Search

BackgroundThis meta-analysis was conducted to evaluate potential differences in symptoms between PD patients with or without RBD.MethodsA systematic search was conducted in PubMed, Cochrane, Embase, and Web of Science databases (as of August 16, 2023), to identify relevant studies on PD and RBD. Statistical analysis was performed using Stata 15.0. Continuous variables were analyzed using the standardized mean difference (SMD) and 95% confidence interval (95% CI), while count data were assessed using the odds ratio (OR) and 95% CI as statistical effect sizes. Heterogeneity among all included studies was tested; for studies with low heterogeneity (I2 < 50%), a fixed-effects model was used to calculate statistical results. For studies with relatively high heterogeneity (I2 > 50%), a random-effects model was applied, followed by sensitivity and subgroup analyses to identify sources of heterogeneity.ResultsA total of 5,672 subjects were involved in this study. Compared to the NRBD group, the UPDRS-III score in the RBD group was significantly higher (SMD = 0.20, 95% CI: [0.11, 0.29], P < 0.001), and the Hoehn-Yahr score in the RBD group was also significantly higher (SMD = 0.29, 95% CI: [0.03, 0.55], P < 0.001). Patients with PD in the RBD group had more severe cognitive impairments than those in the NRBD group (SMD = −0.30, 95% CI: [−0.48, −0.11], P < 0.001). The incidence of hallucination in PD patients in the RBD group was 3.0 times that of the NRBD group (OR = 3.0, 95% CI: [2.15, 4.20], P = 0.110). PD patients in the RBD group also experienced more severe anxiety symptoms (SMD = 0.13, 95% CI: [−0.26, 0.51], P < 0.001), had higher scores in depression scales (SMD = 0.22, 95% CI: [0.02, 0.43], P < 0.001), and higher scores in sleep disorder scales than those in NRBD group (SMD = 0.10, 95% CI: [−0.11, 0.31], P < 0.001).ConclusionResults show PD patients with co-occurring RBD have more severe motor and non-motor symptoms likely due to overlapping affected regions in RBD and PD-related pathology, plus broader neurodegeneration seen in PD patients with RBD.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier CRD42023476331.

Abstract Background and Aim According to the European Society of Gastrointestinal Endoscopy (ESGE), gastroscopy should be conducted within 6 h for complete obstruction and 24 h for incomplete obstruction due to food bolus impaction. This study explores whether adults with acute esophageal food bolus (FB) impaction experience adverse outcomes when their time to esophagogastroduodenoscopy (EGD) deviates from the recommended guidelines. Methods A retrospective review was performed on the records of 248 patients who presented at the study site between 2015 and 2022 with symptoms of FB impaction. Results Two hundred and forty‐eight patients underwent EGD for FB impaction. Grade 1 (erosion, ulceration), Grade 2 (tear), and Grade 3 (perforation) complications were present in 31.6%, 6.9%, and 0.8% of cases, respectively. Of the 134 (54.0%) patients with complete obstruction, 51 (38.1%) received EGD within the recommended 6 h. Of the 114 (46%) patients with incomplete obstructions, 93 (81.6%) received EGD within the recommended 24 h. There was no statistically significant correlation between length of stay (LOS) post‐EGD and any of ingestion to presentation time, presentation to EGD time, or ingestion to EGD time. Age and complication level were greater predictors of longer LOS than presentation to EGD time. Patients who presented in hours were significantly more likely to receive EGD within the 6‐ and 24‐h guidelines than those who presented out of hours (50.7% vs 22.0%). Conclusion Neither time to EGD from ingestion of food bolus nor time to EGD from hospital presentation correlated with complication rate, complication severity, or length of stay post‐EGD.

Objective: To explore the clinical features and prognosis of patients with neuromyelitis optica spectrum disorder (NMOSD) initially presenting with acute brainstem symptoms. Methods: The clinical data of NMOSD patients admitted to two medical centers were collected. The clinical characteristics, laboratory data, neuroimaging features and prognoses of patients with NMOSD with acute brainstem manifestations as initial symptoms (NMOSD-BSMIS) were analyzed. The clinical features and prognosis of patients with NMOSD-BSMIS and patients with NMOSD with other manifestations as initial symptoms (NMOSD-OMIS) were compared. Results: Fifty-two patients (18.37 %, 52/283) initially presented with acute brainstem symptoms. Intractable nausea, vomiting or hiccups, diplopia, vertigo, headache, and facial hypoesthesia were the initial symptoms in most of the patients. The percentage of patients who were positive for serum aquaporin 4 (AQP4)-IgG antibodies was 81.63 % (40/49). MRI revealed that the lesions were usually located in the postrema, dorsal medulla oblongata, pons and other areas around the fourth ventricle. The early-stage misdiagnosis rate was 46.15 %. Compared with those in the non-misdiagnosed group, the age of onset of patients in the NMOSD-BSMIS group was older, and the proportion of patients admitted to the neurology department as the first department was lower in the misdiagnosed group. The annual relapse rate of patients who underwent NMOSD-BSMIS was significantly greater than that of patients who underwent NMOSD-OMIS (P

IntroductionSleep is associated with psychiatric disorders. However, their causality remains unknown.MethodsThe study explored the causal relationship between seven sleep parameters (sleep duration, insomnia, sleep apnea, chronotype, daytime dozing, napping during the day, and snoring) and three psychiatric disorders including major depressive disorder (MDD), schizophrenia, and attention-deficit/hyperactivity disorder (ADHD) using two-sample Mendelian randomization (MR). Genome-wide association study (GWAS) summary data for sleep parameters were obtained from the United Kingdom biobank, FinnGen biobank, and EBI databases. MR-Egger, weighted median, inverse-variance weighted (IVW), simple mode, weighted mode, maximum likelihood, penalized weighted median, and IVW(fixed effects) were used to perform the MR analysis. The heterogeneity was detected by Cochran’s Q statistic. The horizontal pleiotropy was detected by MR Egger. The sensitivity was investigated by the leave-one-out analysis.ResultsInsomnia (OR = 2.02, 95%CI = 1.34–3.03, p = 0.001, False-discovery rate (FDR) corrected p-value = 0.011) and napping during the day (OR = 1.81, 95%CI = 1.34–2.44, FDR corrected p-value

The existing research on the association between apolipoproteins (Apos) and erectile dysfunction (ED) primarily relies on observational studies and does not distinguish between organic and psychogenic causes when diagnosing ED. It is difficult to believe that Apos play a role in psychogenic ED. To address these issues, our study explored the causal relationship between lipoproteins and ED using Mendelian randomization (MR) analysis and differentiate between organic and psychogenic ED through the use of nocturnal penile tumescence and rigidity (NPTR) monitoring. Multivariate MR analysis revealed significant causal associations between high-density lipoprotein (HDL), Apo A1, and Apo B/A1 with ED (OR and 95% CI were 0.33 (0.14-0.78), 3.58 (1.52-8.43), and 0.30 (0.13-0.66)). we conducted statistical and analytical analyses on the data of 212 patients using multivariate analyses and receiver operating characteristic (ROC) curves. Patients with organic ED had significantly lower levels of HDL, Apo A1 and Apo A1/B, whereas patients with organic ED had considerably higher levels of Apo B and low-density lipoprotein (LDL). The diagnostic value of Apos in predicting the risk of organic ED was evaluated using ROC curves. The results indicated that Apo A1 and Apo A1/B demonstrated good predictive value. HDL, Apo A1, and Apo A1/B have been identified as risk factors for ED in our study. Furthermore, our research highlights the significance of Apo A1 and Apo A1/Apo B in the development of organic ED and suggests their potential use as indicators to assess the risks associated with organic ED.

Background/Aims: Prostate cancer is the most frequently diagnosed cancer among men in the United States and is the second leading cause of cancer-related deaths in men. The incidence of prostate cancer is gradually rising due to factors such as aging demographics and changes in dietary habits. The objective of this study is to investigate the metabolic reprogramming changes occurring in prostate cancer and identify potential therapeutic targets. Methods: In this study, we utilized single-cell sequencing to comprehensively characterize the alterations in metabolism and the regulatory role of transcription factors in various subtypes of prostate cancer. Results: In comparison to benign prostate tissue, prostate cancer displayed substantial metabolic variations, notably exhibiting heightened activity in fatty acid metabolism and cholesterol metabolism. This metabolic reprogramming not only influenced cellular energy utilization but also potentially impacted the activity of the androgen receptor (AR) pathway through the synthesis of endogenous steroid hormones. Through our analysis of transcription factor activity, we identified the crucial role of SREBPs, which are transcription factors associated with lipid metabolism, in prostate cancer. Encouragingly, the inhibitor Betulin effectively suppresses prostate cancer growth, highlighting its potential as a therapeutic agent for prostate cancer treatment.

Abstract In the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for Non-Small Cell Lung Cancer (NSCLC), tumors exhibiting main bronchial infiltration (MBI) near the carina and those presenting with complete lung obstructive pneumonia/atelectasis (P/ATL) have been reclassified from T3 to T2. Our investigation into the Surveillance, Epidemiology, and End Results (SEER) database, spanning from 2007 to 2015 and adjusted via Propensity Score Matching (PSM) for additional variables, disclosed a notably inferior overall survival (OS) for patients afflicted with these conditions. Specifically, individuals with P/ATL experienced a median OS of 12 months compared to 15 months (p

The risk factors of severe infections in children during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Beijing remain elusive. SARS-CoV-2-positive children admitted to the intensive care unit (ICU) with collected plasma specimens were enrolled and screened for common pathogens using capillary electrophoresis-based multiplex PCR from December 12, 2022, to January 24, 2023. The SARS-CoV-2 sub-variants were identified using next-generation sequencing. Plasma was positive for two (positive; P), one (suspicious; S), or no (negative; N) SARS-CoV-2 genes were classified as plasmatic RNA-positive (RNAemia; P + S) or without RNAemia (N). Clinical and laboratory data of the enrolled cases were then collected and analyzed. The 34 enrolled children included 26 males and 24 younger than three years. All were negative for other respiratory pathogens. BF.7.14 (18/29) was the predominant subvariant. Viral loads in respiratory specimens, hours from symptom onset to the first respiratory specimen collection (time-variable), with comorbidities and BF.7.14 and BA.5.2 distributions were significantly different in P vs. N and RNAemia vs. without RNAemia group. Among most cases, the T lymphocyte ratios decreased, while the cytokine level and the B lymphocyte ratio increased. The time variables were 2.22 ± 2.05 and 4.00 ± 2.49 days in BF.7.14 and BA.5.2 infections, respectively. In conclusion, SARS-CoV-2 was more likely to cause severe infections among males aged ≤ 3 years old with comorbidities during the SARS-CoV-2 outbreak in Beijing, while RNAemia is more common in children at the early stage of severe BF.7.14 infections, and most had high cytokine levels and B-cell activation.

Global teacher governance is an important strategy to promote the development of the global knowledge economy. It aims to promote the construction of high-quality teachers through various governance means, and realize the comprehensive support for students' learning. In the 1960s, based on the concern of teacher status and teacher training, international organizations went through three stages of concern, exploration and promotion in the process of promoting global teacher governance, and showed a clear development trend. The main strategies of global teacher governance include reshaping teachers' professional status, standardizing teachers' educational responsibilities, leveraging teachers' professional wisdom, and focusing on teachers' professional growth. In the future, its development and promotion require strengthening external resolutions to guide the policy direction of teacher governance, increasing education assistance to improve the overall effectiveness of teacher governance, using policy borrowing to promote best practices in teacher governance, and conducting international evaluations to establish comparative mechanisms for teacher governance.

Predicting the price of soybean meal futures has always been a hot topic in the financial market. It is influenced by many factors and has complex nonlinear characteristics, which makes it difficult to predict accurately. This paper proposes a prediction model for soybean meal futures price based on CNN-ILSTM-SA, which consists of CNN (Convolutional Neural Network), ILSTM (Improved Long Short-Term Memory), and SA (Self-Attention mechanism). CNN can well perform feature extraction on the input time series data. The ILSTM model presented in this paper removes the output gate of LSTM (Long Short-Term Memory) and improves the forget gate and input gate, thus reducing ILSTM’s complexity, shortening training time, and improving learning ability. SA can get the correlation between different input terms and predicted values, and assign different weight coefficients according to the correlation level to improve prediction accuracy. To verify the CNN-ILSTM-SA’s effectiveness, we compare it with eighteen baseline models, and the experimental results show that it is optimal. The MAE (Mean Absolute Error) of CNN-ILSTM-SA is 39.0441, the smallest of all models. As the data of the soybean meal futures price fluctuates in the range of 3500-4500 in experiments, the proportion of the MAE value of 39.0441 is 0.87%-1.15%, which is at an extremely low level; $\mathrm {R}^{2}$ (R-square) is 0.97487, which is closest to 1; The training time is 157.64s.

With China’s electricity spot market about to enter a new stage of “official operation” and large-scale renewable energy connected to the power system, the risk of volatility in spot market prices on the wholesale side of the electricity market is becoming more prominent. To address the issue that the current retail package design of electric power retailers cannot solve the risk of spot electricity price, this paper proposes an optimization approach for retail electricity packages considering customer response., in which the demand response model of retail users and the retail package optimization model are constructed and the DDPG reinforcement learning algorithm is applied to solve the model. Finally, simulation analysis is performed based on historical data and the results show that the optimization method of electricity retail packages taking into account user response effectively mitigates the negative impact of spot electricity price fluctuations and achieves the improvement of economic efficiency; electric power retailers appropriately reduce the pricing level of retail packages to attract new user groups to bring long-term potential revenue and achieve the increase of total revenue; The DDPG reinforcement learning algorithm is used to solve the model, which has an excellent convergence utility and can achieve the dynamic decision-making of electricity retail packages continuously, thereby guiding users to respond promptly.

Abstract Background Identification of intestinal flora composition is significant for exploring the cause and pathogenic mechanisms of the gut-testis axis and clarifying the relationship between microbiota and infertility. Our study aimed to examine the alternation in gut microbiota composition and identify potential microbes associated with development of Asthenozoospermia (AS). Method A total of 580 males were recruited in the outpatient department of Tianjin Medical University General Hospital between September 2021 and March 2023. Sperm parameters were analyzed according to the WHO laboratory manual. The 16 S rRNA gene high-throughput sequencing was performed to detect the gut microbiota composition in fecal samples. LEfSe analysis was used to screen key microbiota. PICRUSt2 software was utilized to predict relevant pathways. Results After rigorous screening, 60 isolated AS patients (AS group) and 48 healthy men (NC group) were enrolled. No significant differences were observed in demographic characteristics (p > 0.05), semen volume (p = 0.718), sperm concentration (p = 0.109), or total sperm count (p = 0.200). Sperm total motility and progressive motility were significantly decreased in the AS group (p

We detected a novel GII.4 variant with an amino acid insertion at the start of epitope A in viral protein 1 of noroviruses from the United States, Gabon, South Africa, and the United Kingdom collected during 2017–2022. Early identification of GII.4 variants is crucial for assessing pandemic potential and informing vaccine development.

In order to realize the variable caliber launching capability of an underwater platform launcher, the structure and safety design of a variable caliber adapter under the deep-sea pressure resistance and the strong dimensional weight constraints were studied in this paper. The adapter adopted the grid tube structure of carbon fiber composite materials. The structure simulation analysis was carried out under four working conditions, including working pressure, test pressure, launch chamber pressure, and launch concentration force, and the safety of the equipment leaving the launch tube under different working conditions was analyzed. The results show that the designed adapter meets the structural strength requirement under the deep-sea pressure resistance and the strong dimensional weight constraints (length ≥ 3 000 mm, weight ≤ 60 kg), and the designed 1∶5 battle taper meets the requirements of the equipment leaving the launch tube safely, realizing the variable diameter launching capability of the launcher. The research results of this paper can provide a reference for the design of the adapter for the underwater platform launcher, and the results of the structural strength analysis of the adapter and safety analysis of equipment leaving the launch tube can guide the adapter environment test and land test.

The aggressive nature and poor prognosis of lung cancer led us to explore the mechanisms driving disease progression. Utilizing our invasive cell-based model, we identified methylthioadenosine phosphorylase (MTAP) and confirmed its suppressive effects on tumorigenesis and metastasis. Patients with low MTAP expression display worse overall and progression-free survival. Mechanistically, accumulation of methylthioadenosine substrate in MTAP-deficient cells reduce the level of protein arginine methyltransferase 5 (PRMT5)-mediated symmetric dimethylarginine (sDMA) modification on proteins. We identify vimentin as a dimethyl-protein whose dimethylation levels drop in response to MTAP deficiency. The sDMA modification on vimentin reduces its protein abundance but trivially affects its filamentous structure. In MTAP-deficient cells, lower sDMA modification prevents ubiquitination-mediated vimentin degradation, thereby stabilizing vimentin and contributing to cell invasion. MTAP and PRMT5 negatively correlate with vimentin in lung cancer samples. Taken together, we propose a mechanism for metastasis involving vimentin post-translational regulation.

The preparation of ethyl acetoacetate is a distinctive, century-old classic organic chemistry laboratory project. Ethyl acetate and sodium metal (sodium ethoxide) are reacted by Claisen ester condensation to produce the sodium salt of ethyl acetoacetate and then obtain the refined product by acidification as well as washing, drying, and distillation under reduced pressure. This article analyzed the reasons for the low product yield and poor purity of the traditional experimental method and found that ethanol was the key to the final product. The improved experimental method used rotary evaporation and washing with saturated calcium chloride solution to remove ethanol. The new experimental method not only retains the characteristics of the original experiment and improves the product yield, but also adds the interesting phenomenon of pointing water into "ice", which cultivates students' learning interest and innovation and achieves a good teaching effect.

BackgroundRecent studies have indicated an association between sedentary behavior (SB), particularly patterns of SB, and bone health. However, it remains uncertain how different patterns of SB in overweight/obesity older women impact their bone health. This study aimed to investigate the association between objectively measured SB patterns and bone health in Chinese community-dwelling overweight/obesity older women.MethodsCross-sectional data were obtained from a baseline survey of Physical Activity and Health in Older Women Study. Quantitative ultrasound was used to measure speed of sound (SOS), broadband ultrasound attenuation (BUA), bone quality index (BQI) and T value to evaluate bone health. SB patterns were measured using triaxial accelerometers, including sedentary time in SB bouts of ≥ 10, 30, and 60 min, number of SB bouts ≥ 10, 30, and 60 min. Multiple linear regression was used to examine the associations of different SB patterns with bone health.ResultsAfter adjusting for confounders, sedentary time in SB bouts ≥ 60 min, number of SB bouts ≥ 60 min were significantly associated with bone health, with a lower SOS [β = −2.75, 95% confidence interval (CI): −4.96 to −0.53, P = 0.015], BUA (β = −1.20, 95% CI: −2.14 to −0.26, P = 0.013), BQI (β = −1.56, 95% CI: −2.63 to −0.49, P = 0.004), T value (β = −0.08, 95% CI: −0.14 to −0.03, P = 0.004) per 60 min increase of sedentary time in SB bouts ≥ 60 min, and a lower SOS (β = −3.97, 95% CI: −7.54 to −0.40, P = 0.029), BUA (β = −1.80, 95% CI: −3.44 to −0.16, P = 0.031), BQI (β = −2.28, 95% CI: −4.08 to −0.47, P = 0.014) and T value (β = −0.12, 95% CI: −0.22 to −0.03, P = 0.013) per bout increase of SB bouts ≥ 60 min, respectively.ConclusionLimiting the duration of prolonged sedentary bouts and minimizing the occurrence of number of SB bouts ≥ 60 min could be essential in bone health management, especially for those older people who are overweight/obesity.

Plastic surgeons can be distinguished in pre-planning much of their surgery by drawing on the skin. The history of marking the body with ink in plastic surgery goes back to the 1400s. The Sommerlad pen was originally developed at the London Hospital in the 1970s. Sommerlad pens and Bonney’s blue ink allow for a consistent weight of the pen in hand, a reliable source of ink, and an ability to vary the thickness of the line drawn. There has been a suspicion that gentian violet, a component of Bonney’s blue ink, is a carcinogen, resulting in supply problems. Animal models have demonstrated the carcinogenic properties of gentian violet, but evidence to support the carcinogenic potential of gentian violet in humans is sparse. In the surgical setting, we must adhere to using published and described ink formulas. Proprietary formulations lack standardisation, and the compounds used are not always disclosed. The concerning findings of in-vitro and animal models are a valuable addition to our knowledge about these compounds; however, to over-extrapolate and restrict its use on humans as a topical skin marker takes away an important component of a plastic surgeon’s armamentarium.