Prediction model for asymptomatic carotid atherosclerosis using retinal microvascular intelligent analysis: A retrospective study.

IMPORTANCE: Early detection and timely diagnosis of asymptomatic carotid atherosclerosis significantly assist in the prevention of ischemic stroke for them. OBJECTIVE: This observational study aimed to develop and validate a novel prediction model to assist in the early diagnosis of carotid atherosclerosis based on new characteristic variables screened by retinal microvascular intelligence analysis. MAIN OUTCOME(S) AND METHOD (S): The least absolute shrinkage and selection operator (LASSO) combined with 10-fold cross-validation were screened for characteristic variables, and nomograms were plotted to demonstrate the prediction model. Receiver operating characteristic (ROC) curves and area under the curve (AUC), calibration plots and brier score (BS), and decision curve analysis (DCA) were used to evaluate the risk model's discrimination, calibration, and clinical applicability. RESULTS: Age, gender, diabetes mellitus (DM), drinking history, vascular branching angle, mean vascular diameter within 0.5-1.0 papillary diameter (PD), curvature tortuosity arteriole in the inferior region of the optic disc, and vascular density in the nasal region of the optic disc were identified as characteristic variables for carotid atherosclerosis with retinal microvascular intelligence analysis. The predictive nomogram model presented good discrimination with AUCs of 0.790 (0.774-0.806), and the calibration curve displayed high consistency between predicted and actual probability. The DCA demonstrated that this nomogram model led to net benefits in a threshold probability range of 20 %-94 % and could be adapted for clinical decision-making. The results of the 100-bootstrap resampling strategy for internal validation also show that the risk model is well discriminated with an AUC of 0.789 and excellent calibration. External validation showed good discrimination with AUCs of 0.703 (0.627 - 0.779) and good calibration, the risk threshold is 10 %-92 % in terms of DCA. CONCLUSIONS AND RELEVANCE: The novel prediction model based on retinal microvascular intelligence analysis constructed in this study could be effective prognoses for predicting the risk of asymptomatic carotid atherosclerosis in a Chinese screening population.

Association Between Triglyceride Glucose Index with Cognitive Impairment and Dementia in Adult Population: A Meta-Analysis.

The current understanding of the correlation between insulin resistance (IR) and cognitive dysfunction is limited. Therefore, the objective of this systematic review and meta-analysis was to assess the association between the triglyceride glucose (TyG) index, a recently suggested indicator of IR, and cognitive impairment and dementia in the adult population. Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings. This meta-analysis included ten observational studies involving 5602409 participants. Compared to those with the low TyG index, subjects with the high TyG index were significantly associated with the risk of cognitive impairment [risk ratio (RR): 1.39, 95% confidence interval (CI): 1.22 to 1.59, p<0.001; I2=45%) and dementia (RR: 1.30, 95% CI: 1.06 to 1.60, p=0.01; I2=50%). The association was consistent for Alzheimer's disease (RR: 1.35, 95% CI: 1.04 to 1.76, p=0.03; I2=54%) and vascular dementia (RR: 1.18, 95% CI: 1.13 to 1.24, p<0.001; I2=0%). Subgroup analyses showed that the association between TyG index with cognitive impairment and dementia were stronger in cross-sectional studies than that in cohort studies (p for subgroup difference=0.02), but not significantly modified by age, sex, or diabetic status of the participants. In conclusion, a high TyG index may be associated with higher risk of cognitive impartment and dementia in adult population.

Influences of Polyphenols on the Properties of Crosslinked Acellular Fish Swim Bladders: Experiments and Molecular Dynamic Simulations.

Acellular fish swim bladders (AFSBs) are a promising biomaterial in tissue engineering, however, they may suffer from rapid degradation due to enzyme invasion. In this work, natural polyphenols, including epigallocatechin gallate (EGCG), proanthocyanidin (PC), tannic acid (TA) and protocatechuic acid (PCA), were utilized to improve the properties of AFSBs through crosslinking modifications. Fourier transform infrared (FTIR) results indicate that the triple helix of the collagen in AFSBs is well preserved after crosslinking. The differential scanning calorimetry (DSC), water contact angle (WCA) and in vitro degradation tests indicate that the polyphenol-crosslinked AFSBs exhibit improved thermal stability, enzymatic stability, hydrophilicity and mechanical properties. Among them, EGCG with multiple phenolic hydroxyl groups and low potential resistance is more favorable for the improvement of the mechanical properties and enzymatic stability of AFSBs, as well as their biocompatibility and integrity with the collagen triple helix. Moreover, the crosslinking mechanism was demonstrated to be due to the hydrogen bonds between polyphenols and AFSBs, and was affected by the molecular size, molecular weight and the hydroxyl groups activity of polyphenol molecules, as clarified by molecular dynamic (MD) simulations. The approach presented in this work paves a path for improving the properties of collagen materials.

Development and validation of a prospective questionnaire for assessing oily sensitive skin.

BACKGROUND: Skin type has a strong influence on how sensitive skin develops, with oily skin accounting for a larger proportion of sensitive skin. However, there has not been a scientifically sound questionnaire for determining oily sensitive (OS)-type skin in prior studies. OBJECTIVES: In order to identify OS-type skin in the general population, we therefore intend to create an OS-type skin evaluation questionnaire, develop various thresholds through data analysis and classify skin based on two dimensions of sensitivity and oiliness. METHODS: A questionnaire with questions regarding subjects' basic information, skin oiliness and skin sensitivity was given to each individual who participated in the study (n = 1297). To define the thresholds for OS-type skin, receiver-operating characteristic (ROC) curves were generated. The results of the lactic acid stinging test (LAST) and noninvasive instrument information obtained were compared with the thresholds mentioned above to verify the effectiveness of this tool. RESULTS: According to the ROC curves, questionnaire cut-off values of 11.5, 20.5 and 29.5 can be used to detect mildly, moderately and severely sensitive skin, respectively. In addition, the questionnaire cut-off values of 22.5 and 31.5 can be used to detect moderately and severely oily skin, respectively. According to our study, the four sensitive-skin groups' LAST scores differed significantly from one another, while the skin sebum levels differed significantly between the three oily groups. Additionally, the EI and LAST scores were significantly correlated with skin sensitivity levels, whereas sebum, moisture and EI were positively correlated with skin oiliness levels. CONCLUSIONS: We developed an OS-type skin evaluation questionnaire that has been tested and shown scientifically to be a promising method for evaluating OS-type skin and to completely examine the traits of sensitive and oily skin.

CONTEXTE: Le type de peau a une forte influence sur la sensibilité de la peau, avec une peau grasse représentant une plus grande proportion de peaux sensibles. Cependant, il n'y a pas eu de questionnaire scientifiquement fiable pour déterminer le type de peau sensible grasse (OS) dans les études antérieures. OBJECTIFS: Afin d'identifier la peau grasse et sensible dans la population générale, nous avons donc l'intention de créer un questionnaire d'évaluation de la peau grasse et sensible, d'élaborer différents seuils par l'analyse des données et de catégoriser à partir de deux dimensions de sensibilité et d'état huileux. MÉTHODES: Un questionnaire comprenant des questions sur les informations de base des sujets, la sécrétion de sébum de la peau et la sensibilité cutanée a été distribué à chaque individu ayant participé à l'étude (n = 1297). Pour définir les seuils des peaux grasse et sensible, des courbes sensibilité/spécificité (receiver-operating characteristic, ROC) ont été générées. Les résultats du test de picotement à l'acide lactique (LAST) et les informations obtenues à l'aide d'instruments non invasifs ont été comparés aux seuils mentionnés ci-dessus pour vérifier l'efficacité de cet outil. RÉSULTATS: Selon les courbes ROC, des valeurs limites du questionnaire de 11,5, 20,5 et 29,5 peuvent être utilisées pour détecter une sensibilité cutanée légère, modérée et sévère, respectivement. De plus, les valeurs de seuil du questionnaire de 22,5 et 31,5 peuvent être utilisées pour détecter respectivement une peau modérément et sévèrement grasse. Selon notre étude, les scores LAST des quatre groupes à peau sensible différaient significativement les uns des autres, tandis que les taux de sébum cutané différaient significativement entre les trois groupes à peau grasse. De plus, les scores IE et LAST étaient significativement corrélés avec les taux de sensibilité cutanée, tandis que le sébum, l'humidité et l'IE étaient positivement corrélés avec les taux de graisse cutané. CONCLUSIONS: Nous avons développé un questionnaire d'évaluation de la peau grasse et sensible qui a été testé et qui s'est avéré scientifiquement être une méthode prometteuse pour évaluer la peau grasse et sensible et pour examiner complètement les caractéristiques de la peau sensible et grasse.

Young Chinese female body skin pigmentation map: A pilot study.

BACKGROUND: Most studies have discussed variations in facial skin colour based on age, gender, and anatomical site within a specific ethnic group. However, skin pigmentation on the body is also a concern for many people. AIM: The aim of this study is to gather baseline data for Chinese young females, conduct a comprehensive assessment of body skin pigmentation, and create a body skin pigmentation map. METHOD: Individual type angle (ITA°) was registered by CL 400 and melanin index (MI) was registered by MX 18 in 100 body points of 20 Chinese females. A total of 12,000 measurements were recorded. RESULT: Our results showed significant differences among the symmetrical points on both sides of the body, including the clavicle, inner wrists, groin, inner ankle, elbow, armpit, waist side, the space between the thumb and index finger, instep, back shoulder, and popliteal space. Of all the points tested on the body, the points with the most severe skin pigmentation were the back of the neck, the heel, the elbow, and the popliteal space. CONCLUSION: This is the first comprehensive study of skin pigmentation conducted on the human body. In young Chinese women, the points with the most severe skin pigmentation were the back of the neck, heels, elbows, and the popliteal space.

Detection of driver drowsiness level using a hybrid learning model based on ECG signals.

OBJECTIVES: Fatigue has a considerable impact on the driver's vehicle and even the driver's own operating ability. METHODS: An intelligent algorithm is proposed for the problem that it is difficult to classify the degree of drowsiness generated by the driver during the driving process. By studying the driver's electrocardiogram (ECG) during driving, two models were established to jointly classify the ECG signals as awake, stress, and fatigue or drowsiness states for drowsiness levels. Firstly, the deep learning method was used to establish the model_1 to predict the drowsiness of the original ECG, and model_2 was developed using the combination of principal component analysis (PCA) and weighted K-nearest neighbor (WKNN) algorithm to classify the heart rate variability characteristics. Then, the drowsiness prediction results of the two models were weighted according to certain rules, and the hybrid learning model combining dilated convolution and bidirectional long short-term memory network with PCA and WKNN algorithm was established, and the mixed model was denoted as DiCNN-BiLSTM and PCA-WKNN (DBPW). Finally, the validity of the DBPW model was verified by simulation of the public database. RESULTS: The experimental results show that the average accuracy, sensitivity and F1 score of the test model in the dataset containing multiple drivers are 98.79, 98.81, and 98.79 % respectively, and the recognition accuracy for drowsiness or drowsiness state is 99.33 %. CONCLUSIONS: Using the proposed algorithm, it is possible to identify driver anomalies and provide new ideas for the development of intelligent vehicles.

Multi-omics analysis of lung tissue metabolome and proteome reveals the therapeutic effect of Shegan Mahuang Decoction against asthma in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Shegan Mahuang Decoction (SMD) is a classic traditional Chinese medicine (TCM) formula for asthma treatment, but the anti-asthma mechanism of SMD is still not fully studied. AIMS OF THE STUDY: In this study, we established an ovalbumin (OVA)-induced asthma rat model and treated it with SMD to observe its anti-asthma effect and explore the related mechanism. MATERIALS AND METHODS: We evaluated the anti-inflammatory effect of SMD via testing the levels of immunoglobulin E (IgE), C-reactive protein (CRP), interleukin-4 (IL-4), interleukin-6 (IL-6) in serum and performing the hematoxylin-eosin (H&E) staining of lung tissue slices. We analyzed the variations of metabolites and proteins in the lung tissue of different groups using liquid chromatography-mass spectrometry (LC-MS)-based untargeted metabolomics and TMT-based proteomics approaches. The metabolic biomarkers and differentially expressed proteins (DEPs) were picked, and the related signal transduction pathways were also investigated. In addition, the key proteins on the signaling pathway were validated through western blotting (WB) experiment to reveal the anti-asthma mechanism of SMD. RESULTS: The results showed that the SMD could significantly reduce the serum levels of IgE, CRP, IL-4, and IL-6 and attenuate the OVA-induced pathological changes in lung tissue. A total of 34 metabolic biomarkers and 84 DEPs were screened from rat lung tissue, which were mainly associated with lipid metabolism, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation, the excessive production of reactive oxygen species (ROS), and lysosome pathway. Besides, SMD could inhibit the myeloid differentiation factor 88 (MyD88)/inhibitor of kappa B kinase (IKK)/nuclear factor-kappa B (NF-κB) signaling pathway to exhibit anti-inflammatory activities. CONCLUSIONS: SMD exhibited a therapeutic effect on asthma, which possibly be exerted by inhibiting the MyD88/IKK/NF-κB signaling pathway.

Effect of Zr on the Microstructure and High-Temperature Phase Separation Evolution of SiOC Aerogels.

SiZrOC aerogels were synthesized through the pyrolysis of the zirconium source-doped SiOC system using zirconyl chloride octahydrate (ZrOCl2·8H2O) at temperatures ranging from 900 to 1300 °C. This study investigates the microstructure evolution and phase separation of SiOC and SiZrOC aerogels during the pyrolysis process. Upon pyrolysis, both aerogels exhibited a Si-O-C structure with a high thermal stability. The introduction of zirconium elements significantly enhanced the pore volume (3.20 cm3/g) and porosity (96.0%) and reduced the thermal conductivity (0.023 W·m-1·K-1) of the organic-inorganic precursor aerogel. Moreover, the three-dimensional pore structure was retained even under high-temperature pyrolysis conditions. SiZrOC-1100 displayed a high specific surface area of 273.52 m2/g, a high pore volume of 1.70 cm3/g, and a low thermal conductivity of 0.033 W·m-1·K-1. At high temperatures, the SiZrOC phase transformation produces tetragonal ZrO2, which inhibits the graphitization process of free carbon and the growth of SiC grains. Furthermore, the phase separation process of the SiOxCy matrix structure generated oxygen-rich SiOxC4-x units, while carbon-rich SiOxC4-x units were negligible below a pyrolysis temperature of 1200 °C. Between 900 and 1200 °C, SiZrOC is composed of amorphous SiOC, amorphous ZrO2, microcrystalline t-ZrO2, and free carbon phase. These findings provide valuable insights into the preparation of high-performance SiOC aerogels.

Mutation divergence over space in tumour expansion.

Mutation accumulation in tumour evolution is one major cause of intra-tumour heterogeneity (ITH), which often leads to drug resistance during treatment. Previous studies with multi-region sequencing have shown that mutation divergence among samples within the patient is common, and the importance of spatial sampling to obtain a complete picture in tumour measurements. However, quantitative comparisons of the relationship between mutation heterogeneity and tumour expansion modes, sampling distances as well as the sampling methods are still few. Here, we investigate how mutations diverge over space by varying the sampling distance and tumour expansion modes using individual-based simulations. We measure ITH by the Jaccard index between samples and quantify how ITH increases with sampling distance, the pattern of which holds in various sampling methods and sizes. We also compare the inferred mutation rates based on the distributions of variant allele frequencies under different tumour expansion modes and sampling sizes. In exponentially fast expanding tumours, a mutation rate can always be inferred for any sampling size. However, the accuracy compared with the true value decreases when the sampling size decreases, where small sampling sizes result in a high estimate of the mutation rate. In addition, such an inference becomes unreliable when the tumour expansion is slow, such as in surface growth.

A new Chinese crow's feet grading scale based on the DermaTOP system.

Many Chinese wrinkle studies continue to use non-Chinese scales because few Chinese-based wrinkle scales have been developed. The study aims to develop a crow's feet grading scale for Chinese individuals. We enrolled 608 healthy Chinese subjects and measured data through the DermaTOP system. We chose exploratory factor analysis (EFA) to reduce the dimensions of the data. A three-factor structure was obtained by using EFA, and it explained a cumulative total of 89.551% of the variance. A computational formula was obtained by calculating the total factor tilt scores and taking the variance contribution rate of three factors as the weight. Based on the computational formula, a grading map was designed and tested. The model validation was conducted using both subjective assessments from the expert panel and objective results from the model calculations. The results showed that our grading scale model is stable. This study developed a Chinese crow's feet (CCF) grading scale, which included a parameter, a grading map, and literal descriptions. The CCF grading scale is a validated tool for evaluating the effects of cosmetics or specific therapies. More importantly, the CCF scale was developed based on objective data, which may inspire new ideas for wrinkle grading scale development in the future.

A three-dimensional adaptive rational interpolation algorithm for removing TMS-EEG pulse artifacts.

Objective.Transcranial magnetic stimulation in combination with electroencephalography (TMS-EEG) has been widely used to study the reactivity and connectivity of brain regions. In order to efficiently and fast solve the pulse artifacts problem caused by TMS electromagnetic pulses, a three-dimensional adaptive rational quadratic Hermite interpolation algorithm is proposed.Approach.Firstly, a three-dimensional signal matrix is obtained by a signal recombination algorithm, where the removed window is automatically obtained by a derivative threshold. Secondly, the adaptive rational quartic Hermite interpolation algorithm is used to interpolate the removed window. Finally, the performance of the algorithm is verified using simulated and public database data.Main results.The simulation results show that the proposed algorithm improves the SNR by 23.88%-47.60%, reduces the RMSE by 46.52%-81.11%, reduces the average MAE by 47.83%-58.33%, and reduces the time consumption of the proposed algorithm by 45.90% compared with the piecewise cubic Hermite interpolation algorithm.Significance.Therefore, TMS-EEG pulse artifacts can be removed effectively and quickly with the proposed algorithm.

Optimization of an Artificial Solid Electrolyte Interphase Formed on an Aluminum Anode and Its Application in Rechargeable Aqueous Aluminum Batteries.

Electrochemical cells that incorporate aluminum (Al) as the active material have become increasingly popular due to the advantages of high energy density, cost-effectiveness, and superior safety features. Despite the progress made by research groups in developing rechargeable Al//MxOy (M = Mn, V, etc.) cells using an aqueous Al trifluoromethanesulfonate-based electrolyte, the reactions occurring at the Al anode are still not fully understood. In this study, we explore the artificial solid electrolyte interphase (ASEI) on the Al anode by soaking it in AlCl3/urea ionic liquid. Surprisingly, our findings reveal that the ASEI actually promotes the corrosion of Al by providing chloride anions rather than facilitating the transport of Al3+ ions during charge/discharge cycles. Importantly, the ASEI significantly enhances the cycling stability and activity of Al cells. The primary reactions occurring at the Al anode during the charge/discharge cycle were determined to be irreversible oxidation and gas evolution. Furthermore, we demonstrate the successful realization of urea-treated Al (UTAl)//AlxMnO2 cells (discharge operating voltage of ∼1.45 V and specific capacity of 280 mAh/g), providing a platform to investigate the underlying mechanisms of these cells further. Overall, our work highlights the importance of ASEI in controlling the corrosion of Al in aqueous electrolytes, emphasizing the need for the further development of electrolytic materials that facilitate the transport of Al3+ ions in rechargeable Al batteries.

Efficacy and Safety of Butylphthalide in Patients With Acute Ischemic Stroke: A Randomized Clinical Trial.

Importance: DL-3-n-butylphthalide (NBP) is a drug for treating acute ischemic stroke and may play a neuroprotective role by acting on multiple active targets. The efficacy of NBP in patients with acute ischemic stroke receiving reperfusion therapy remains unknown. Objective: To assess the efficacy and safety of NBP in patients with acute ischemic stroke receiving reperfusion therapy of intravenous thrombolysis and/or endovascular treatment. Design, Setting, and Participants: This multicenter, double-blind, placebo-controlled, parallel randomized clinical trial was conducted in 59 centers in China with 90-day follow-up. Of 1236 patients with acute ischemic stroke, 1216 patients 18 years and older diagnosed with acute ischemic stroke with a National Institutes of Health Stroke Scale score ranging from 4 to 25 who could start the trial drug within 6 hours from symptom onset and received either intravenous recombinant tissue plasminogen activator (rt-PA) or endovascular treatment or intravenous rt-PA bridging to endovascular treatment were enrolled, after excluding 20 patients who declined to participate or did not meet eligibility criteria. Data were collected from July 1, 2018, to May 22, 2022. Interventions: Within 6 hours after symptom onset, patients were randomized to receive NBP or placebo in a 1:1 ratio. Main Outcomes and Measures: The primary efficacy outcome was the proportion of patients with a favorable outcome based on 90-day modified Rankin Scale score (a global stroke disability scale ranging from 0 [no symptoms or completely recovered] to 6 [death]) thresholds of 0 to 2 points, depending on baseline stroke severity. Results: Of 1216 enrolled patients, 827 (68.0%) were men, and the median (IQR) age was 66 (56-72) years. A total of 607 were randomly assigned to the butylphthalide group and 609 to the placebo group. A favorable functional outcome at 90 days occurred in 344 patients (56.7%) in the butylphthalide group and 268 patients (44.0%) in the placebo group (odds ratio, 1.70; 95% CI, 1.35-2.14; P < .001). Serious adverse events within 90 days occurred in 61 patients (10.1%) in the butylphthalide group and 73 patients (12.0%) in the placebo group. Conclusions and Relevance: Among patients with acute ischemic stroke receiving intravenous thrombolysis and/or endovascular treatment, NBP was associated with a higher proportion of patients achieving a favorable functional outcome at 90 days compared with placebo. Trial Registration: ClinicalTrials.gov Identifier: NCT03539445.

The pivotal role of Bifida Ferment Lysate on reinforcing the skin barrier function and maintaining homeostasis of skin defenses in vitro.

BACKGROUND: The semiactive or inactive probiotics or their extracts used in dermatology have interesting properties to ameliorate signs of irritated skin and enhance the skin barrier. Bifidobacterium, as the most common probiotics, which has been found to be effective in reducing acne and improving the skin barrier function of atopic dermatitis. Bifida Ferment Lysate (BFL) can be obtained from Bifidobacterium by fermentation and extraction. PURPOSE: In this study, we investigated the effect of a topically used BFL on the skin using in vitro evaluation methods. RESULTS: The results showed that upregulation of skin physical barrier gene (FLG, LOR, IVL, TGM1, and AQP3) and antimicrobial peptide gene (CAMP and hBD-2) in HaCaT cells by BFL might be responsible for skin barrier resistance. In addition, BFL had strong antioxidant properties representing a dose-dependent increasing of the scavenging capacity of DPPH, ABTS, hydroxyl, and superoxide radicals. BFL treatment also fundamentally inhibited the intracellular ROS and MDA production and improved the activities of antioxidant enzymes (CAT and GSH-Px) in H2 O2 -stimulated HaCaT cells. As a good immunomodulatory factor, BFL efficiently decreased the secretion of IL-8 and TNF-α cytokines, and COX-2 mRNA expression in LPS-induced THP-1 macrophages. CONCLUSION: BFL can strengthen the skin barrier function and stimulate skin barrier resistance, to reinforce the skin against oxidative stress and inflammatory stimuli.

Review of microwave imaging algorithms for stroke detection.

Microwave imaging is one of the rapidly developing frontier disciplines in the field of modern medical imaging. The development of microwave imaging algorithms for reconstructing stroke images is discussed in this paper. Compared with traditional stroke detection and diagnosis techniques, microwave imaging has the advantages of low price and no ionizing radiation hazards. The research hotspots of microwave imaging algorithms in the field of stroke are mainly reflected in the design and improvement of microwave tomography, radar imaging, and deep learning imaging. However, the current research lacks the analysis and combing of microwave imaging algorithms. In this paper, the development of common microwave imaging algorithms is reviewed. The concept, research status, current research hotspots and difficulties, and future development trends of microwave imaging algorithms are systematically expounded. The microwave antenna is used to collect scattered signals, and a series of microwave imaging algorithms are used to reconstruct the stroke image. The classification diagram and flow chart of the algorithms are shown in this Figure. (The classification diagram and flow chart are based on the microwave imaging algorithms.).

Clinical Validation of the Comprehensive Complication Index in a Pancreaticoduodenectomy Cohort.

INTRODUCTION: Although the Clavien-Dindo classification (CDC) is the most widely utilized method for quantifying surgical complications, it fails to properly capture all events. To address this, the comprehensive complication index (CCI) was introduced. The purpose of this study was to compare the CCI and CDC as predictors of postoperative length of stay (PLOS) and total hospitalization costs in patients undergoing pancreaticoduodenectomy (PD). METHODS: Data were collected from February 2018 to February 2021. Complications were graded on the CDC scale and the CCI was calculated for each patient. The correlations between CDC and CCI with PLOS and hospitalization costs were compared. Linear analyses were performed to identify factors associated with PLOS and costs. RESULTS: 291 patients were enrolled with an average age of 61.2 years. 286 of them developed postoperative complications at CDC grade 1 (17.8%), 2 (59.9%), 3a (13.4%), 3b (4.5%), 4 (2.1%), and 5 (0.6%). Median CCI of the study cohort was 30.8. Spearman's correlation analysis showed the CDC and CCI were significantly correlated with PLOS and hospitalization costs, but the CCI showed a stronger correlation with PLOS (+0.552 day of stay for each additional CCI point; CCI: ρ = 0.663 vs. CDC: ρ = 0.581; p = 0.036). There were no significant differences in the correlations between total hospitalization costs and the CDC or CCI (CCI: ρ = 0.566 vs. CDC: ρ = 0.565; p = 0.78). CONCLUSION: CCI is an accurate tool for quantifying morbidities after PD and shows a stronger correlation with PLOS compared with the CDC.

Spectrally non-overlapping background noise disturbs echolocation via acoustic masking in the CF-FM bat, Hipposideros pratti.

The environment noise may disturb animal behavior and echolocation via three potential mechanisms: acoustic masking, reduced attention and noise avoidance. Compared with the mechanisms of reduced attention and noise avoidance, acoustic masking is thought to occur only when the signal and background noise overlap spectrally and temporally. In this study, we investigated the effects of spectrally non-overlapping noise on echolocation pulses and electrophysiological responses of a constant frequency-frequency modulation (CF-FM) bat, Hipposideros pratti. We found that H. pratti called at higher intensities while keeping the CFs of their echolocation pulses consistent. Electrophysiological tests indicated that the noise could decrease auditory sensitivity and sharp intensity tuning, suggesting that spectrally non-overlapping noise imparts an acoustic masking effect. Because anthropogenic noises are usually concentrated at low frequencies and are spectrally non-overlapping with the bat's echolocation pulses, our results provide further evidence of negative consequences of anthropogenic noise. On this basis, we sound a warning against noise in the foraging habitats of echolocating bats.

Review: Role and regulatory mechanism of inhibin in animal reproductive system.

Inhibin (INH) is a glycoprotein hormone secreted by the gonads that inhibit the synthesis and secretion of follicle-stimulating hormone (FSH). Increasing evidence indicates that INH plays a significant role in the development of the reproductive system including follicle development, ovulation rate, corpus luteum formation and ablation, steroid hormone synthesis and spermatogenesis, subsequently affecting the reproductive capacity of animals such as litter size and egg production. There are currently three main views on how INH inhibits FSH synthesis and secretion: influencing the activity of adenylate cyclase, the expression of follicle-stimulating hormone receptor or gonadotropin-releasing hormone receptor, and the competition system of inhibin-activin. This review discusses the current findings on the structure, function, and mechanism of action of INH in the reproductive system of animals.

Pharmacogenetic association of the NR1H3 promoter variant with antihypertensive response among patients with hypertension: A longitudinal study.

Background: The genetic factors in assessing therapeutic efficacy and predicting antihypertensive drug response are unclear. Therefore, this study aims to identify the associations between variants and antihypertensive drug response. Methods: A longitudinal study including 1837 hypertensive patients was conducted in Northern China and followed up for a median 2.24 years. The associations of 11 candidate variants with blood pressure changes in response to antihypertensive drugs and with the risk of cardiovascular events during the follow-up were examined. The dual-luciferase assay was carried out to assess the effect of genetic variants on gene transcriptional activity. Results: The variant rs11039149A>G in the promoter of nuclear receptor subfamily 1 group H member 3 (NR1H3) was associated with the change in systolic blood pressure (ΔSBP) in response to calcium channel blockers (CCBs) monotherapy. Patients carrying rs11039149AG genotype showed a significant increase of systolic blood pressure (SBP) at follow-up compared with AA carriers, and the difference of ΔSBP between AG and AA carriers was 5.94 mm Hg (95%CI: 2.09-9.78, p = 0.002). In 1,184 patients with CCBs therapy, SBP levels decreased in AA carriers, but increased in AG carriers, the difference of ΔSBP between AG and AA carriers was 8.04 mm Hg (95%CI: 3.28-12.81, p = 0.001). Further analysis in 359 patients with CCBs monotherapy, the difference of ΔSBP between AG and AA carriers was 15.25 mm Hg (95%CI: 6.48-24.02, p = 0.001). However, there was no significant difference in ΔSBP between AG and AA carriers with CCBs multitherapy. The rs11039149A>G was not associated with the cardiovascular events incidence during the follow-up. Additionally, transcriptional factor forkhead box C1 (FOXC1) bound to the NR1H3 promoter containing rs11039149A and significantly increased the transcriptional activity, while rs11039149 A to G change led to a loss-of-function and disabled FOXC1 binding. For the other 10 variants, associations with blood pressure changes or risk of cardiovascular events were not observed. Conclusion: Hypertensive patients with rs11039149AG genotype in the NR1H3 gene have a significant worse SBP control in response to CCBs monotherapy compared with AA carriers. Our findings suggest that the NR1H3 gene might act as a promising genetic factor to affect individual sensitivity to antihypertensive drugs.

Role of T2 mapping of magnetic resonance imaging in the differentiation of endometrial cancer and benign endometrial lesions

PURPOSE: The T2 mapping of magnetic resonance imaging (MRI) in endometrial cancer (EC), benign endometrial lesions (BELs), and normal endometrium (NE) has rarely been reported. This study aimed to determine the T2 values of MRI in EC, BELs, and NE to investigate whether the T2 values can differentiate them and to assess the aggressiveness of EC. METHODS: In total, 73 patients [EC, 51 (age, 57.4 ± 5.4 years); BELs, 22 (age, 57.8 ± 11.8 years)] and 23 normal volunteers (age, 56.1 ± 6.6 years) were included. The T2 values of MRI of the EC (type I and II), BEL, and NE groups were described and compared. The relationships between the T2 values of MRI in EC and the pathological characteristics [International Federation of Gynecology and Obstetrics (FIGO) stage and grade] were analyzed. RESULTS: The median T2 values of NE, BEL, and EC were 197.5 (142.9-324.0) ms, 131.1 (103.2-247.9) ms, and 103.0 (71.6-243.5) ms (P < 0.001), respectively. The median T2 values of type I and type II EC were 100.8 (71.62-130.44) ms and 125.7 (119.7-243.5) ms, respectively. There were significant differences in the T2 values among the NE, BEL, type I EC, and type II EC groups (P < 0.001) except for between the type II EC and BEL groups (P = 0.938). The T2 value of MRI in type I EC was significantly lower than that in type II EC (P = 0.001). There were no significant differences in patients with type I EC having different FIGO stages (P = 0.273) or tumor grades (P = 0.686). CONCLUSION: T2 mapping of MRI has the potential to quantitatively differentiate between EC, BELs, and NE as well as between type I and type II EC.