[The association between portal vein thrombosis and rebleeding after non-urgent endoscopic treatment of esophagogastric varices]

Objective: To investigate the association between portal vein thrombosis and rebleeding after non-urgent endoscopic treatment of esophagogastric varices. Methods: The cirrhotic patients with esophagogastric varices diagnosed in the People's Hospital of Zhengzhou University from January 2017 to March 2023 were retrospectively collected. The patients were divided into thrombotic group and non-thrombotic group according to the presence or absence of portal vein thrombosis. The failure rate of endoscopic treatment and rebleeding rate in different periods were compared between the two groups. Receiver operating characteristic (ROC) curve was used to select the best cutoff value of gastric varicose diameter that affected total rebleeding during follow-up in both groups. The influencing factors of rebleeding within 12 and 36 months in both groups were analyzed, and the influencing factors of rebleeding within 36 months in thrombus group were further analyzed. Results: A total of 106 patients were enrolled, including 53 patients in the thrombotic group [male 37, female 16, aged 18-78 (54±13) years] and 53 patients in the non-thrombotic group [male 37, female 16, aged 27-83 (55±12) years]. The follow-up time of the two groups were (20±15) and (25±15) months, respectively. The total rebleeding rate in the thrombotic group was higher than that in the non-thrombotic group [30.2% (16/53) vs 13.2% (7/53), P˂0.05]. The rebleeding rates within 6, 12, 24 and 36 months in the thrombotic group were higher than those in the non-thrombotic group [18.9% (10/53) vs 5.7% (3/53), 18.9% (10/53) vs 5.7% (3/53), 28.3% (15/53) vs 9.4% (5/53), 30.2% (16/53) vs 11.3% (6/53), all P˂0.05]. The best cut-off value of the diameter of gastric varices that affects the total rebleeding in the two groups was 10.4 mm (10 mm was selected as the best cut-off value for the convenience of practical clinical application). Hemoglobin ˂ 85 g/L (HR=0.202, 95%CI: 0.043-0.953, P=0.043), 10 mm ˂ the diameter of GV ≤ 15 mm (HR=5.321, 95%CI: 1.161-24.390, P=0.031) and endoscopic variceal ligation combined with endoscopic tissue adhesive injection (EVL+ETAI) (HR=7.172, 95%CI: 1.910-26.930, P=0.004) were the risk factors for the first gastroesophageal variceal rebleeding within 12 months after non-urgent endoscopic treatment. EVL+ETAI (HR=3.811, 95%CI: 1.441-10.084, P=0.007) and portal vein thrombosis (HR=4.026, 95%CI: 1.483-10.932, P=0.006) were the risk factors for the first gastroesophageal variceal rebleeding within 36 months after non-urgent endoscopic treatment. The study found that, 10 mm ˂ the diameter of GV ≤ 15 mm (HR=7.503, 95%CI: 1.568-35.890, P=0.012) was the risk factor for rebleeding within 36 months in the thrombotic group. Conclusion: Portal vein thrombosis is a risk factor for rebleeding after non-urgent endoscopic treatment of esophagogastric varices.

Partial replacement of soybean meal with microalgae biomass on in vitro ruminal fermentation may reduce ruminal protein degradation

The objective of this study was to evaluate the effects of partially replacing soybean meal (SBM) with algal sources on in vitro ruminal fermentation. Using 6 fermenters in a 3 × 3 replicated Latin square with 3 periods of 10 d each, we tested 3 treatments: a control diet (CRT) with SBM at 17.8% of the diet dry matter (DM); and 50% SBM biomass replacement with either Chlorella pyrenoidosa (CHL); or Spirulina platensis (SPI). The basal diet was formulated to meet the requirements of a 680-kg Holstein dairy cow producing 45 kg/d of milk with 3.5% fat and 3% protein. All diets had a similar nutritional composition (16.0% CP; 34.9% NDF; 31.0% starch, DM basis) and fermenters were provided with 106 g DM/d split into 2 portions. After 7 d of adaptation, samples were collected for 3 d of each period for analyses of ruminal fermentation at 0, 1, 2, 4, 6, and 8 h after morning feeding for evaluation of the ruminal fermentation kinetics. For the evaluation of the daily production of total metabolites and for the evaluation of nutrient degradability, samples from the effluent containers were collected daily. Statistical analysis was performed with the MIXED procedure of SAS with treatment, time, and their interactions considered as fixed effects; day, square, and fermenter were considered as random effects. Orthogonal contrasts (CRT vs. algae; and CHL vs. SPI) were used to depict the treatment effect, and significance was declared when P ≤ 0.05. Fermenters that received algae-based diets had a greater propionate molar concentration and molar proportion when compared with the fermenters fed CRT diets. In addition, those algae-fed fermenters had lower branched short-chain fatty acids (BSCFA) and isoacids (IA), which are biomarkers of ruminal protein degradation, along with lower ammonia (NH3-N) concentration and greater nonammonia nitrogen (NAN). When contrasting with fermenters fed SPI-diets, fermenters fed based CHL-diets had a lower molar concentration of BSCFA and IA, along with lower NH3-N concentration and flow, and greater NAN, bacterial nitrogen flow, and efficiency of nitrogen utilization. Those results indicate that CHL protein may be more resistant to ruminal degradation, which would increase efficiency of nitrogen utilization. In summary, partially replacing SBM with algae biomass, especially with CHL, is a promising strategy to improve the efficiency of nitrogen utilization, due to the fact that fermenters fed CHL-based diets resulted in a reduction in BSCFA and IA, which are markers of protein degradation, and it would improve the efficiency of nitrogen utilization. However, further validation using in vivo models are required.

[Effects of canagliflozin on amino acid metabolism in atherosclerotic mice]

Objective: To explore the possible anti-atherosclerotic mechanisms of glucose co-transporter-2 inhibitor canagliflozin. Methods: ApoE-/-mice fed on Western diet were randomly assigned into the model group (n=10) and the canagliflozin group (n=10). C57BL/6J mice fed on normal diet were chosen as the control group (n=10). Mice in the canagliflozin group were gavaged with canagliflozin for 14 weeks. The presence and severity of atherosclerosis were evaluated with HE and oil red O stainings in aortic root section slices. PCR assay was performed to determine the mRNA expression levels of nitric oxide synthase. Hepatic transcriptome analysis and hepatic amino acid detection were conducted using RNA-seq and targeted LC-MS, respectively. Results: HE staining and oil red O staining of the aortic root showed that AS models were successfully established in ApoE-/-mice fed on Western diet for 14 weeks. Canagliflozin alleviated the severity of atherosclerosis in pathology. Hepatic transcriptome analysis indicated that canagliflozin impacted on amino acid metabolism, especially arginine synthesis in ApoE-/-mice. Targeted metabolomics analysis of amino acids showed that canagliflozin reduced hepatic levels of L-serine, L-aspartic acid, tyrosine, L-hydroxyproline, and L-citrulline, but raised the hepatic level of L-arginine. Compared to the model group, the canagliflozin group exhibited higher serum arginine and nitric oxide levels as well as elevated nitric oxide mRNA expression in aortic tissues (P<0.05). Conclusion: Canagliflozin regulated the amino acid metabolism, reduced the levels of glucogenic amino acids,and promoted the synthesis of arginine in atherosclerotic mice.

Perineural Treatment with High Mobility Group Box-1 Monoclonal Antibody Prevents Initiation of Pain-Like Behaviors in Female Mice with Trigeminal Neuropathy

Post-traumatic trigeminal neuropathy (PTTN) is a type of chronic pain caused by damage to the trigeminal nerve. A previous study reported that pretreatment with anti-high mobility group box-1 (HMGB1) neutralizing antibodies (nAb) prevented the onset of PTTN following distal infraorbital nerve chronic constriction injury (dIoN-CCI) in male mice. Clinical evidence indicates a high incidence of PTTN in females. Although our previous study found that perineural HMGB1 is crucial in initiation of PTTN in male mice, it is currently unknown whether HMGB1 is also involved in the pathogenesis of PTTN in female mice. Therefore, in the current study, we examined the effect of anti-HMGB1 nAb on pain-like behavior in female mice following dIoN-CCI surgery. We found that dIoN-CCI surgery enhanced reactivity to mechanical and cold stimuli in female mice, which was suppressed by treatment with anti-HMGB1 nAb. Moreover, the increase in macrophages after dIoN-CCI was significantly attenuated by pretreatment with anti-HMGB1 nAb. Furthermore, anti-HMGB1 nAb treatment inhibited microglial activation in the trigeminal spinal tract nucleus. These data suggest that HMGB1 also plays a crucial role in the onset of PTTN after nerve injury in female mice. Thus, anti-HMGB1 nAb could be a novel therapeutic agent for inhibiting the onset of PTTN in female and male mice.

Prediction of anxious depression using multimodal neuroimaging and machine learning

Anxious depression is a common subtype of major depressive disorder (MDD) associated with adverse outcomes and severely impaired social function. It is important to clarify the underlying neurobiology of anxious depression to refine the diagnosis and stratify patients for therapy. Here we explored associations between anxiety and brain structure/function in MDD patients. A total of 260 MDD patients and 127 healthy controls underwent three-dimensional T1-weighted structural scanning and resting-state functional magnetic resonance imaging. Demographic data were collected from all participants. Differences in gray matter volume (GMV), (fractional) amplitude of low-frequency fluctuation ((f)ALFF), regional homogeneity (ReHo), and seed point-based functional connectivity were compared between anxious MDD patients, non-anxious MDD patients, and healthy controls. A random forest model was used to predict anxiety in MDD patients using neuroimaging features. Anxious MDD patients showed significant differences in GMV in the left middle temporal gyrus and ReHo in the right superior parietal gyrus and the left precuneus than HCs. Compared with non-anxious MDD patients, patients with anxious MDD showed significantly different GMV in the left inferior temporal gyrus, left superior temporal gyrus, left superior frontal gyrus (orbital part), and left dorsolateral superior frontal gyrus; fALFF in the left middle temporal gyrus; ReHo in the inferior temporal gyrus and the superior frontal gyrus (orbital part); and functional connectivity between the left superior temporal gyrus(temporal pole) and left medial superior frontal gyrus. A diagnostic predictive random forest model built using imaging features and validated by 10-fold cross-validation distinguished anxious from non-anxious MDD with an AUC of 0.802. Patients with anxious depression exhibit dysregulation of brain regions associated with emotion regulation, cognition, and decision-making, and our diagnostic model paves the way for more accurate, objective clinical diagnosis of anxious depression.

A Machine Learning Analysis of Big Metabolomics Data for Classifying Depression: Model Development and Validation

BACKGROUND

Many metabolomics studies of depression have been performed, but these have been limited by their scale. A comprehensive in silico analysis of global metabolite levels in large populations could provide robust insights into the pathological mechanisms underlying depression and candidate clinical biomarkers.

METHODS

Depression-associated metabolomics was studied in 2 datasets from the UK Biobank database: participants with lifetime depression (N = 123,459) and participants with current depression (N = 94,921). The Whitehall II cohort (N = 4744) was used for external validation. CatBoost machine learning was used for modeling, and Shapley additive explanations were used to interpret the model. Fivefold cross-validation was used to validate model performance, training the model on 3 of the 5 sets with the remaining 2 sets for validation and testing, respectively. Diagnostic performance was assessed using the area under the receiver operating characteristic curve.

RESULTS

In the lifetime depression and current depression datasets and sex-specific analyses, 24 significantly associated metabolic biomarkers were identified, 12 of which overlapped in the 2 datasets. The addition of metabolic features slightly improved the performance of a diagnostic model using traditional (nonmetabolomics) risk factors alone (lifetime depression: area under the curve 0.655 vs. 0.658 with metabolomics; current depression: area under the curve 0.711 vs. 0.716 with metabolomics).

CONCLUSIONS

The machine learning model identified 24 metabolic biomarkers associated with depression. If validated, metabolic biomarkers may have future clinical applications as supplementary information to guide early and population-based depression detection.

Psychosocial factors of insomnia in depression: a network approach

BACKGROUND

Insomnia symptoms in patients with major depressive disorder (MDD) are common and deleterious. Childhood trauma, personality traits, interpersonal distress, and social support contribute to insomnia, but how they interact to affect insomnia remains uncertain.

METHODS

A total of 791 patients with MDD completed the Insomnia Severity Index, Eysenck Personality Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, Childhood Trauma Questionnaire, Social Support Rating Scale and Hamilton Depression Scale-17. This study utilized network analyses to identify the central symptoms of insomnia and their associations with psychosocial factors.

RESULTS

Worrying about sleep was identified as the central symptom in the insomnia network, insomnia and associated personality network, insomnia and associated interpersonal disturbance network, insomnia and associated childhood trauma network, insomnia and associated social support network, and the integrated network of insomnia symptoms and associated psychosocial factors. In the networks of insomnia symptoms and individual psychosocial factors, most psychosocial factors (other than childhood trauma) were directly or indirectly related to insomnia symptoms; however, neuroticism was the only factor directly associated with insomnia symptoms before and after controlling for covariates. In the final integrated network of insomnia symptoms and psychosocial factors, neuroticism was a bridge node and mediated the relationships of social support and interpersonal disturbances with insomnia symptoms, which is clearly presented in the shortest pathways.

CONCLUSIONS

Worrying about sleep and neuroticism were prominent in the integrated network of insomnia symptoms and associated psychosocial factors, and the edge between them connected psychosocial factors and insomnia symptoms in MDD patients.

The Mediation Role of Sleep Disturbances between Vitamin D and Depressive Symptoms: A Cross-Sectional Study

Depression and sleep disturbances are highly prevalent health problems that have been suggested to be associated with vitamin D deficiency. This study investigated whether sleep disturbances affect the association between vitamin D and depressive symptoms. A total of 425 patients with depression were included in this study. Spearman correlation coefficients were chosen to assess the relation between vitamin D concentrations and depressive symptomatology (according to the PHQ-9 and HAMD-17 scores). The GLM Mediation Model in the Medmod module for data analysis in Jamovi 2.2.5 was used to analyze the mediation models for sleep disturbances. Vitamin D concentrations were significantly correlated with PHQ-9 and HAMD-17 scale scores. In addition, item 3 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of PHQ-9, and item 4 was suggested to have a mediating effect between vitamin D and depressive symptoms in the mediating model of HAMD-17. Sleep disturbances (especially difficulty falling asleep) are mediators between vitamin D and depressive symptoms, suggesting that increasing vitamin D levels at the right time to regulate sleep disturbances may improve depression symptoms, yet further research is necessary.

KatG catalase deficiency confers bedaquiline hyper-susceptibility to isoniazid resistant Mycobacterium tuberculosis

Multidrug-resistant tuberculosis (MDR-TB) is a growing source of global mortality and threatens global control of tuberculosis (TB) disease. The diarylquinoline bedaquiline (BDQ) recently emerged as a highly efficacious drug against MDR-TB, defined as resistance to the first-line drugs isoniazid (INH) and rifampin. INH resistance is primarily caused by loss-of-function mutations in the catalase KatG, but mechanisms underlying BDQ's efficacy against MDR-TB remain unknown. Here we employ a systems biology approach to investigate BDQ hyper-susceptibility in INH-resistant Mycobacterium tuberculosis . We found hyper-susceptibility to BDQ in INH-resistant cells is due to several physiological changes induced by KatG deficiency, including increased susceptibility to reactive oxygen species and DNA damage, remodeling of transcriptional programs, and metabolic repression of folate biosynthesis. We demonstrate BDQ hyper-susceptibility is common in INH-resistant clinical isolates. Collectively, these results highlight how altered bacterial physiology can impact drug efficacy in drug-resistant bacteria.

The Role of Radiation Therapy for Metastatic Cervical Cancer

PURPOSE/OBJECTIVE(S)

Survival rates for women with metastatic cervical cancer (CC) are low, with limited management options. Radiation therapy (RT) for metastatic disease has led to prolonged survival in other malignancies, however, the data are scarce in CC. Herein, we evaluated the effect of RT for metastatic CC.

MATERIALS/METHODS

A total of 58 patients with metastatic CC between September 2019 and January 2023 were retrospectively analyzed. All the patients were treated with platinum-based chemotherapy combined with targeted therapy or immunotherapy followed with or without RT (NRT). The recent efficacy, survival status and prognostic factors were analyzed statistically.

RESULTS

Objective response rate (ORR) was 63.6% with one complete and twenty partial responses in RT group (n = 33) and 40.0% with two complete and eight partial responses in NRT group (n = 25), respectively (p = 0.074). Disease control rate (DCR) of the RT and NRT groups were 79.4% vs 80.0%, respectively (p = 0.861). Median follow-up time was 17 months (3-39months). In RT group, 11(33.3%) patients experienced local regional or distant failure and 9 (27.3%) patients were dead. In NRT group, 15(60%) patients had progression and 8 (32%) patients dead. There was no significant difference between the two groups in overall survival (OS); however, RT group displayed superior progression-free survival (PFS) (1-year OS: 72.7% vs. 68.0%, p = 0.460; 1-year PFS: 66.7% vs. 40.0%, p = 0.039). The multivariate analysis showed that RT, immunotherapy, lymph node metastasis only relevant predictor of superior PFS but not OS. In subgroup analysis, patients treated with RT appeared to have a better PFS in some specific cohorts, such as age>45 years (72.0% vs 36.4% P = 0.015), squamous carcinoma histology (71.0% vs 40.9% P = 0.017), metastatic at diagnosis (75.0% vs 47.6% P = 0.012), non-targeted therapy (72.4% vs 43.8% P = 0.040). No significant increase in treatment-related toxicity was observed in the RT group compared with the NRT group.

CONCLUSION

RT provided superior PFS in metastatic CC patients compared to NRT, and well tolerated. Moreover, RT, immunotherapy, lymph node metastasis only were independent significant prognostic factors for PFS. Subgroup analysis showed that combination of RT and chemotherapy obtained favorable PFS in metastatic CC patients with age>45 years, squamous carcinoma histology, metastatic at diagnosis, non-targeted therapy. Studies with a larger sample size and longer follow-up are warranted.

Hyperthermia Enhances the Radiosensitivity of Pancreatic Cancer Cells by Inhibiting Wnt2B Signaling

PURPOSE/OBJECTIVE(S)

Pancreatic cancer (PC) is a highly lethal human malignance. Due to unobvious symptoms at early stage, most of the patients with PC are diagnosed at late stages and lose the chance of surgical resection. Furthermore, PC patients are resistant to chemoradiotherapy and therefore show a dismal survival. Hyperthermia is commonly used as a sensitizer of chemotherapy or radiotherapy for the clinical treatment of human cancers. Our study aimed to investigate whether hyperthermia can improve the radiosensitivity of PC cells and uncover the involved mechanisms.

MATERIALS/METHODS

PC cells BxPC3, CFPAC-1 and PANC1 were heated to 43 ℃ 1 h before exposure to ionizing irradiation (IR). The radiosensitivity of PC cells were detected in vitro by colony formation assay, immunofluence analysis and western blotting. The mechanisms studies have been conducted using qRT-PCR analysis, cDNA/siRNA transfection and comet assay.

RESULTS

Hyperthermia significantly enhanced the radiosensitivity of PC cells by decreasing their colony formation and increasing DNA damage following IR. By qRT-PCR analysis of Wnt genes expressions, we found Wnt2B was significantly down-regulated in PC-3 cells which were treated with the combination of hyperthermia and IR compared with hyperthermia or IR alone. Functional assays showed that the expression level of Wnt2B was inversely associated with the radiosensitivity of PC-3 cells. Furthermore, we found hyperthermia inhibited the expression of DNA repair proteins such as p-BRCA1 and p-MRE11 in PC cells following IR CONCLUSION: Hyperthermia can significantly enhance the radiosensitivity of PC cells in a Wnt2B signaling-dependent manner.

First-principles property assessment of hybrid formate perovskites

Hybrid organic-inorganic formate perovskites, AB(HCOO)3, are a large family of compounds that exhibit a variety of phase transitions and diverse properties, such as (anti)ferroelectricity, ferroelasticity, (anti)ferromagnetism, and multiferroism. While many properties of these materials have already been characterized, we are not aware of any study that focuses on the comprehensive property assessment of a large number of formate perovskites. A comparison of the properties of materials within the family is challenging due to systematic errors attributed to different techniques or the lack of data. For example, complete piezoelectric, dielectric, and elastic tensors are not available. In this work, we utilize first-principles density functional theory based simulations to overcome these challenges and to report structural, mechanical, dielectric, piezoelectric, and ferroelectric properties of 29 formate perovskites. We find that these materials exhibit elastic stiffness in the range 0.5-127.0 GPa; highly anisotropic linear compressibility, including zero and even negative values; dielectric constants in the range 0.1-102.1; highly anisotropic piezoelectric response with the longitudinal values in the range 1.18-21.12 pC/N; and spontaneous polarizations in the range 0.2-7.8 μC/cm2. Furthermore, we propose and computationally characterize a few formate perovskites that have not been reported yet.

The association of new-onset diabetes with subsequent diagnosis of pancreatic cancer-novel use of a large administrative database

BACKGROUND

Screening options for pancreatic ductal adenocarcinoma (PDAC) are limited. New-onset type 2 diabetes (NoD) is associated with subsequent diagnosis of PDAC in observational studies and may afford an opportunity for PDAC screening. We evaluated this association using a large administrative database.

METHODS

Patients were identified using claims data from the OptumLabs® Data Warehouse. Adult patients with NoD diagnosis were matched 1:3 with patients without NoD using age, sex and chronic obstructive pulmonary disease (COPD) status. The event of PDAC diagnosis was compared between cohorts using the Kaplan-Meier method. Factors associated with PDAC diagnosis were evaluated with Cox's proportional hazards modeling.

RESULTS

We identified 640 421 patients with NoD and included 1 921 263 controls. At 3 years, significantly more PDAC events were identified in the NoD group vs control group (579 vs 505; P < 0.001). When controlling for patient factors, NoD was significantly associated with elevated risk of PDAC (HR 3.474, 95% CI 3.082-3.920, P < 0.001). Other factors significantly associated with PDAC diagnosis were increasing age, increasing age among Black patients, and COPD diagnosis (P ≤ 0.05).

CONCLUSIONS

NoD was independently associated with subsequent diagnosis of PDAC within 3 years. Future studies should evaluate the feasibility and benefit of PDAC screening in patients with NoD.

Bacterial antibiotic resistance among cancer inpatients in China: 2016-20

BACKGROUND

The incidence of infections among cancer patients is as high as 23.2-33.2% in China. However, the lack of information and data on the number of antibiotics used by cancer patients is an obstacle to implementing antibiotic management plans.

AIM

This study aimed to investigate bacterial infections and antibiotic resistance in Chinese cancer patients to provide a reference for the rational use of antibiotics.

DESIGN

This was a 5-year retrospective study on the antibiotic resistance of cancer patients.

METHODS

In this 5-year surveillance study, we collected bacterial and antibiotic resistance data from 20 provincial cancer diagnosis and treatment centers and three specialized cancer hospitals in China. We analyzed the resistance of common bacteria to antibiotics, compared to common clinical drug-resistant bacteria, evaluated the evolution of critical drug-resistant bacteria and conducted data analysis.

FINDINGS

Between 2016 and 2020, 216 219 bacterial strains were clinically isolated. The resistance trend of Escherichia coli and Klebsiella pneumoniae to amikacin, ciprofloxacin, cefotaxime, piperacillin/tazobactam and imipenem was relatively stable and did not significantly increase over time. The resistance of Pseudomonas aeruginosa strains to all antibiotics tested, including imipenem and meropenem, decreased over time. In contrast, the resistance of Acinetobacter baumannii strains to carbapenems increased from 4.7% to 14.7%. Methicillin-resistant Staphylococcus aureus (MRSA) significantly decreased from 65.2% in 2016 to 48.9% in 2020.

CONCLUSIONS

The bacterial prevalence and antibiotic resistance rates of E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, S. aureus and MRSA were significantly lower than the national average.

Striatum-related spontaneous coactivation patterns predict treatment response on positive symptoms of drug-naive first-episode schizophrenia with risperidone monotherapy

Background

Evidence from functional magnetic resonance imaging (fMRI) studies of schizophrenia suggests that interindividual variation in the stationary striatal functional circuit may be correlated with antipsychotic treatment response. However, little is known about the role of the dynamic striatum-related network in predicting patients’ clinical improvement. The spontaneous coactivation pattern (CAP) technique has recently been found to be important for elucidating the non-stationary nature of functional brain networks.

Methods

Forty-two drug-naive first-episode schizophrenia patients underwent fMRI and T1W imaging before and after 8 weeks of risperidone monotherapy. The striatum was divided into 3 subregions, including the putamen, pallidum, and caudate. Spontaneous CAPs and CAP states were utilized to measure the dynamic characteristics of brain networks. We used DPARSF and Dynamic Brain Connectome software to analyze each subregion-related CAP and CAP state for each group and then compared the between-group differences in the neural network biomarkers. We used Pearson’s correlation analysis to determine the associations between the neuroimaging measurements with between-group differences and the improvement in patients’ psychopathological symptoms.

Results

In the putamen-related CAPs, patients showed significantly increased intensity in the bilateral thalamus, bilateral supplementary motor areas, bilateral medial, and paracingulate gyrus, left paracentral lobule, left medial superior frontal gyrus, and left anterior cingulate gyrus compared with healthy controls. After treatment, thalamic signals in the putamen-related CAP 1 showed a significant increase, while the signals of the medial and paracingulate gyrus in the putamen-related CAP 3 revealed a significant decrease. The increase in thalamic signal intensity in the putamen-related CAP 1 was significantly and positively correlated with the percentage reduction in PANSS_P.

Conclusion

This study is the first to combine striatal CAPs and fMRI to explore treatment response-related biomarkers in the early phase of schizophrenia. Our findings suggest that dynamic changes in CAP states in the putamen-thalamus circuit may be potential biomarkers for predicting patients’ variation in the short-term treatment response of positive symptoms.

Inflammatory bowel disease and the long-term risk of depression: A prospective cohort study of the UK biobank

OBJECTIVE

Depression is more common in patients with chronic inflammatory diseases, but whether inflammatory bowel disease (IBD), a chronic, relapsing immune-mediated disease, is associated with a higher risk of depression remains uncertain.

METHOD

We studied 497,134 participants in the UK Biobank, including 3561 IBD patients. Multivariate Cox proportional risk models were constructed to investigate the risk associated with IBD and depression adjusting for potential confounding factors including sociodemographic, lifestyle, and family history variables.

RESULTS

The average age of participants was 56.54 ± 8.09 years; 54.3% were female and 90.4% were white. Over a mean follow-up period of 13.3 years, the cumulative incidence of depression was 8.2% (95% CI: 7.3%-9.1%) in IBD patients compared with 4.9% (95% CI: 4.9%-5.0%) in individuals without IBD. Compared with non-IBD participants, the adjusted hazard ratio (HR) for depression among IBD patients was 1.56 (95% CI: 1.39-1.76), with an adjusted HR of 1.54 (95% CI: 1.25-1.90) in Crohn's disease and 1.52 (95% CI: 1.30-1.78) in ulcerative colitis, respectively.

CONCLUSION

IBD patients had a significantly higher risk of depression than non-IBD participants after adjusting for multiple confounding factors. We recommend screening for depression in middle-aged adults with IBD and no established history of depression.

Assessment of brain imaging and cognitive function in a modified rhesus monkey model of depression

Depression incurs a huge personal and societal burden, impairing cognitive and social functioning and affecting millions of people worldwide. A better understanding of the biological basis of depression could facilitate the development of new and improved therapies. Rodent models have limitations and do not fully recapitulate human disease, hampering clinical translation. Primate models of depression help to bridge this translational gap and facilitate research into the pathophysiology of depression. Here we optimized a protocol for administering unpredictable chronic mild stress (UCMS) to non-human primates and evaluated the influence of UCMS on cognition using the classical Wisconsin General Test Apparatus (WGTA) method. We used resting-state functional MRI to explore changes in amplitude of low-frequency fluctuations and regional homogeneity in rhesus monkeys. Our work highlights that the UCMS paradigm effectively induces behavioral and neurophysiological (functional MRI) changes in monkeys but without significantly impacting cognition. The UCMS protocol requires further optimization in non-human primates to authentically simulate changes in cognition associated with depression.

Effects of testis testosterone deficiency on gene expression in the adrenal gland and skeletal muscle of ducks

1. Testosterone has an anabolic effect on skeletal muscle. The testes produce most of the testosterone in vivo, while the adrenal glands contribute smaller amounts. When testis testosterone is deficient the adrenal gland increases steroid hormone synthesis, which is referred to as compensatory testicular adaptation (CTA).2. To reveal the effects of testis testosterone deficiency on adrenal steroid hormones synthesis and skeletal muscle development, gene expression related to adrenal steroid hormones synthesis and skeletal muscle development were determined by RNA-seq.3. The results showed that castrating male ducks had significant effects on their body weight but no significant impact on cross-sectional area (CSA) or density of pectoral muscle fibres. In skeletal muscle protein metabolism, expression levels of the catabolic gene atrogin1/MAFbx and the anabolic gene eEF2 were significantly higher, with concomitant increases after castration. The adrenal glands' alteration of the steroid hormone 11β-hydroxylase (CYP11B1) was significantly lower following castration.4. Expression pattern analysis showed that the adrenal glands' glucocorticoid receptor (NR3C1/GR) had a potential regulatory relationship with the skeletal muscle-related genes (Pax7, mTOR, FBXO32, FOXO3, and FOXO4).5. The data showed that castration affected muscle protein metabolism, adrenal steroid and testosterone synthesis. In addition, it was speculated that, after castration, steroid hormones produced by the adrenal gland could have a compensatory effect, which might mediate the changes in skeletal muscle protein metabolism and development.

Virtual histology of morphometric similarity network after risperidone monotherapy and imaging-epigenetic biomarkers for treatment response in first-episode schizophrenia

BACKGROUND

Antipsychotic treatment has been conceived to alter brain connectivity, but it is unclear how the changes of network phenotypes relate to the underlying transcriptomics. Given DNA methylation (DNAm) may alter transcriptional levels, we further integrated an imaging-transcriptomic-epigenetic analysis to explore multi-omics treatment response biomarkers.

METHODS

Forty-two treatment-naive first-episode schizophrenia patients were scanned by TI weighted (T1W) imaging and DTI before and after 8-week risperidone monotherapy, and their peripheral blood genomic DNAm values were examined in parallel with MRI scanning. Morphometric similarity network (MSN) quantified with DTI and T1W data were used as a marker of treatment-related alterations in interareal cortical connectivity. We utilized partial least squares (PLS) to examine spatial associations between treatment-related MSN variations and cortical transcriptomic data obtained from the Allen Human Brain Atlas.

RESULTS

Longitudinal MSN alterations were related to treatment response on cognitive function and general psychopathology symptoms, while DNAm values of 59 PLS1 genes were on negative and positive symptoms. Virtual-histology transcriptomic analysis linked the MSN alterations with the neurobiological, cellular and metabolic pathways or processes, and assigned MSN-related genes to multiple cell types, specifying neurons and glial cells as contributing most to the transcriptomic associations of longitudinal changes in MSN.

CONCLUSIONS

We firstly reveal how brain-wide transcriptional levels and cell classes capture molecularly validated cortical connectivity alterations after antipsychotic treatment. Our findings represent a vital step towards the exploration of treatment response biomarkers on the basis of multiple omics rather than a single omics type as a strategy for advancing precise care.

Measuring childhood trauma in young adults with depression: A latent profile analysis

Childhood traumas are important risk factors for depression in young adults. However, the co-occurrence of childhood traumas is complex, and the specific effects of different types of childhood traumas on depression need further exploration. The aim of this study was to assess the co-occurrence of childhood traumas and the impact of different profiles of childhood trauma on depression. A total of 1053 young adults with depression in China participated. PHQ-9, SHAPS, GAD-7, CTQ-SF, and NLES were evaluated. Latent profile analysis (LPA) was conducted to identify profiles of childhood trauma. The effects of different childhood trauma profiles on depression, anxiety, and anhedonia were assessed using stepwise linear regression. LPA suggested three profiles: no or low childhood traumas, moderate childhood trauma with emotional abuse and childhood neglect, and high childhood trauma with high levels of all trauma types. Regression analyses suggested that high levels of emotional abuse and childhood neglect significantly affected anhedonia. Childhood adverse events cluster in young adults with depression, allowing grouping into three distinct profiles. Specific childhood trauma patterns predict anhedonia symptoms in adult depression.

Blockade of receptor for advanced glycation end-products with azeliragon ameliorates streptozotocin-induced diabetic neuropathy

Treatment options for diabetic neuropathy are suboptimal, so development of a new therapeutic strategy is urgent. We focused on the role of receptor for advanced glycation end-products (RAGE) in diabetic neuropathy. We elaborated the effects of azeliragon (orally available small-molecule antagonist of RAGE) on streptozotocin (STZ)-induced mechanical hypersensitivity in mice. A reduction in mechanical nociceptive threshold observed 28 days after STZ treatment was improved by single administration of azeliragon (10 and 30 mg/kg) at 3 h, but this effect disappeared at 24 h. Conversely, repeat administration (three times; days 28, 30, and 32) of azeliragon (30 mg/kg) enhanced the antinociceptive effect significantly compared with that obtained upon single administration, and this effect persisted at least up to 24 h. The antinociceptive effect of azeliragon (30 mg/kg) was almost comparable with that of pregabalin (30 mg/kg). These drug treatments had no effect on blood glucose levels. Our findings suggest that RAGE might be an effective target for diabetic neuropathy treatment.

Comparative analysis of nitrate evolution patterns during pollution episodes: Method development and results from Tianjin, China

Particulate nitrate plays an increasingly important role in the formation of air pollution process, while the main mechanisms of nitrate concentration change are different in each stage, same as the driving factors. In this study, we proposed an episode-based analysis to illustrate the typical nitrate evolution patterns and identify the possible impacting factors in different evolution stages. Applying into twelve air pollution episodes, three typical patterns of nitrate evolution were abstracted, and the corresponding conceptual models were constructed. All the pollution episodes were grouped by their evolving shapes, which were driven by physical and chemical processes. Episodes started slowly typically arose from gradual pollutant accumulation, both locally and regionally, and chemical formation under high humidity. Type 1 ("hump-shaped type"), accounting for 66.3 % of the total episode durations, including two "peak" concentrations, displays a rapid growth rate which could up to 4.6 μg m^-3 h^-1 in average, mainly relying on the sharp drop in the planetary boundary layer height. Short scavenging processes and thoroughly dissipated stages of the pollution episodes always accompanied by strong north wind affected by Siberia-Mongolia cold current. Type 2 ("triangle-shaped type", 24.3 %) shows a gentle growth rate and short duration. Compared with Type 1, chemical process may be more important "source" for the increase of nitrate concentration during Type 2. Type 3 ("trapezoid-shaped type", 9.4 %) presents a long platform stage, during which high humidity (RH > 90 %) provides favorable conditions for wet removal and secondary production, and the updraft can carry pollutants to high altitude. The source and sink are roughly balanced for Type 3. Our study highlights the importance of pattern identification for understanding the nitrate evolution behavior, it may also provide insights for pollution prediction and scientific mitigation strategies.

Screening Children's Intellectual Disabilities with Phonetic Features, Facial Phenotype and Craniofacial Variability Index

BACKGROUND

Intellectual Disability (ID) is a kind of developmental deficiency syndrome caused by congenital diseases or postnatal events. This syndrome could be intervened as soon as possible if its early screening was efficient, which may improve the condition of patients and enhance their self-care ability. The early screening of ID is always achieved by clinical interview, which needs in-depth participation of medical professionals and related medical resources.

METHODS

A new method for screening ID has been proposed by analyzing the facial phenotype and phonetic characteristic of young subjects. First, the geometric features of subjects' faces and phonetic features of subjects' voice are extracted from interview videos, then craniofacial variability index (CVI) is calculated with the geometric features and the risk of ID is given with the measure of CVI. Furthermore, machine learning algorithms are utilized to establish a method for further screening ID based on facial features and phonetic features.

RESULTS

The proposed method using three feature sets, including geometric features, CVI features and phonetic features was evaluated. The best performance of accuracy was closer to 80%.

CONCLUSIONS

The results using the three feature sets revealed that the proposed method may be applied in a clinical setting in the future after continuous improvement.

Longitudinal multi-omics alterations response to 8-week risperidone monotherapy: Evidence linking cortical thickness, transcriptomics and epigenetics

Background

Antipsychotic treatment-related alterations of cortical thickness (CT) and clinical symptoms have been previously corroborated, but less is known about whether the changes are driven by gene expression and epigenetic modifications.

Methods

Utilizing a prospective design, we recruited 42 treatment-naive first-episode schizophrenia patients (FESP) and 38 healthy controls. Patients were scanned by TI weighted imaging before and after 8-week risperidone monotherapy. CT estimation was automatically performed with the FreeSurfer software package. Participants' peripheral blood genomic DNA methylation (DNAm) status, quantified by using Infinium^® Human Methylation 450K BeadChip, was examined in parallel with T1 scanning. In total, CT measures from 118 subjects and genomic DNAm status from 114 subjects were finally collected. Partial least squares (PLS) regression was used to detect the spatial associations between longitudinal CT variations after treatment and cortical transcriptomic data acquired from the Allen Human Brain Atlas. Canonical correlation analysis (CCA) was then performed to identify multivariate associations between DNAm of PLS1 genes and patients' clinical improvement.

Results

We detected the significant PLS1 component (2,098 genes) related to longitudinal alterations of CT, and the PLS1 genes were significantly enriched in neurobiological processes, and dopaminergic- and cancer-related pathways. Combining Laplacian score and CCA analysis, we further linked DNAm of 33 representative genes from the 2,098 PLS1 genes with patients' reduction rate of clinical symptoms.

Conclusions

This study firstly revealed that changes of CT and clinical behaviors after treatment may be transcriptionally and epigenetically underlied. We define a "three-step" roadmap which represents a vital step toward the exploration of treatment- and treatment response-related biomarkers on the basis of multiple omics rather than a single omics type as a strategy for advancing precise care.

A lightweight CNN and Transformer hybrid model for mental retardation screening among children from spontaneous speech

Mental retardation (MR) is a group of mental disorders characterized by low intelligence and social adjustment difficulties. Early diagnosis is beneficial for the timely intervention of children with MR to ease the degree of disability. Children with MR always have impaired speech functions compared to normal children, which is significant for clinical diagnosis. On the basis of this, our study proposes a spontaneous speech-based framework (MT-Net) for screening MR, which merges mobile inverted bottleneck convolutional blocks (MBConv) and visual Transformer blocks. MT-Net takes log-mel spectrograms converted from raw interview speech as data source, and utilizes MBConv and visual Transformer to learn low-level and high-level features well. In addition, SpecAugment, a data augmentation strategy, has been used to expand our audio dataset to further enhance the performance of MT-Net. The experimental results show that our proposed MT-Net outperforms Transformer networks (ViT) and convolutional neural networks (ResNet18, MobileNetV2, EfficientNetV2), achieving accuracy of 91.60% after using SpecAugment. Our proposed MT-Net has fewer parameters, low computing consumption and high prediction accuracy, which is expected to be an auxiliary screening tool for MR.

Effects of betaine supplementation on reproductive performance of breeding geese

1. An experiment feeding three concentrations of betaine was conducted using breeding geese to analyse the reproductive performance, serum biochemical indexes, egg quality and intestinal immunity.2. A total of 450 female and 90 male Jiangnan White breeding geese were divided into three treatments, with five pen replicates each containing 30 female geese and 6 male geese.3. The results showed that there was no significant effect on the reproductive performance, serum biochemical indexes or jejunal villi goblet cells of geese with different levels of betaine in the diet (P>0.05). Compared with the control group, the addition of 2.5 g/kg betaine to the diet showed a tendency to increase egg mass (P>0.05) the betaine content in the yolk (P<0.05). Feeding betaine significantly increased the height of jejunal villi and egg yolk total cholesterol content in female geese (P<0.05).4. In conclusion, adding betaine to the goose diet was effective in its ability to improve intestinal structures and increase egg production. Adding 2.5 g/kg betaine to feed significantly increased the content of TCHOL and betaine in goose eggs.

Evaluating the performance of chemical transport models for PM2.5 source apportionment: An integrated application of spectral analysis and grey incidence analysis

Evaluating the performance of source apportionment (SA) models is difficult due to the non-observable nature of source contribution in reality. Here we propose a new approach to assess the performance of Chemical Transport Models (CTMs) for SA based on wavelet time-frequency spectral analysis and Grey Incidence Analysis (GIA). For each source category, certain species that better reflect the periodic characteristics of the emission sources were selected as the chemical tracers. The consistency of the time series between the simulated source contributions and the observed source-specific chemical tracers was then examined using a GIA model based on the perspective of similarity, and characterized by the GIA scores. By applying this method to six typical pollution episodes, we evaluated the performance of the Comprehensive Air Quality Model with Extensions-Particle Source Apportionment Technology (CAMx-PSAT) model for PM_2.5 SA from different temporal and spatial scales. The source- and episode-dependent optimal average time and main source regions were obtained. This approach is robust for facilitating a relatively meticulous evaluation of the performance of CTMs for PM_2.5 SA, and provides additional insight for decision-making for heavy pollution emergencies.

Using network analysis to identify central symptoms of college students' mental health

BACKGROUND

Mental health problems are becoming increasingly common among college students, including depression, anxiety and sleep disturbances, which can affect their daily life and learning and even lead to suicide. The purpose of this study was to explore the gender differences in mental health symptoms among Chinese college students.

METHODS

The study population included 29,099 college students. All participants were assessed with the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7), the Insomnia Severity Index (ISI), and the Suicidal Behaviors Questionnaire-Revised (SBQ-R). We assessed and compared network and centrality in females and males separately, as well as students with suicidal ideation.

RESULTS

Satisfaction with current sleep pattern (I4), worry about different things (A3) and irritable (A6) appeared to be the most central symptoms in the female network. In the male network, satisfaction with current sleep pattern (I4), tired or little energy (D4) and feeling down, hopeless (D2) were the most central symptoms. In both suicidal ideation networks, the top five central symptoms included four anxiety symptoms and one sleep symptom.

LIMITATIONS

This study used cross-sectional data and could not examine the dynamic relationship between symptoms.

CONCLUSION

There were gender differences in college students' mental health network. In addition to poor quality sleep, the central symptoms of the female network were anxiety symptoms, while those of the male were mainly depression symptoms. There were no gender difference in the suicidal ideation network and the central symptoms were anxiety symptoms and difficulty falling asleep.

Suicidal ideation in college students having major depressive disorder: Role of childhood trauma, personality and dysfunctional attitudes

BACKGROUND

Suicide in college students is a major public health concern. Suicidal ideation (SI) is associated with childhood trauma, personality, dysfunctional attitudes and depressive symptoms, but how they interact to predict SI remains unclear.

METHODS

Using cross-sectional design and convenience sampling method, a survey was conducted among 565 college students having major depressive disorder (MDD). The Childhood Trauma Questionnaire, Eysenck Personality Questionnaire, Dysfunctional Attitudes Scale and Hamilton Depression Scale assessed participants' psychosocial factors. Chi-square test, t-test, Pearson correlation, and Structural Equation Model were used in data analysis.

RESULTS

Overall, 66.02% of participants with MDD had SI. Those with SI showed significant differences in physical abuse, emotional abuse, physical neglect, emotional neglect, psychoticism, neuroticism, extroversion, dysfunctional attitudes and depressive symptoms compared with those without SI. Childhood trauma, psychoticism, neuroticism, extroversion and dysfunctional attitudes affected SI through chain mediation. In addition, depressive symptoms, psychoticism, neuroticism and extroversion directly affected SI.

LIMITATIONS

The convenience sampling method may limit the generalizability of the findings. Results may be biased due to the self-report nature of the data collection procedure, the number of research subjects and differences in suicide risk assessment. The cross-sectional study cannot be used to infer causality.

CONCLUSIONS

The factors of childhood trauma, personality and dysfunctional attitudes affect SI through chain mediation. In addition, depressive symptoms and personality independently predict the occurrence of SI.

Effects of dietary supplementation of gestating sows with adenosine 5 '-monophosphate or adenosine on placental angiogenesis and vitality of their offspring

Our previous study found that dietary nucleotide supplementation, including adenosine 5 '-monophosphate (AMP), could increase AMP content in sow milk and promote piglet growth, but its effects on placental efficiency and piglet vitality remains unknown. This experiment aimed to investigate the effects of dietary AMP or its metabolite adenosine (ADO) supplementation on sow reproductive performance and placental angiogenesis. A total of 135 sows with a similar farrowing time were blocked by backfat and body weight (BW) at day 65 of gestation, and assigned to 1 of 3 dietary treatment groups (n = 45 per treatment): basal diet, basal diet supplemented with 0.1% AMP, or 0.1% ADO, respectively. Placental analysis and the characteristics of sows and piglets unveiled that compared with control (CON) group, AMP or ADO supplementation could improve sow placental efficiency (P<0.05) and newborn piglet vitality (P<0.05), increase piglet birth weight (P<0.05), and reduce stillbirth rate (P<0.05). More importantly, AMP or ADO supplementation could increase the contents of AMP, ADO, and their metabolites in placentae (P<0.05). Meanwhile, AMP or ADO supplementation could also increase placental vascular density (P<0.05) and the expression of vascular endothelial growth factor A (P<0.05), as well as promote the migration and tube formation of porcine iliac artery endothelial cells (P<0.05). Overall, maternal dietary AMP or ADO supplementation could increase their contents in the placenta, thereby improving placental angiogenesis and neonatal piglet vitality.

[Comparison of criteria for metabolically healthy overweight/obesity in Shanghai Changfeng study]

Objective: To establish a more suitable and practicable criterion of metabolically healthy overweight/obesity (MHO/O) in Chinese, a comparison study on different criteria of MHO/O was conducted in subjects aged over 45-year-old in Shanghai Changfeng Community. Method: A total of 3 301 overweight/obese subjects over 45 years old (men 1 521, women 1 789) in Shanghai Changfeng Community was included in the study. According to the inclusion or exclusion of waist circumference (WC), homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.5, and numbers of abnormal metabolic components, the MHO/O criteria were divided into 7 types: Adult Treatment Panel Ⅲ (ATP-Ⅲ) (with WC)<1 component, ATP-Ⅲ (with WC)<2 components, ATP-Ⅲ (with WC)<3 components, ATP-Ⅲ (without WC)<1 component, ATP-Ⅲ (without WC)<2 components, adjusted metabolic associated fatty liver disease (MAFLD) criteria<1 component, and adjusted MAFLD criteria<2 components. The prevalence of MHO/O and its relationship with the changes of body mass index (BMI), and the differences of the characteristics of MHO/O among the 7 types of metabolic health standards were compared. Result: The prevalence of MHO/O according to the ATP-Ⅲ (with WC)<1, ATP-Ⅲ (with WC)<2, ATP-Ⅲ (with WC)<3, ATP-Ⅲ (without WC)<1, ATP-Ⅲ (without WC)<2, adjusted MAFLD criteria<1, and adjusted MAFLD criteria<2 was 2.85%, 15.48%, 39.87%, 8.00%, 33.66%, 2.33%, 12.24%, respectively. The prevalence of MHO/O decreased as BMI increased. When BMI ≥ 28 kg/m², the prevalence of MHO/O by ATP-Ⅲ (with WC)<1 and adjusted MAFLD criteria<1 dropped to 0. Conclusion: The adjusted MAFLD criterion without abnormal metabolic components is the most practicable definition of MHO/O.

Electronic health literacy among older adults in the context of the COVID-19 pandemic: A mixed methods study

Aim

This study aimed to investigate eHealth literacy about coronavirus disease 2019 (COVID‐19) among older adults during the pandemic.

Background

The COVID‐19 pandemic promoted the development of online health care. Higher demand for accessing information from the Internet was seen.

Methods

This was a sequential explanatory mixed‐method study, involving a survey of older adults to explore the status and influencing factors of eHealth literacy regarding COVID‐19. Semi‐structured interviews were used to understand experiences and challenges regarding information retrieval, judgment and utilization.

Results

A total of 337 older adults participated in the online questionnaire survey. Overall, older adults had slightly higher scores on eHealth literacy during the COVID‐19 pandemic. Participants' location in the past month and current health issues were associated with eHealth literacy. Qualitative data were collected from nine older adults and included that some older adults retrieved health‐related information during the pandemic. However, those who used non‐smartphones described difficulties in information retrieval. A glut of misinformation has resulted in an ‘infodemic’, which has not only increased the difficulty of judging information but also posed challenges in information utilization for older adults.

Conclusion

Improving older adults' eHealth literacy is essential in promoting an improved response to major public health events and in providing better health care for this group in the future. It is essential that government health agencies and health care providers provide evidence‐based health information via social media platforms. Further efforts are needed to combine aspects of traditional and online health care services and provide reliable and updated online information and resources for older adults.

Implications for Nursing Management

Providing evidence to eHealth literacy improvement and health management of older adults in the context of public health events.

The association between preoperative Mini-Cog© score and postoperative delirium (POD): a retrospective cohort study

Background

The onset of delirium after major surgery is associated with worse in-hospital outcomes for major surgical patients. Best practice recommends assessing surgical patients for delirium risk factors and this includes screening for cognitive impairment. The Mini-Cog© is a short instrument which has been shown to predict postoperative delirium (POD) and other complications in elderly patients undergoing major elective surgery. The primary aim of this study was to ascertain whether a positive preoperative Mini-Cog© is associated with postoperative delirium in elective colorectal surgery patients at high-risk of mortality due to age or comorbidity. Secondary outcomes were 90-day mortality and length of stay.

Methods

This is a retrospective analysis of data gathered prospectively between October 2015 and December 2017. Baseline data were collected at a preoperative screening clinic, and postoperative data during daily ward rounds by the Perioperative Medicine team at The York Hospital.

Results

Three hundred nineteen patients were included in the final analysis, of which 52 (16%) were found to be cognitively impaired on the Mini-Cog©. Older patients (median difference 10 years, p < 0.001) and patients with cognitive impairment (OR 3.04, 95%CI 1.15 to 8.03, p = 0.019) were more likely to develop postoperative delirium in univariate analysis; however, cognitive impairment (OR 0.492, 95%CI 0.177 to 1.368, p = 0.174) loses its significance when controlled for by confounding factors in a logistic regression model. Cognitive impairment (OR 4.65, 95%CI 1.36 to 15.9, p = 0.02), frailty (OR 7.28, 95%CI 1.92 to 27.58, p = 0.009), American Society of Anesthesiologists (ASA) grade (OR 5.95, 95%CI 1.54 to 22.94, p = 0.006) and age (median difference 10 years, p = 0.002) were significantly associated with 90-day mortality in univariate analysis. Sex was the only factor significantly associated with length of stay in the multiple regression model, with males having a 3-day longer average length of stay than females (OR = 2.94, 95%CI 0.10–5.78).

Conclusions

Mini-Cog© is not independently associated with post-operative delirium in high-risk elective colorectal surgery patients in this cohort. Mini-Cog© shows promise as a possible predictor of 90-day mortality. Larger studies exploring preoperative cognitive status and postoperative confusion and mortality could improve risk-stratification for surgery and allocation of resources to those patients at higher risk.

Unusual Properties of Hydrogen-Bonded Ferroelectrics: The Case of Cobalt Formate

Hybrid organic-inorganic perovskites is a class of materials with diverse chemically tunable properties and outstanding potential for multifunctionality. We use first-principles simulations to predict room temperature ferroelectricity in a representative of the formate family, [NH_{2}NH_{3}][Co(HCOO)_{3}]. The ferroelectricity arises as a "by-product" of structural transition driven by the stabilization of the hydrogen bond. As a consequence the coupling with the electric field is relatively weak giving origin to large intrinsic coercive fields and making material immune to the depolarizing fields known for its detrimental role in nanoscale ferroelectrics. Insensitivity to the electric field and the intrinsic dynamics of the order-disorder transition in such material leads to the supercoercivity defined as significant increase in the coercive field with frequency. Room temperature polarization measurements provide further support for the predictions.

Trapping Alkaline Earth Rydberg Atoms Optical Tweezer Arrays

Neutral atom qubits with Rydberg-mediated interactions are a leading platform for developing large-scale coherent quantum systems. In the majority of experiments to date, the Rydberg states are not trapped by the same potential that confines ground state atoms, resulting in atom loss and constraints on the achievable interaction time. In this Letter, we demonstrate that the Rydberg states of an alkaline earth atom, ytterbium, can be stably trapped by the same red-detuned optical tweezer that also confines the ground state, by leveraging the polarizability of the Yb^{+} ion core. Using the previously unobserved ^{3}S_{1} series, we demonstrate trapped Rydberg atom lifetimes exceeding 100  μs, and observe no evidence of auto- or photoionization from the trap light for these states. We measure a coherence time of T_{2}=59  μs between two Rydberg levels, exceeding the 28  μs lifetime of untrapped Rydberg atoms under the same conditions. These results are promising for extending the interaction time of Rydberg atom arrays for quantum simulation and computing, and are vital to capitalize on the extended Rydberg lifetimes in circular states or cryogenic environments.

The Influence of Family-Related Factors on Suicide in Major Depression Patients

OBJECTIVE

To explore the influence of family-related factors on suicide-related behaviors of patients with major depression disorder, and to provide scientific evidence for effective preventive measures.

METHODS

A total of 852 outpatients at Renmin Hospital of Wuhan University were enrolled in this cross-sectional study from April 2019 to January 2021. The general demographic information and family-related information of the patients were collected via a general information questionnaire, the Family Assessment Device, the Egna Minnen av Barndoms Uppfostran, and the Childhood Trauma Questionnaire.

RESULTS

Participants without suicide-related behaviors accounted for 10.45% of the total sample, those with suicidal ideation accounted for 47.54%, those with suicidal plans accounted for 24.77% and with suicidal attempts for 17.25%. Patients with major depression disorder who have lower education level, who were separated from their parents, who have severely impaired family function, who experienced childhood abuse, and whose parents adopted apathetic and severe child-rearing styles had a higher risk of suicide-related behaviors. In the multivariate regression model, degree of major depression disorder, education and child-rearing style were independent risk factors for suicide-related behaviors.

CONCLUSION

Patients with major depression disorder who have been separated from their parents, have severely impaired family function, were abused in childhood or have been exposed to improper childrearing styles have a greater risk of suicide. Family-related factors play a predictive role in suicide in patients with major depression disorder. More attention should be paid to family-related factors to reduce the occurrence of suicidal ideation and attempt.

Dysfunctional Attitudes Mediate the Relationship Between Childhood Emotional Neglect and Anhedonia in Young Adult Major Depression Patients

BACKGROUND

Childhood traumas are well-established risk factors for major depressive disorder (MDD). However, the relationship between childhood traumas types and MDD symptoms is unclear. The present study tested the hypothesis that childhood traumas affect specific types of anhedonia in depression and the mediating role of dysfunctional attitude.

METHODS

Within this cross-sectional study, 310 young adult patients with MDD completed the PHQ-9, CTQ-SF, DAS, and SHAPS. The statistical analyses used the Mann-Whitney U test, Spearman's rank correlation, and multiple regression analysis. Mediation analyses were tested by the structural equation model (SEM).

RESULTS

Spearman's rank correlation analysis showed positive correlations between the SHAPS, CTQ-SF, and DAS total score (p < 0.05). The EA, EN, PN, and SHAPS scores were positively correlated (p < 0.05). Among the four factors of anhedonia, social interaction and interest/pastimes were positively correlated with EA, EN, and PN (p < 0.05), the sensory experience was positively correlated with EN (p < 0.01), and diet did not correlate with childhood traumas. Stepwise regression analysis showed that dysfunctional attitude and emotional neglect were the main influencing factors of sensory experience (p < 0.001) and social interaction (p < 0.001). Dysfunctional attitude and physical neglect were the main factors influencing interest/pastimes (p < 0.001). SEM analysis found that dysfunctional mediated between childhood traumas and anhedonia.

CONCLUSIONS

The degree of anhedonia was related to dysfunctional attitudes and childhood traumas. The childhood emotional neglect experience was the most important and was related to sensory and social anhedonia. Dysfunctional attitudes played a mediating role between childhood neglect and anhedonia. Early psychotherapy targeting young adult MDD patients with childhood emotional neglect may help decrease symptoms of anhedonia.

Central high mobility group box-1 induces mechanical hypersensitivity with spinal microglial activation in a mouse model of hemi-Parkinson's disease

Parkinson's disease (PD) patients often complain of pain, but this problem has been neglected and is poorly understood. High mobility group box-1 (HMGB1), an alarmin/damage-associated molecular patterns protein, is increased in the cerebrospinal fluid in PD patients. However, little is known of the relationship between HMGB1 and pain associated with PD. Here, we investigated the role of central HMGB1 in the regulation of nociceptive hypersensitivity in a mouse model of PD. Male ddY mice were microinjected unilaterally with 6-hydroxydopamine (6OHDA) into the striatum. These hemi-PD mice were treated with anti-HMGB1 neutralizing antibody (nAb; 10 µg in 10 µL) by intranasal (i.n.) administration. The mechanical hypersensitivity of the hind paws was evaluated with the von Frey test. Spinal microglial activity was analyzed by immunostaining for ionized calcium-binding adapter molecule 1. The 6OHDA-administered mice displayed unilateral loss of dopamine neurons in the substantia nigra and mechanical hypersensitivity in both hind paws. Moreover, spinal microglia were activated in these hemi-PD mice. Twenty-eight days after the 6OHDA injections, repeated i.n., but not systemic, treatment with anti-HMGB1 nAb inhibited the bilateral mechanical hypersensitivity and spinal microglial activation. However, the anti-HMGB1 nAb did not ameliorate the dopamine neuron loss. Moreover, intracerebroventricular injection with recombinant HMGB1 induced mechanical hypersensitivity. These findings indicate that HMGB1 is involved in the maintenance of nociceptive symptoms in hemi-PD mice via spinal microglial activation. Therefore, central HMGB1 may have potential as a therapeutic target for pain associated with PD.