A predictive model for the risk of sepsis within 30 days of admission in patients with traumatic brain injury in the intensive care unit: a retrospective analysis based on MIMIC-IV database.

PURPOSE: Traumatic brain injury (TBI) patients admitted to the intensive care unit (ICU) are at a high risk of infection and sepsis. However, there are few studies on predicting secondary sepsis in TBI patients in the ICU. This study aimed to build a prediction model for the risk of secondary sepsis in TBI patients in the ICU, and provide effective information for clinical diagnosis and treatment. METHODS: Using the MIMIC IV database version 2.0 (Medical Information Mart for Intensive Care IV), we searched data on TBI patients admitted to ICU and considered them as a study cohort. The extracted data included patient demographic information, laboratory indicators, complications, and other clinical data. The study cohort was divided into a training cohort and a validation cohort. In the training cohort, variables were screened by LASSO (Least absolute shrinkage and selection operator) regression and stepwise Logistic regression to assess the predictive ability of each feature on the incidence of patients. The screened variables were included in the final Logistic regression model. Finally, the decision curve, calibration curve, and receiver operating character (ROC) were used to test the performance of the model. RESULTS: Finally, a total of 1167 patients were included in the study, and these patients were randomly divided into the training (N = 817) and validation (N = 350) cohorts at a ratio of 7:3. In the training cohort, seven features were identified as key predictors of secondary sepsis in TBI patients in the ICU, including acute kidney injury (AKI), anemia, invasive ventilation, GCS (Glasgow Coma Scale) score, lactic acid, and blood calcium level, which were included in the final model. The areas under the ROC curve in the training cohort and the validation cohort were 0.756 and 0.711, respectively. The calibration curve and ROC curve show that the model has favorable predictive accuracy, while the decision curve shows that the model has favorable clinical benefits with good and robust predictive efficiency. CONCLUSION: We have developed a nomogram model for predicting secondary sepsis in TBI patients admitted to the ICU, which can provide useful predictive information for clinical decision-making.

The safety and effectiveness of α-synuclein immunotherapy vs. placebo for the treatment of Parkinson's disease: a systematic review and meta-analysis.

BACKGROUND: There is no consensus on the efficacy of using α-synuclein as the primary immunotherapy site for Parkinson's disease (PD). The present study sought to investigate the safety and effectiveness of α-synuclein immunotherapy for treating PD. METHODS: The databases of CNKI, CBM, Cochrane Library, PubMed, Web of Science, and Embase were searched for randomized controlled trials (RCTs). Cochrane Collaboration's bias assessment tool was used to assess the risk of bias in the included articles, and the included PD patients older than 18 years adopted immunotherapy. Stata 15.0 was employed for statistical analysis. RESULTS: A total of 6 RCTs were eligible for the present study, involving 606 immunotherapy recipients (using alpha-synuclein immunotherapy) and 254 control individuals (placebo). Our meta-analysis found no statistical difference in the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) total score [weighted mean difference (WMD): -0.72, 95% confidence interval (CI): -1.56 to 0.13, P=0.099], adverse event incidence [relative risk (RR): 1.06, 95% CI: 0.98 to 1.15, P=0.150], headache incidence (RR: 0.95, 95% CI: 0.67 to 1.34, P=0.773), and constipation incidence (RR: 1.47, 95% CI: 0.77 to 2.78, P=0.242). However, the infection rate in the immunotherapy group was higher than in the control group (RR: 2.29, 95% CI: 1.40 to 3.74, P=0.003). The above results indicate that immunotherapy is significantly different from placebo in MDS-UPDRS and adverse event incidence, but it can reduce the incidence of infection rate. CONCLUSIONS: Existing results showed that α-synuclein immunotherapy had no significant effect on PD. high-quality, multi-center, and large-scale clinical studies are desired to corroborate our findings.

Endocrine Disorder in Patients With Craniopharyngioma.

Craniopharyngioma is an intracranial congenital epithelial tumor growing along the pathway of the embryonic craniopharyngeal tube. The main clinical symptoms of patients with craniopharyngioma include high intracranial pressure, visual field defect, endocrine dysfunction, and hypothalamic dysfunction. At present, the preferred treatment remains the surgical treatment, but the recovery of endocrine and hypothalamic function following surgery is limited. In addition, endocrine disorders often emerge following surgery, which seriously reduces the quality of life of patients after operation. So far, research on craniopharyngioma focuses on ways to ameliorate endocrine dysfunction. This article reviews the latest research progress on pathogenesis, manifestation, significance, and treatment of endocrine disorders in patients with craniopharyngioma.

Exploration of the pathogenic factors of neonatal jaundice and the clinical effect of blue phototherapy.

OBJECTIVE: To study the pathogenic factors of neonatal jaundice and the clinical effect of blue light phototherapy. METHODS: We selected 240 children with neonatal jaundice admitted to our hospital from January 2018 to January 2019 as the research subjects, and divided them into a control group and experimental group by a random grouping method, with 120 cases in each group. The control group received conventional treatment, and the experimental group received blue phototherapy. We observed the therapeutic effect on the two groups and analyzed the onset factors, compared the transcutaneous bilirubin value, serum bilirubin level, the time for the jaundice to subside after treatment, lactate dehydrogenase (LDH), creatine kinase (CK) in the myocardial enzyme spectrum, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to show liver function. RESULTS: Rate of effective treatment in the experimental group was higher than that in the control group. The transcutaneous bilirubin values and serum bilirubin levels of the two groups of children with jaundice were reduced after treatment (P<0.001), and the decrease in the experimental group after treatment was more notable (P<0.001). Jaundice subsided after treatment in the experimental group faster than in the control group (P<0.001). Children with jaundice in the experimental group had lower indexes of LDH, CK, ALT and AST compared with those of the control group (P<0.05). CONCLUSION: Phototherapy is a preferable method for neonatal jaundice and worthy of clinical application.

Improved model on fluorescence decay in singlet fission materials.

Singlet fission (SF) materials are a kind of promising material for breaking the solar cell efficiency limit. Here we rebuild the four-electron spin Hamiltonian under our coordinate system and present an improved model described by the population evolution equations on fluorescence decay (FD) dynamics that contain several detailed physical processes. The improved model for total random molecular orientation gives a more consistent fitting on the experimental data [G. B. Piland et al., J. Phys. Chem. C, 2013, 117, 1224] about time-resolved FD of amorphous rubrene thin films in the presence of a strong magnetic field. The fitting can reflect the relative rates of the real physical processes. Further on, our results show two kinds of magnetic field effect for the variety of two molecular relative orientations with respect to each other and the magnetic field by investigating the singlet projection and FD dynamics of the system.

Collective dynamics of a spin-orbit-coupled Bose-Einstein condensate.

We study the collective dynamics of the spin-orbit coupled two pseudospin components of a Bose-Einstein condensate trapped in a quasi-one-dimensional harmonic potential, by using variational and directly numerical approach of binary mean-field Gross-Pitaevskii equations. The results show that, because of strong coupling of spin-orbit coupling (SOC), Rabi coupling, and atomic interaction, the collective dynamics of the system behave as complex characters. When the Rabi coupling is absent, the density profiles of the system preserve the Gauss type and the wave packets do harmonic oscillations. The amplitude of the collective oscillations increases with SOC. Furthermore, when the SOC strength increases, the dipole oscillations of the two pseudospin components undergo a transition from in-phase to out-of-phase oscillations. When the Rabi coupling present, there will exist a critical value of SOC strength (which depends on the Rabi coupling and atomic interaction). If the SOC strength is less than this critical value, the density profiles of the system can preserve the Gauss type and the wave packets do anharmonic (the frequency of dipole oscillations depends on SOC) oscillations synchronously (i.e., in-phase oscillations). However, if the SOC strength is larger than this critical value, the wave packets are dynamically fragmented and the stable dipole oscillations of the system can not exist. The collective dynamics of the system can be controlled by adjusting the atomic interaction, SOC, and Rabi-coupling strength.

An efficient and high-throughput approach for experimental validation of novel human gene predictions.

A highly automated RT-PCR-based approach has been established to validate novel human gene predictions with no prior experimental evidence of mRNA splicing (ab initio predictions). Ab initio gene predictions were selected for high-throughput validation using predicted protein classification, sequence similarity to other genomes, colocalization with an MPSS tag, or microarray expression. Initial microarray prioritization followed by RT-PCR validation was the most efficient combination, resulting in approximately 35% of the ab initio predictions being validated by RT-PCR. Of the 7252 novel genes that were prioritized and processed, 796 constituted real transcripts. In addition, high-throughput RACE successfully extended the 5' and/or 3' ends of >60% of RT-PCR-validated genes. Reevaluation of these transcripts produced 574 novel transcripts using RefSeq as a reference. RT-PCR sequencing in combination with RACE on ab initio gene predictions could be used to define the transcriptome across all species.