Analyzing brain-activation responses to auditory stimuli improves the diagnosis of a disorder of consciousness by non-linear dynamic analysis of the EEG.

Although auditory stimuli benefit patients with disorders of consciousness (DOC), the optimal stimulus remains unclear. We explored the most effective electroencephalography (EEG)-tracking method for eliciting brain responses to auditory stimuli and assessed its potential as a neural marker to improve DOC diagnosis. We collected 58 EEG recordings from patients with DOC to evaluate the classification model's performance and optimal auditory stimulus. Using non-linear dynamic analysis (approximate entropy [ApEn]), we assessed EEG responses to various auditory stimuli (resting state, preferred music, subject's own name [SON], and familiar music) in 40 patients. The diagnostic performance of the optimal stimulus-induced EEG classification for vegetative state (VS)/unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) was compared with the Coma Recovery Scale-Revision in 18 patients using the machine learning cascade forward backpropagation neural network model. Regardless of patient status, preferred music significantly activated the cerebral cortex. Patients in MCS showed increased activity in the prefrontal pole and central, occipital, and temporal cortices, whereas those in VS/UWS showed activity in the prefrontal and anterior temporal lobes. Patients in VS/UWS exhibited the lowest preferred music-induced ApEn differences in the central, middle, and posterior temporal lobes compared with those in MCS. The resting state ApEn value of the prefrontal pole (0.77) distinguished VS/UWS from MCS with 61.11% accuracy. The cascade forward backpropagation neural network tested for ApEn values in the resting state and preferred music-induced ApEn differences achieved an average of 83.33% accuracy in distinguishing VS/UWS from MCS (based on K-fold cross-validation). EEG non-linear analysis quantifies cortical responses in patients with DOC, with preferred music inducing more intense EEG responses than SON and familiar music. Machine learning algorithms combined with auditory stimuli showed strong potential for improving DOC diagnosis. Future studies should explore the optimal multimodal sensory stimuli tailored for individual patients.Trial registration: The study is registered in the Chinese Registry of Clinical Trials (Approval no: KYLL-2023-414, Registration code: ChiCTR2300079310).

Factors related to satisfaction with community-based home aging services in Shandong, China.

Purpose: This study investigated the satisfaction of current community-based home care services and its factors in adults aged ≥60 years. Methods: Using stratified cluster random sampling, we surveyed 1,494 older adults in Jinan and Qingdao, Shandong province, between 2021 and 2023. The baseline and satisfaction surveys were designed by our research team, and the questionnaires were conducted in the form of structured interviews. Kruskal-Wallis H-test and Logistic regression analysis were used to explore the influencing factors of satisfaction. Results: The satisfaction was mainly affected by age (p = 0.007), marital status (p < 0.001), pre-retirement occupation (p = 0.003), economic source (p < 0.001), and mode of residence (p = 0.001) in the study of 1,494 older adults. Under the influence of multiple factors, the evaluation of older adults services, married [OR = 4.039, 95% CI: 1.176-13.877] were more inclined to be average, and their occupations were agriculture, forestry, animal husbandry, fishery, and water production workers [OR = 0. 237, 95% CI: 0.068-0.819] and production and transportation equipment operators and related personnel [OR = 0.153, 95% CI: 0.024-0.966] or [OR = 0.153, 95% CI: 0.029-0.820] tended to be more dissatisfied. Conclusion: The satisfaction level of community-based home care services is relatively high among older adults, and it is mainly affected by factors such as age, marital status, pre-retirement occupation, source of financial resources, and mode of residence. Addressing the emotional needs of older adults, lowering the cost of aging, and integrating health care and aging seamlessly are among the ongoing challenges that we need to tackle.

Safety and effectiveness of rehabilitation training for stroke complicated with muscular call vein thrombosis: An observational study.

This study aimed to explore the safety and effectiveness of rehabilitation treatment for stroke patients with muscular call vein thrombosis (MCVT) in the lower limbs. A total of 173 patients were recruited with stroke complicated by MCVT, including 130 who received rehabilitation training and 43 who did not receive rehabilitation training. The t test and chi-square test were used to analyze the basic data of the 2 groups. There were no significant differences in the Fugl-Meyer Assessment scores between 2 groups at the beginning of recruitment (P = .149). There was a significant difference in the Fugl-Meyer Assessment scores of the lower limbs in patients with MCVT after 3 weeks of rehabilitation treatment (P < .001), and there was a significant difference in the rate of MCVT recanalization and extension between the 2 groups (χ2 = 11.646, P = 0001). Combined with anticoagulation therapy, rehabilitation training did not increase the thrombosis progression of MCVT and was effective in the recovery of lower limb motor function in stroke patients.

Baseline characteristics and changes of biomarkers in disease course predict prognosis of patients with COVID-19.

The outbreak of coronavirus disease (COVID-19) has brought great challenges to the world. The objectives of this study were to describe the baseline characteristics and changes of biomarkers of these COVID-19 patients and identify predictive value of the above markers for patient death. Using patient death as the observational endpoints, clinical data of inpatients in a special ward for COVID-19 in Wuhan, China were retrospectively collected. Univariate and multivariate Cox regression analyses were used to evaluate prognostic value of baseline characteristics and laboratory data changes. This study included clinical data of 75 patients. Age, c-reactive protein (CRP) and interleukin-6 levels were independent predictors of patient death. Survivors were characterized as having declining neutrophil counts, D-dimer, N-terminal pronatriuretic peptide, troponin I (TnI) and c-reactive protein levels, while counts of lymphocyte gradually came back. Non-survivors were characterized with increasing white blood cell counts (WBC) and neutrophil counts. Changes of WBC, TnI and interleukin-6 were also independently associated with patient death. Older age, baseline CRP and IL-6 levels may be used as meaningful predictors to identify patients with poor prognosis. Changes of biomarkers should be closely monitored in the management of patients with COVID-19, while constantly increasing levels of WBC, TnI and interleukin-6 in the disease course also predict patient death.

Abnormal liver-related biomarkers in COVID-19 patients and the role of prealbumin.

Background/Aims: We aimed to evaluate the distribution of abnormal liver-related biomarkers in patients with coronavirus disease (COVID-19) and explore the prognostic value of elevated liver enzymes and abnormal liver synthetic capacity with regards to patient mortality. Patients and Methods: This retrospective observational study included 80 laboratory-confirmed COVID-19 cases. Data were collected from the electronic medical record system by a trained team of physicians. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin, and prealbumin levels at admission and on day 7 after admission were collected. The primary outcome of the current study was patient mortality. Results: Abnormal ALT, AST, TB, albumin, and prealbumin levels were observed in 11 (13.8%), 15 (18.8%), 5 (6.3%), 22 (27.5%), and 31 (38.8%) patients, respectively. Male gender correlated with elevated ALT and AST levels (p = 0.027 and 0.036, respectively). Higher levels of AST and lower levels of albumin and prealbumin were associated with patient mortality (p = 0.009, 0.002, and 0.003, respectively). Multivariate Cox regression analysis identified patient age (p = 0.013, HR 1.108) and prealbumin levels (p = 0.015, HR 0.986) as independent predictors for patient mortality. However, changes in liver-related biomarkers were not associated with poor outcome in multivariate analysis (p > 0.05). Conclusions: Abnormalities in albumin and prealbumin levels are common among COVID-19 patients and hypoprealbuminemia independently predicts adverse outcome and should be carefully considered in clinical practice. Moreover, changes in liver-related biomarkers is not a salient feature of COVID-19.

Scalp-cluster acupuncture with electrical stimulation can improve motor and living ability in convalescent patients with post-stroke hemiplegia.

OBJECTIVE: To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster (SC) acupuncture combined with electrical stimulation (ES) and to evaluate the feasibility of this treatment to improve motor and living abilities. METHODS: Twenty patients were enrolled and divided into two groups: SC acupuncture and SC acupuncture with ES (SC and SC + ES, respectively). All participants also received rehabilitation training. All participants were blindly evaluated using the Fugl-Meyer assessment scale for motor ability, the modified Barthel Index for living ability, and a scale for the degree of neurological deficits. Outcome was assessed at three points before randomized grouping, at the beginning or treatment, and after 4 weeks of treatment. RESULTS: Following 4 weeks treatment, all the patients exhibited significant improvements in aspects of motor ability, living ability, and the severity of neurological deficits. The experimental group (SC + ES) scored higher on the Fugl-Meyer assessment scale (68 ¡À 12) and the modified Barthel Index (49 ¡À 9) than the control (SC) group (50 ¡À 13, 36 ¡À 13, respectively). CONCLUSION: When patients with post-stroke hemiplegia are treated using SC acupuncture with ES, motor and living ability can improve more than if they were treated with SC acupuncture alone.

High expression levels of Cyr61 and VEGF are associated with poor prognosis in osteosarcoma.

Cysteine Rich Angiogenic Inducer 61 (Cyr61) and Vascular Endothelial Growth Factor (VEGF) are signaling proteins involved in the regulation of tumor angiogenesis and progression. The purpose of this study was to investigate the clinicopathological and prognostic significance of Cyr61 and VEGF expressions in osteosarcoma. Immunohistochemical staining was performed to evaluate the expression of both the proteins in 84 osteosarcoma samples. Correlation between Cyr61/VEGF expressions and clinicopathological parameters was determined using Rank sum test and Spearman's rank correlation coefficient. Prognostic factors were identified using univariate and multivariate Cox regression analysis. The expressions of Cyr61 and VEGF were weak in 26.2% and 17.9%, moderate in 26.2% and 23.8%, and strong in 47.6% and 58.3% of osteosarcoma samples, respectively. Cyr61 and VEGF expressions moderately correlated with each other in osteosarcoma, and exhibited significant association with Enneking stage and distant metastasis. In addition, the high expression of both proteins significantly correlated with short overall survival time in these patients. The key finding in this study was that both Cyr61 and VEGF expressions were independent prognostic indicators of overall survival. In summary, our results indicate that expression of Cyr61 and VEGF may serve as important prognostic predictors in patients with osteosarcoma.

Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial.

[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.