The intake of solid fat and cheese may be associated with a reduced risk of Helicobacter pylori infection status: a cross-sectional study based on NHANES 1999-2000.

BACKGROUND: Diet plays an important role in Helicobacter pylori (HP) infection, and our objective was to investigate potential connections between dietary patterns, specific food groups, and HP infection status in U.S. adults. METHODS: The data for this study was obtained from the NHANES (National Health and Nutrition Survey) database for the year 1999-2000. This cross-sectional study involved the selection of adults aged 20 years and older who had undergone dietary surveys and HP testing. Factor analysis was employed to identify dietary patterns, and logistic regression models were utilized to assess the association between these dietary patterns and specific food groups with HP infection status. RESULT: Based on the inclusion and exclusion criteria, our final analysis included 2,952 individuals. The median age of participants was 51.0 years, and 48.7% were male. In the study population, the overall prevalence of HP infection was 44.9%. Factor analysis revealed three distinct dietary patterns: High-fat and high-sugar pattern (including solid fats, refined grains, cheese, and added sugars); Vegetarian pattern (comprising fruits, juices, and whole grains); Healthy pattern (encompassing vegetables, nuts and seeds, and oils). Adjusted results showed that the high-fat and high-sugar pattern (OR = 0.689, 95% CI: 0.688-0.690), vegetarian pattern (OR = 0.802, 95% CI: 0.801-0.803), and healthy pattern (OR = 0.717, 95% CI: 0.716-0.718) were all linked to a lower likelihood of HP infection. Further analysis of the high-fat and high-sugar pattern revealed that solid fats (OR = 0.717, 95% CI: 0.716-0.718) and cheese (OR = 0.863, 95% CI: 0.862-0.864) were protective factors against HP infection, while refined grains (OR = 1.045, 95% CI: 1.044-1.046) and added sugars (OR = 1.014, 95% CI: 1.013-1.015) were identified as risk factors for HP infection. CONCLUSION: Both the Vegetarian pattern and the Healthy pattern are associated with a reduced risk of HP infection. Interestingly, the High-fat and High-sugar pattern, which is initially considered a risk factor for HP infection when the score is low, becomes a protective factor as the intake increases. Within this pattern, animal foods like solid fats and cheese play a protective role, while the consumption of refined grains and added sugars increases the likelihood of HP infection.

Innate lymphoid cell subsets in the pathogenesis of primary biliary cholangitis.

BACKGROUND AND AIM: Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by destructive lymphocytic cholangitis and specific anti-mitochondrial antibodies. Innate lymphoid cells (ILCs) have been reported to play a role in liver homeostasis and autoimmunity. METHODS: We evaluated the features of peripheral ILC1s and ILC3 in patients with PBC and hepatic ILC1 and ILC3 in two different PBC mouse models (dominant-negative transforming growth factor-beta receptor II [dnTGFßRII] and 2-octynoic acid-bovine serum albumin [2OA-BSA]). RESULTS: A total of 115 patients and 18 healthy controls were enrolled in the study. Decreased circulating ILC1/3s were observed in early-stage PBC patients, and the numbers of ILC1/3s were negatively correlated with specific parameters and the proportion of T-helper (Th) 1 and Th17 cells. Reduced numbers of ILC1s were observed in PBC mouse models with different etiologies. ILC1-deficient mice had more severe hepatic inflammation after inducing the 2OA-BSA model. Continuous low-dose injections of lipopolysaccharide (LPS) reduced ILC1 levels in mice, consistent with the lower level of ILC1s in PBC patients with high LPS (> 50 ng/mL), and aggravated hepatic lymphocyte infiltration. CONCLUSION: Patients with PBC had decreased ILC1s, which were negatively correlated with CD4+ T cells. Deficient ILC1 populations led to disease exacerbations in mice. Our results indicated that ILC1s may participate in the pathogenesis of PBC.

Large field-of-view thermal imaging via all-silicon meta-optics.

A broad range of imaging and sensing technologies in the infrared require large field-of-view (FoV) operation. To achieve this, traditional refractive systems often employ multiple elements to compensate for aberrations, which leads to excess size, weight, and cost. For many applications, including night vision eye-wear, air-borne surveillance, and autonomous navigation for unmanned aerial vehicles, size and weight are highly constrained. Sub-wavelength diffractive optics, also known as meta-optics, can dramatically reduce the size, weight, and cost of these imaging systems, as meta-optics are significantly thinner and lighter than traditional refractive lenses. Here, we demonstrate 80° FoV thermal imaging in the long-wavelength infrared regime (8-12 µm) using an all-silicon meta-optic with an entrance aperture and lens focal length of 1 cm.

Clinical characteristics and treatment outcomes of acute severe autoimmune hepatitis.

BACKGROUND AND AIM: Acute severe autoimmune hepatitis (AS-AIH) is a rare cause of acute liver failure (ALF), which is often neglected and delayed in treatment. The purpose of this study was to analyze the clinical characteristics and therapeutic effects of AS-AIH. METHODS: Retrospective analysis was performed. AIH was diagnosed according to the International Autoimmune Hepatitis Group (IAIHG) criteria revised in 1999. AS-AIH was defined as an acute presentation (onset of symptoms to presentation of ≤ 26 weeks) and INR of ≥ 1.5, and no histologic evidence of cirrhosis. RESULTS: Twelve patients were diagnosed as AS-AIH. At baseline, median immunoglobulin G was 28.35 g/L (range, 11.4-49.2). Ten (83.3%) patients were antinuclear antibodies and/or anti-smooth muscle antibodies positive. The prominent histologic characteristics were lobular necrosis/inflammation (91.7%) and plasma cell infiltration (100%). All patients received corticosteroid therapy. Death occurred in 2 (16.7%) patients within 30 days resulted from ALF. The average interval between the onset of symptoms and initiation of corticosteroid therapy in deceased patients was 65 days, compared with 19 days for survivors. CONCLUSIONS: AS-AIH is an uncommon disease with poor outcomes. Patients with acute severe hepatitis of unknown cause should be minded the possibility of AS-AIH and corticosteroids should be considered as soon as possible.

Long-term Outcomes of Autologous Peripheral Blood Stem Cell Transplantation in Patients With Cirrhosis.

BACKGROUND & AIMS: Peripheral blood stem cells (PBSCs) mobilized with colony-stimulating factor can promote liver regeneration and increase liver function in patients with liver diseases. However, the long-term effects of stem cell treatments on survival and risk of hepatocellular carcinoma (HCC) in patients with cirrhosis have not been determined. We investigated the long-term effects of autologous stem cell transplantation and risk of HCC in patients with cirrhosis. METHODS: We performed a retrospective analysis of 2 cohorts of patients with decompensated cirrhosis who received transplantations of autologous PBSCs (n = 282) or standard medical treatment (SMT, n = 286) in China from January 1, 2006, through December 31, 2016. Patients were followed up until death or liver transplantation. Mortality data were obtained by case records and confirmed by telephone calls. Survival time was calculated and HCC was confirmed by computed tomography or ultrasound. We used propensity score matching to adjust the differences between the 2 groups. Survival and incidence of HCC were analyzed and Cox proportional hazard regression was used to determine the prognostic factors. RESULTS: After propensity score matching, time of survival was significantly higher in the PBSC group than the SMT group (P = .001). The adjusted rate of 5-year survival was 71.2% in the PBSC group and 52.1% in the SMT group. The overall incidence of HCC did not differ significantly between the PBSC and SMT groups (21.1% vs 20.4%; P = .999). Significant improvement of liver functions was observed at 1 year, 2 years, 3 years, and 5 years after PBSC transplantation compared with the SMT group. CONCLUSIONS: In a long-term analysis of patients with decompensated cirrhosis, autologous transplants of PBSCs significantly improved long-term survival compared with a control group. PBSC transplant did not appear to increase the risk of HCC.

Induction of hepatocyte-like cells from human umbilical cord-derived mesenchymal stem cells by defined microRNAs.

Generating functional hepatocyte-like cells (HLCs) from mesenchymal stem cells (MSCs) is of great urgency for bio-artificial liver support system (BALSS). Previously, we obtained HLCs from human umbilical cord-derived MSCs by overexpressing seven microRNAs (HLC-7) and characterized their liver functions in vitro and in vivo. Here, we aimed to screen out the optimal miRNA candidates for hepatic differentiation. We sequentially removed individual miRNAs from the pool and examined the effect of transfection with remainder using RT-PCR, periodic acid-Schiff (PAS) staining and low-density lipoprotein (LDL) uptake assays and by assessing their function in liver injury models. Surprisingly, miR-30a and miR-1290 were dispensable for hepatic differentiation. The remaining five miRNAs (miR-122, miR-148a, miR-424, miR-542-5p and miR-1246) are essential for this process, because omitting any one from the five-miRNA combination prevented hepatic trans-differentiation. We found that HLCs trans-differentiated from five microRNAs (HLC-5) expressed high level of hepatic markers and functioned similar to hepatocytes. Intravenous transplantation of HLC-5 into nude mice with CCl4 -induced fulminant liver failure and acute liver injury not only improved serum parameters and their liver histology, but also improved survival rate of mice in severe hepatic failure. These data indicated that HLC-5 functioned similar to HLC-7 in vitro and in vivo, which have been shown to resemble hepatocytes. Instead of using seven-miRNA combination, a simplified five-miRNA combination can be used to obtain functional HLCs in only 7 days. Our study demonstrated an optimized and efficient method for generating functional MSC-derived HLCs that may serve as an attractive cell alternative for BALSS.

Polymorphisms in the vitamin D receptor gene and risk of primary biliary cirrhosis: a meta-analysis.

BACKGROUND AND AIM: Primary biliary cirrhosis (PBC) is a chronic and progressive cholestatic autoimmune liver disease. Although many studies have evaluated the association between many functional polymorphisms in the vitamin D receptor (VDR) gene and PBC risk, debates still exist. Our aim is to evaluate the association between VDR gene polymorphisms, including TaqI (rs731236), BsmI (rs1544410), and ApaI (rs7975232), and the risk of PBC by a systematic review. METHODS: We searched literatures in PubMed, SCOPUS, and EMBASE until July 2013. We calculated pooled odds ratios (OR) and 95% confidence intervals (CIs) using a fixed effects model or a random effects model for the risk to PBC associated with different VDR gene polymorphisms. And the heterogeneity assumption decided the effect model. RESULTS: A total of six relevant studies, with 1322 PBC cases and 2264 controls, were included in this meta-analysis. The results indicated that TaqI (rs731236) polymorphism was significantly associated with PBC risk (for T vs t OR = 0.75, 95% CI 0.63, 0.89, Pz = 0.001; TT + Tt vs tt OR = 0.62, 95% CI 0.44, 0.86, Pz = 0.005; OR = 0.74, 95% CI 0.58, 0.94, Pz = 0.016 for recessive model), while ApaI (rs7975232) or BsmI (rs1544410) polymorphism did not. CONCLUSION: Based on current evidences from published studies, the cumulative effect of TaqI polymorphism in VDR was significantly associated with PBC. Larger studies with mixed ethnicity subjects and stratified by clinical and sub clinical characteristics are needed to validate our findings.

Meta-analysis of efficacy and safety of fast-track surgery in gastrectomy for gastric cancer.

BACKGROUND: Fast-track surgery (FTS) is a promising program for surgical patients and has been applied to several surgical diseases. FTS is much superior to conventional perioperative care. Our aim was to evaluate and compare the safety and efficacy of FTS and conventional perioperative care for patients undergoing gastrectomy using a systematic review. METHODS: We searched the literature in PubMed, SCOPUS, and EMBASE up to November 2013. No language restriction was applied. Weighted mean differences (WMDs) and odds ratios (ORs) with their 95 % confidence intervals (CIs) were used for analysis by a fixed or a random effects model according to the heterogeneity assumption. RESULTS: In the present meta-analysis, we included five randomized controlled trials and one controlled clinical trial from five studies. Compared with conventional care, FTS shortened the duration of flatus (WMD -21.08; 95 % CI -27.46 to -14.71, z = 6.48, p < 0.00001 in the open surgery group; WMD -8.20; 95 % CI -12.87 to -3.53, z = 3.44, p = 0.0006 in the laparoscopic surgery group), accelerated the decrease in C-reactive protein (WMD -15.56; 95 % CI 21.28 to 9.83, z = 5.33, p < 0.00001), shortened the postoperative stay (WMD -2.00; 95 % CI -2.69 to -1.30, z = 5.64, p < 0.00001), and reduced hospitalization costs (WMD -447.72; 95 % CI -615.92 to -279.51, z = 5.22, p < 0.00001). FTS made no significant difference in operation times (p = 0.93), intraoperative blood loss (p = 0.79), or postoperative complications (p = 0.07). CONCLUSIONS: Based on current evidence, the FTS protocol was feasible for gastric cancer patients who underwent gastrectomy (distal subtotal gastrectomy, proximal subtotal gastrectomy, or radical total gastrectomy) via open or laparoscopic surgery. Larger studies are needed to validate our findings.

Broadband thermal imaging using meta-optics.

Subwavelength diffractive optics known as meta-optics have demonstrated the potential to significantly miniaturize imaging systems. However, despite impressive demonstrations, most meta-optical imaging systems suffer from strong chromatic aberrations, limiting their utilities. Here, we employ inverse-design to create broadband meta-optics operating in the long-wave infrared (LWIR) regime (8-12 µm). Via a deep-learning assisted multi-scale differentiable framework that links meta-atoms to the phase, we maximize the wavelength-averaged volume under the modulation transfer function (MTF) surface of the meta-optics. Our design framework merges local phase-engineering via meta-atoms and global engineering of the scatterer within a single pipeline. We corroborate our design by fabricating and experimentally characterizing all-silicon LWIR meta-optics. Our engineered meta-optic is complemented by a simple computational backend that dramatically improves the quality of the captured image. We experimentally demonstrate a six-fold improvement of the wavelength-averaged Strehl ratio over the traditional hyperboloid metalens for broadband imaging.

Meta-analysis: the relationship between TNF-alpha polymorphisms and susceptibility to primary biliary cirrhosis.

BACKGROUND/AIMS: To investigate the possible influence of TNF-α gene promoter polymorphisms in conferring a predisposition to PBC patients. METHODOLOGY: We performed a meta-analysis of nine articles searched from PubMed up to July 2010 that investigated the association between two TNF-α polymorphisms (-308 and -238) and PBC. RESULTS: The data showed no significant association between TNF-α-308, -238 gene polymorphisms and the susceptibility to PBC in the global group (OR=0.95, 95%CI=0.80-1.13, p=0.55; OR=1.00, 95%CI=0.65-1.55, p=0.99, respectively). Stratified by sub-groups (European, American, Asian), TNF -308 minor allele, but not -238, was found to be a protective factor in the European population (OR= 0.81, 95%CI=0.67-0.99, p=0.04; OR=0.99, 95%CI=0.55-1.77, p=0.97, respectively). Moreover, no significant difference was observed between TNF-α-308 alleles and PBC when stratified by histological stages (stages I-II, OR=0.68, 95%CI=0.32-1.48, p=0.33; stages III-IV, OR=0.69, 95%CI=0.41-1.15, p=0.15). CONCLUSIONS: TNF-α promoter polymorphisms might not be associated with PBC risk. However, studies with larger population of varying ethnicity and stratified by clinical and laboratory characteristics are needed to validate our findings.

Spatial distribution and risk assessment of conazole fungicides in surface seawater of the East China Sea.

Conazole fungicides (CFs), the common-used pesticide in agriculture distributed widely in the environment. This research analyzed the occurrence, potential sources, and risks of eight CFs in the East China Sea surface seawater in the early summer of 2020. The total CF concentration ranged from 0.30 to 6.20 ng/L, with an average value of 1.64 ± 1.24 ng/L. Fenbuconazole, hexaconazole, and triadimenol were the major CFs that comprised >96 % of the total concentration. The Yangtze River was identified as the significant source of CFs from the coastal regions to the off-shore inputs. Ocean current was the first-order factor controlling the content and distribution of CFs in the East China Sea. Although risk assessment revealed CFs posed a low or no substantial risk to ecology and human health, long-term monitoring was also encouraged. This study provided a theoretical foundation for assessing CFs' pollution levels and potential risks in the East China Sea.

Network analysis of the relationships between problematic smartphone use and anxiety, and depression in a sample of Chinese college students.

Background: Problematic smartphone use (PSU) is associated with both anxiety and depression. However, the relationships between components of PSU and symptoms of anxiety or depression have not been investigated. Hence, the aim of this study was to closely examine the relationships between PSU and anxiety and depression to identify the pathological mechanisms underpinning those relationships. A second aim was to identify important bridge nodes to identify potential targets for intervention. Methods: Symptom-level network structures of PSU and anxiety, and PSU and depression were constructed to investigate the connections between the variables and evaluate the bridge expected influence (BEI) of each node. Network analysis using data from 325 Chinese healthy college students was performed. Results: Five strongest edges appeared within the communities in both the PSU-anxiety and PSU-depression networks. The "Withdrawal" component had more connections with symptoms of anxiety or depression than any other PSU node. In particular, the edges between "Withdrawal" and "Restlessness" and between "Withdrawal" and "Concentration difficulties" were the strongest cross-community edges in the PSU-anxiety network and PSU-depression network, respectively. Furthermore, "Withdrawal" had the highest BEI in the PSU community in both networks. Conclusions: These findings provide preliminary evidence of the pathological pathways linking PSU with anxiety and depression, with "Withdrawal" linking PSU with both anxiety and depression. Hence, "Withdrawal" may be a potential target for preventing and intervening in cases of anxiety or depression.

The military occupational stress response scale: Development, reliability, and validity.

Soldiers in the military are exposed to numerous stressors, including some that are of an extreme nature. The main objective of this military psychology research study was to evaluate soldiers' occupational stress. Even though several tools have been developed to measure stress in this population, to date, none have focused on occupational stress. Hence, we developed the Military Occupational Stress Response Scale (MOSRS) to provide a tool to objectively measure soldiers' occupational stress responses. An initial pool of 27 items was assembled from the literature, existing instruments, and interviews with soldiers. Of those 27, 17 were included in the MOSRS. The scale was subsequently completed by soldiers from one military region, and exploratory factor analysis (EFA) and confirmatory factor analysis were conducted using Mplus8.3 and IBM SPSS 28.0 software, respectively. A total of 847 officers and soldiers were selected for scale testing, and 670 subjects were retained after data cleaning and screening according to the set criteria. After performing the Kaiser-Meyer-Olkin (KMO) and Bartlett's test, principal components analysis (PCA) was appropriate. The PCA yielded a three-factor model (physiological, psychological, and behavioral responses) with the items and factors strongly correlated. The confirmatory factor analysis revealed loads ranging from between 0.499 and 0.878 for each item. The Cronbach's α coefficient of the MOSRS was between 0.710 and 0.900, and the Omega reliability was between 0.714 and 0.898, which were all higher than the critical standard value of 0.7, indicating that the scale has good reliability. Analysis of the discrimination validity of each dimension revealed that the scale has good discrimination validity. The MOSRS demonstrated sound psychometric characteristics with acceptable reliability and validity, suggesting that it could be used to assess occupational stress in military personnel.

Ocean current redistributed the currently using Organoamine Pesticides in Arctic summer water.

In a comprehensive study on the presence and distribution of Currently Using Organoamine Pesticides (CUOAPs) in the Arctic Ocean, this study collected and analyzed 36 surface seawater samples during the summer of 2021. The study detected 36 CUOAPs, 17 of these compounds at levels exceeding the Method Detection Limits (MDLs). Concentrations of CUOAPs ranged from 0.11 to 2.94 ng/L, exhibiting an average of 1.83 ± 0.83 ng/L. Spatial distribution analysis revealed lower CUOAP concentrations in the central Arctic Ocean, with Cycloate constituting the most abundant component (23.66 %). The investigation identified terrestrial inputs and long-range atmospheric transport as potential sources of CUOAPs in the Arctic Ocean region. The origins of individual CUOAPs appeared to be associated with application procedures and their propensity for co-occurrence at low latitudes. The study also examined the role of ocean currents in the transport and redistribution of CUOAPs in surface seawater across different regions. While ocean currents played a significant role, the influence of sea ice cover on CUOAP distribution was minimal. An ecological risk assessment analysis underscored the need for regional attention to the presence of CUOAPs in the Arctic Ocean.

Spatiotemporal variations, surface inventory, and cross regional impact of current-use organoamine pesticides in Chinese Marginal Seas.

Current-use Organoamine Pesticides (CUOAPs) are a growing concern as emerging pesticide pollutants that were initially discovered on a large scale in Chinese Marginal Seas (CMSs). The highest level was detected in the East China Sea in the late spring and decreased in the following order: East China Sea (early spring) > the South China Sea > the Bohai Sea. The crucial role played by the Yangtze and Yellow rivers as significant terrestrial sources were established. The fluctuations in the land application and riverine input led to variations in the source, distribution, and seasonal patterns of CUOAPs. Terrestrial-exported CUOAPs were transported and redistributed spatially by the surface ocean currents, resulting in significant regional disparities. The results displayed a pronounced terrestrial source signature and a cross-regional impact. By the ocean current transport, CMSs will likely become a secondary source region for the surrounding seas.

Millimeter-scale focal length tuning with MEMS-integrated meta-optics employing high-throughput fabrication.

Miniature varifocal lenses are crucial for many applications requiring compact optical systems. Here, utilizing electro-mechanically actuated 0.5-mm aperture infrared Alvarez meta-optics, we demonstrate 3.1 mm (200 diopters) focal length tuning with an actuation voltage below 40 V. This constitutes the largest focal length tuning in any low-power electro-mechanically actuated meta-optic, enabled by the high energy density in comb-drive actuators producing large displacements at relatively low voltage. The demonstrated device is produced by a novel nanofabrication process that accommodates meta-optics with a larger aperture and has improved alignment between meta-optics via flip-chip bonding. The whole fabrication process is CMOS compatible and amenable to high-throughput manufacturing.

Oxidative Stress and Gut Microbiome in Inflammatory Skin Diseases.

Oxidative stress plays a dominant role in inflammatory skin diseases. Emerging evidence has shown that the close interaction occurred between oxidative stress and the gut microbiome. Overall, in this review, we have summarized the impact of oxidative stress and gut microbiome during the progression and treatment for inflammatory skin diseases, the interactions between gut dysbiosis and redox imbalance, and discussed the potential possible role of oxidative stress in the gut-skin axis. In addition, we have also elucidated the promising gut microbiome/redox-targeted therapeutic strategies for inflammatory skin diseases.

Wireless Rehabilitation Training Sensor Arrays Made with Hot Screen-Imprinted Conductive Hydrogels with a Low Percolation Threshold.

Herein, we propose a highly sensitive wireless rehabilitation training ball with a piezoresistive sensor array for patients with Parkinson's disease (PD). The piezoresistive material is a low percolation threshold conductive hydrogel which is formed with polypyrrole (PPy) nanofibers (NFs) as a conductive filler derived from a polydopamine (PDA) template. The proton acid doping effect and molecular template of PDA are essential for endowing PPy NFs with a high aspect ratio, leading to a low percolation threshold (∼0.78 vol %) and a low Young's 004Dodulus of 37.69 kPa and hence easy deformation. The piezoresistive sensor exhibited a static and dynamic stability of 10,000 s and 15,000 cycle times, respectively. This stability could be attributed to the increased hydrophilicity of conductive fillers, enhancing the interfacial strength between the conductive filler and the matrix. The interaction between the PDA-PPy NFs and the hydrogel matrix endows the hydrogel with toughness and ensures the stability of the device. Additionally, the microdome structure of the conductive hydrogel, produced by hot screen-imprinting, dramatically improves the sensitivity of the piezoresistive sensor (∼856.14 kPa-1). The microdome conductive hydrogel can distinguish a subtle pressure of 15.40 Pa compared to the control hydrogel without a microstructure. The highly sensitive piezoresistive sensor has the potential to monitor the hand-grip force, which is not well controlled by patients with PD. The rehabilitation training ball assembled with a sensor array on the surface and a wireless chip for communication inside is built and used to monitor the pressure in real time through the WeChat applet. Thus, this work has significantly broadened the application of hydrogel-based flexible piezoresistive sensors for human activity monitoring, which provides a promising strategy to realize next-generation electronics.

Impact of Clostridioides difficile infection on patient-reported quality of life.

OBJECTIVE: We investigated the quality of life (QoL) of patients hospitalized with C. difficile infection (CDI). DESIGN: Prospective survey study. SETTING: US tertiary-care referral center, acute-care setting. PARTICIPANTS: Adults hospitalized with a diagnosis of CDI, defined as ≥3 episodes of unformed stool in 24 hours and a positive laboratory test for C. difficile. METHODS: We surveyed patients from July 2019 to March 2020 using the disease-specific Cdiff32 questionnaire and the generic PROMIS GH survey. We compared differences in Cdiff32 scores among demographic and clinical subgroups (including CDI severity, CDI recurrence, and various comorbidities) using 2-sample t tests. We compared PROMIS GH scores to the general population T score of 50 using 1-sample t tests. We performed multivariable linear regression to identify predictors of Cdiff32 scores. RESULTS: In total, 100 inpatients (mean age, 58.6 ±17.1 years; 53.0% male; 87.0% white) diagnosed with CDI completed QoL surveys. PROMIS GH physical health summary scores (T = 37.3; P < .001) and mental health summary scores (T = 43.4; P < .001) were significantly lower than those of the general population. In bivariate analysis, recurrent CDI, severe CDI, and number of stools were associated with lower Cdiff32 scores. In multivariable linear regression, recurrent CDI, severe CDI, and each additional stool in the previous 24 hours were associated with significantly decreased Cdiff32 scores. CONCLUSIONS: Patients hospitalized with CDI reported low scores on the Cdiff32 and PROMIS GH, demonstrating a negative impact of CDI on QoL in multiple health domains. The Cdiff32 questionnaire is particularly sensitive to QoL changes in patients with recurrent or severe disease.

Endogenous Follistatin-like 1 guarantees the immunomodulatory properties of mesenchymal stem cells during liver fibrotic therapy.

BACKGROUND: Mesenchymal stem cell (MSC) therapy has been shown to be a promising option for liver fibrosis treatment. However, critical factors affecting the efficacy of MSC therapy for liver fibrosis remain unknown. Follistatin-like 1 (FSTL1), a TGF-ß-induced matricellular protein, is documented as an intrinsic regulator of proliferation and differentiation in MSCs. In the present study, we characterized the potential role of FSTL1 in MSC-based anti-fibrotic therapy and further elucidated the mechanisms underlying its action. METHODS: Human umbilical cord-derived MSCs were characterized by flow cytometry. FSTL1low MSCs were achieved by FSTL1 siRNA. Migration capacity was evaluated by wound-healing and transwell assay. A murine liver fibrotic model was created by carbon tetrachloride (CCl4) injection, while control MSCs or FSTL1low MSC were transplanted via intravenous injection 12 weeks post CCl4 injection. Histopathology, liver function, fibrosis degree, and inflammation were analysed thereafter. Inflammatory cell infiltration was evaluated by flow cytometry after hepatic nonparenchymal cell isolation. An MSC-macrophage co-culture system was constructed to further confirm the role of FSTL1 in the immunosuppressive capacity of MSCs. RNA sequencing was used to screen target genes of FSTL1. RESULTS: FSTL1low MSCs had comparable gene expression for surface markers to wildtype but limited differentiation and migration capacity. FSTL1low MSCs failed to alleviate CCl4-induced hepatic fibrosis in a mouse model. Our data indicated that FSTL1 is essential for the immunosuppressive action of MSCs on inflammatory macrophages during liver fibrotic therapy. FSTL1 silencing attenuated this capacity by inhibiting the downstream JAK/STAT1/IDO pathway. CONCLUSIONS: Our data suggest that FSTL1 facilitates the immunosuppression of MSCs on macrophages and that guarantee the anti-fibrotic effect of MSCs in liver fibrosis.