Quadruplex Droplet Digital PCR Assay for Screening and Quantification of SARS-CoV-2.

The ongoing COVID-19 pandemic, caused by the rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since early 2020, has highlighted the need for sensitive and reliable diagnostic methods. Droplet digital PCR (ddPCR) has demonstrated superior performance over the gold-standard reverse transcription PCR (RT-PCR) in detecting SARS-CoV-2. In this study, we explored the development of a multiplex ddPCR assay that enables sensitive quantification of SARS-CoV-2, which could be utilized for antiviral screening and the monitoring of COVID-19 patients. We designed a quadruplex ddPCR assay targeting four SARS-CoV-2 genes and evaluated its performance in terms of specificity, sensitivity, linearity, reproducibility, and precision using a two-color ddPCR detection system. The results showed that the quadruplex assay had comparable limits of detection and accuracy to the simplex ddPCR assays. Importantly, the quadruplex assay demonstrated significantly improved performance for samples with low viral loads and ambiguous results compared to the standard qRT-PCR approach. The developed multiplex ddPCR represents a valuable alternative and complementary tool for the diagnosis of SARS-CoV-2 and potentially other pathogens in various application scenarios beyond the current COVID-19 pandemic. The improved sensitivity and reliability of this assay could contribute to more effective disease monitoring and antiviral screening during the ongoing public health crisis.

LIFE-Seq: a universal Large Integrated DNA Fragment Enrichment Sequencing strategy for deciphering the transgene integration of genetically modified organisms.

Molecular characterization of genetically modified organisms (GMOs) yields basic information on exogenous DNA integration, including integration sites, entire inserted sequences and structures, flanking sequences and copy number, providing key data for biosafety assessment. However, there are few effective methods for deciphering transgene integration, especially for large DNA fragment integration with complex rearrangement, inversion and tandem repeats. Herein, we developed a universal Large Integrated DNA Fragments Enrichment strategy combined with PacBio Sequencing (LIFE-Seq) for deciphering transgene integration in GMOs. Universal tilling DNA probes targeting transgenic elements and exogenous genes facilitate specific enrichment of large inserted DNA fragments associated with transgenes from plant genomes, followed by PacBio sequencing. LIFE-Seq were evaluated using six GM events and four crop species. Target DNA fragments averaging ~6275 bp were enriched and sequenced, generating ~26 352 high fidelity reads for each sample. Transgene integration structures were determined with high repeatability and sensitivity. Compared with next-generation whole-genome sequencing, LIFE-Seq achieved better data integrity and accuracy, greater universality and lower cost, especially for transgenic crops with complex inserted DNA structures. LIFE-Seq could be applied in molecular characterization of transgenic crops and animals, and complex DNA structure analysis in genetics research.

Shape transformation and manipulation of a vesicle by active particles.

Langevin dynamics simulations are employed to study the shape transformation of a two-dimensional vesicle induced by active particles both inside and outside. We find that the shape of the vesicle changes from circle, to capsule, and eventually to dumbbell with the enhancement of the particle activity. Under the cooperation between the inside and the outside active particles, such significant shape transformation is realized by tuning the activity in a small range. And unexpectedly, the fluctuations of the capsule and the dumbbell shapes are not completely random but mostly along the direction of the short axis. In the situation of strong activity, the inside of the dumbbell vesicle is analogous to a system of two chambers, which are connected by a narrow channel. Intriguingly, we observe the vibration of the channel width, accompanied with the exchange of active particles between the two chambers. We also find that dynamical manipulation of the vesicle shape is possible through tuning the particle activity dynamically. This work provides new ideas to the control of the vesicle morphology and new insights into the dynamics in the vesicle's shape transformation.

Fronto-parietal coherence response to tDCS modulation in patients with disorders of consciousness.

AIM OF THE STUDY: A transcranial direct current stimulation (tDCS) protocol (20 min, 2 mA, anodal electrode at the left dorsolateral prefrontal cortex and cathodal electrode at the right supraorbital area) was applied in patients with different degrees of disorders of consciousness (DoC). Although previous research indicates that it could improve patients' coma recovery scale-revised (CRS-R) scores, the brain's electrophysiological responses to tDCS are still unclear. Therefore, the present study was performed to explore the underlying brain responses of patients in a minimally conscious state (MCS) and an unresponsive wakefulness syndrome (UWS) to tDCS modulation. MATERIALS AND METHODS: Seventeen patients with DoC were recruited in a sham controlled crossover study receiving real and sham tDCS. EEG coherence was used to measure functional connectivity changes induced by the tDCS modulation. RESULTS: After real tDCS modulation, the fronto-parietal coherence significantly increased in the theta band and decreased in the gamma band in the MCS group. No significant changes were found in the UWS group. The coherence responses significantly correlated with the patients' baseline CRS-R scores. No distinct alteration occurred in the sham session for either the MCS or UWS patients. CONCLUSIONS: The coherence responses to the present tDCS protocol may be a tool for diagnosing MCS versus UWS, as they may be a crucial cause of the different clinical effects in the two states.

miR-139-5p suppresses cancer cell migration and invasion through targeting ZEB1 and ZEB2 in GBM.

Invasion and migration of glioblastoma multiforme (GBM) is a multistep process and an important phenotype that causes this disease to invade surrounding tissues in the brain. Recent studies have highlighted that miRNAs play a pivotal role in controlling GBM cell plasticity. In this report, we used wound healing and transwell assays to identify a novel role of miR-139-5p in inhibition of GBM cell migration and invasion. Bioinformatics coupled with luciferase and Western blot assays also revealed that miR-139-5p inhibited expression of ZEB1 and ZEB2, which are master regulators of tumor metastasis. MiR-139-5p specifically interacts with the 3'-UTR regions of ZEB1 and ZEB2, attenuating their expression in GBM cells. To corroborate this finding, we rescued ZEB1 and ZEB2 expression and found partial but significant increases in miR-139-5p-suppressed invasion of GBM cells. The biological relevance of our study was validated by analyzing levels of miR-139-5p in GBM tissue. We found that its expression significantly downregulated compared to normal tissue and shorter overall survival rates in patients with lower miR-139-5p expression. These results confirm that miR-139-5p suppresses GBM migration and invasion and highlight its potential as a biomarker and therapeutic target for treating GBM.

Breakdown of oscillatory effective networks in disorders of consciousness.

INTRODUCTION: Combining transcranial magnetic stimulation with electroencephalography (TMS-EEG), oscillatory reactivity can be measured, allowing us to investigate the interaction between local and distant cortical oscillations. However, the extent to which human consciousness is related to these oscillatory effective networks has yet to be explored. AIMS: We tend to investigate the link between oscillatory effective networks and brain consciousness, by monitoring the global transmission of TMS-induced oscillations in disorders of consciousness (DOC). RESULTS: A cohort of DOC patients was included in this study, which included 28 patients with a minimally conscious state (MCS) and 20 patients with vegetative state/unresponsive wakefulness syndrome (VS/UWS). Additionally, 25 healthy controls were enrolled. The oscillatory reactivity to single-pulse TMS of the frontal, sensorimotor and parietal cortex was measured using event-related spectral perturbation of TMS-EEG. The temporal-spatial properties of the oscillatory reactivity were illustrated through life time, decay gradients and accumulative power. In DOC patients, an oscillatory reactivity was observed to be temporally and spatially suppressed. TMS-EEG of DOC patients showed that the oscillations did not travel as far in healthy controls, in terms of both temporal and spatial dimensions. Moreover, cortical theta reactivity was found to be a reliable indicator in distinguishing DOC versus healthy controls when TMS of the parietal region and in distinguishing MCS versus VS/UWS when TMS of the frontal region. Additionally, a positive correlation was observed between the Coma Recovery Scale-Revised scores of the DOC patients and the cortical theta reactivity. CONCLUSIONS: The findings revealed a breakdown of oscillatory effective networks in DOC patients, which has implications for the use of TMS-EEG in DOC evaluation and offers a neural oscillation viewpoint on the neurological basis of human consciousness.

Long-term HD-tDCS modulates dynamic changes of brain activity on patients with disorders of consciousness: A resting-state EEG study.

OBJECTIVE: High-definition transcranial direct current stimulation (HD-tDCS) has been an effective neurostimulation method in the treatment of disorders of consciousness (DOC). However, the effects and mechanism of HD-tDCS are still unclear. METHODS: This study recruited 8 DOC patients and applied 20-min sessions of 2 mA HD-tDCS (central anode electrode at Pz) for 14 consecutive days. We record DOC patients' EEG data and Coma Recovery Scale-Revised (CRS-R) values at four time point: baseline (T0), after 1 day's and 7,14 days' parietal HD-tDCS treatment (T1, T2, T3). Power spectral density (PSD), relative power (RP), spectral entropy and spectral exponent were calculated to evaluate the EEG dynamic changes of DOC patients during long-term parietal HD-tDCS. At last, we calculated the correlation between changes of EEG features and changes of CRS-R values. RESULT: After 1 day's parietal HD-tDCS, DOC patients' CRS-R value had not changed (8.25 ± 1.91). HD-tDCS improved DOC patients' CRS-R value at T2 (9.75 ± 1.91, p < 0.05) and at T3 (11.38 ± 2.77, p < 0.05), compared with that at T0 (8.25 ± 1.91). As the treatment time increased, the EEG PSD decayed more slowly. Specifically, the delta frequency band RP decreased, while the alpha, beta, and gamma frequency bands RP increased. EEG oscillation characteristics changed but not significant at T1 (p > 0.05), and showed significant changes at T2 and T3 (p < 0.05). The spectral entropy continuously increased and the spectral exponent continuously decreased from T0 to T3. Specifically, the spectral entropy and spectral exponent of the parietal and occipital regions were significantly higher at T2 and T3 than that at T0 (p < 0.05). In addition, The changes in EEG features of the parietal and occipital lobes were correlated with changes in CRS-R value, especially between T2 and T0. CONCLUSION: Long-term parietal HD-tDCS can improve the consciousness level and brain activity in DOC patients. Resting-state EEG can evaluate the dynamic changes of brain activity in DOC patients during HD-tDCS. EEG oscillation and non-oscillatory activity might be used to explain the mechanism of HD-tDCS on DOC patients.

Modulation of GPER1 alleviates early brain injury via inhibition of A1 reactive astrocytes activation after intracerebral hemorrhage in mice.

Background: Early brain injury (EBI) caused by inflammatory responses in acute phase of Intracerebral hemorrhage (ICH) plays a vital role in the pathological progression of ICH. Increasing evidences demonstrate A1 reactive astrocytes are associated with the severity of EBI. G-protein coupled estrogen receptor 1 (GPER1) has been proved mediating the neuroprotective effects of estrogen in central nervous system (CNS) disease. However, whether GPER1 plays a protective effect on ICH and A1 reactive astrocytes activation is not well studied. Methods: ICH model was established by infused the autologous whole blood into the right basal ganglia in wild type and GPER1 knockout mice. GPER1 specific agonist G1 and antagonist G15 were administered by intraperitoneal injection at 1 h or 0.5 h after ICH. Neurological function was detected on day 1 and day 3 by open field test and corner turn test following ICH. Besides, A1 reactive astrocytes were determined by immunofluorescence staining after ICH on day 3. To further identify the possible mechanism of GPER1 mediated neuroprotective effect, Western blot assays was performed after ICH on day 3. Results: After ICH, G1 treatment alleviated mice neurobehavior deficits on day 1 and day 3. Meanwhile, G1 treatment also significantly reduced the GFAP positive astrocytes and the C3 positive cells after ICH. Interestingly, G15 reversed the protective effect of G1 on the neurobehavior of ICH mice. Meanwhile, the expression of GFAP+C3+ A1 reactive astrocytes were also reduced by activation of GPER1. Mechanistic studies indicated TLR4 and NF-κB mediated the neuroprotective effect of GPER1. Conclusion: Generally, activation of GPER1 alleviated the EBI through inhibiting A1 reactive astrocytes activation via TLR4/NF-κB pathway after ICH in mice. Additionally, GPER1may be a promising target for ICH treatment.

Establishment and validation of a bad outcomes prediction model based on EEG and clinical parameters in prolonged disorder of consciousness.

Objective: This study aimed to explore the electroencephalogram (EEG) indicators and clinical factors that may lead to poor prognosis in patients with prolonged disorder of consciousness (pDOC), and establish and verify a clinical predictive model based on these factors. Methods: This study included 134 patients suffering from prolonged disorder of consciousness enrolled in our department of neurosurgery. We collected the data of sex, age, etiology, coma recovery scales (CRS-R) score, complications, blood routine, liver function, coagulation and other laboratory tests, resting EEG data and follow-up after discharge. These patients were divided into two groups: training set (n = 107) and verification set (n = 27). These patients were divided into a training set of 107 and a validation set of 27 for this study. Univariate and multivariate regression analysis were used to determine the factors affecting the poor prognosis of pDOC and to establish nomogram model. We use the receiver operating characteristic (ROC) and calibration curves to quantitatively test the effectiveness of the training set and the verification set. In order to further verify the clinical practical value of the model, we use decision curve analysis (DCA) to evaluate the model. Result: The results from univariate and multivariate logistic regression analyses suggested that an increased frequency of occurrence microstate A, reduced CRS-R scores at the time of admission, the presence of episodes associated with paroxysmal sympathetic hyperactivity (PSH), and decreased fibrinogen levels all function as independent prognostic factors. These factors were used to construct the nomogram. The training and verification sets had areas under the curve of 0.854 and 0.920, respectively. Calibration curves and DCA demonstrated good model performance and significant clinical benefits in both sets. Conclusion: This study is based on the use of clinically available and low-cost clinical indicators combined with EEG to construct a highly applicable and accurate model for predicting the adverse prognosis of patients with prolonged disorder of consciousness. It provides an objective and reliable tool for clinicians to evaluate the prognosis of prolonged disorder of consciousness, and helps clinicians to provide personalized clinical care and decision-making for patients with prolonged disorder of consciousness and their families.

Ligand-mediated endocytosis of nanoparticles in neural stem cells: implications for cellular magnetic resonance imaging.

Neural stem cells (NSCs) have great prospects in therapy for neurological disorders. However, the correlation between improved function and stem cell transplantation has not been fully elucidated. A non-invasive method for stem cell tracking is crucial for clinical studies. In the present study, NSCs were infected with lentiviral vectors, and the expression of transferrin receptor (TfR) in neural stem cells after lentivirus transfection (TfR-NSC) was confirmed by western blot analysis. TfR-NSCs were incubated with 1.8 nM ultra-small super-paramagnetic iron oxide nanoparticles (USPIOs) or transferrin (Tf)-conjugate of USPIO nanoparticles (Tf-USPIOs). Tf-USPIO enhanced the cellular iron content in TfR-NSCs 80 ± 18 % compared to USPIOs. These results demonstrated that TfR overexpressed in neural stem cells specifically internalized Tf-USPIOs. Furthermore, the results indicate that TfR reporter imaging may be a valuable way to evaluate the efficacy of neural stem cell treatment.

Alterations in brain network functional connectivity and topological properties in DRE patients.

Objective: The study aimed to find the difference in functional network topology on interictal electroencephalographic (EEG) between patients with drug-resistant epilepsy (DRE) and healthy people. Methods: We retrospectively analyzed the medical records as well as EEG data of ten patients with DRE and recruited five sex-age-matched healthy controls (HC group). Each participant remained awake while undergoing video-electroencephalography (vEEG) monitoring. After excluding data that contained abnormal discharges, we screened EEG segments that were free of artifacts and put them together into 20-min segments. The screened data was bandpass filtered to different frequency bands (delta, theta, alpha, beta, and gamma). The weighted phase lag index (wPLI) and the network properties were calculated to evaluate changes in the topology of the functional network. Finally, the results were statistically analyzed, and the false discovery rate (FDR) was used to correct for differences after multiple comparisons. Results: In the full frequency band (0.5-45 Hz), the functional connectivity in the DRE group during the interictal period was significantly lower than that in the HC group (p < 0.05). Compared to the HC group, in the full frequency band, the DRE group exhibited significantly decreased clustering coefficient (CC), node degree (D), and global efficiency (GE), while the characteristic path length (CPL) significantly increased (p < 0.05). In the sub-frequency bands, the functional connectivity of the DRE group was significantly lower than that of the HC group in the delta band but higher in the alpha, beta, and gamma bands (p < 0.05). The statistical results of network properties revealed that in the delta band, the DRE group had significantly decreased values for D, CC, and GE, but in the alpha, beta, and gamma bands, these values were significantly increased (p < 0.05). Additionally, the CPL of the DRE group significantly increased in the delta and theta bands but significantly decreased in the alpha, beta, and gamma bands (p < 0.05). Conclusion: The topology structure of the functional network in DRE patients was significantly changed compared with healthy people, which was reflected in different frequency bands. It provided a theoretical basis for understanding the pathological network alterations of DRE.

Coupling of different antioxidative systems in rice under the simultaneous influence of selenium and cadmium.

Selenium (Se) elevates the antioxidant ability of rice against cadmium (Cd) stress, but previous studies only focused on the variation in antioxidant enzymes or nonenzymatic substances induced by Se under Cd stress and ignored the relationships between different antioxidant parameters during the interaction. Here, hydroponic experiments with rice were performed by adding both Cd and Se at doses in the range of 0-50 µM to explore the physiological responses of rice and their relationships in the presence of different levels of Se and Cd. Exogenous Cd markedly promoted the activity of antioxidant enzymes with the exception of catalase (CAT) and the concentration of nonenzymatic substances in aerial parts. Se enhanced the antioxidant capacity by improving the activities of all the enzymes tested in this study and increasing the concentrations of nonenzymatic compounds. The couplings among different antioxidant substances within paddy rice were then determined based on cluster and linear fitting results and their metabolic process and physiological functions. The findings specifically highlight that couplings among the ascorbic acid (AsA)-glutathione (GSH) cycle, glutathione synthase (GS)-phytochelatin synthetase (PCS) coupling system and glutathione peroxidase (GPX)-superoxide dismutase (SOD) coupling system in aerial parts helps protect plants from Cd stress. These coupling systems form likely due to the fact that one enzyme generated a product that could be the substrate for another enzyme. Noticeably, such coupling systems do not emerge in roots because the stronger damage to roots than other organs activates the ascorbate peroxidase (APX)-GPX-CAT and PCS-GS-SOD systems with distinct functions and structures. This study provides new insights into the detoxification mechanisms of rice caused by the combined effect of Se and Cd.

An ultra-sensitive one-pot RNA-templated DNA ligation rolling circle amplification-assisted CRISPR/Cas12a detector assay for rapid detection of SARS-CoV-2.

Rapid, sensitive, and one-pot diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays an extremely important role in point-of-care testing (POCT). Herein, we report an ultra-sensitive and rapid one-pot enzyme-catalyzed rolling circle amplification-assisted CRISPR/FnCas12a assay, termed OPERATOR. OPERATOR employs a single well-designed single-strand padlock DNA, containing a protospacer adjacent motif (PAM) site and a sequence complementary to the target RNA which procedure converts and amplifies genomic RNA to DNA by RNA-templated DNA ligation and multiply-primed rolling circle amplification (MRCA). The MRCA amplicon of single-stranded DNA is cleaved by the FnCas12a/crRNA complex and detected via a fluorescence reader or lateral flow strip. OPERATOR presents outstanding advantages including ultra-sensitivity (1.625 copies per reaction), high specificity (100%), rapid reaction speed (∼30 min), easy operation, low cost, and on-spot visualization. Furthermore, we established a POCT platform by combining OPERATOR with rapid RNA release and a lateral flow strip without professional equipment. The high performance of OPERATOR in SARS-CoV-2 tests was confirmed using both reference materials and clinical samples, and the results suggest that is readily adaptable for point-of-care testing of other RNA viruses.

The accuracy of different mismatch negativity amplitude representations in predicting the levels of consciousness in patients with disorders of consciousness.

Introduction: The mismatch negativity (MMN) index has been used to evaluate consciousness levels in patients with disorders of consciousness (DoC). Indeed, MMN has been validated for the diagnosis of vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state (MCS). In this study, we evaluated the accuracy of different MMN amplitude representations in predicting levels of consciousness. Methods: Task-state electroencephalography (EEG) data were obtained from 67 patients with DoC (35 VS and 32 MCS). We performed a microstate analysis of the task-state EEG and used four different representations (the peak amplitude of MMN at electrode Fz (Peak), the average amplitude within a time window -25- 25 ms entered on the latency of peak MMN component (Avg for peak ± 25 ms), the average amplitude of averaged difference wave for 100-250 ms (Avg for 100-250 ms), and the average amplitude difference between the standard stimulus ("S") and the deviant stimulus ("D") at the time corresponding to Microstate 1 (MS1) (Avg for MS1) of the MMN amplitude to predict the levels of consciousness. Results: The results showed that among the four microstates clustered, MS1 showed statistical significance in terms of time proportion during the 100-250 ms period. Our results confirmed the activation patterns of MMN through functional connectivity analysis. Among the four MMN amplitude representations, the microstate-based representation showed the highest accuracy in distinguishing different levels of consciousness in patients with DoC (AUC = 0.89). Conclusion: We discovered a prediction model based on microstate calculation of MMN amplitude can accurately distinguish between MCS and VS states. And the functional connection of the MS1 is consistent with the activation mode of MMN.

Dynamic Changes of Brain Activity in Patients With Disorders of Consciousness During Recovery of Consciousness.

The disorder of brain activity dynamics is one of the main characteristics leading to disorders of consciousness (DOC). However, few studies have explored whether the dynamics of brain activity can be modulated, and whether the dynamics of brain activity can help to evaluate the state of consciousness and the recovery progress of consciousness. In current study, 20 patients with minimally conscious state (MCS) and 13 patients with vegetative state (VS) were enrolled, and resting state electroencephalogram (EEG) data and the coma recovery scale-revised (CRS-R) scores were collected three times before and after high-definition transcranial direct current stimulation (HD-tDCS) treatment. The patients were divided into the improved group and the unimproved group according to whether the CRS-R scores were improved after the treatment, and the dynamic changes of resting state EEG microstate parameters during treatment were analyzed. The results showed the occurrence per second (OPS) of microstate D was significantly different between the MCS group and VS group, and it was positively correlated with the CRS-R before the treatment. After 2 weeks of the treatment, the OPS of microstate D improved significantly in the improved group. Meanwhile, the mean microstate duration (MMD), ratio of time coverage (Cov) of microstate C and the Cov of microstate D were significantly changed after the treatment. Compared with the microstates parameters before the treatment, the dynamic changes of parameters with significant difference in the improved group showed a consistent trend after the treatment. In contrast, the microstates parameters did not change significantly after the treatment in the unimproved group. The results suggest that the dynamics of EEG brain activity can be modulated by HD-tDCS, and the improvement in brain activity dynamics is closely related to the recovery of DOC, which is helpful to evaluate the level of DOC and the progress of recovery of consciousness.

Assessing residual motor function in patients with disorders of consciousness by brain network properties of task-state EEG.

Recent achievements in evaluating the residual consciousness of patients with disorders of consciousness (DOCs) have demonstrated that spontaneous or evoked electroencephalography (EEG) could be used to improve consciousness state diagnostic classification. Recent studies showed that the EEG signal of the task-state could better characterize the conscious state and cognitive ability of the brain, but it has rarely been used in consciousness assessment. A cue-guide motor task experiment was designed, and task-state EEG were collected from 18 patients with unresponsive wakefulness syndrome (UWS), 29 patients in a minimally conscious state (MCS), and 19 healthy controls. To obtain the markers of residual motor function in patients with DOC, the event-related potential (ERP), scalp topography, and time-frequency maps were analyzed. Then the coherence (COH) and debiased weighted phase lag index (dwPLI) networks in the delta, theta, alpha, beta, and gamma bands were constructed, and the correlations of network properties and JFK Coma Recovery Scale-Revised (CRS-R) motor function scores were calculated. The results showed that there was an obvious readiness potential (RP) at the Cz position during the motor preparation process in the MCS group, but no RP was observed in the UWS group. Moreover, the node degree properties of the COH network in the theta and alpha bands and the global efficiency properties of the dwPLI network in the theta band were significantly greater in the MCS group compared to the UWS group. The above network properties and CRS-R motor function scores showed a strong linear correlation. These findings demonstrated that the brain network properties of task-state EEG could be markers of residual motor function of DOC patients. Supplementary Information: The online version contains supplementary material available at 10.1007/s11571-021-09741-7.

Multidimensional Assessment of Electroencephalography in the Neuromodulation of Disorders of Consciousness.

In the present study, we aimed to elucidate changes in electroencephalography (EEG) metrics during recovery of consciousness and to identify possible clinical markers thereof. More specifically, in order to assess changes in multidimensional EEG metrics during neuromodulation, we performed repeated stimulation using a high-density transcranial direct current stimulation (HD-tDCS) protocol in 42 patients with disorders of consciousness (DOC). Coma Recovery Scale-Revised (CRS-R) scores and EEG metrics [brain network indicators, spectral energy, and normalized spatial complexity (NSC)] were obtained before as well as fourteen days after undergoing HD-tDCS stimulation. CRS-R scores increased in the responders (R +) group after HD-tDCS stimulation. The R + group also showed increased spectral energy in the alpha2 and beta1 bands, mainly at the frontal and parietal electrodes. Increased graphical metrics in the alpha1, alpha2, and beta1 bands combined with increased NSC in the beta2 band in the R + group suggested that improved consciousness was associated with a tendency toward stronger integration in the alpha1 band and greater isolation in the beta2 band. Following this, using NSC as a feature to predict responsiveness through machine learning, which yielded a prediction accuracy of 0.929, demonstrated that the NSC of the alpha and gamma bands at baseline successfully predicted improvement in consciousness. According to our findings reported herein, we conclude that neuromodulation of the posterior lobe can lead to an EEG response related to consciousness in DOC, and that the posterior cortex may be one of the key brain areas involved in the formation or maintenance of consciousness.

A new surgical method of treatment spontaneous intracranial hemorrhage.

OBJECTIVE: This study aimed to determine the safety and effectiveness of DTI-assisted neuroendoscopy for treating intracranial hemorrhage (ICH). METHODS: This retrospective study included clinical data from 260 patients with spontaneous supratentorial ICH who received neuroendoscopic hematoma removal. Patients were separated into groups based on the surgery method they received: DTI-assisted neuroendoscopy (69 cases) and standard neuroendoscopy (191 cases). All patients were followed up for 6 months. Multivariate logistic regression analyzed the risk factors affecting the prognosis of patients. The outcomes of the two groups were compared using Kaplan-Meier survival curves. RESULTS: The prognostic modified Rankin Scale (mRS) score was significantly better (P = 0.027) in the DTI-assisted neuroendoscopy group than in the standard neuroendoscopy group. Logistic regression analysis showed that DTI-assisted neuroendoscopy is an independent protective factor for a favorable outcome (model 1: odds ratio [OR] = 0.42, P = 0.015; model 2: OR = 0.40, P = 0.013). Kaplan-Meier survival curves were used to show that the median time for a favorable outcome was 66 days (95% confidence interval [CI] = 48.50-83.50 days) in the DTI-assisted neuroendoscopy group and 104 days (95% CI = 75.55-132.45 days) in the standard neuroendoscopy group. Log-rank testing showed that the DTI-assisted neuroendoscopy group had a lower pulmonary infection rate (χ 2 = 4.706, P = 0.030) and a better prognosis (χ 2 = 5.223, P = 0.022) than the standard neuroendoscopy group. The survival rate did not differ significantly between the DTI-assisted neuroendoscopy group and the standard neuroendoscopy group (P > 0.05). CONCLUSIONS: The use of DTI in neuroendoscopic hematoma removal can significantly improve neurological function outcomes in patients, but it does not significantly affect the mortality of patients.

Cranioplasty for patients with disorders of consciousness.

BACKGROUND: Cranioplasty (CP) is necessary for patients with disorders of consciousness (DOC) and skull defects. However, due to the complexity of these conditions, the surgical indications are conservative, and there are few published reports. This study aimed to assess the outcomes and complications of CP in patients with DOC, and to optimize the management of transcalvarial herniation (TCH) and hydrocephalus. METHODS: A total of 87 patients with DOC who underwent CP at our center between December 2016 and April 2019 were selected. The patients were divided into traumatic brain injury (TBI) and non-TBI groups, and the complications, outcomes, and costs were compared. Factors associated with prognosis and surgical complications were identified using multivariate logistic regression analysis. RESULTS: Postoperative complications occurred in 18 patients (20.7%). The complication rate was higher in the TBI group than in the non-TBI group (P=0.031). Preoperative ventriculoperitoneal shunt (VPS) was identified as a risk factor for incision complication (P=0.032), and non-traumatic cause tended to be a protective factor against postoperative hydrocephalus (P=0.055). One year after CP, 25 patients (28.7%) regained full consciousness [Extended Glasgow Outcome Scale (GOSE) ≥3] and 10 patients (11.5%) achieved partial self-care (GOSE =4). Multivariate analyses revealed that minimally conscious state (MCS) vs. vegetative state/unresponsive wakefulness syndrome (VS/UWS) (P=0.000) and early CP (P=0.023) were potential indicators for the recovery of consciousness. CONCLUSIONS: Our findings suggest that CP is safe in patients with DOC and may be beneficial for the recovery of consciousness. Early surgery and surgery for MCS provide better results. Timely CP in patients with TCH can help to reduce preoperative VPS, control incision complications, and detect and intervene in potential hydrocephalus.

Exogenous selenium (cadmium) inhibits the absorption and transportation of cadmium (selenium) in rice.

Antagonism between selenium (Se) and cadmium (Cd) has been demonstrated in plants. However, a mutual suppression threshold for Se and Cd has not been identified in previous studies using Cd or Se individually. To fill this knowledge gap, we determined the levels of Se and Cd in various tissues of rice under concentration gradients of Se and Cd with different Se application times via hydroponic experiments. The results showed that the application of exogenous Se or Cd reduced the uptake and transport of the other. When the molar ratio of Se/Cd (R (Se/Cd)) was higher than 1, the concentration and transfer factor of Cd (TF-Cd) in all parts of rice simultaneously reached the lowest values. The minimum Se absorption in rice was obtained at R (Cd/Se) greater than 20, while no inhibition threshold was found for Se transport. In addition, approximately 1:1 R (Se/Cd) was observed in roots and the addition of exogenous Cd or Se promoted the enrichment of the other element in roots. These data suggested a mutual inhibition of Se and Cd in their absorption, transportation and accumulation in rice, which might be related to the formation of insoluble Cd-Se complexes in roots. This study provided new insights into a plausible explanation of the interactions between Se and Cd and contributed to the remediation and treatment of combined Se and Cd pollution in farmland systems.