Vitamin D, vitamin D supplementation and atrial fibrillation risk in the general population: updated systematic review and meta-analysis of prospective studies.

Background: Since the association of vitamin D with atrial fibrillation (AF) risk is still unclear, we conducted this updated meta-analysis of prospective studies to identify the relationship between vitamin D or vitamin D supplementation and AF in the general population. Methods: We conducted a comprehensive search of multiple databases up to May 2023 for studies reporting vitamin D and AF. The hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled by a random-effects model. Results: A total of seven studies were included in this meta-analysis. Vitamin D deficiency (<20 ng/ml) was associated with increased AF incidence (HR: 1.12, 95% CI: 1.005-1.25). The HR was not significant with vitamin D insufficiency (20-30 ng/ml; HR: 1.09, 95% CI: 0.98-1.21). Each 10 ng/ml increase in serum vitamin D was associated with a significantly decreased AF incidence (HR: 0.95, 95% CI: 0.93-0.97). Two studies reported the effect of vitamin D supplements on AF incidence but reached inconsistent results. Conclusions: Vitamin D deficiency or insufficiency was associated with an increased risk of AF in the general population. The role of vitamin D supplementation in AF prevention needs further investigation.

Clinical application of double-capsule fecal catheter device in ICU patients with fecal incontinence.

OBJECTIVE: To explore and analyze the clinical effect and potential value of a double-capsule fecal catheter device in patients with fecal incontinence in the intensive care unit (ICU). METHODS: A total of 107 patients with fecal incontinence who were admitted to the ICU of the First Affiliated Hospital of Gannan Medical University from May 2017 to April 2023 were selected and randomly divided into the observation group and the control group, with 68 cases in the observation group and 39 cases in the control group. The observation group was given a double-capsule fecal catheter device, and the control group was given an ordinary fecal catheter device for drainage. The clinical baseline data, adverse events, skin conditions, changes of patients' quality of life (QoL), indicators from laboratory test, working pressure and burden of nursing, average length of stay (ALOS) and prognosis of patients were compared between the two groups. RESULTS: There was no significant difference in age, gender, body mass index (BMI), hypertension history, diabetes mellitus history and smoking history between the observation group and the control group (all P>0.05). The occurrence probability of the number of catheter obstructions, perianal leakage, catheter prolapse and the incidence of discomfort reactions in the observation group were significantly lower than those in the control group, and the difference was statistically significant (P<0.01). After the use of the double-capsule fecal catheter device, the skin condition of the patient's perineum and perianal area was significantly improved and remained dry and comfortable for a long time, and the recovery of the primary disease in patients with fecal incontinence was also more optimistic. After application of the double-capsule fecal catheter device, the scores of QoL significantly increased in patients from the observation group (P<0.05). After using the double-capsule fecal catheter device, the levels of WBC, neutrophils count, PCT and IL-6 in the observation group were significantly lower than those in the control group after nursing (P<0.05). However, there was no significant difference in levels of CRP, TNF-α, albumin and prealbumin between the two groups (P>0.05). The responsible nurses of the patients in the control group expressed significantly higher nursing work burden than the observation group (P<0.05). Patients in the observation group had shorter ALOS and lower mortality than those in the control group (P<0.01). CONCLUSION: The application of the novel double-capsule fecal catheter device can reduce the adverse events and working pressure and burden of nursing, it also improved skin condition and patients' QoL. Correspondingly, it improved relevant prognostic indicators during the patient's hospitalization. It has beneficial clinical practicability and popularity for fecal incontinence in patients, and it is worthy of use and promotion.

Screening for osteoporosis based on IQon spectral CT virtual low monoenergetic images: Comparison with conventional 120 kVp images.

Objectives: To explore the differences between low kiloelectron volt (keV) virtual monoenergetic images (VMIs) using IQon spectral CT and conventional CT (120 kVp) in the diagnosis of osteoporosis. Methods: This retrospective study included 317 patients who underwent IQon spectral CT and dual-energy X-ray absorptiometry (DXA) examination. Commercial deep learning-based software was used for the fully automated extraction of the CT values of the first to fourth lumbar vertebrae (L1-L4) from two different low-keV levels (including 40/70 keV) VMIs and conventional 120 kVp images. The DXA examination results served as the standard of reference (normal [T-score ≥ -1], osteopenia [-2.5 < T-score < -1], and osteoporosis [T-score < -2.5]). Osteoporosis diagnosis models were constructed using machine learning classifiers (logistic regression, support vector machine, random forest, XGBoost, and multilayer perceptron) based on the average CT values of L1-L4. The area under the receiver operating characteristic curve (AUC) and DeLong test were performed to compare differences in the performance of the osteoporosis diagnosis model between virtual low-keV VMIs and standard 120 kVp images. Results: Random forest-based prediction model obtained good overall performance among all classifiers, and macro/micro average AUC values of 0.820/840, 0.834/853, and 0.831/852 were obtained based on 40/70 keV and 120 kVp images, respectively. The model presented no significant difference between low-keV VMIs and standard 120 kVp images for the diagnosis of osteoporosis (p > 0.05). Conclusions: The performance of the osteoporosis diagnosis model using IQon spectral CT simulating the low tube voltage scanning condition (less than 120 kVp) was also satisfactory. Bone density screening evaluation can be performed with a combination of low-dose lung scanning CT, greatly reducing the radiation dose without affecting the diagnosis.

The effectiveness of the modified Epley maneuver for the treatment of posterior semicircular canal benign paroxysmal positional vertigo.

Objective: To compare the repositioning effect of the modified Epley maneuver and the traditional Epley maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV). Methods: Sixty-five patients with unilateral PC-BPPV were randomly divided into two groups. The control group received the traditional Epley maneuver, while the experimental group received the modified Epley maneuver, which prolonged the time in the healthy side lying position and the final bowing position. The number of successful repositions after one, two, and three attempts and the total number of successful repositions were recorded and compared between the two groups. A BPPV virtual simulation model was used to analyze the mechanism of the modified Epley maneuver. Results: The first repositioning success rate of the experimental group was significantly higher than that of the control group (85% vs. 63%, p = 0.040). The experimental group achieved 100% repositioning success rate after two attempts, while the control group needed three attempts to reach 86% repositioning success rate. Four cases in the control group experienced canal switching during the repositioning process, while none in the experimental group did. The BPPV virtual simulation model showed that the modified Epley maneuver could facilitate the passage of otoliths through the posterior arm of the posterior semicircular canal, especially through the location of obstruction. Conclusion: The modified Epley maneuver is more effective than the traditional Epley maneuver in improving the single repositioning success rate and reducing the canal switching rate for PC-BPPV. This study provides a new option for the treatment of BPPV.

Small-Molecule Electron Transport Layer with Siloxane-Functionalized Side Chains for Nonfullerene Organic Solar Cells.

Active layer materials with silicone side chains have been broadly reported to have excellent long-term stability in harsh environments. However, the application of conjugated materials with silicone side chains in electron transport layers (ETLs) has rarely been reported. In this research, we synthesized for the first time a siloxane-modified perylene-diimide derivative (PDI-OSi) consisting of a side-chain substituent of siloxane and a conjugated group of perylene-diimide (PDI). The inserted siloxane functional groups not only can strengthen the light transmittance of PDI-OSi but also can remarkably expand its solubility and improve the film-forming ability and air stability of the material. Second, introducing siloxane-containing side chains can dramatically lower the work function and interfacial barrier of the electrode, thereby achieving a favorable ohmic contact. In addition, the moderate surface energy of siloxane functional groups makes PDI-OSi hydrophobic, which is conducive to forming excellent miscibility with hydrophobic active layers to promote charge transfer. When PDI-OSi is used as an ETL in organic solar cells (OSCs), operative exciton dissociation and more favorable surface morphology enable OSCs to realize a power conversion efficiency (PCE) of 13.99%. These results indicate that side-chain engineering with siloxane pendants is a facile strategy for constructing efficient OSCs.

Recent Advances and Prospects of Small Molecular Organic Thermoelectric Materials.

Thermoelectric (TE) materials possess unique energy conversion capabilities between heat and electrical energy. Small organic semiconductors have aroused widespread attention for the fabrication of TE devices due to their advantages of low toxicity, large area, light weight, and easy fabrication. However, the low TE properties hinder their large-scale commercial application. Herein, the basic knowledge about TE materials, including parameters affecting the TE performance and the remaining challenges of the organic thermoelectric (OTE) materials, are initially summarized in detail. Second, the optimization strategies of power factor, including the selection and design of dopants and structural modification of the dope-host are introduced. Third, some achievements of p- and n-type small molecular OTE materials are highlighted to briefly provide their future developing trend; finally, insights on the future development of OTE materials are also provided in this study.

LIAF-Net: Leaky Integrate and Analog Fire Network for Lightweight and Efficient Spatiotemporal Information Processing.

Spiking neural networks (SNNs) based on the leaky integrate and fire (LIF) model have been applied to energy-efficient temporal and spatiotemporal processing tasks. Due to the bioplausible neuronal dynamics and simplicity, LIF-SNN benefits from event-driven processing, however, usually face the embarrassment of reduced performance. This may because, in LIF-SNN, the neurons transmit information via spikes. To address this issue, in this work, we propose a leaky integrate and analog fire (LIAF) neuron model so that analog values can be transmitted among neurons, and a deep network termed LIAF-Net is built on it for efficient spatiotemporal processing. In the temporal domain, LIAF follows the traditional LIF dynamics to maintain its temporal processing capability. In the spatial domain, LIAF is able to integrate spatial information through convolutional integration or fully connected integration. As a spatiotemporal layer, LIAF can also be used with traditional artificial neural network (ANN) layers jointly. In addition, the built network can be trained with backpropagation through time (BPTT) directly, which avoids the performance loss caused by ANN to SNN conversion. Experiment results indicate that LIAF-Net achieves comparable performance to the gated recurrent unit (GRU) and long short-term memory (LSTM) on bAbI question answering (QA) tasks and achieves state-of-the-art performance on spatiotemporal dynamic vision sensor (DVS) data sets, including MNIST-DVS, CIFAR10-DVS, and DVS128 Gesture, with much less number of synaptic weights and computational overhead compared with traditional networks built by LSTM, GRU, convolutional LSTM (ConvLSTM), or 3-D convolution (Conv3D). Compared with traditional LIF-SNN, LIAF-Net also shows dramatic accuracy gain on all these experiments. In conclusion, LIAF-Net provides a framework combining the advantages of both ANNs and SNNs for lightweight and efficient spatiotemporal information processing.

T3 level may be a helpful marker to predict disease prognosis of acute central nervous system viral infections.

AIM OF THE STUDY: Acute central nervous system viral infections are progressive and inflammatory diseases with inflammatory cells infiltrating into the central nervous system (CNS), and thyroid hormone (TH) level is associated with the oxidative and antioxidant status. Variations in oxidative stress and antioxidant status are related to the pathogenesis of inflammatory diseases. Our study aimed to investigate the possible correlation between viral infections in CNS and TH levels of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3). MATERIALS AND METHODS: We measured serum concentrations of TSH, fT4, and fT3 in 206 individuals, including 59 viral meningitis (VM) patients, 60 viral encephalitis (VE) patients, and 87 healthy controls. RESULTS: Our findings showed that VE and VM patients had lower levels of fT3 and higher levels of fT4 compared with healthy controls, whether male or female. Moreover, levels of TSH and fT3 in patients with viral infections in CNS were inversely correlated with disease prognosis measured by the Glasgow Outcome Scale. CONCLUSIONS: Variations in TH level may represent the oxidative status and are surrogate biomarkers for disease prognosis of acute central nervous system viral infections.

The efficacy of greater occipital nerve block for the treatment of migraine: A systematic review and meta-analysis.

Greater occipital nerve (GON) block has some potential in treating migraine. We conduct a systematic review and meta-analysis to investigate the impact of GON block on pain management of migraine. We have systematically searched randomized controlled trials (RCTs) assessing the efficacy of GON block versus placebo for migraine in various databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. The primary outcome is pain intensity. Meta-analysis is performed using the random-effect model. Seven RCTs are included in the meta-analysis. Compared with control intervention in migraine patients, GON block intervention can significantly reduce pain intensity (Mean difference = -1.24; 95% CI = -1.98 to -0.49; P = 0.001) and analgesic medication consumption (Mean difference = -1.10; 95% CI = -2.07 to -0.14; P = 0.02), but has no remarkable impact on head duration (Mean difference = -6.96; 95% CI = -14.09 to 0.18; P = 0.0.06) and adverse events (RR = 0.93; 95% CI = 0.52 to 1.65; P = 0.80). GON block intervention is able to significantly reduce pain intensity and analgesic medication consumption in migraine patients.

Palladium-Catalyzed Tandem Regioselective Oxidative Coupling from Indoles and Maleimides: One-Pot Synthesis of Indolopyrrolocarbazoles and Related Indolylmaleimides.

An efficient Pd(II)-catalyzed approach for the direct synthesis of indolo[3,2-a]pyrrolo[3,4-c]carbazole-6,8-diones has been developed from both free and protected (NH) indoles and maleimides via a regioselective tandem oxidative coupling reaction. The yields are moderate to excellent. In addition, 2-substituted indoles are suitable substrates in this protocol, leading to the formation of indolylmaleimides. The present methodology provides a concise route to highly functionalized indolopyrrolocarbazole derivatives.