Factors associated with the disease family burden of caregivers of myasthenia gravis patients in northwestern China: A cross-sectional study

BACKGROUND

Patients with myasthenia gravis (MG) lose part of their working or living ability due to illness, and bring burden to caregivers. The purpose of this study was to explore the factors related to caregivers' disease family burden for MG patients in Northwest China.

METHODS

The study utilized our Myasthenia Gravis database and distributed online questionnaires to both MG patients and their caregivers. The questionnaires included a general data collection form, the Patient Health Questionnaire-9 (PHQ-9) scale, and the Caregivers' Family Burden Scale of Disease (FBSD). Univariate analysis and multivariate linear regression analysis were run, with FBSD as the outcome variable for separate analyses.

RESULTS

178 MG patients were eligible for inclusion in the analysis, of whom 80 patients' caregivers had a positive family burden of MG. The daily activity burden of the family and the economic burden of the family were the heaviest among the six dimensions of the caregivers' family disease burdens. The factors independently associated with FBSD were depression symptom level, MG severity classification and family's monthly per capita income (p < 0.05).

CONCLUSIONS

Depression symptom level, MG severity classification and family's monthly per capita income are independent factors related to the caregivers' disease family burden for MG patients.

Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study

Background

The safety of COVID-19 vaccines has been clarified in clinical trials; however, some immunocompromised patients, such as myasthenia gravis (MG) patients, are still hesitant to receive vaccines. Whether COVID-19 vaccination increases the risk of disease worsening in these patients remains unknown. This study aims to evaluate the risk of disease exacerbation in COVID-19-vaccinated MG patients.

Methods

The data in this study were collected from the MG database at Tangdu Hospital, the Fourth Military Medical University, and the Tertiary Referral Diagnostic Center at Huashan Hospital, Fudan University, from 1 April 2022 to 31 October 2022. A self-controlled case series method was applied, and the incidence rate ratios were calculated in the prespecified risk period using conditional Poisson regression.

Results

Inactivated COVID-19 vaccines did not increase the risk of disease exacerbation in MG patients with stable disease status. A few patients experienced transient disease worsening, but the symptoms were mild. It is noted that more attention should be paid to thymoma-related MG, especially within 1 week after COVID-19 vaccination.

Conclusion

COVID-19 vaccination has no long-term impact on MG relapse.

Hypoxia inducible factor-3α promotes osteosarcoma progression by activating KDM3A-mediated demethylation of SOX9

Hypoxia/oxygen-sensing signally is closely associated with many tumor progressions, including osteosarcoma (OS). Previous research principally focused on the function of hypoxia-inducible factor (HIF)-1α and HIF-2α as the major hypoxia-associated transcription factors in OS, however, the role of HIF-3α has not been investigated. Our study found that HIF-3α was upregulated in OS tissues and cell lines. HIF-3α overexpression facilitated cell proliferation and invasion, and inhibited apoptosis, whereas HIF-3α knockdown showed the opposite results. Chromatin immunoprecipitation analysis revealed that lysine demethylase 3A (KDM3A) expression was transcriptionally activated by HIF-3α under hypoxia, and KDM3A occupied the SRY-box transcription factor 9 (SOX9) gene promoter region through H3 lysine 9 dimethylation (H3K9me2). Additionally, rescue results revealed that KDM3A or SOX9 overexpression reversed the effects of HIF-3α silence on cell functions. The Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) pathway inhibitor cucurbitacin I suppressed the promotive effects of HIF-3α overexpression on cell proliferation, invasion and TAK2/STAT3 pathway. Finally, OS cell line MG-63 transfected with HIF-3α short hairpin RNA (HIF-3α shRNA) were subcutaneously injected into nude mice, and the results found that HIF-3α knockdown significantly inhibited the xenograft tumor growth of OS in vivo. In conclusion, this study reveals that HIF-3α promotes OS progression in vitro and in vivo by activating KDM3A-mediated SOX9 promoter demethylation, which may provide a potential therapeutic mechanism for OS.

[Clinical characteristics of congenital nephrogenic diabetes insipidus]

The purpose of this study was to improve the ability to visualize and diagnose congenital nephrogenic diabetes insipidus (CNDI). The clinical manifestations, laboratory examination findings, imaging features and treatment outcomes of 22 patients with CNDI admitted to the First Affiliated Hospital of Zhengzhou University from May 2013 to May 2020 were retrospectively analyzed. Among the 22 patients with CNDI, 86.4% (19 cases) were male. The age of the 22 patients ranged from 2 months to 47 years old, in which 20 cases were younger than 30 years old and 2 cases were older than 30 years old. The clinical manifestations were polydipsia and polyuria, accompanied with various degrees of fever, defects in growth and development, and increased serum creatinine in some patients. Fifteen patients (68.2%) had different degrees of bilateral kidney and ureteral hydronephrosis, and increased residual urine volume in the bladder. Pituitary magnetic resonance imaging (MRI) enhanced scan showed that the high signal intensity in the posterior pituitary lobe was not detectable in 5 cases (22.7%), and blurred in 6 cases (27.3%). Seven tested patients were all found AVPR2 gene mutation. For patients with suspected CNDI, water-inhibiting vasopressin test and genetic testing should be performed in time so as to confirm diagnosis and treat as early as possible.

Raman spectroscopic study of frustrated ferroelectric phase in hydroxyl salts Co2(OH)3Br/Co2(OD)3Br

We report on an investigation of the temperature-dependent ordering of the hydrogen/deuterium atoms in geometrically frustrated magnets Co₂(OH)₃Br and its deuterated Co₂(OD)₃Br, to shed light on the origin of the newly-identified ferroelectricity using Raman spectroscopy. Significant changes in the Raman frequencies and line-widths of the Raman-active modes were observed below ∼260 K in Co₂(OD)₃Br and ∼240 K in Co₂(OH)₃Br, respectively, the analysis of which revealed strong spin-phonon couplings in this system. Further, for Co₂(OD)₃Br, six new phonon bands appeared below around 260 K, with the corresponding intensities obeying a power-law equationI∝1-T/Tc2βwhereinT_c= 260 K, suggesting that an ordering process occurred below ∼260 K. The ordering process subsequently affected the local structure and brought out the reported ferroelectric phase, which is considered as frustrated. Meanwhile, in Co₂(OH)₃Br, only one new band was observed below ∼240 K, followed by two 'softened' modes correlated to the [OH] sub-lattice below ∼185 K, wherein an incomplete ordering was suggested. The present work reveals a new multiferroic system combining geometrically frustrated magnetism and deuterium ordering-type ferroelectricity.

Depiction of carbohydrate-active enzyme diversity in Caldicellulosiruptor sp. F32 at the genome level reveals insights into distinct polysaccharide degradation features

Diverse and distinctive encoding sequences of CAZyme in the genome of Caldicellulosiruptor sp. F32 enable the deconstruction of unpretreated lignocellulose.

Raman spectroscopic study of the frustrated spin 1/2 antiferromagnet clinoatacamite

Raman spectroscopy is a valuable and complementary tool for studying geometrically frustrated magnetic systems due to the intrinsic spin-phonon coupling. Here, we report on a Raman spectroscopic study of the geometrically frustrated spin 1/2 antiferromagnet microcrystalline clinoatacamite Cu2(OH)3Cl, focusing on the anomalous transition into the intermediate phase at T(c1) = 18.1 K. By measuring the temperature-dependent (295-4 K) full spectral profiles and main representative modes in spectral regions from 4000 to 95 cm(-1), we observed probable signatures of successive magnetic transitions near T(c1) = 18 K and T(c2) = 6.4 K in the Raman band frequencies and peak widths of the representative modes. Further, we observed a pronounced Raman spectroscopy background featuring a broad continuum at all temperatures. A quantitative analysis reveals that spin fluctuations may exist on a picosecond time scale in the intermediate phase. The short time scale falls out of the μSR time window; therefore, in the intermediate phase, the μSR study as reported in (2005 Phys. Rev. Lett. 95 057201) apparently only probed the local field of the ordered spins but overlooked the quickly fluctuating ones. This is likely to give a reasonable explanation of the fact that only a small entropy release occurs at T(c1) = 18 K although a long-range order is formed.

[Mid-infrared and Raman spectral analysis of geometrically frustrated natural atacamite]

At room temperature, the mid-infrared spectra of geometrically frustrated natural atacamite (hydroxyl copper chloride, beta-Cu2(OH)3Cl) in the range of 4 000-400 cm(-1) were measured by FTIR spectrometers, and meanwhile its Raman spectrum in the range of 4 000-95 cm(-1) was obtained by Jobin Yvon LabRAM HR800 Raman spectrometer. According to its crystal structure parameters, the authors confirmed the characteristic peaks of sample 4 000-2 500-1 000 cm(-1) in the functional group region and 1 000-550-200-95 cm(-1) in the fingerprint region, and also explored its microscopic origin Five distinct regions were assigned: the hydroxyl stretching vibration v(O-H) determined by the overall environment around the hydroxyl group; the overtones generated by the sum or multiplication of fundamental frequencies of hydroxyl bending vibration; the hydroxyl bending vibration modes delta(O-H) of the combination of delta(Cu-O-H) and delta(O-H...HCl); the vibration modes of strongly bonded planar CuO4 units; the vibration modes of weakly bonded linear-triatomic chain Cl-Cu-O/Cl. The bands were assigned in accordance with its crystal structure parameters, which is more reasonable to establish the relationship between its molecular structure and its respective spectral properties.