixation count were collected to evaluate the searching performance of participants. Results showed that when faced with familiar icons, whether the graphic type of icons was facet or linear did not affect the user's experience, but when other factors of the interaction interface changed, facet icons provided a more stable experience for users. And compared to the rectangular layout, the circular layout method provided a more stable experience for users when the location of icons in the interactive interface changed, but icons located in the top half of the interactive interface were easier to find than those located in the bottom half, regardless of whether the layout was circular or rectangular. These results could be used in the layout and icon design of the interactive interfaces to facilitate their optimization.

Measurement of pressure discomfort threshold in auricular concha for in-ear wearables design.

In an effort to mitigate the homogenization of in-ear wearables, designers have been focusing on finding new solutions to enhance user comfort. While the concept of pressure discomfort thresholds (PDT) in humans has been applied to product design, research on the auricular concha remains scarce. In this study, we conducted an experiment to measure the PDT at six points in the auricular concha of 80 participants. Our results showed that the tragus was the most sensitive area and that gender, symmetry, and Body Mass Index (BMI)had no significant effect on PDT. Based on these findings, we generated pressure sensitivity maps of the auricular concha to aid in the optimization of in-ear wearable design.

The prognostic value of whole-genome DNA methylation in response to Leflunomide in patients with Rheumatoid Arthritis.

Objective: Although Leflunomide (LEF) is effective in treating rheumatoid arthritis (RA), there are still a considerable number of patients who respond poorly to LEF treatment. Till date, few LEF efficacy-predicting biomarkers have been identified. Herein, we explored and developed a DNA methylation-based predictive model for LEF-treated RA patient prognosis. Methods: Two hundred forty-five RA patients were prospectively enrolled from four participating study centers. A whole-genome DNA methylation profiling was conducted to identify LEF-related response signatures via comparison of 40 samples using Illumina 850k methylation arrays. Furthermore, differentially methylated positions (DMPs) were validated in the 245 RA patients using a targeted bisulfite sequencing assay. Lastly, prognostic models were developed, which included clinical characteristics and DMPs scores, for the prediction of LEF treatment response using machine learning algorithms. Results: We recognized a seven-DMP signature consisting of cg17330251, cg19814518, cg20124410, cg21109666, cg22572476, cg23403192, and cg24432675, which was effective in predicting RA patient's LEF response status. In the five machine learning algorithms, the support vector machine (SVM) algorithm provided the best predictive model, with the largest discriminative ability, accuracy, and stability. Lastly, the AUC of the complex model(the 7-DMP scores with the lymphocyte and the diagnostic age) was higher than the simple model (the seven-DMP signature, AUC:0.74 vs 0.73 in the test set). Conclusion: In conclusion, we constructed a prognostic model integrating a 7-DMP scores with the clinical patient profile to predict responses to LEF treatment. Our model will be able to effectively guide clinicians in determining whether a patient is LEF treatment sensitive or not.

A functional near-infrared spectroscopy study of the effects of video game-based bilateral upper limb training on brain cortical activation and functional connectivity.

Video game-based therapies are widely used in rehabilitation. Compared with conventional bilateral upper limb training (CBULT), the effects of video game-based bilateral upper limb training (VGBULT) on brain cortical activation and functional connectivity, still not fully clear. We have developed a VGBULT system, and measured the brain activity of 20 elderly subjects (10 male, mean age = 62.4 ± 5.8) while performing CBULT and VGBULT tasks by using functional near infrared spectroscopy (fNIRS). The results showed that the cerebral cortex of the two groups both showed significant activation (p < 0.05), compared with the baseline; In the VGBLUT group, the activation of motor cortex (MC) and prefrontal cortex (PFC) was stronger, and the functional connectivity between PFC and MC was also enhanced. This study showed that VGBULT is potentially more beneficial for the elderly neural activities and cognitive control, and provides a theoretical basis for future research and development of such rehabilitation products. Moreover, fNIRS is a reliable tool for tracking brain activation in the evaluation of retraining regimens.

Age-related changes in brain functional networks under multisensory-guided hand movements assessed by the functional near - Infrared spectroscopy.

OBJECTIVES: This study aims to explore the age-related effects of hand rehabilitation training under multisensory stimulation interaction on brain functional networks. METHODS: A multisensory stimulation training glove (MSTG) was designed to realize 3 sensory guidance modes, namely audio-visual guidance (AVG), visual guidance (VG) and no guidance (NG). This study recruited 20 older subjects as the experimental group and 22 young people as the control group. Functional near-infrared spectroscopy (fNIRS) was used to monitor haemoglobin concentration in the motor cortex (MC), prefrontal cortex (PFC), temporary lo be (TL) and occipital lobe (OL) under three different guidance stages, and further analysed the cortical activation and functional connectivity (FC). RESULTS: Multisensory guidance stage showed more activation and higher FC in all subjects. The activated brain regions of the older subjects showed bilateral activation, which is consistent with the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model. In terms of brain region coordination, older people have a more balanced and denser functional network in the left and right hemispheres compared to younger people. Meanwhile, multisensory stimulation produced a positive training effect on the number of training and reaction time. CONCLUSION: Audio-visual combined stimulation had a significant gain effect on hand training at different ages. However, older adults induce a wider range of cortical activations. At the same time, young and older people have different intercortical coordination networks. All these results provide theoretically and applied references for multisensory stimulation in the prevention and rehabilitation of ageing and brain neurological disorders.