Predictive Value of Malnutrition, Identified via Different Nutritional Screening or Assessment Tools, for Functional Outcomes in Patients with Stroke: A Systematic Review and Meta-Analysis.

BACKGROUND: Malnutrition affects more than half of patients with stroke. Although malnutrition leads to more deaths, a longer hospital stay, and higher costs, there is still a lack of consensus regarding the impact of malnutrition on physical functional outcomes in patients with stroke, and there are large differences in the diagnostic effects of nutritional screening or assessment tools for malnutrition. This study aimed to explore the impact of malnutrition in patients with stroke and assess the significance of current nutritional screening and assessment tools for these patients. METHODS: Six databases were systematically searched until October 2022. Cohort studies meeting the eligibility criteria were included. Pooled effects were calculated using random-effects models. RESULTS: Twenty-six studies with 21,115 participants were included. The pooled effects of malnutrition on poor functional outcome, FIM points, and dysphagia were OR = 2.72 (95% CI = 1.84-4.06), WMD = -19.42(95% CI = -32.87--5.96), and OR = 2.80 (95% CI = 1.67-4.67), respectively. CONCLUSION: Malnutrition adversely affects the recovery of physical and swallowing functions in patients with stroke. Nutritional assessments consistently predict the outcomes of physical function in patients with stroke.

Pharmacokinetics, safety, and tolerability of TQC3564, a novel CRTh2 receptor antagonist: report of the first-in-human single- and multiple-dose escalation trials in healthy Chinese subjects.

BACKGROUND: This is the first-in-human study to evaluate the pharmacokinetics, safety, and tolerability of TQC3564 (a novel CRTh2 receptor antagonist) in healthy Chinese subjects. RESEARCH DESIGN AND METHODS: This project was a phase Ia clinical study of TQC3564 as a single-ascending dose (SAD) (25 to 1200 mg) and a multiple-ascending dose (MAD) (100 or 500 mg, QD) as well as a two-period crossover food-effect study (300 mg). RESULTS:     In the SAD and MAD study, TQC3564 were found to be safe and well tolerated, without dose-dependent adverse events (AEs), and all AEs were mild or moderate in severity. In the SAD study, the median tmax of TQC3564 was 2.5-4.5 h, and t1/2 was 8.13-35.7 h. Exposure was increased after food intake. The MAD study results showed that steady-state was achieved on day 4. Moreover, no apparent TQC3564 plasma accumulation was detected on day 7. CONCLUSIONS: In healthy subjects, TQC3564 at a single dose of 25-1200 mg or 100-500 mg at multiple doses (QD) was safe and tolerable with acceptable PK profiles, indicating that TQC3564 has potential as a therapeutic option for asthma. (This study has been registered at http://www.chinadrugtrials.org.cn/ under identifier CTR20192397.).

Association between perceived life stress and subjective well-being among Chinese perimenopausal women: a moderated mediation analysis.

BACKGROUND: The impact of perceived life stress on subjective well-being has been well-established; while few studies have explored the mediating and moderating mechanisms of the association between perceived life stress and subjective well-being among perimenopausal women. This study is aimed at exploring the mediating effect of depressive symptoms and the role of interests/hobbies as a moderator in the association between perceived life stress and subjective well-being among perimenopausal women. METHODS: The participants were 1,104 perimenopausal women at the age of 40 to 60, who were asked to complete a paper-based questionnaire. A single item was used to measure self-perceived life stress and interests/hobbies. The Zung Self-rating Depression Scale (SDS) and Subjective Well-being Scale for Chinese Citizens (SWBS-CC) were applied to assess both depressive symptoms and subjective well-being. Multiple linear regression analysis and the PROCESS macro were adopted to analyse not only the mediating effect of depressive symptoms but also the moderating role of interests/hobbies. RESULTS: Perceived life stress was negatively associated with subjective well-being (B =  - 1.424, ß =  - 0.101, P < 0.001). The impact of perceived life stress on subjective well-being was partially mediated by depressive symptoms (mediation effect = -0.760, 95% confidence intervals (CI) [-1.129, -0.415]). In addition, the interaction term between depressive symptoms and interests/hobbies was significantly related to subjective well-being (ß =  - 0.060, P < 0.05), indicating moderating effect. Moderated mediation had a significant index (Index = -0.220, SE = 0.099, 95% CI [-0.460, -0.060]). CONCLUSIONS: Perceived life stress was negatively related to subjective well-being. The impact of perceived life stress on subjective well-being was mediated by depressive symptoms. Besides, interests/hobbies moderated the indirect effect of depressive symptoms on the relationship between perceived life stress and subjective well-being.

Associations of sleep quality, anxiety symptoms and social support with subjective well-being among Chinese perimenopausal women.

BACKGROUND: Few studies have explored the internal pathway of the association between sleep quality and subjective well-being among perimenopausal women. METHODS: A survey was performed of 1063 perimenopausal women aged 40 to 60 years who participated in a regular health examination conducted at the First Hospital of Jilin University, China. Participants were asked to complete a study questionnaire. The Pittsburgh Sleep Quality Index, Zung Self-rating Anxiety Scale, Perceived Social Support Scale and Subjective Well-being Scale for Chinese Citizens were used to assess sleep quality, anxiety symptoms, social support and subjective well-being, respectively. The data were analyzed using t-tests, analysis of variance, Pearson correlation analysis, multiple linear regression analysis and the PROCESS macro. RESULTS: The mean total subjective well-being score was 90.14 ± 12.80. The correlation analyzes showed that sleep quality (r = -0.341, P < 0.001) and anxiety symptoms (r = -0.490, P < 0.001) were negatively correlated with subjective well-being. Social support was positively correlated with subjective well-being (r = 0.480, P < 0.001). The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms (Effect = -0.462, 95% CI = [-0.577, -0.363]). In addition, social support moderated the association between anxiety symptoms and subjective well-being (Index = -0.006, 95% CI = [-0.012, -0.001]). LIMITATIONS: This was a cross-sectional study. CONCLUSIONS: The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms, and social support moderated the association between anxiety symptoms and subjective well-being among perimenopausal women.

Non-palm Plant Volatile α-Pinene Is Detected by Antenna-Biased Expressed Odorant Receptor 6 in the Rhynchophorus ferrugineus (Olivier) (Coleoptera: Curculionidae).

The majority of insects rely on a highly complex and precise olfactory system to detect various volatile organic compounds released by host and non-host plants in environments. The odorant receptors (ORs) are considered to play an important role in odor recognition and the molecular basis of ORs, particularly in coleopterans they are relatively poorly understood. The red palm weevil (RPW), Rhynchophorus ferrugineus (Olivier) (Coleoptera: Curculionidae), is one of the most destructive pests of the global palm industry. Although feeding and egg oviposition behaviors of RPW can be repelled by some non-palm plant volatiles, such as α-pinene, geraniol, or 1-octen-3-ol, there is limited understanding of how RPW recognizes the non-host plant volatiles. In this study, three candidate RferOrs were identified from the Rfer-specific clade, and the tissue expression analysis used was mainly expressed in the antennae of both sexes. Functional characterization of RferOr6, RferOr40, and RferOr87 was analyzed by using the Xenopus oocyte expression system, and the results indicated that RferOr6/RferOrco was narrowly tuned to α-pinene. The behavioral experiment showed that α-pinene at the concentrations of 10 and 100 µg/µl can cause a significantly repelled behavioral response of RPW. In conclusion, this study reveals that RferOr6 is an antenna-biased expressed OR used by RPW to detect the volatile compound α-pinene in non-palm plants, and our results provide a foundation for further in vivo functional studies of Or6 in RPW, including in vivo knockout/knockdown and feeding/ovipositing behavioral studies of RPW and further pest control.

Spätzle Homolog-Mediated Toll-Like Pathway Regulates Innate Immune Responses to Maintain the Homeostasis of Gut Microbiota in the Red Palm Weevil, Rhynchophorus ferrugineus Olivier (Coleoptera: Dryophthoridae).

Spätzle (Spz) is a dimeric ligand that responds to the Gram-positive bacterial or fungal infection by binding Toll receptors to induce the secretion of antimicrobial peptides. However, whether the Toll-like signaling pathway mediates the innate immunity of Rhynchophorus ferrugineus to modulate the homeostasis of gut microbiota has not been determined. In this study, we found that a Spz homolog, RfSpätzle, is a secretory protein comprising a signal peptide and a conservative Spz domain. RT-qPCR analysis revealed that RfSpätzle was significantly induced to be expressed in the fat body and gut by the systemic and oral infection with pathogenic microbes. The expression levels of two antimicrobial peptide genes, RfColeoptericin and RfCecropin, were downregulated significantly by RfSpätzle knockdown, indicating that their secretion is under the regulation of the RfSpätzle-mediated signaling pathway. After being challenged by pathogenic microbes, the cumulative mortality rate of RfSpätzle-silenced individuals was drastically increased as compared to that of the controls. Further analysis indicated that these larvae possessed the diminished antibacterial activity. Moreover, RfSpätzle knockdown altered the relative abundance of gut bacteria at the phylum and family levels. Taken together, these findings suggest that RfSpätzle is involved in RPW immunity to confer protection and maintain the homeostasis of gut microbiota by mediating the production of antimicrobial peptides.

Effect of Cold Application on Pain and Bruising in Patients With Subcutaneous Injection of Low-Molecular-Weight Heparin: A Meta-Analysis.

To evaluate the effect of cold application on pain and bruising after the subcutaneous injection of low-molecular-weight heparin, 8 electronic databases were searched for randomized controlled trials and quasiexperimental studies from the inception of the databases to June 2019. Review Manager 5.3 software was used for the heterogeneity test and meta-analysis. A total of 8 studies including 694 participants were analyzed. The cold application group assessed with the Verbal Descriptor Scale pain assessment tool showed significant reductions in pain intensity immediately after injection. Compared to the control group, the cold application group showed a reduction in the occurrence of bruises at 12 hours, 24 hours, and 48 hours after injection. There was no significant difference in the area of bruising in the cold application group at 48 hours after injection, but the area of bruising at 72 hours after injection was significantly reduced. These results show that cold application can reduce the incidence of pain and bruising after subcutaneous injection of low-molecular-weight heparin and reduce the area of bruising 72 hours after injection. Additional studies with larger sample sizes are needed to confirm these findings.

Intestinal Microbiota Confer Protection by Priming the Immune System of Red Palm Weevil Rhynchophorus ferrugineus Olivier (Coleoptera: Dryophthoridae).

The immune system of animals, including insects, is the vital factor to maintain the symbiotic interactions between animals and their associated microbes. However, the effects of gut microbiota on insect immunity remain mostly elusive. Red palm weevil (RPW), Rhynchophorus ferrugineus Olivier, is a destructive pest of palm trees worldwide, which has forged alliances with its gut microbiota. Here, we found that the aposymbiotic insects succumbed at a significantly faster rate than conventionally reared (CR) ones upon bacterial infection. Physiological assays confirmed that CR insects had stronger antimicrobial activity and higher phenoloxidase activity in contrast to germfree (GF) ones, indicating that the systemic immune responses of GF individuals were compromised markedly. Interestingly, under the bacterial challenge conditions, the reassociation of gut microbiota with GF insects could enhance their survival rate by rescuing their immunocompetence. Furthermore, comparative transcriptome analysis uncovered that 35 immune-related genes, including pathogen recognition receptors, effectors and immune signaling pathway, were significantly downregulated in GF insects as compared to CR ones. Collectively, our findings corrobate that intestinal commensal bacteria have profound immunostimulatory effects on RPW larvae. Therefore, knowledge on the effects of gut microbiota on RPW immune defenses may contribute to of set up efficient control strategies of this pest.

The Promoting Effect of Gut Microbiota on Growth and Development of Red Palm Weevil, Rhynchophorus ferrugineus (Olivier) (Coleoptera: Dryophthoridae) by Modulating Its Nutritional Metabolism.

Red palm weevil (RPW), Rhynchophorus ferrugineus Olivier, is a destructive pest for palm trees worldwide. Recent studies have shown that RPW gut is colonized by microbes and alterations in gut microbiota can significantly modify its hemolymph nutrition content. However, the exact effects of gut microbiota on RPW phenotype and the underlying mechanisms remain elusive. Here germ-free (GF) RPW larvae were generated from dechorionated eggs which were reared on sterilized artificial food under axenic conditions. Compared with controls, the larval development of GF RPW individuals was markedly depressed and their body mass was reduced as well. Furthermore, the content of hemolymph protein, glucose and triglyceride were dropped significantly in GF RPW larvae. Interestingly, introducing gut microbiota into GF individuals could significantly increase the levels of the three nutrition indices. Additionally, it has also been demonstrated that RPW larvae monoassociated with Lactococcus lactis exhibited the same level of protein content with the CR (conventionally reared) insects while feeding Enterobacter cloacae to GF larvae increased their hemolymph triglyceride and glucose content markedly. Consequently, our findings suggest that gut microbiota profoundly affect the development of this pest by regulating its nutrition metabolism and different gut bacterial species show distinct impact on host physiology. Taken together, the establishment of GF and gnotobiotic RPW larvae will advance the elucidation of molecular mechanisms behind the interactions between RPW and its gut microbiota.

An IMD-like pathway mediates the intestinal immunity to modulate the homeostasis of gut microbiota in Rhynchophorus ferrugineus Olivier (Coleoptera: Dryophthoridae).

Most animals have established the mutualistic interactions with their intestinal microbes which provide multiple benefits to their host physiology. However, the mechanisms behind hosts determine the load and composition of gut microbiota are still poorly understood outside dipteran insects. Here, the gene, encoding the NF-κB-like transcription factor Relish, being designated as RfRelish, was identified and analyzed in red palm weevil (RPW), Rhynchophorus ferrugineus Olivier. We revealed that the abundance of RfRelish transcripts in the fat body, hemolymph and gut are significantly higher than that in non-immunity-related tissues, and its expression level can be markedly induced by bacterial challenges. When RfRelish was silenced, the ability of individuals to clear the pathogenic bacteria in body cavity and gut was significantly compromised, suggesting that both the systemic and gut local immunity were impaired dramatically by RfRelish knockdown. Additionally, the silenced insects exhibited increased gut bacterial load, and the relative abundance of some gut bacteria was changed as compared to controls. Collectively, our findings demonstrate that the IMD-like pathway restricts the proliferation of gut bacteria and shapes the commensal community structure in the intestine of R. ferrugineus by mediating the secretion of antimicrobial peptides. We provide a striking example on how an insect pest maintains the homeostasis of gut microbiota via a conserved immune pathway without compromising the advantages of the mutualistic relationships.

Identification of three prophenoloxidase-activating factors (PPAFs) from an invasive beetle Octodonta nipae Maulik (Coleoptera: Chrysomelidae) and their roles in the prophenoloxidase activation.

A typical characteristic of the insect innate immune system is the activation of the serine protease cascade in the hemolymph. As being the terminal component of the extracellular serine protease cascade in the prophenoloxidase (proPO) activating system, proPO-activating factors (PPAFs) activated by the upstream cascade may generate active phenoloxidase, which then induces downstream melanization. In the present study, we reported three PPAFs from the nipa palm hispid beetle Octodonta nipae (Maulik) (designated as OnPPAF1, OnPPAF2, OnPPAF3). All three OnPPAFs contained a single clip domain at the amino-terminus followed by a trypsin-like serine protease domain at the carboxyl-terminus, except the Ser in the active sites of OnPPAF2 and OnPPAF3 was substituted with Gly. Transcript expression analysis revealed that all OnPPAFs were highly expressed in hemolymph, whereas OnPPAF2 showed an extremely low mRNA abundance compared with that of OnPPAF1 and OnPPAF3, and that the abundance of all three OnPPAFs was dramatically increased upon bacterial challenge. Knockdown of OnPPAF1 or OnPPAF3 resulted in a reduction of hemolymph phenoloxidase activity and an inhibition of hemolymph melanization, whereas the knockdown of OnPPAF2 did not affect the proPO cascade. Our work thus implies that the three OnPPAFs may have different functions and regulation during immune responses in O. nipae.