Connectivity of the insular subdivisions differentiates posttraumatic headache-associated from nonheadache-associated mild traumatic brain injury: an arterial spin labelling study.

OBJECTIVE: The insula is an important part of the posttraumatic headache (PTH) attributed to mild traumatic brain injury (mTBI) neuropathological activity pattern. It is composed of functionally different subdivisions and each of which plays different role in PTH neuropathology. METHODS: Ninety-four mTBI patients were included in this study. Based on perfusion imaging data obtained from arterial spin labelling (ASL) perfusion magnetic resonance imaging (MRI), this study evaluated the insular subregion perfusion-based functional connectivity (FC) and its correlation with clinical characteristic parameters in patients with PTH after mTBI and non-headache mTBI patients. RESULTS: The insular subregions of mTBI + PTH (mTBI patients with PTH) and mTBI-PTH (mTBI patients without PTH) group had positive perfusion-based functional connections with other insular nuclei and adjacent discrete cortical regions. Compared with mTBI-PTH group, significantly increased resting-state perfusion-based FC between the anterior insula (AI) and middle cingulate cortex (MCC)/Rolandic operculum (ROL), between posterior insula (PI) and supplementary motor area (SMA), and decreased perfusion-based FC between PI and thalamus were found in mTBI + PTH group. Changes in the perfusion-based FC of the left posterior insula/dorsal anterior insula with the thalamus/MCC were significant correlated with headache characteristics. CONCLUSIONS: Our findings provide new ASL-based evidence for changes in the perfusion-based FC of the insular subregion in PTH patients attributed to mTBI and the association with headache features, revealing the possibility of potential neuroplasticity after PTH. These findings may contribute to early diagnosis of the disease and follow-up of disease progression.

The willingness to continue using wearable devices among the elderly: SEM and FsQCA analysis.

BACKGROUND: With population aging and the scarcity of resources for elderly individuals, wearable devices pose opportunities and challenges for elderly care institutions. However, few studies have examined the effects of technical characteristics, personal characteristics, and health promotion on the willingness of elderly individuals to continue using wearable devices. OBJECTIVE: This study explored the effects of technical characteristics and personal characteristics on the willingness of elderly individuals to continue using wearable devices through health promotion, drawing on the technology acceptance model and the value attitude behaviour model. METHODS: We obtained 265 valid samples through questionnaire surveys and used structural equation modelling (SEM) and fuzzy set qualitative comparative analysis (FsQCA) to clarify the complex causal patterns of elderly people's willingness to continue using wearable devices. RESULTS: The SEM results showed that perceived usefulness, perceived reliability, self-perceived ageing, and health promotion affected willingness to continue using wearable devices. However, perceived ease of use had no effect. FsQCA showed that elderly individuals are highly willing to continue using wearable devices, yielding five solutions. Perceived ageing was essential in four of these solutions. The impact of perceived ease of use on continued use intention was dynamic and complex. CONCLUSIONS: This study used two methods to provide insight into the willingness of elderly individuals to continue using wearable devices. In addition, this study discussed associated implications, limitations, and future research directions.

Clinical validation of an AI-based motion correction reconstruction algorithm in cerebral CT.

OBJECTIVES: To evaluate the clinical performance of an artificial intelligence (AI)-based motion correction (MC) reconstruction algorithm for cerebral CT. METHODS: A total of 53 cases, where motion artifacts were found in the first scan so that an immediate rescan was taken, were retrospectively enrolled. While the rescanned images were reconstructed with a hybrid iterative reconstruction (IR) algorithm (reference group), images of the first scan were reconstructed with both the hybrid IR (motion group) and the MC algorithm (MC group). Image quality was compared in terms of standard deviation (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), the mean squared error (MSE), peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), and mutual information (MI), as well as subjective scores. The diagnostic performance for each case was evaluated accordingly by lesion detectability or the Alberta Stroke Program Early CT Score (ASPECTS) assessment. RESULTS: Compared with the motion group, the SNR and CNR of the MC group were significantly increased. The MSE, PSNR, SSIM, and MI with respect to the reference group were improved by 44.1%, 15.8%, 7.4%, and 18.3%, respectively (all p < 0.001). Subjective image quality indicators were scored higher for the MC than the motion group (p < 0.05). Improved lesion detectability and higher AUC (0.817 vs 0.614) in the ASPECTS assessment were found for the MC to the motion group. CONCLUSIONS: The AI-based MC reconstruction algorithm has been clinically validated for reducing motion artifacts and improving diagnostic performance of cerebral CT. KEY POINTS: • An artificial intelligence-based motion correction (MC) reconstruction algorithm has been clinically validated in both qualitative and quantitative manner. • The MC algorithm reduces motion artifacts in cerebral CT and increases the diagnostic confidence for brain lesions. • The MC algorithm can help avoiding rescans caused by motion and improving the efficiency of cerebral CT in the emergency department.

Association of artificial intelligence use and the retention of elderly caregivers: A cross-sectional study based on empowerment theory.

AIM: The purpose of this study is to investigate how the use of artificial intelligence is associated with the retention of elderly caregivers. BACKGROUND: The turnover of elderly caregivers is high and increasing. Elderly care institutions are beginning to use artificial intelligence to support caregivers in their work, and the use of technology is critical to staff retention. Empowerment of elderly caregivers has been neglected by managers and researchers. METHODS: This cross-sectional study involved 511 elderly caregivers in 25 elderly institutions. Six validated standardized scales were used for data collection, and the software SPSS and SmartPLS were used for data analysis. RESULTS: The quality of artificial intelligence has a significant positive effect on empowerment. Artificial intelligence psychological empowerment (ß = .355, p < .001) and artificial intelligence structural empowerment (ß = .375, p < .001) both had positive effects on retention intention, and the jointly explained variance (R2 ) was 42.6%. CONCLUSIONS: The results show that a significant relationship exists between artificial intelligence empowerment and retention intention. Elderly caregivers with more structural empowerment have higher retention intention. IMPLICATIONS FOR NURSING MANAGEMENT: Artificial intelligence suppliers need to pay attention to the role of product quality in elderly care services, continuously improve artificial intelligence quality, and strengthen the application and routine maintenance of artificial intelligence technologies. Elderly care institution managers should pay special attention to artificial intelligence structural empowerment (such as artificial intelligence-related education and training, learning and development opportunities, and resource support).

Altered static and dynamic functional network connectivity in post-traumatic headache.

BACKGROUND: Post-traumatic headache (PTH) is a very common symptom following mild traumatic brain injury (mTBI), yet much remains unknown about the underlying pathophysiological mechanisms of PTH. Neuroimaging studies suggest that aberrant functional network connectivity (FNC) may be an important factor in pain disorders. The present study aimed to investigate the functional characteristics of static FNC (sFNC) and dynamic FNC (dFNC) in mTBI patients with PTH. METHODS: With Institutional Review Board (IRB) approval, we prospectively recruited 50 mTBI patients with PTH, who were diagnosed with ICHD-3 beta diagnostic criteria and 39 mTBI without PTH who were well matched for age, gender and education. Resting-state functional magnetic resonance imaging (fMRI) scanning (3.0 T, Philips Medical Systems, Netherlands), Montreal Cognitive Assessment (MoCA) and headache symptom measurement (headache frequency and headache intensity) were performed. The resting-state fMRI sequence took 8 min and 10 s. Independent component analysis and sliding window method were applied to examine the FNC on the basis of nine resting-state networks, namely, default mode network (DMN), sensorimotor network (SMN), executive control network (ECN), auditory network (AuN), attention network (AN), salience network (SN), visual network (VN), and cerebellum network (CN). The differences in sFNC and dFNC were determined and correlated with clinical variables using Pearson rank correlation. RESULTS: For sFNC, compared with mTBI patients without PTH, mTB with PTH group showed four altered interactions, including decreased interactions in SN-SMN and VN-DMN pairs, increased sFNC in SN-ECN and SMN-DMN pairs. For dFNC, significant group differences were found in State 2, including increased connectivity alteration in the DMN with CN, DMN with SMN, and AuN with CN. Significant reduced connectivity changes in the DMN with VN was found in State 4. Furthermore, the number of transitions (r=0.394, p=0.005) between states was positively associated with headache frequency. Additionally, dwell time (r=-0.320, p=0.025) in State 1 was negatively correlated with MoCA score. CONCLUSIONS: MTBI patients with PTH are characterized with altered sFNC and dFNC, which could provide new perspective to understand the neuropathological mechanism underlying the PTH to determine more appropriate management, and may be a useful imaging biomarker for identifying and predicting mTBI with PTH.

Cerebral Blood Flow and Its Connectivity Deficits in Mild Traumatic Brain Injury at the Acute Stage.

Objective: The influence of cognitive impairment after mild traumatic brain injury (mTBI) on cerebral vascular perfusion has been widely concerned, yet the resting-state cerebral blood flow (CBF) connectivity alterations based on arterial spin labeling (ASL) in mild traumatic brain injury (mTBI) remain unclear. This study investigated region CBF and CBF connectivity features in acute mTBI patients, as well as the associations between CBF changes and cognitive impairment. Materials and Methods: Forty-five acute mTBI patients and 42 health controls underwent pseudocontinuous arterial spin labeling (pCASL) perfusion magnetic resonance imaging (MRI). The alterations in regional CBF and relationship between the CBF changes and cognitive impairment were detected. The ASL-CBF connectivity of the brain regions with regional CBF significant differences was also compared between two groups. Neuropsychological tests covered seven cognitive domains. Associations between the CBF changes and cognitive impairment were further investigated. Results: Compared with the healthy controls, the acute mTBI patients exhibited increased CBF in the bilateral inferior temporal gyrus (ITG) and decreased CBF in the right middle frontal gyrus (MFG), the bilateral superior frontal gyrus (SFG), and the right cerebellum posterior lobe (CPL). In the mTBI patients, significant correlations were identified between the CBF changes and cognitive impairment. Importantly, the acute mTBI patients exhibited CBF disconnections between the right CPL and right fusiform gyrus (FG) as well as bilateral ITG, between the left SFG and left middle occipital gyrus (MOG), and between the right SFG and right FG as well as right parahippocampal gyrus. Conclusion: Our results suggest that acute mTBI patients exhibit both regional CBF abnormalities and CBF connectivity deficits, which may underlie the cognitive impairment of the acute mTBI patients.

Natural indole-containing alkaloids and their antibacterial activities.

As the growth in resistance to bacterial infection treatments poses a grave threat to global health in the 21st century, there is a constant need to explore novel antibacterial agents that have the ability to overcome drug resistance. Indole-containing alkaloids are widely distributed in nature, and a variety of indole-containing alkaloids have already been applied in clinical practice, proving that indole-containing alkaloids are fascinating and privileged scaffolds for the development of novel drugs. Moreover, indole-containing alkaloids could exert their antibacterial activity through the inhibition of efflux pumps, the biofilm, filamentous temperature-sensitive protein Z, and methicillin-resistant Staphylococcus aureus pyruvate kinase; so, indole-containing alkaloids constitute an important source of novel antibacterial agents. This review is an endeavor to highlight the advances in the development of indole-containing alkaloids with antibacterial potential, covering articles published in the recent 10 years.

Altered hypothalamic functional connectivity in post-traumatic headache after mild traumatic brain injury.

BACKGROUND: Post-traumatic headache (PTH) is one of the most frequent symptoms following mild traumatic brain injury (mTBI). Neuroimaging studies implicate hypothalamic function connectivity (FC) disruption as an important factor in pain disorders. However, it is unknown whether there are alterations in the hypothalamus-based resting state FC within PTH following mTBI at the acute stage and its relationship with headache symptom measurement. METHODS: Forty-four mTBI patients with PTH, 27 mTBI patients without PTH and 43 healthy controls who were well matched for age, gender, and years of education were enrolled in this study. All participants underwent resting-state functional magnetic resonance imaging (fMRI) scanning as well as headache symptom measurement and cognitive assessment. Hypothalamic resting state networks were characterized by using a standard seed-based whole-brain correlation method. The bilateral hypothalamic FC was compared among the three groups. Furthermore, the correlations between hypothalamic resting state networks and headache frequency, headache intensity and MoCA scores was investigated in mTBI patients with PTH using Pearson rank correlation. RESULTS: Compared with mTBI patients without PTH, mTBI patients with PTH at the acute stage presented significantly decreased left hypothalamus-based FC with the right middle frontal gyrus (MFG) and right medial superior frontal gyrus (mSFG), and significantly decreased right hypothalamus-based FC with the right MFG. Decreased FC of the right MFG was significantly positively associated with headache frequency and headache intensity (r = 0.339, p = 0.024; r = 0.408, p = 0.006, respectively). Decreased FC of the right mSFG was significantly positively associated with headache frequency and headache intensity (r = 0.740, p < 0.0001; r = 0.655, p < 0.0001, respectively). CONCLUSION: Our data provided evidence of disrupted hypothalamic FC in patients with acute mTBI with PTH, while abnormal FC significantly correlated with headache symptom measurement. Taken together, these changes may play an essential role in the neuropathological mechanism of mTBI patients with PTH.

Enrichment of oral microbiota in early cystic precursors to invasive pancreatic cancer.

OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can progress to invasive pancreatic cancer. Associations between oncogenesis and oral microbiome alterations have been reported. This study aims to investigate a potential intracystic pancreatic microbiome in a pancreatic cystic neoplasm (PCN) surgery patient cohort. DESIGN: Paired cyst fluid and plasma were collected at pancreatic surgery from patients with suspected PCN (n=105). Quantitative and qualitative assessment of bacterial DNA by qPCR, PacBio sequencing (n=35), and interleukin (IL)-1ß quantification was performed. The data were correlated to diagnosis, lesion severity and clinical and laboratory profile, including proton-pump inhibitor (PPI) usage and history of invasive endoscopy procedures. RESULTS: Intracystic bacterial 16S DNA copy number and IL-1ß protein quantity were significantly higher in IPMN with high-grade dysplasia and IPMN with cancer compared with non-IPMN PCNs. Despite high interpersonal variation of intracystic microbiota composition, bacterial network and linear discriminant analysis effect size analyses demonstrated co-occurrence and enrichment of oral bacterial taxa including Fusobacterium nucleatum and Granulicatella adiacens in cyst fluid from IPMN with high-grade dysplasia. The elevated intracystic bacterial DNA is associated with, but not limited to, prior exposure to invasive endoscopic procedures, and is independent from use of PPI and antibiotics. CONCLUSIONS: Collectively, these findings warrant further investigation into the role of oral bacteria in cystic precursors to pancreatic cancer and have added values on the aetiopathology as well as the management of pancreatic cysts.

A preliminary report: genistein attenuates cerebral ischemia injury in ovariectomized rats via regulation of the PI3K-Akt-mTOR pathway.

Stroke is a leading cause of disability and death in the worldwide. Therefore, prevention of stroke is critically important. Genistein, a natural phytoestrogen extracted from soybeans, has been found to be a potential neuroprotective agent for stroke prevention. However, the role of genistein and its underlying mechanism in ovariectomized rats has been rarely evaluated. In this study, ovariectomized rats were treated with genistein (10 mg/kg) or vehicle daily for two weeks before they received middle cerebral artery occlusion (MCAO) and reperfusion. Seventy-two hours after reperfusion, the neurological function was evaluated by Garcia test, infarct volumes were detected by 2,3,5-triphenyltetrazolium chloride staining; and neuronal damage and cell apoptosis were detected by Nissl and Tunel staining in the ischemic penumbra, respectively. In addition, Western blotting was used to detect the activity of PI3K-Akt-mTOR signal pathway in the ischemic penumbra in different groups. And we found that genistein treatment in ovariectomized rats significantly improved neurological outcomes, reduced infarct volumes, decreased neuronal damage and cell apoptosis, and increased the activity of PI3K-Akt-mTOR signal pathway. Our findings indicated that treatment genistein could alleviate neuronal apoptosis induced by cerebral ischemia in ovariectomized rats via promoting the activity of PI3K-Akt-mTOR signal pathway, which provides a new molecular mechanism for the neuroprotective effects of genistein against stroke.

Incidental extracerebral findings on brain nonenhanced magnetic resonance imaging: frequency, nondetection rate, and clinical importance.

PURPOSE: This study aims to elucidate the frequency, nondetection rate, and clinical importance of incidental extracerebral findings (IECFs) on brain nonenhanced magnetic resonance imaging (MRI). METHODS: A total of 8284 brain MRIs performed between January 1, 2015 and December 31, 2015 were evaluated for the presence of IECFs and the distribution of IECFs was analyzed. IECFs were categorized as E1 (clinically unimportant, e.g., sinus mucosal thickening); E2 (likely unimportant, e.g., pharyngeal mucosal symmetrical thickening); and E3 (potentially important, e.g., pharyngeal mucosal asymmetrical thickening). The nondetection rate was determined by comparing the results of the structured approach with the initial MRI reports. The medical records were examined for patients with E3 IECFs to assess clinical importance and outcome of these lesions. RESULTS: A total of 5992 IECFs were found in 4469 of the 8284 patients (54.0%). E1 findings constituted 82.2% (4924/5992) of all IECFs; E2 constituted 16.6% (995/5992) and E3 constituted 1.2% (73/5992). Overall IECFs and E1 findings were significantly more common in male patients (P < 0.05). Statistically significant difference was also seen between the different age groups (P < 0.001). The nondetection rate was 56.9% (3409/5992) for overall IECFs and 32.9% (24/73) for E3 IECFs. Of the 73 patients with E3 IECFs, 34 (46.6%) received final diagnosis and appropriate treatment during the study period. CONCLUSIONS: IECFs are prevalent in clinical patients on brain MR images with a nondetection rate of 32.9% for potentially important (E3) findings. The reporting of IECFs according to clinical importance is helpful for patients' management.

Combined Counterclockwise Maxillomandibular Advancement and Uvulopalatopharyngoplasty Surgeries for Severe Obstructive Sleep Apnea.

As the most effective surgical technique maxillomandibular advancement (MMA) has been used to treat severe obstructive sleep apnea (OSA) in adults, particularly for those who are intolerant of continuous positive airway pressure. Yet for large-scale advancement, it is faced with esthetic problems with marked skeletal protrusion especially for people with convex facial profile. In this study, the authors performed counterclockwise MMA combined with quantified uvulopalatopharyngoplasty (UPPP) surgeries on Chinese adult patients with severe OSA, in order to initially explore the efficacy of these procedures on Chinese populations and provide evidence for esthetic advantages. As the primary procedure counterclockwise MMA was applied on 10 patients, achieving a forward distance of the mandible and the maxilla for 10.6 and 6.7 mm, respectively, and the occlusion plane rotated counterclockwise of 6.2°. After a follow-up of beyond 12 months, polysomnography results showed the apnea-hypopnea index (AHI) significantly decreased from 64.3 to 11.0 per hour, achieving surgical success of 90%. Upper airway measurements demonstrated that the retropalatal and retrolingual spaces got enlarged greatly, resulting in significant AHI reduction and oxygen saturation elevation. More importantly, cephalometric analysis revealed that SNA and SNB were enlarged but in well control without visual abnormalities. Follow-up results showed large-scale advancement of the maxilla and mandible were stable in treating severe OSA. Quantified UPPP surgeries guaranteed no functional insufficiency in pronouncing and swallowing and played auxiliary role in enlarging the upper airway. Thus, procedures of counterclockwise MMA combined with quantified UPPP surgeries might find more application especially in patients with severe OSA with convex facial profile in future.

SIRT2 inhibition exacerbates neuroinflammation and blood-brain barrier disruption in experimental traumatic brain injury by enhancing NF-κB p65 acetylation and activation.

Sirtuin 2 (SIRT2) is a member of the sirtuin family of NAD(+) -dependent protein deacetylases. In recent years, SIRT2 inhibition has emerged as a promising treatment for neurodegenerative diseases. However, to date, there is no evidence of a specific role for SIRT2 in traumatic brain injury (TBI). We investigated the effects of SIRT2 inhibition on experimental TBI using the controlled cortical impact (CCI) injury model. Adult male mice underwent CCI or sham surgery. A selective brain-permeable SIRT2 inhibitor, AK-7, was administrated 30 min before injury. The volume of the brain edema lesion and the water content of the brain were significantly increased in mice treated with AK-7 (20 mg/kg), compared with the vehicle group, following TBI (p < 0.05 at 1 day and p < 0.05 at 3 days, respectively). Concomitantly, AK-7 administration greatly worsened neurobehavioral deficits on days 3 and 7 after CCI. Furthermore, blood-brain barrier disruption and matrix metalloproteinases (MMP)-9 activity increased following SIRT2 inhibition. AK-7 treatment increased TBI-induced microglial activation both in vivo and in vitro, accompanied by a large increase in the expression and release of inflammatory cytokines. Mechanistically, SIRT2 inhibition increased both K310 acetylation and nuclear translocation of NF-κB p65, leading to enhanced NF-κB activation and up-regulation of its target genes, including aquaporin 4 (AQP4), MMP-9, and pro-inflammatory cytokines. Together, these data demonstrate that SIRT2 inhibition exacerbates TBI by increasing NF-κB p65 acetylation and activation. Our findings provide additional evidence of an anti-inflammatory effect of SIRT2. SIRT2 is a member of the sirtuin family of NAD+-dependent protein deacetylases. Our study suggests that the SIRT2 inhibitor AK-7 exacerbates traumatic brain injury (TBI) via a potential mechanism involving increased acetylation and nuclear translocation of NF-κB p65, resulting in up-regulation of NF-κB target genes, including aquaporin 4 (AQP4), matrix metalloproteinase 9 (MMP-9), and pro-inflammatory cytokines. Our findings provide additional evidence of an anti-inflammatory effect of SIRT2.

Individualized therapy for treating obstructive sleep apnea in pediatric Crouzon syndrome patients.

PURPOSE: Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA. METHODS: In this paper, we have introduced four Crouzon syndrome children of different severity in suffering from OSA and maxillofacial deformities. Detailed information was given including clinical manifestations, radiological findings, and polysomnography detections. Based on the above findings, different but effective treatment options for these children's OSA problems were adopted, either by surgeries including distraction osteogenesis and craniomaxillofacial surgeries with or without tonsillectomy or by noninvasive continuous positive airway pressure (CPAP) therapy. RESULTS: Follow-up studies for more than 1 year showed problems of OSA and nocturnal hypoxia of those four patients were all alleviated greatly, as well as maxillofacial deformities. Combined with pre-operative and post-operative orthodontics, one patient also got optimal results in better facial profile and dental occlusion. CONCLUSION: Thus, based on adequate clinical evaluations and patients' conditions including age, disease severity, and esthetic considerations, individualized therapy should be made and performed carefully to obtain optimized results in treating OSA for pediatric Crouzon syndrome patients.

Effect of storage temperature on the viability of human periodontal ligament fibroblasts.

BACKGROUND: The viability of periodontal ligament fibroblasts (PDLF) can affect the long-term prognosis of replanted avulsed teeth. When immediate replantation of an avulsed tooth is not possible, the cells should be incubated in a physiological storage medium instantly to maintain their biological activity. The ability of different storage media to preserve PDLF viability has been previously evaluated. However, few studies have showed the effect of temperature on the viability of PDLF cultured with various storage media in vitro. MATERIAL AND METHODS: This study was designed to measure PDLF activity by CCK-8 assay to compare the effectiveness at 4, 22 (room temperature), and 37°C under various storage media. RESULTS: Statistical analysis demonstrated that tap water, saline, and saliva decreased cell viability as the storage temperature increased. But the temperature played only a minor role on cell viability when cells were incubated in Hank's balanced salt solution (HBSS), Dubelco's modified Eagle's medium (DMEM), or milk. CONCLUSIONS: Within the parameters of this study, it seems that room temperature is adequate for storing the avulsed teeth in HBSS, DMEM, or milk in the extra-alveolar period.

Emerging MRI and metabolic neuroimaging techniques in mild traumatic brain injury.

Traumatic brain injury (TBI) is one of the leading causes of death worldwide, and mild traumatic brain injury (mTBI) is the most common traumatic injury. It is difficult to detect mTBI using a routine neuroimaging. Advanced techniques with greater sensitivity and specificity for the diagnosis and treatment of mTBI are required. The aim of this review is to offer an overview of various emerging neuroimaging methodologies that can solve the clinical health problems associated with mTBI. Important findings and improvements in neuroimaging that hold value for better detection, characterization and monitoring of objective brain injuries in patients with mTBI are presented. Conventional computed tomography (CT) and magnetic resonance imaging (MRI) are not very efficient for visualizing mTBI. Moreover, techniques such as diffusion tensor imaging, magnetization transfer imaging, susceptibility-weighted imaging, functional MRI, single photon emission computed tomography, positron emission tomography and magnetic resonance spectroscopy imaging were found to be useful for mTBI imaging.

Aberrant dynamic properties of whole-brain functional connectivity in acute mild traumatic brain injury revealed by hidden Markov models.

OBJECTIVES: This study aimed to investigate the temporal dynamics of brain activity and characterize the spatiotemporal specificity of transitions and large-scale networks on short timescales in acute mild traumatic brain injury (mTBI) patients and those with cognitive impairment in detail. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI) was acquired for 71 acute mTBI patients and 57 age-, sex-, and education-matched healthy controls (HCs). A hidden Markov model (HMM) analysis of rs-fMRI data was conducted to identify brain states that recurred over time and to assess the dynamic patterns of activation states that characterized acute mTBI patients and those with cognitive impairment. The dynamic parameters (fractional occupancy, lifetime, interval time, switching rate, and probability) between groups and their correlation with cognitive performance were analyzed. RESULTS: Twelve HMM states were identified in this study. Compared with HCs, acute mTBI patients and those with cognitive impairment exhibited distinct changes in dynamics, including fractional occupancy, lifetime, and interval time. Furthermore, the switching rate and probability across HMM states were significantly different between acute mTBI patients and patients with cognitive impairment (all p < 0.05). The temporal reconfiguration of states in acute mTBI patients and those with cognitive impairment was associated with several brain networks (including the high-order cognition network [DMN], subcortical network [SUB], and sensory and motor network [SMN]). CONCLUSIONS: Hidden Markov models provide additional information on the dynamic activity of brain networks in patients with acute mTBI and those with cognitive impairment. Our results suggest that brain network dynamics determined by the HMM could reinforce the understanding of the neuropathological mechanisms of acute mTBI patients and those with cognitive impairment.

Comparative transcriptome analyses reveal regulatory network and hub genes of aluminum response in roots of elephant grass (Cenchrus purpureus).

Aluminum (Al) toxicity severely restricts the growth and productivity of elephant grass in acidic soils around the world. However, the molecular mechanisms of Al response have not been investigated in elephant grass. In this study, we conducted phenotype, physiology, and transcriptome analysis of elephant grass roots in response to Al stress. Phenotypic analysis revealed that a low concentration of Al stress improved root growth while higher Al concentrations inhibit root growth. Al stress significantly increased the citrate (CA) content in roots, while the expression levels of genes related to citrate synthesis were substantially changed. The multidrug and toxic compound extrusion (MATE) family were identified as hub genes in the co-expression network of Al response in elephant grass roots. Phylogenetic analysis showed that hub genes CpMATE93 and CpMATE158 belonged to the same clade as other MATE genes reported to be involved in citrate transport. Additionally, overexpression of CpMATE93 conferred Al resistance in yeast cells. These results provide a theoretical basis for further studies of molecular mechanisms in the elephant grass response to Al stress and could help breeders develop elite cultivars with Al tolerance.

Overexpression of P5CDH from Cleistogenes songorica improves alfalfa growth performance under field drought conditions.

Water stress affects the metabolic regulation and delays the growth and development of alfalfa, causing a reduction in biomass. New alfalfa germplasm was created with improved drought tolerance in greenhouse conditions by introducing the key gene P5CDH1 from C. songorica, a xerophytic grass. However, the field adaptability and response mechanism of new drought-tolerant alfalfa germplasms under water stress are still unclear. In the present study, the yield and quality traits of transgenic CsP5CDH1 alfalfa lines under water stress and normal irrigation conditions were measured and analyzed for two years. The genetic variance components of the tested traits were calculated from the data fitted by the mixed linear model. The plant height of all lines showed significant genotypic variation (σ2g) (P < 0.05), and the stem diameter, stem number, and dry weight of all lines had a significant genotype × environment interaction (σ2ge) (P < 0.05). The heritability (H) of plant height, stem diameter, stem number, dry weight and leaf-to-stem ratio of alfalfa lines were 0.87, 0.52, 0.59, 0.52 and 0.50, respectively. There were significant genotype × environment interactions (σ2ge) (P < 0.05) for the quality traits of all lines. The heritabilities (H) of acid detergent fiber and neutral detergent fiber were 0.65 and 0.64, respectively. The results of transcriptional expression analysis with RNA-seq showed that the genes MsProDH1, MsProDH4, MsProDH5, MsP5CDH1, MsP5CS5, MsP5CS9, and MsP5CR1, which are involved in the proline metabolism pathway, played an important role in the drought tolerance of innovative alfalfa germplasm. Under water stress, with the regulation of key genes in the proline metabolism pathway, the proline content of all alfalfa lines increased to varying degrees. Among them, the proline content in the shoots and roots of transgenic line L6 was 7.29 times and 12.22 times that under normal irrigation conditions, respectively. The present study helped to clarify that the new germplasm of alfalfa transformed with the CsP5CDH gene synthesized a large amount of proline under water stress, and effectively slowed leaf water loss, thus improving the drought resistance of alfalfa.

Porphyromonas gingivalis as a promotor in the development of the alcoholic liver disease via ferroptosis.

Alcoholic liver disease (ALD) is a liver disease caused by heavy drinking. Porphyromonas gingivalis (P.g), a major cause of periodontitis, whose antibodies are elevated in severe ALD patients in the plasma. The purpose of this study is to further study the role and the molecular mechanism of P.g in the progress of ALD. In this study, saliva of patients with ALD was collected. Then, an animal model of ALD with oral P.g administration was established, pathology of liver and spleen, intestinal microorganisms and metabolites were analyzed. The molecular mechanism of P.g on ALD was analyzed in vitro. ALD and intestinal microflora and metabolite changes were observed more serious in the alcohol and P.g groups than the alcohol group. Moreover, ferroptosis was aggravated by P.g in the liver. Meanwhile, P.g promoted ferroptosis accomplication with alcohol in vitro, which can be reversed by ferroptosis inhibitors. In conclusion, P.g aggravates ALD through exacerbation gut microbial metabolic disorder in mice with alcohol, which maybe depend on ferroptosis activation in hepatocytes. The study provides a new strategy for prevention and treatment of ALD by improving the oral micro-environment.