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Background: Few efficient and simple models for the early prediction of Parkinson’s disease (PD) exists. Objective: To develop and validate a novel nomogram for early identification of PD by incorporating microRNA (miRNA) expression profiles and clinical indicators. Methods: Expression levels of blood-based miRNAs and clinical variables from 1,284 individuals were downloaded from the Parkinson’s Progression Marker Initiative database on June 1, 2022. Initially, the generalized estimating equation was used to screen candidate biomarkers of PD progression in the discovery phase. Then, the elastic net model was utilized for variable selection and a logistics regression model was constructed to establish a nomogram. Additionally, the receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves were utilized to evaluate the performance of the nomogram. Results: An accurate and externally validated nomogram was constructed for predicting prodromal and early PD. The nomogram is easy to utilize in a clinical setting since it consists of age, gender, education level, and transcriptional score (calculated by 10 miRNA profiles). Compared with the independent clinical model or 10 miRNA panel separately, the nomogram was reliable and satisfactory because the area under the ROC curve achieved 0.72 (95% confidence interval, 0.68-0.77) and obtained a superior clinical net benefit in DCA based on external datasets. Moreover, calibration curves also revealed its excellent prediction power. Conclusion: The constructed nomogram has potential for large-scale early screening of PD based upon its utility and precision.

BACKGROUND Mental health problems are a crucial global public health concern. Owing to their cost-effectiveness and accessibility, conversational agent interventions (CAIs) are promising in the field of mental health care. OBJECTIVE This study aims to present a thorough summary of the traits of CAIs available for a range of mental health problems, find evidence of efficacy, and analyze the statistically significant moderators of efficacy via a meta-analysis of randomized controlled trial. METHODS Web-based databases (Embase, MEDLINE, PsycINFO, CINAHL, Web of Science, and Cochrane) were systematically searched dated from the establishment of the database to October 30, 2021, and updated to May 1, 2022. Randomized controlled trials comparing CAIs with any other type of control condition in improving depressive symptoms, generalized anxiety symptoms, specific anxiety symptoms, quality of life or well-being, general distress, stress, mental disorder symptoms, psychosomatic disease symptoms, and positive and negative affect were considered eligible. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were extracted by 2 independent reviewers, checked by a third reviewer, and pooled using both random effect models and fixed effects models. Hedges g was chosen as the effect size. RESULTS Of the 6900 identified records, a total of 32 studies were included, involving 6089 participants. CAIs showed statistically significant short-term effects compared with control conditions in improving depressive symptoms (g=0.29, 95% CI 0.20-0.38), generalized anxiety symptoms (g=0.29, 95% CI 0.21-0.36), specific anxiety symptoms (g=0.47, 95% CI 0.07-0.86), quality of life or well-being (g=0.27, 95% CI 0.16-0.39), general distress (g=0.33, 95% CI 0.20-0.45), stress (g=0.24, 95% CI 0.08-0.41), mental disorder symptoms (g=0.36, 95% CI 0.17-0.54), psychosomatic disease symptoms (g=0.62, 95% CI 0.14-1.11), and negative affect (g=0.28, 95% CI 0.05-0.51). However, the long-term effects of CAIs for the most mental health outcomes were not statistically significant (g=−0.04 to 0.39). Personalization and empathic response were 2 critical facilitators of efficacy. The longer duration of interaction with conversational agents was associated with the larger pooled effect sizes. CONCLUSIONS The findings show that CAIs are research-proven interventions that ought to be implemented more widely in mental health care. CAIs are effective and easily acceptable for those with mental health problems. The clinical application of this novel digital technology will conserve human health resources and optimize the allocation of mental health services. CLINICALTRIAL PROSPERO CRD42022350130; https://tinyurl.com/mvhk6w9p

Haisheng Hu,1,* Xiangqing Hou,2,* Wenting Luo,1 Yusi Li,2 Huimin Huang,1 Xiaoying Huang,1 Baoqing Sun,1 Xiaohua Douglas Zhang2 1Department of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University (State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health), Guangzhou, People’s Republic of China; 2Faculty of Health Sciences, University of Macau, Macau, People’s Republic of China*These authors contributed equally to this workCorrespondence: Baoqing SunDepartment of Allergy and Clinical Immunology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of ChinaTel +86 20 8306 2865Email sunbaoqing@vip.163.comXiaohua Douglas ZhangFaculty of Health Sciences, University of Macau, Taipa, Macau, People’s Republic of ChinaTel +86 853 88224813Email douglaszhang@um.edu.moAbstract: This study investigated the molecule sensitized pattern of atopic dermatitis patients who co-sensitized to shrimp, cockroaches, crab and house dust mites allergens and promoted the development of clinical accurate diagnosis and treatment.Keywords: specific immunoglobulin E, sIgE, atopic dermatitis, cross-reaction

Rabies is an acute lethal infectious disease caused by lyssavirus infection. In 2018, the World Health Organization (WHO) proposed a global strategic plan to end human rabies deaths by 2030. However, systematic studies of the global rabies disease burden and epidemiological trends are scarce.We extracted the disease burden and epidemiological data of global rabies in the preceding 30 years from the Global Burden of Disease (GBD) study 2019 and performed a comprehensive analysis.In 2019, the incident cases of rabies worldwide were 14075.51 (95% uncertainty interval, UI: 6124.33-21618.11), and the number of deaths was 13743.44 (95%UI: 6019.13-17938.53), both of which were lower than that in 1990. With the improvement of the Socio-demographic Index (SDI), the incident cases, the number of deaths, age-standardized incidence rate (ASIR) and death rate (ASDR), and disability-adjusted life years (DALYs) of rabies all showed downward trends. Adolescents and adults under the age of 50 represented the majority of rabies cases worldwide.The global disease burden of rabies had declined over the past 30 years. Furthermore, the disease burden of rabies was closely related to the SDI level.

Emotion reactivity and emotion dysregulation have been implicated in risk for suicidality. However, it remains unclear whether emotion reactivity and emotion dysregulation are predictive factors of suicide ideation, the progression from suicide ideation to suicide attempt, or both. The present study explored the relationship among emotion reactivity, emotion dysregulation, suicide ideation, and suicide attempt within a sample of Chinese undergraduates (n = 1596). According to lifetime suicidality, the current sample was divided into three groups: (a) non-ideators (no lifetime suicide ideation and no lifetime suicide attempts), (b) suicide ideators (with lifetime suicide ideation and no lifetime suicide attempts), and (c) suicide attempters (with lifetime suicide ideation and lifetime suicide attempts). Results of multinomial logistic regression suggested that compared to non-ideators, suicide ideators reported greater problems with emotion reactivity, and greater difficulties in emotion dysregulation, especially for emotion regulation strategies and emotional clarity. Compared to suicide ideators, suicide attempters reported greater difficulties in emotion dysregulation, especially for controlling impulses of negative emotions and emotional awareness. Emotion reactivity and emotion dysregulation are differentially associated with lifetime suicidality, and these findings provide preliminary guidance for suicide prevention and intervention.

This study aimed to validate the skin temperature on sacral region and vascular attributes as early warning signs of pressure injury.Totally 415 patients admitted to the adult intensive care unit from August 2018 to April 2019 were prospectively screened. Daily blood pressure and blood glucose affecting vascular attributes and the relative skin temperature of sacral region were measured for 10 consecutive days. Collect the changes of these indicators during the occurrence of pressure injury. The optimal cut-off values of indicators were determined by X-tile analysis. The risk ratios of indicators associated with pressure injury were compared using the Cox proportional hazards regression model.There were no obvious interactions among blood pressure, blood glucose and relative skin temperature (P 0.05). The optimal cutoff value for above indicators was 63.5 mmHg, 9.9 mmol/L and -0.1 °C, respectively. The incidence of pressure injury peaked on the 4th and 5th day after hospitalization when categorizing the patients into low- and high-risk groups according to the cutoff values (P 0.05). Based on relative skin temperature, patients in the high-risk group were more likely to develop pressure injury (hazard ratio = 6.36, 95% confidence interval = 3.91, 10.36), when compared to the other two indicators of blood pressure and blood glucose.Stringent skin temperature and vascular attributes measurements were necessary for preventing pressure injury. Nursing measures should be taken according to warning sings to reduce the incidence of pressure injury.

Mugwort, timothy, and birch are commonly spread pollen allergens across China. Although several studies have described the rates of sensitization to mugwort, timothy, and birch in China, most of them just on specific whole-allergen extracts but little was known about the co-sensitization characteristics of its allergen components. This study aimed to explore the patterns of sensitization to mugwort, timothy, birch, and their major allergen components.Serum specific IgE (sIgE) levels of allergen components of mugwort, timothy, birch, and cross-reactive carbohydrate determinants (CCD) were detected in 160 patients whose serum showed positive results to at least one of mugwort, timothy, and birch allergens via EUROBlotMaster system. Skin prick testing was utilized to assess the allergic reaction of grass, weed, and tree allergens. Latent class analysis was used to identify underlying patterns of sensitization to a series of allergen components and their corresponding extracts.88.8% of patients with allergic rhinitis and/or asthma were positive for mugwort-sIgE, 30% for timothy-sIgE, and 32.5% for birch-sIgE. By using the LCA model, three sensitization patterns as "Mugwort, Art v 4, Bet v 2 and Phl p 12 co-sensitized", "Timothy, mugwort, and CCD co-sensitized", "Mugwort and Art v 1 co-sensitized" were revealed based on optimal statistical fit in this study. Compared with other clusters, participants in "Mugwort, Art v 4, Bet v 2 and Phl p 12 co-sensitized" pattern were associated with higher sensitization rates of common grass and tree pollens allergen. The spearman's coefficient between CCD and timothy was larger than the corresponding values of CCD with mugwort or birch.CCD and profilin, as minor allergens in pollens, were associated with other pollen sIgE false positives presumably due to cross-reactivity. Patients sensitized with profilin had a significantly higher risk of sensitization to other pollens.

Mugwort is a common pollen allergen in western China, and this study aimed to investigate the patterns of molecular sensitization to major grass pollen allergens (mugwort, ragweed, bermuda grass, and timothy grass) and cross-reactive carbohydrate determinants (CCD) in children who were sensitized to mugwort in western China. Serum-specific IgE (sIgE) of major allergen components and CCD were detected among 121 mugwort SPT-positive children via the EUROBlotMaster system if the mugwort-sIgE was positive (MSP). A CCD inhibition test was further performed on the serum of patients with positive CCD-sIgE. Latent class analysis was used to identify the patterns of potential sensitization to major grass pollen allergens. Of a total of 100 patients with mugwort-sIgE positive (MSP), 52.0, 41.0, and 31.0% of them were positive to Art v 1, Art v 3, and Art v 4, respectively. An optimal model with three latent classes was determined using grass pollen allergens, components, and CCD. The sensitization patterns can be summarized as (1) MSP and cosensitized to ragweed, bermuda grass, and timothy grass (23.74%); (2) MSP and cosensitized to Art v 1 (54.08%); (3) MSP and cosensitized to Art v 4, Cyn d 12, Phl p 12 (22.18%). Additionally, CCD sIgE levels had a significant positive correlation with ragweed, bermuda grass, and timothy grass (P < 0.05), and CCD-Inhibitor can highly inhibit the above allergens sIgE. Our findings suggest that Art v 4 was the typical cross-reaction component of mugwort, which is cosensitized to Phl p 12 and Cyn d 12. A wide cross-reaction among ragweed, bermuda grass, and timothy grass caused by CCD was observed.

Background: Because of the limited epidemiological evidence on the association between acute air pollutants and allergy, there is a need to investigate this association, especially between the short-term exposure to air pollution and the serum Immunoglobulin E (IgE)-mediated allergy. Methods: A total of 39,569 IgE test results and demographic characteristics were obtained in the First Affiliated Hospital of Guangzhou Medical University between August 2012 and September 2019. Ninety-nine specific allergens were tested according to clinical diagnosis. The logistic regression was used to assess the effects of CO, NO2 and PM2.5 exposure on the risk of sensitization to specific inhalant/food allergens. Generalized additive models with multivariate adjustments were utilized to model the exposure-response relationship. Stratified analyses were performed to estimate the reliability of correlations in various subgroups. Findings: Single-pollutant models indicate that the 3-day moving average (lag2–4) of CO, PM2.5 or NO2 is associated with the increased risk for allergic diseases related to specific inhaled allergens. In multi-pollutant models, the adjusted Odds Ratio (OR) 95% (Confidence Interval, CI) increases by 8% (95% CI, 2%–15%) for per increment of 0.2 mg/m3 in CO levels, and rises by 8% (95% CI, 2%–13%) for each increase of 16.3 μg/m3 in PM2.5 concentration. The associations are stronger in youngsters (

Aims and objectives To verify the ability of infrared thermography in objectively identifying pressure injury and its application value in the early warning of pressure injury. Background There is subjectivity in assessing the risk of pressure injury as well as diagnosis in clinical settings, which makes early detection and prevention difficult. Design Prospective, cohort study. Method Four hundred and fifteen patients admitted to the adult intensive care units were enrolled by a convenience sampling method, and they received a follow‐up monitoring for 10 days. The risk of pressure injury was assessed via Braden scale, and thermal images of sacral area were obtained by infrared thermal imager once a day. The predictive effects of infrared thermography and Braden scale on pressure injury were compared by the receiver operating characteristic curve from which the optimal cutoff value of skin temperature for predicting pressure injury was determined. The effect of skin temperature on pressure injury was described and compared, using Kaplan‐Meier curve and Cox proportional hazard regression model respectively. We followed STROBE checklist for reporting the study. Results The relative temperature of sacral area was negatively correlated with the risk of pressure injury. The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale. Based on the relative temperature optimal cutoff value (‐0.1°C), Kaplan‐Meier curve and Cox proportional hazard regression model analysis showed the incidence of pressure injury with relative temperature below ‐0.1°C was higher than the group with relative temperature above ‐0.1°C. Conclusions Infrared thermography can objectively and accurately identify local hypothermia warnings of pressure injury before visual recognition. The application of infrared thermography into routine pressure injury risk assessment provides a timely and reliable method for nursing practitioners. Relevance to clinical practice Infrared thermography has great value of clinical application in daily pressure injury assessment. It is of great significance to make a faster and more objective clinical judgment for patients at risk of pressure injury.

Increased rates of exposure to Toxoplasma gondii have been found in patients with psychiatric disorders globally, but there is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Zhejiang Province, Southeastern China. In a case-control survey, we measured IgG and IgM class antibodies against T. gondii in 798 patients from a public psychiatric hospital in the city of Wenzhou, Zhejiang Province, and in 681 non-psychiatric controls from the general population in the same region. Subjects in each group were matched by sex and age with an enzyme-linked immunoassay. Seroprevalence of anti-Toxoplasma IgG antibodies in psychiatric patients (13.3%, 106/798) was significantly higher than in the control population (9.4%, 64/681) (P = 0.022). Anti-Toxoplasma IgM antibodies were also significantly higher in the psychiatric patients (4.1%, 33/798) than in the control group (1.9%, 13/681) (P = 0.016). Additionally, we found significantly elevated seropositive rates of anti-Toxoplasma IgG and IgM in patients with schizophrenia, as well as those with bipolar disorder. The identification of specific anti-Toxoplasma antibodies in psychiatric patients may be useful for assessing infection and timely initiation of treatment.

BACKGROUND In view of the important function of nuclear receptor liver receptor homolog 1 (LRH 1) in various biological processes and the physiological changes accompanying unexplained recurrent spontaneous abortion (USRA), our study was carried out to investigate the potential roles of LRH-1 in USRA. MATERIAL AND METHODS Thirty patients with URSA at early the early state of pregnancy were selected, and 30 patients with normal early pregnancy were also selected from Aug 2015 to Sep 2016 as a control group. The expression of LRH-1 protein in decidua and villi were detected by immunohistochemistry and Western blot analysis, and the expression of LRH-1 mRNA was detected by RT-PCR. The expression levels of CYP19 and P450scc were detected by RT-PCR and Western blot analysis at mRNA and protein levels, respectively. RESULTS The levels of LRH-1, CYP19, and P450scc mRNA and protein in villi of the patients in the URSA group were significantly lower than in the control group. There were no significant differences between the URSA group and control group in the levels of LRH-1, CYP19, and P450scc mRNA and protein in villi in decidua. CONCLUSIONS URSA was related to the reduced expression level of LRH-1 in villous tissues but not in decidua, and expression of LRH-1 may be related to the expression of CYP19 and P450scc. We believe that the expression level of LRH-1 can be used as a marker in the early diagnosis of URSA, and the regulation of LRH-1 expression many lead to new URSA treatments.