Incidence trends of acute viral hepatitis caused by four viral etiologies between 1990 and 2019 at the global, regional and national levels.

BACKGROUND: Hepatitis is a major public health challenge and a leading cause of death worldwide. We aimed to study the cause-specific incidence and temporal trends of acute viral hepatitis (AVH). METHODS: Data on AVH etiologies were available from the Global Burden of Disease study 2019. Estimated annual percentage change (EAPC) was used to quantify temporal trend in AVH age-standardized incidence rates (ASIRs) by region, sex and aetiology. RESULTS: From 1990 to 2019, the global incidence of AVH increased by 8.02%, from 244 350 063 in 1990 to 263 951 645 in 2019, with an average decreasing ASIR of 0.52% (95% CI -0.58% to -0.45%) annually. The ASIR of AVH due to hepatitis B virus (HBV) decreased, while those of hepatitis A (HAV), hepatitis C (HCV) and hepatitis E (HEV) remained stable, with EAPCs (95% CI) of -1.47 (-1.58 to -1.36), 0 (-0.09 to 0.09), -0.35 (-0.83 to -0.13), and -0.16 (-0.41 to 0.09) respectively. Although the number of new AVH cases increased in the low sociodemographic index (SDI), low-middle SDI regions, the ASIRs decreased in all five SDI regions. Globally, HAV and HBV are the leading causes of acute hepatitis. The EAPC is significantly associated with a baseline ASIR of less than 5500 per 100 000 population (ρ = -0.44), and with the 2019 human development index (HDI) (ρ = 0.16) for AVH. CONCLUSIONS: Although the ASIR of AVH showed a generally decreasing trend, the burden of AVH remains a major public health challenge globally. The findings may be helpful for policymakers in establishing appropriate policies to reduce the viral hepatitis burden.

Sorafenib Plus Hepatic Arterial Infusion Chemotherapy in Advanced Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIM: The clinical utility of sorafenib plus hepatic arterial infusion chemotherapy (SoraHAIC) in advanced hepatocellular carcinoma (HCC) patients remains unclear. We, therefore, conducted the current meta-analysis to systematically evaluate the efficacy and safety of SoraHAIC therapy on major outcomes with advanced HCC patients. METHODS: A systematic search of The Cochrane Library, PubMed, and Embase databases was performed. The major outcomes in patients with advanced HCC were divided into SoraHAIC group and sorafenib group, which included overall response rate, overall survival, progressive disease, and adverse events. RESULTS: Involving a total of 726 patients from 5 included studies, our meta-analysis demonstrated that SoraHAIC showed significantly more improvement than sorafenib alone in overall response rate [risk ratio=3.08; 95% confidence interval (CI), 1.38-6.89; P=0.006] and complete response (risk ratio=5.84; 95% CI, 1.85-18.45; P=0.003). With regard to survival outcome, the combination therapy also significantly prolongs the median overall survival than sorafenib monotherapy (hazard ratio=0.59; 95% CI, 0.35-1.00; P=0.05). In addition, the risk of adverse events such as anemia, neutropenia, and thrombocytopenia was significantly greater in the combination group than in the sorafenib group (P<0.05 for all). CONCLUSIONS: This meta-analysis indicated that SoraHAIC seems to be efficient and safe for advanced HCC patients. However, additional large-scale randomized controlled trials are needed to further investigate the clinical benefit.

The burden of primary liver cancer caused by specific etiologies from 1990 to 2019 at the global, regional, and national levels.

BACKGROUND: Liver cancer is one of the most common cancers worldwide. We aimed to report the burden of liver cancer at the global, regional, and national levels in 204 countries from 1990 to 2019, stratified by etiology, sex, age, and sociodemographic index (SDI). METHODS: Data of mortality, incidence, and disability-adjusted life years (DALYs) of liver cancer and its etiology were available from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2019. The trends in the liver cancer burden were assessed by the annual percentage change. All estimates are presented as numbers and age-standardized rates (ASRs) per 100,000 population, with uncertainty intervals (UIs). RESULTS: Globally, 484,577 (95% UI 444,091-525,798) mortalities, 534,364 (486,550-588,639) incident cases, and 12,528,422 (11,400,671-13,687,675) disability-adjusted life years (DALYs) due to liver cancer occurred in 2019. The ASRs were 5.95 (5.44-6.44), 6.51 (5.95-7.16), and 151.08 (137.53-164.8) per 100,000 population for the mortalities, incidences, and DALYs, respectively. From 1990 to 2019, the numbers increased, whereas the ASRs decreased. Hepatitis B and Hepatitis C are the major causes of liver cancer mortality. The liver cancer mortality in 2019 increased with age, peaking at 65-69 and 70-74 age group in males and females, respectively, and the number was higher in males than in females. Generally, there were nonlinear associations between the ASR and SDIs values at the regional and national levels. China had the highest numbers of mortalities, incident cases, and DALYs, whereas Mongolia has the highest ASR in 2019. CONCLUSION: Liver cancer remains a major public health issue worldwide, but etiological and geographical variations exist. It is necessary to increase awareness of the population regarding liver cancer, its etiologies and the importance of early detection, and diagnosis and treatment.

Donor pretreatment with adenosine monophosphate-activated protein kinase activator protects cardiac grafts from cold ischaemia/reperfusion injury.

OBJECTIVES: Adenosine monophosphate-activated protein kinase (AMPK) is a master regulator of energy metabolism and has been shown to be protective in ischaemia/reperfusion injury (IRI). We hypothesized that preactivation of AMPK with an activator before donor heart procurement could protect heart grafts from cold IRI. METHODS: Donor Sprague-Dawley rats were injected intravenously with AMPK activator 5-amino-imidazole-4-carboxamide ribonucleotide (AICAR) or vehicle 30 min before heart procurement. Heart grafts were then preserved in histidine-tryptophan-ketoglutarate (HTK) solution at 4°C for 8 h. After preservation, grafts were immediately mounted on the Langendorff perfusion system and perfused with Krebs-Henseleit buffer at 37°C for 1 h. Adenosine triphosphate (ATP) and malondialdehyde (MDA) content in graft tissue were quantified post-preservation and post-reperfusion. After reperfusion, isolated heart function was assessed using a pressure transducer; cumulative release of creatine kinase (CK) and lactate dehydrogenase (LDH) into the perfusate was measured to assess cardiomyocyte necrosis; ultrastructural changes in the mitochondria of the grafts were examined using transmission electron microscopy (TEM). RESULTS: After preservation, myocardial ATP content in the pretreated hearts was significantly higher than in the control hearts (3.247 ± 0.3034 vs 1.817 ± 0.2533 µmol/g protein; P < 0.05). AICAR-pretreated heart grafts exhibited significantly higher coronary flow (9.667 ± 0.3159 vs 8.033 ± 0.2459 ml/min; P < 0.05) and left ventricular developing pressure (58.67 ± 2.894 vs 42.67 ± 3.333 mmHg; P < 0.05) than the vehicle treated after reperfusion. Cumulative release of CK (300.0 ± 25.30 vs 431.7 ± 42.39 U/l; P < 0.05) and LDH (228.0 ± 16.68 vs 366.8 ± 57.41 U/l; P < 0.05) in the perfusate was significantly lower in the AICAR-pretreated group than that in the control group. Myocardial MDA content was also reduced in the pretreated group (0.5167 ± 0.1046 vs 0.9333 ± 0.1333 nmol/mg protein; P < 0.05). TEM suggested that the mitochondrial structure of AICAR-pretreated hearts was much better preserved. Moreover, AICAR-pretreated hearts significantly diminished cytosolic cytochrome c release after reperfusion. CONCLUSIONS: This study demonstrates that pretreatment with AMPK activator AICAR significantly protects heart grafts from extended cold IRI. This novel protocol may be useful and feasible in clinical heart transplantation.

Employing an active mental task to enhance the performance of auditory attention-based brain-computer interfaces.

OBJECTIVE: A majority of auditory brain-computer interfaces (BCIs) use the attentional modulation of auditory event-related potentials (ERPs) for communication and control. This study investigated whether the performance of an ERP-based auditory BCI can be further improved by increasing the mental efforts associated with the execution of the attention-related task. METHODS: Subjects mentally selected a target among a random sequence of spoken digits. Upon the detection of the target digit, the subjects were required to perform an active mental task (AMT) - mentally discriminating the gender property of the target voice. The total number of presented digits was manipulated to investigate possible influences of the number of choices. The subjects also participated in two control experiments, in which they were asked to (1) press a button to report their discrimination results or (2) simply count the appearance of the target digit without performing the AMT. RESULTS: Two ERP components, that is, a negative shift around 200 ms (Nd) over the fronto-central area and a positive deflection during 500-600 ms (late positive component, LPC) over the central-parietal area, were modulated by execution of the AMT. Compared to a counting task, the AMT resulted in paradigm-specific enhanced LPC responses. The latency of the LPC was significantly correlated with the behavioural reaction time, indicating that the LPC could originate from a response-related brain network similar to P3b. The AMT paradigm resulted in an increase of 4-6% in BCI classification accuracies, compared to a counting paradigm that was considered to represent the traditional auditory attention BCI paradigms (p < 0.05). In addition, the BCI classification accuracies were not significantly affected by the number of BCI choices in the AMT paradigm. CONCLUSIONS: (1) LPC was identified as the AMT-specific ERP component and (2) the performance of auditory BCIs can be improved from the human response side by introducing additional mental efforts when executing attention-related tasks. SIGNIFICANCE: The neurophysiological characteristics of the recently proposed auditory BCI paradigm using an AMT were explored. The results suggest the proposed paradigm as a candidate for improving the performance of auditory BCIs.

[Differences in peripheral blood gene expression profiles between liver and kidney transplantation recipients].

OBJECTIVE: To investigate the differences in the gene expression profiles of the peripheral blood immune cells between liver and kidney transplantation recipients. METHODS: A dataset containing the gene expression profiles of 27 liver transplantation recipients and 25 kidney transplantation recipients (from GSE22229 and GSE28842, respectively) was downloaded from the GEO database. By combining gene set enrichment analysis (GSEA) and biological network analysis of the differentially expressed genes using Cytoscape software, we analyzed the core genes closely related to liver or kidney transplantations. RESULTS: GSEA identified 20 highly overlapping genes for liver transplantation and another 20 for kidney transplantation using leading edge analysis. Fourteen hub nodes (gene) for liver transplantation and 13 for kidney transplantation were identified by cytoscape software using interaction network analysis. Five core genes related to liver transplantation and 5 to kidney transplantation were obtained by integrating GSEA and biological network analysis. CONCLUSION: Controlling the transcription and translation of the genes of the peripheral blood immune cells is the main immune regulation mechanism in liver transplantation recipients, but in the recipients of kidney transplantation, the protein interaction network plays a more prominent role. Energy metabolism and functional regulation of the immune cells are closely related. The core genes in peripheral blood immune cells related to liver or kidney transplantation may play key roles in regulating immune functions.

An N200 speller integrating the spatial profile for the detection of the non-control state.

The N200 speller is a recently developed non-flashing visual brain-computer interface (BCI) paradigm utilizing the overt attention modulation effects on motion-onset visual evoked potentials (mVEP). In this study, a novel algorithm is proposed and applied in an online N200 speller. The proposed algorithm integrates the spatial information of the speller matrix to provide a more precise description of the mVEP response patterns, which is defined as the 'spatial profile'. More importantly, only control state data are used in the algorithm to train a classifier that nonetheless can detect the non-control state effectively. Compared to an algorithm with similar structure but not using the spatial profile information, the proposed algorithm shows significantly higher performance for the recognition of the non-control state while achieving a comparable performance for classifying different control states. Offline and online classification results show that the proposed N200 speller is a promising step toward a practical, online non-flashing BCI system for daily use.

Integrating the spatial profile of the N200 speller for asynchronous brain-computer interfaces.

The N200 speller is a novel brain-computer interface (BCI) paradigm utilizing the overt attention effects on motion onset visual evoked potentials (mVEP). However, the asynchronous performance of the N200 BCI has not been fully explored. In this paper, a novel algorithm was proposed, integrating the spatial profile of the visual speller to provide a more precise description of the mVEP responses. Most importantly, only control state data were used in the algorithm to train a classifier which can detect the non-control state effectively. Using offline recorded data, the asynchronous performance of the proposed algorithm was shown to be significantly better than that of a similar algorithm without using the spatial information. The proposed algorithm can be used for developing a practical, asynchronous N200 BCI system.

One-dimensional spatial dark soliton-induced channel waveguides in lithium niobate crystal.

The anisotropic dependence of the formation of one-dimensional (1-D) spatial dark solitons on the orientation of intensity gradients in lithium niobate crystal is numerically specified. Based on this, we propose an approach to fabricate channel waveguides by employing 1-D spatial dark solitons. By exposure of two 1-D dark solitons with different orientations, channel waveguides can be created. The structures of the channel waveguides can be tuned by adjustment of the widths of the solitons and/or the angles between the two exposures. A square channel waveguide is experimentally demonstrated in an iron-doped lithium niobate crystal by exposure of two orthogonal 1-D dark solitons in sequence.