The influence of biological rhythms on the initial onset of status epilepticus in critically ill inpatients and the study of its predictive Model.

This study aims to explore the relationship between the circadian rhythms of critically ill patients and the incidence of Status Epilepticus (SE), and to develop a predictive model based on circadian rhythm indicators and clinical factors. We conducted a diurnal rhythm analysis of vital sign data from 4413 patients, discovering significant differences in the circadian rhythms of body temperature, blood oxygen saturation, and heart rate between the SE and non-SE groups, which were correlated with the incidence of SE. We also employed various machine learning algorithms to identify the ten most significant variables and developed a predictive model with strong performance and clinical applicability. Our research provides a new perspective and methodology for the study of biological rhythms in critically ill patients, offering new evidence and tools for the prevention and treatment of SE. Our findings are consistent or similar to some in the literature, while differing from or supplementing others. We observed significant differences in the vital signs of epileptic patients at different times of the day across various diagnostic time groups, reflecting the regulatory effects of circadian rhythms. We suggest heightened monitoring and intervention of vital signs in critically ill patients, especially during late night to early morning hours, to reduce the risk of SE and provide more personalized treatment plans.

The Roles of WNT Signaling Pathways in Skin Development and Mechanical-Stretch-Induced Skin Regeneration.

The WNT signaling pathway plays a critical role in a variety of biological processes, including development, adult tissue homeostasis maintenance, and stem cell regulation. Variations in skin conditions can influence the expression of the WNT signaling pathway. In light of the above, a deeper understanding of the specific mechanisms of the WNT signaling pathway in different physiological and pathological states of the skin holds the potential to significantly advance clinical treatments of skin-related diseases. In this review, we present a comprehensive analysis of the molecular and cellular mechanisms of the WNT signaling pathway in skin development, wound healing, and mechanical stretching. Our review sheds new light on the crucial role of the WNT signaling pathway in the regulation of skin physiology and pathology.

Headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC-MS) and odor activity value (OAV) to reveal the flavor characteristics of ripened Pu-erh tea by co-fermentation.

Introduction: Pu-erh tea is a geographical indication product of China. The characteristic flavor compounds produced during the fermentation of ripened Pu-erh tea have an important impact on its quality. Methods: Headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC-MS) and odor activity value (OAV) is used for flavor analysis. Results: A total of 135 volatile compounds were annotated, of which the highest content was alcohols (54.26%), followed by esters (16.73%), and methoxybenzenes (12.69%). Alcohols in ripened Pu-erh tea mainly contribute flower and fruit sweet flavors, while methoxybenzenes mainly contribute musty and stale flavors. The ripened Pu-erh tea fermented by Saccharomyces: Rhizopus: Aspergillus niger mixed in the ratio of 1:1:1 presented the remarkable flavor characteristics of flower and fruit sweet flavor, and having better coordination with musty and stale flavor. Discussion: This study demonstrated the content changes of ripened Pu-erh tea's flavor compounds in the fermentation process, and revealed the optimal fermentation time. This will be helpful to further understand the formation mechanism of the characteristic flavor of ripened Pu-erh tea and guide the optimization of the fermentation process of ripened Pu-erh tea.

Circadian rhythms of vital signs are associated with in-hospital mortality in critically ill patients: A retrospective observational study.

Vital signs have been widely used to assess the disease severity of patients, but there is still a lack of research on their circadian rhythms. The objective is to explore the circadian rhythms of vital signs in critically ill patients and establish an in-hospital mortality prediction model. Study patients from the recorded eICU Collaborative Research Database were included in the present analyses. The circadian rhythms of vital signs are analyzed in critically ill patients using the cosinor method. Logistic regression was used to screen independent predictors and establish a prediction model for in-hospital mortality by multivariate logistic regression analysis and to show in the nomogram. Internal validation is used to evaluate the prediction model by bootstrapping with 1000 resamples. A total of 29,448 patients were included in the current analyses. The Mesor, Amplitude, and Peak time of vital signs, such as heart rate (HR), temperature, respiration rate (RR), pulse oximetry-derived oxygen saturation (SpO2), and blood pressure (BP), were significant differences between survivors and non-survivors . Logistic regression analysis showed that Mesor, Amplitude, and Peak time of HR, RR, and SpO2 were independent predictors for in-hospital mortality in critically ill patients. The area under the curve (AUC) and c-index of the prediction model for the Medical intensive care unit (MICU) and Surgical intensive care unit (SICU) were 0.807 and 0.801, respectively. The Hosmer-Lemeshow test P-values were 0.076 and 0.085, respectively, demonstrating a good fit for the prediction model. The calibration curve and decision curve analysis (DCA) also demonstrated its accuracy and applicability. Internal validation assesses the consistency of the results. There were significant differences in the circadian rhythms of vital signs between survivors and non-survivors in critically ill patients. The prediction model established by the Mesor, Amplitude, and Peak time of HR, RR, and SpO2 combined with the Acute Physiology and Chronic Health Evaluation (APACHE) IV score has good predictive performance for in-hospital mortality and may eventually support clinical decision-making.Abbreviations: ICU: Intensive care unit; MICU: Medical intensive care unit; SICU: Surgical intensive care unit; HR: Heart rate; RR: Respiration rate; SpO2: Pulse oximetry-derived oxygen saturation; BP: Blood pressure; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; APACHE: Acute Physiology and Chronic Health Evaluation; bpm: beats per min; BMI: Body mass index; OR: Odd ratio; CI: Confidential interval; IQR: Interquartile range; SD: Standard deviation; ROC: Receiver operating characteristic; AUC: area under the curve; DCA: Decision curve analysis; IRB: Institutional review board.

Adipose-derived stem cells regulate CD4+ T-cell-mediated macrophage polarization and fibrosis in fat grafting in a mouse model.

Autologous fat grafting is becoming increasingly common worldly. However, the long-term retention of fat grafting is still unpredictable due to the inevitable fibrosis arising during tissue repair. Fibrosis may be regulated by T-cell immune responses that are influenced by adipose-derived stem cells (ASCs). Therefore, we hypothesized that overly abundant ASCs might promote fibrosis by promoting T-cell immune responses to adipose tissue. We performed 0.3 ml fat grafts with 104/ml, 106/ml and 108/ml ASCs and control group in C57 BL/6 mice in vivo. We observed retention, fibrosis, T-cell immunity, and macrophage infiltration over 12 weeks. Besides, CD4+ T-helper 1 (Th1) cells and T-helper 2 (Th2) cells were co-cultured with ASCs or ASCs conditioned media (ASCs-CM) in vitro. We detected the ratio of Th2%/Th1%. Results showed that the retention rate was higher in 104 group, while even lower in 108 group with significantly increased inflammation and fibrosis than control group at week 12 in vivo. There was no significance between control group and 106 group. Also, 108 group increased the infiltration of M2 macrophages, CD4+ T-cells and Th2/Th1 ratio. In vitro, the ratio of Th2%/Th1% induced by ASCs-transwell group was higher than ASCs-CM group and showed concentration-dependent. Accordingly, high concentrations of ASCs in adipose tissue can promote Th1-Th2 shifting, and excessive Th2 cells might promote the persistence of M2 macrophages and increase the level of fibrosis which lead to a decrease in the long-term retention of fat grafts. Also, we found ASCs promoted Th1-Th2 shifting in vitro.

The impact of eating behaviors during COVID-19 in health-care workers: A conditional process analysis of eating, affective disorders, and PTSD.

Objective: The incidence of post-traumatic stress disorder (PTSD) increased among healthcare workers (HCWs) during the outbreak of COVID-19. The purpose of this study was to examine the relationship between eating behavior and PTSD, considering the mediation effect of anxiety, depression and sleep. Methods: A total of 101 HCWs completed a survey. The Food-Frequency Questionnaires (FFQ) were used to evaluate the diet. A special survey was conducted on the eating time of each shift mode. The PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), and Morning-Evening Questionnaire (MEQ) were utilized to assess clinical symptoms. Results: There was a statistically significant correlation between the night shift eat midpoint (NEMP) and PTSD symptoms, anxiety and depression as significant mediators. The last meal jet lag between night shift and day shift (NDLM) was related to PTSD symptoms significantly, and sleep and anxiety were significant mediators. The relationship between animal-based protein pattern and PTSD symptoms was statistically significant, and anxiety was the significant mediator. Conclusions: The earlier the HCWs eat in the night shift, the lighter the symptoms of PTSD. This is mediated by improving anxiety, depression and sleep disorder. Furthermore, the consumption of animal protein could reduce symptoms of PTSD by improving anxiety.

Sini powder with paroxetine ameliorates major depressive disorder by modulating circadian rhythm: A randomized, double-blind, placebo-controlled trial.

Circadian rhythm disorder is a significant risk factor for mental diseases, and the recovery of circadian rhythm function has gradually become a signal of effective antidepressant therapy. Sini powder (SNP) is a classical, traditional Chinese formula for depression treatment. However, few clinical reports have been recorded. This randomized, double-blinded, controlled trial (ChiCTR1900022700) aimed to explore the efficacy of SNP on depression via regulating circadian rhythm. In total, 36 patients with major depressive disorder (MDD) were enrolled for 4-weeks medication and 6-weeks follow-up. HAMD-24 score and circadian rhythm index, including dim light melatonin onset (DLMO) and phase angle difference (PAD), were included in the assessment. DLMO and PAD were statistically significant in the SNP group after 4 weeks of treatment (p < .05) and with greater improvement in DLMO (p = .03). In addition, DLMO and the HAMD-24 score showed a positive correlation (p < .05); the HAMD-24 score degree decreased significantly over time (p < .001). Similarly, interaction effects were shown significantly between group and time (p = .049). The duration of SNP supplementation was relatively short, and the sample size was relatively small. SNP granules combined with paroxetine tablets have definite efficacy in improving the circadian rhythms of MDD patients, reflecting the therapeutic advantages of traditional Chinese medicine as antidepressants.

A Reliable Method for Chin Augmentation by Mechanical Micronization of Lipoaspirates.

BACKGROUND: Desire for improved aesthetic contour of the lower third of the face has resulted in an increase in chin augmentation. Although many fillers, including hyaluronic acid (HA), autologous fat and stromal vascular fraction gel (SVF-gel), have been used to improve facial morphology, chin augmentation requires fillers that provide greater support. METHODS: The elastic and viscous moduli of SVF-gel and Coleman fat were assessed in vitro by rheological testing, whereas their elasticity were evaluated in vivo by ultrasonic elastography. Results in vitro were compared with those of highly elastic HA (HE-HA) and highly viscous HA (HV-HA), whereas results in vivo were compared with HE-HA. Changes in chin volume, SVF-gel retention rate and absorptivity for at least 12 months were measured by 3D white light scanning. Questionnaires were administered to assess patient satisfaction. RESULTS: The elastic and viscous modulus of SVF-gel was, respectively, slightly lower than HE-HA and HV-HA but higher than the other two in vitro, with the elasticity of the three layers of SVF-gel lower than HE-HA but slightly higher than normal control in vivo. The average retention rate was 62.34±3.34% at 12 months. The absorptivity of 90% of the samples was <3% from 6 to 12 months, which was considered stable. Patients expressed satisfaction with their results. CONCLUSION: SVF-gel has ideal rheologic characteristics in vitro, which has slightly higher elasticity than normal fat tissue of chin in vivo, and could keep well retention rate for chin augmentation in clinic. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An Efficacy Study of a New Radical Treatment for Acne Vulgaris Using Fat Injection.

BACKGROUND: Fat grafting is a popular operative approach for rejuvenation. Some patients requiring facial fat grafting also have acne. Fat grafting may improve acne in some patients. OBJECTIVES: The aim of this study was to assess whether fat grafting can improve acne and to analyze the mechanism of action by which such improvement occurs. METHODS: Preoperative and postoperative digital photographs were examined retrospectively in 229 patients who underwent fat grafting to compare the numbers of inflammatory acne lesions. In addition, 18 patients with acne who were treated by injection of subdermal stromal vascular fraction gel (SVF-gel) were examined prospectively. The numbers of inflammatory acne lesions before and after treatment were measured, and changes in the levels of CD4+ T-cell infiltration were determined from immunohistochemical staining. RESULTS: Of the 229 retrospectively evaluated patients who underwent fat grafting, 22 had acne and had complete follow-up data; in these patients, the numbers of acne lesions were significantly lower after than before treatment. The 18 patients who received subdermal SVF-gel injection showed evident improvements in inflammatory lesions after more than 1 year of follow-up. CD4+ T-cell infiltration was significantly decreased at week 4. CONCLUSIONS: Facial fat grafting can improve inflammatory acne lesions, perhaps because adipose-derived stem cells, which are plentiful in SVF-gel, reduce CD4+ T-cell-mediated inflammation responses.

Transcriptional control of local auxin distribution by the CsDFB1-CsPHB module regulates floral organogenesis in cucumber.

Plant cystatins are cysteine proteinase inhibitors that play key roles in defense responses. In this work, we describe an unexpected role for the cystatin-like protein DEFORMED FLORAL BUD1 (CsDFB1) as a transcriptional regulator of local auxin distribution in cucumber (Cucumis sativus L.). CsDFB1 was strongly expressed in the floral meristems, floral primordia, and vasculature. RNA interference (RNAi)-mediated silencing of CsDFB1 led to a significantly increased number of floral organs and vascular bundles, together with a pronounced accumulation of auxin. Conversely, accompanied by a decrease of auxin, overexpression of CsDFB1 resulted in a dramatic reduction in floral organ number and an obvious defect in vascular patterning, as well as organ fusion. CsDFB1 physically interacted with the cucumber ortholog of PHABULOSA (CsPHB), an HD-ZIP III transcription factor whose transcripts exhibit the same pattern as CsDFB1 Overexpression of CsPHB increased auxin accumulation in shoot tips and induced a floral phenotype similar to that of CsDFB1-RNAi lines. Furthermore, genetic and biochemical analyses revealed that CsDFB1 impairs CsPHB-mediated transcriptional regulation of the auxin biosynthetic gene YUCCA2 and the auxin efflux carrier PIN-FORMED1, and thus plays a pivotal role in auxin distribution. In summary, we propose that the CsDFB1-CsPHB module represents a regulatory pathway for local auxin distribution that governs floral organogenesis and vascular differentiation in cucumber.

Amino Acid Transporters in Plants: Identification and Function.

Amino acid transporters are the main mediators of nitrogen distribution throughout the plant body, and are essential for sustaining growth and development. In this review, we summarize the current state of knowledge on the identity and biological functions of amino acid transporters in plants, and discuss the regulation of amino acid transporters in response to environmental stimuli. We focus on transporter function in amino acid assimilation and phloem loading and unloading, as well as on the molecular identity of amino acid exporters. Moreover, we discuss the effects of amino acid transport on carbon assimilation, as well as their cross-regulation, which is at the heart of sustainable agricultural production.