Association of depression and sleep quality with frailty: a cross-sectional study in China.

Background: With the rapid growth of global aging, frailty has become a serious public health burden, affecting the life quality of older adults. Depressive symptoms (depression hereafter) and sleep quality are associated with frailty, but the pathways in which sleep quality and depression affect frailty remain unclear. Method: This cross-sectional study included 1866 community-dwelling older adults. Demographic characteristics and health-related data of them was collected, and we also assessed frailty, depression, and sleep quality. Descriptive statistics were carried out and ordinal logistic regression analysis was used to identify the factors correlated with frailty. Spearman correlation analysis and mediation analysis were employed to assess associations between sleep quality, depression and frailty. Two-sided p < 0.05 was considered as significant. Results: The results showed that 4.1% older adults were frail and 31.0% were pre-frail. Ordinal logistic regression showed that age, consumptions of vegetables, exercise, sleep quality, depression, number of chronic diseases, chronic pain, and self-rated health were correlated with frailty. Spearman correlation analysis revealed that frailty was associated with depression and sleep quality. There was a mediation effect that sleep quality was a significant and positive predictor of frailty (total effect = 0.0545, 95% boot CI = 0.0449-0.0641), and depression was a mediator between sleep quality and frailty (mediation effect = 60.4%). Conclusion: Depression and poor sleep quality may be early indicators of frailty in older adults. Improving the sleep quality and psychological state of older adults can improve frailty, which is beneficial for healthy aging.

Synergistic effect of paeoniflorin combined with luteolin in alleviating Lipopolysaccharides-induced acute lung injury.

ETHNOPHARMACOLOGICAL RELEVANCE: Acute lung injury (ALI) is an acute multifactorial infectious disease caused by trauma, pneumonia, shock and sepsis. Paeoniae Radix Rubra (Paeonia lactiflora Pall. or Paeonia veitchii Lynch, Chishao in Chinese, CS) and Salviae Miltiorrhizae Radix et Rhizoma (Salvia miltiorrhiza Bge., Lamiaceae, Danshen in Chinese, DS) are common traditional Chinese medicines (TCMs). CS-DS herb pair has been widely used to promote blood circulation and eliminate blood stasis in Chinese clinical practice, appearing in a variety of prescriptions. However, it is still unclear for the effect and active ingredients of the herb pair on ALI. AIM OF THE STUDY: The study investigated the effect and active ingredients of CS-DS herb pair and demonstrated the synergistic effect and mechanisms of the active ingredients. MATERIALS AND METHODS: Lipopolysaccharides (LPS)-stimulated RAW264.7 macrophage cells and BALB/c mice were used to establish an ALI model to investigate the effect of CS-DS herb pair on ALI. Network pharmacology and molecular docking were used to analyze the active ingredients and potential mechanisms of the herb pair. The synergistic effects and mechanisms of active ingredients on ALI were validated by in vitro and in vivo experiments. RESULTS: CS-DS herb pair had a synergistic effect on LPS-induced ALI. Based on the network pharmacology, the compounds paeoniflorin and luteolin were screened. Both paeoniflorin and luteolin had good affinity for NF-κB and MAPK by molecular docking. LPS stimulation of RAW264.7 cells resulted in a significant increase in ROS, NO, TNF-α, IL-6 and IL-1ß, while the paeoniflorin combined with luteolin significantly reduced their expressions. In the LPS-induced ALI model, the combination also reduced the expression of inflammatory factors and oxidative stress levels. Furthermore, LPS activated the NF-κB and MAPK signaling pathways, whereas the combination decreased the expression of proteins in both pathways. CONCLUSION: CS-DS herb pair alleviated LPS-induced ALI with the active ingredients paeoniflorin and luteolin, which suppressed inflammation and oxidative stress via regulation of NF-κB and MAPK signaling pathways.

Mediating effect of sleep quality on the association between job stress and health-related productivity loss among workers in R&D enterprises in Shanghai.

Background: Past research indicates that occupational stress negatively predicts health-related productivity. Simultaneously, sleep problem among workers may stem from job stress, subsequently leading to a decline in sleep quality and resulting in reduced health productivity. Therefore, this study aims to idenitify whether the sleep quality of employees functions as a mediator in the process through which job stress impacts health productivity. Objectives: This study aimed to assess the status and analyze differences in quality of sleep, job stress, and health-related productivity loss (HRPL) among workers in research and development (R&D) enterprises in Minhang District, Shanghai. We also assessed the mediating effect of sleep quality on the relationship between job stress and HRPL. Methods: A total of 3,216 workers in R&D firms aged between 18 and 60 years participated in this study (mean age 35.15 years; standard deviation 8.44; male-to-female ratio≈2:1). The Nakata Insomnia Questionnaire, the Chinese version of the Brief Job Stress Questionnaire revised edition, and the Chinese version of the Work Productivity and Activity Impairment Questionnaire were used in this study. And the Kruskal-Wallis test, Hierarchical Multiple Regression Analysis, and Path Analysis were utilized for data analysis in this study. Results: There were significant differences in the positive detection rate of insomnia among participants according to age, educational level, marital status, position, length of service, and level of financial difficulties (all P < 0.05). We also found significant differences in the positive detection rate of HRPL among participants according to age, marital status, length of service, and level of financial difficulties (all P < 0.05); participants with insomnia scored higher for HRPL than those without insomnia (6.00 vs. 4.20, P < 0.001). Additionally, participants with job stress problems had higher HRPL than those without these issues (7.00 vs. 4.20, P < 0.001). Our findings suggest that sleep quality plays a mediating role between job stress and HRPL (all P < 0.05). Conclusions: Occupational health professionals must pay particular attention to job stress, sleep quality, and their influencing factors to positively influence the wellbeing of workers while improving productivity.

Sex steroid and cognitive function among community-dwelling older men with or without vascular risk factors: a cross-sectional study.

BACKGROUND: The relationship of testosterone and estradiol concentrations with cognitive function among community-dwelling older men was inconclusive. To examine the association of serum testosterone and estradiol concentrations with cognitive function in older men with or without vascular risk factors (VRFs). METHODS: This cross-sectional study consisted of 224 community-dwelling men aged 65-90 years in the Songjiang District of Shanghai, China. Serum testosterone and estradiol were measured by electrochemiluminescence immunoassay. The following five factors were defined as VRFs in this study: obesity, history of hypertension, diabetes, stroke, and coronary heart disease. Multivariable linear regression was used to examine the association of testosterone and estradiol with the Mini-Mental State Examination (MMSE) in participants with or without VRF. Restricted cubic spline (RCS) regression was performed to account for the nonlinearity of these associations. RESULTS: An inverted "U" shaped non-linear relationship was found between testosterone concentration and MMSE score in men with one VRF (P overall =.003, non-linear P =.002). Estradiol showed an inverted "U" shaped non-linear relationship with MMSE score independent of VRFs (men without VRF, P overall =.049, non-linear P =.015; men with one VRF, overall P =.007, non-linear P =.003; men with two or more VRFs, overall P =.009, non-linear P =.005). CONCLUSION: In older men, an optimal level of sex steroid concentration may be beneficial to cognitive function and the VRFs should be considered when interpreting the relationship between sex steroid and cognitive function.

Mechanisms underlying the synergistic effects of chuanxiong combined with Chishao on treating acute lung injury based on network pharmacology and molecular docking combined with preclinical evaluation.

ETHNOPHARMACOLOGICAL RELEVANCE: The herb pair of Chuanxiong Rhizome (Ligusticum chuanxiong Hort., Chuanxiong in Chinese, CX) and Paeoniae Radix Rubra (Paeonia lactiflora Pall. Or Paeonia veitchii Lynch, Chishao in Chinese, CS) is a famous blood activating and stasis resolving pair that is often found in traditional Chinese medicine (TCM) formulas for the treatment of acute lung injury (ALI). However, the relationship of CX-CS herb pair to ALI and its underlying mechanisms are unclear. AIM OF THE STUDY: The study explored the effect and mechanisms of CX-CS herb pair in LPS induced ALI by network pharmacology and molecular docking combined with preclinical evaluation. MATERIALS AND METHODS: The related targets of the active compounds of CX-CS herb pair in regulating ALI were screened by network pharmacology. PPI was constructed and the potential pathways were investigated by GO and KEGG. The contribution of each active ingredient of CX-CS herb pair to ALI were calculated by network-based efficacy. The interactions between potential targets and active ingredients were evaluated by molecular docking. LPS stimulated RAW264.7 cells and mice model experiments were adopted to verify the effect of CX-CS herb pair on ALI. RESULTS: A total of 25 compounds and 193 targets were identified in the CX-CS herb pair, of which 19 compounds and 64 targets were associated with ALI, and six compounds including baicalin, ellagic acid, baicalein, beta-sitosterol, paeoniflorin and ferulic acid accounted for 93.12% of the total combination index for ALI prevention. The CX-CS herbal pair against ALI was associated with PI3K/AKT and MAPK signaling pathways by GO and KEGG analysis. The screened active compounds showed good affinity for TNF, MAPK, and AKT by molecular docking. In vitro and in vivo tests showed that CX combined with CS synergistically inhibited LPS-induced ALI at 1:3, suppressed the release of TNF-α, IL-1ß and IL-6, inhibited the accumulation of ROS, as well as regulated the content of SOD, MDA and GSH. Meanwhile, the herb pair was effective in inhibiting the expression of p38, ERK, IκBα, p65, caspase 3, PARP, and up-regulating the levels of AKT and Bcl-2/Bax. CONCLUSIONS: Our study confirmed the synergistic effect of CX-CS herb pair on the prevention of ALI by inhibiting inflammation, oxidative stress, and apoptosis through MAPK/NF-κB and PI3K/AKT signaling pathways.

Modulating Consciousness through Awareness Training Program and Its Impacts on Psychological Stress and Age-Related Gamma Waves.

Aging often leads to awareness decline and psychological stress. Meditation, a method of modulating consciousness, may help individuals improve overall awareness and increase emotional resilience toward stress. This study explored the potential influence of the Awareness Training Program (ATP), a form of consciousness modulation, on age-related brain wave changes and psychological stress in middle-aged adults. Eighty-five participants with mild stress were recruited and randomly assigned to ATP (45.00 ± 8.00 yr) or control (46.67 ± 7.80 yr) groups, matched by age and gender. Ten-minute resting-state EEG data, obtained while the participants' eyes were closed, were collected using a 128-channel EEG system (EGI). A strong positive Pearson correlation was found between fast-wave (beta wave, 12-25 Hz; gamma wave, 25-40 Hz) EEG and age. However, after the 7-week ATP intervention, this correlation became insignificant in the ATP group. Furthermore, there was a significant reduction in stress levels, as measured by the Chinese version of the 10 item Perceived Stress Scale (PSS-10), in the ATP group. These results suggest that ATP may help modulate age-related effects on fast brain waves, as evidenced by the reduced correlation magnitude between age and gamma waves, and lower psychological stress. This suggests that ATP, as a form of consciousness modulation, may improve stress resilience and modulate age-related gamma wave changes.

Ethnic disparities in cardiovascular and renal responses to canagliflozin between Asian and White patients with type 2 diabetes mellitus: A post hoc analysis of the CANVAS Program.

AIM: To assess the potential heterogeneity in cardiovascular (CV), renal and safety outcomes of canagliflozin between Whites and Asians, as well as these outcomes in each subgroup. MATERIALS AND METHODS: The CANVAS Program enrolled 10 142 patients with type 2 diabetes, comprising 78.34% Whites and 12.66% Asians. CV, renal and safety outcomes were comprehensively analysed using Cox regression models, while intermediate markers were assessed using time-varying mixed-effects models. Racial heterogeneity was evaluated by adding a treatment-race interacion term. RESULTS: Canagliflozin showed no significant racial disparities in the majority of the CV, renal and safety outcomes. The heterogeneity (p = .04) was observed on all-cause mortality, with reduced risk in Whites (hazard ratio 0.84; 95% confidence interval 0.71-0.99) and a statistically non-significant increased risk in Asians (hazard ratio 1.64; 95% confidence interval 0.94-2.90). There was a significant racial difference in acute kidney injury (p = .04) and a marginally significant racial heterogeneity for the composite of hospitalization for heart failure and CV death (p = .06) and serious renal-related adverse events (p = .07). CONCLUSION: Canagliflozin reduced CV and renal risks similarly in Whites and Asians; however, there was a significant racial discrepancy in all-cause mortality. This distinction may be attributed to the fact that Asian patients exhibited diminished CV protection effects and more renal adverse events with canagliflozin, potentially resulting from the smaller reductions in weight and uric acid. These findings highlight the importance of investigating the impact of race on treatment response to sodium-glucose cotransporter-2 inhibitors and provide more precise treatment strategies.

Association between alcohol use and frailty among elder adults in three Chinese cities.

BACKGROUND: Frailty is often described as a condition of the elderly and alcohol use is associated with frailty. The aim of this study is to examine the associations between alcohol use and frailty in three cities in elder adults. METHODS: A cross-sectional study was conducted in three cities in China from June 2017 to October 2018. In total, 2888 residents aged ≥65 years old were selected by using a multi-level stage sampling procedure. Alcohol use was assessed by Focusing on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers (CAGE) four-item questionnaire. Frailty was measured by a validated Chinese version of the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. Multinomial logistic regressions were used to examine the association of alcohol use with pre-frailty and frailty after controlling for varied covariates. RESULTS: In general, the prevalence of pre-frailty and frailty was 38.64 and 20.26%, respectively. After controlling for covariates and interaction of age and problematic drinking, non-problematic drinkers neither had association with pre-frailty (OR: 1.15, 95%CI:0.86-1.52) nor with frailty (OR:0.90, 95%CI:0.60-1.36), and problematic drinkers neither had association with frailty (OR: 1.21, 95%CI:0.83-1.76), while problematic drinkers had high odd ratios of frailty (OR:3.28, 95%CI:2.02-5.33) compared with zero-drinker. CONCLUSIONS: Our study found a positive association between problematic drinking and frailty, no relationship between non-problematic drinking and (pre-)frailty compared with zero-drinking among Chinese elder adults. Based on previous findings and ours, we conclude it is important for the prevention of frailty to advocate no problematic drinking among elder adults.

Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China.

It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI = 0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.

How long were older people expected to live with or without sarcopenia? Multistate modeling of a national cohort study.

Objectives: Sarcopenia is well known to be associated with mortality, but there is a lack of evidence on the estimates of life expectancy (LE) for sarcopenia in China. This study aims to estimate total life expectancy (TLE) and sarcopenia-specific LE in community-dwelling older Chinese adults with and without sarcopenia. Methods: This study included participants aged 60 years and older who enrolled in the cohort in 2011 and 2013 and at least completed one follow-up until 2015 as part of the China Health and Retirement Longitudinal Study (CHARLS). The criteria for defining sarcopenia were based on the guidelines established by the Asian Working Group on Sarcopenia in 2019. TLE and sarcopenia-specific LE were estimated for the total population and subgroups using continuous-time multistate modeling. Results: A total of 6,029 participants (49.2% women) with an average age of 68.4 (SD: 6.56) years were included in the study. The baseline prevalence of sarcopenia and possible sarcopenia was 19.5 and 44.9%, respectively. We observed that sarcopenia stages naturally deteriorated to worse stages (including death, by 24.4%) and returned to better stages (17.1%) during a median follow-up of 3.92 years (IQR: 2.00 ~ 4.00). The average TLE at the age of 60 was 20.9 [95% CI: 20.2-21.5] years (22.1 [95% CI: 19.6-24.6] for non-sarcopenic older adults, 20.9 [95% CI: 19.5-22.3] for possible sarcopenic, and 18.7 [95% CI: 16.4-21.1] for sarcopenic). Men, former and current smokers, and those living in northwest China had less TLE. Sarcopenic older adults, those with lower education, those who are unmarried, those with agriculture hukou, and those living in rural and northwest China were expected to live fewer years with non-sarcopenia. Sarcopenic older people, men, those with agriculture hukou, and those living in rural and southwest China were expected to live more years with sarcopenia. Discussion: The results improved our understanding of the relationship between sarcopenia and life expectancy. We suggested that targeted strategies should be considered in high-risk populations and underdeveloped regions to prevent sarcopenia and improve non-sarcopenic life years for the older population.

Social capital, depressive symptomatology, and frailty among older adults in the western areas of China.

We aimed to explore the relationship between social capital (SC) and frailty, and the mediation role of depressive symptoms in this relationship. A cross-sectional study among 2,591 older adults aged ≥60 years old was conducted from September 2020 to May 2021. SC, depressive symptoms, and frailty were measured using the social capital scale, the 9-item patient health questionnaire, and the FRAIL scale, respectively. The mediation model was tested by Bootstrap PROCESS. After controlling for socio-demographical covariates, the SC was negatively correlated with frailty (r = -0.07, P = 0.001), and depressive symptomatology (r = -0.08, P<0.001); while the depressive symptomatology was positively correlated with frailty (r = 0.33, P<0.001). Logistic regression results showed that SC was associated with a lower risk of frailty (OR = 0.94; 95% CI: 0.92-0.97; P<0.001). Depressive symptomatology partially mediated (explained 36.4% of the total variance) the association between SC and frailty. Those findings suggest that SC may protect older adults from frailty by reducing depressive symptoms. Prevention and intervention implications were also discussed.

Long-term practice of intuitive inquiry meditation modulates EEG dynamics during self-schema processing.

Objective: Intuitive inquiry meditation is a unique form of Buddhist Zen/Chan practice in which individuals actively and intuitively utilize the cognitive functions to cultivate doubt and explore the concept of the self. This event-related potential (ERP) study aimed to investigate the neural correlates by which long-term practice of intuitive inquiry meditation induces flexibility in self-schema processing, highlighting the role of doubt and belief processes in this exploration. Methods: Twenty experienced and eighteen beginner meditators in intuitive inquiry meditation were recruited for this ERP study. The interactions of doubt and belief processes with concepts of the self and Buddha were investigated. A 128-channel electroencephalography (EEG) system was used to collect EEG data. The ERP data were processed and analyzed using EEGLAB. Results: The data showed a double dissociation between beginners and experienced meditators (monks) in the concepts of the self and Buddha: intuitive inquiry meditation reduced the brain activity of beginners when viewing Buddha image but not when viewing a picture of themselves. However, in experienced meditators, intuitive inquiry meditation reduced brain activity when they viewed images of themselves but not when they viewed Buddha image. Further event-related spectral perturbation (ERSP) analysis revealed that experienced meditators had a greater theta spectral power and higher intertrial coherence (ITC), indicating that they could more flexibly modulate ongoing cognitive processes than beginner meditators. Conclusion: Intuitive inquiry meditation could help beginner meditators detach from the concept of Buddha but not from that of the self. However, in experienced meditators, the opposite was true. ERSP analysis showed that only experienced meditators exhibited significant alterations in brain activity dynamics during intuitive inquiry meditation, which might enable these practitioners to become spontaneously detached from the concept of the self. These findings revealed the neural mechanism by which long-term practice of intuitive inquiry meditation can influence the doubting process and its effect on self-schema processing.

Hepatic DDAH1 mitigates hepatic steatosis and insulin resistance in obese mice: Involvement of reduced S100A11 expression.

Dimethylarginine dimethylaminohydrolase 1 (DDAH1) is an important regulator of plasma asymmetric dimethylarginine (ADMA) levels, which are associated with insulin resistance in patients with nonalcoholic fatty liver disease (NAFLD). To elucidate the role of hepatic DDAH1 in the pathogenesis of NAFLD, we used hepatocyte-specific Ddah1-knockout mice (Ddah1HKO) to examine the progress of high-fat diet (HFD)-induced NAFLD. Compared to diet-matched flox/flox littermates (Ddah1f/f), Ddah1HKO mice exhibited higher serum ADMA levels. After HFD feeding for 16 weeks, Ddah1HKO mice developed more severe liver steatosis and worse insulin resistance than Ddah1f/f mice. On the contrary, overexpression of DDAH1 attenuated the NAFLD-like phenotype in HFD-fed mice and ob/ob mice. RNA-seq analysis showed that DDAH1 affects NF-κB signaling, lipid metabolic processes, and immune system processes in fatty livers. Furthermore, DDAH1 reduces S100 calcium-binding protein A11 (S100A11) possibly via NF-κB, JNK and oxidative stress-dependent manner in fatty livers. Knockdown of hepatic S100a11 by an AAV8-shS100a11 vector alleviated hepatic steatosis and insulin resistance in HFD-fed Ddah1HKO mice. In summary, our results suggested that the liver DDAH1/S100A11 axis has a marked effect on liver lipid metabolism in obese mice. Strategies to increase liver DDAH1 activity or decrease S100A11 expression could be a valuable approach for NAFLD therapy.

EEG-based investigation of effects of mindfulness meditation training on state and trait by deep learning and traditional machine learning.

Introduction: This study examines the state and trait effects of short-term mindfulness-based stress reduction (MBSR) training using convolutional neural networks (CNN) based deep learning methods and traditional machine learning methods, including shallow and deep ConvNets as well as support vector machine (SVM) with features extracted from common spatial pattern (CSP) and filter bank CSP (FBCSP). Methods: We investigated the electroencephalogram (EEG) measurements of 11 novice MBSR practitioners (6 males, 5 females; mean age 35.7 years; 7 Asians and 4 Caucasians) during resting and meditation at early and late training stages. The classifiers are trained and evaluated using inter-subject, mix-subject, intra-subject, and subject-transfer classification strategies, each according to a specific application scenario. Results: For MBSR state effect recognition, trait effect recognition using meditation EEG, and trait effect recognition using resting EEG, from shallow ConvNet classifier we get mix-subject/intra-subject classification accuracies superior to related previous studies for both novice and expert meditators with a variety of meditation types including yoga, Tibetan, and mindfulness, whereas from FBSCP + SVM classifier we get inter-subject classification accuracies of 68.50, 85.00, and 78.96%, respectively. Conclusion: Deep learning is superior for state effect recognition of novice meditators and slightly inferior but still comparable for both state and trait effects recognition of expert meditators when compared to the literatures. This study supports previous findings that short-term meditation training has EEG-recognizable state and trait effects.

Effects of antimicrobial peptide and tributyrin on fecal microflora and blood indices of female calves.

This study evaluated the effects of antimicrobial peptide (AMP) and tributyrin (TB) on dairy calves in terms of growth performance, immunity, oxidative stress, and intestinal microflora. A total of 40 female calves were divided into four treatment groups (n = 10): basal diet +0.015% essential oil, basal diet +0.03% AMP, basal diet +0.15% TB, and basal diet +0.03% AMP + 0.15% TB. AMP and TB supplementation increased the average daily gain (ADG) and weaning weight, while reducing diarrhea occurrence. Additionally, AMP and TB supplementation reduced the levels of reactive oxygen species (ROS) and malonaldehyde (MDA), while increasing superoxide dismutase (SOD) levels and serum immunoglobulin M (IgM) levels. However, the combined use of AMP and TB did not significantly affect the average daily feed intake, ADG, weaning weight, or diarrhea incidence but decreased ROS levels, while increasing SOD levels as well as MDA and IgM levels. Moreover, AMP and TG supplementation increased the relative abundance of several beneficial fiber- and mucin-degrading bacteria in the gut, in contrast to combined AMP and TB supplementation. The 16S rRNA results showed that AMP supplementation significantly increased the relative abundance of Rikenellaceae_RC9_gut_group, Ruminococcaceae_UCG-014 and [Eubacterium]_coprostanoligenes group (p < .01), and significantly decreased the relative abundance of Ruminococcaceae_UCG-005 and Christensenellaceae_R-7_group (p < .01). The TB supplementation significantly increased the abundances of Rikenellaceae_RC9_gut_group and Ruminococcaceae_UCG-005 (p < .01), and significantly decreased the relative abundances of Ruminococcaceae_UCG-014, [Eubacterium]_coprostanoligenes group and Christensenellaceae_R-7_group (p < .01). The combined use of AMP and TB significantly increased the relative abundance of Rikenellaceae_RC9_gut_group and Bacteroides (p < .01), and significantly decreased the relative abundance of Ruminococcaceae_UCG-014, [Eubacterium]_coprostanoligenes group and Christensenellaceae_R-7_group (p < .01). In summary, diets supplemented with either AMP or TB improved the intestinal microflora, growth performance, and health of weaned calves, but combined use was detrimental to calf performance.

Tracking gaze position from EEG: Exploring the possibility of an EEG-based virtual eye-tracker.

INTRODUCTION: Ocular artifact has long been viewed as an impediment to the interpretation of electroencephalogram (EEG) signals in basic and applied research. Today, the use of blind source separation (BSS) methods, including independent component analysis (ICA) and second-order blind identification (SOBI), is considered an essential step in improving the quality of neural signals. Recently, we introduced a method consisting of SOBI and a discriminant and similarity (DANS)-based identification method, capable of identifying and extracting eye movement-related components. These recovered components can be localized within ocular structures with a high goodness of fit (>95%). This raised the possibility that such EEG-derived SOBI components may be used to build predictive models for tracking gaze position. METHODS: As proof of this new concept, we designed an EEG-based virtual eye-tracker (EEG-VET) for tracking eye movement from EEG alone. The EEG-VET is composed of a SOBI algorithm for separating EEG signals into different components, a DANS algorithm for automatically identifying ocular components, and a linear model to transfer ocular components into gaze positions. RESULTS: The prototype of EEG-VET achieved an accuracy of 0.920° and precision of 1.510° of a visual angle in the best participant, whereas an average accuracy of 1.008° ± 0.357° and a precision of 2.348° ± 0.580° of a visual angle across all participants (N = 18). CONCLUSION: This work offers a novel approach that readily co-registers eye movement and neural signals from a single-EEG recording, thus increasing the ease of studying neural mechanisms underlying natural cognition in the context of free eye movement.

Assessing the impact of the 2018 tetanus guidelines on knowledge and practices of emergency physicians in trauma patients: a national survey study.

Background: Tetanus remains a significant public health issue in China, with the approach of anti-tetanus prophylaxis in the emergency department resulting in both overuse, particularly of human tetanus immune globulin (TIG), and underuse with the tetanus vaccine. This is largely due to the absence of updated guidelines on tetanus prophylaxis before 2018. Our study aimed to evaluate the effects of the 2018 Chinese tetanus guidelines on the knowledge and practices of emergency physicians about tetanus prevention in trauma patients. Methods: From November 2019 to April 2020, we conducted a web-based survey involving 499 emergency physicians. The survey included a questionnaire covering knowledge, attitudes, and practices related to tetanus. We assessed the influence of the 2018 tetanus guidelines on the knowledge and practices of emergency physicians related to tetanus prevention for patients with trauma using multiple regression analysis. Results: The survey results showed that only 45.3% of the participants had received formal training on tetanus immunization, despite 53.3% reporting the availability of tetanus vaccines at their institutions. Physicians typically prescribed tetanus antitoxin or human TIG instead of tetanus toxoid (TT) to treat injuries, regardless of the patient's TT vaccination history. Among the respondents, those who were aware of the 2018 tetanus guidelines had higher mean scores on the general knowledge, risk knowledge, and treatment knowledge scales, with increases of 6%, 13%, and 9%, respectively, compared to those who were unaware of the guidelines. Awareness of the 2018 tetanus guidelines was associated with a high level of knowledge, as indicated by the general knowledge score, recommendation knowledge score, and total knowledge score, after adjusting for the effects of all variables on the knowledge, attitudes, and practices of the participants. A high level of education was also associated with a high level of knowledge indicated by the recommendation knowledge score and total knowledge score. Conclusions: Our study highlights a substantial gap in the attitudes, knowledge, and practices of emergency physicians in China regarding tetanus immunization. The results suggest an urgent need to promote the Chinese Expert Consensus Guidelines on tetanus to improve emergency physicians' knowledge and competence in tetanus prophylaxis. The findings underscore the importance of enhancing physicians' awareness of the latest guidelines to ensure appropriate and effective treatment for patients with tetanus-prone injuries.

Incremental learning for an evolving stream of medical ultrasound images via counterfactual thinking.

Despite the fact that traditional deep learning (DL) approaches provide promising accuracy and efficiency in medical ultrasound image analysis, they cannot replace the physician in making a diagnosis since the DL model is only appropriate in static application scenarios. Currently, most DL-based models are incapable of learning new tasks in the dynamic clinical environments due to the catastrophic forgetting of old tasks. To address the above problem, we propose an incremental classifier that is sequentially trained on evolving tasks for medical ultrasound images by counterfactual thinking. Specifically, the proposed model consists of a feature extractor and a classifier that can add new classes at any time during training. Toward a more discriminative model in the continual learning setting, a contrastive strategy is designed to leverage fine-grained information by generating a series of counterfactual regions. For model optimization, we design a multi-task loss made up of a knowledge distillation loss, a cross-entropy loss, and a contrasting loss. This objective jointly enjoys the merits of less forgetting, better accuracy, and fine-grained information utilization. A newly collected dataset with 52 medical ultrasound classification tasks is used to demonstrate the effectiveness of our method. The proposed approach achieves 76.59%, 11.67%, and 7.93% in terms of the average incremental accuracy, forgetting rate, and feature retention, respectively.

Inhibitory dysfunction may cause prospective memory impairment in temporal lobe epilepsy (TLE) patients: an event-related potential study.

Introduction: Prospective memory (PM) is the ability to remember future intentions, and PM function is closely related to independence in daily life, particularly in patients with temporal lobe epilepsy (TLE). As PM involves various cognitive components of attention, working memory, inhibition and other executive functions, this study investigated how TLE may affect PM components and the underlying neural mechanisms. Methods: Sixty-four subjects were recruited, including 20 refractory TLE patients, 18 well-controlled TLE patients and 26 age-matched healthy controls. A set of neuropsychological tests was administered to assess specific brain functions. An event-related potential (ERP) task was used to further explore how PM and its components would be differentially affected in the two TLE types. Results: Our findings revealed that: (1) refractory TLE patients scored lower than the healthy controls in the digit span, Verbal Fluency Test and Symbol Digit Modalities Test; (2) refractory TLE patients exhibited impaired PM performance and reduced prospective positivity amplitudes over the frontal, central and parietal regions in ERP experiments when compared to the healthy controls; and (3) decreased P3 amplitudes in the nogo trials were observed over the frontal-central sites in refractory but not in well-controlled TLE patients. Discussion: To our knowledge, this is the first ERP study on PM that has specifically identified PM impairment in refractory but not in well-controlled TLE patients. Our finding of double dissociation in PM components suggests that inhibition dysfunction may be the main reason for PM deficit in refractory TLE patients. The present results have clinical implications for neuropsychological rehabilitation in TLE patients.