Thrombo-inflammatory prognostic score can predict the outcome of stroke: a retrospective cohort study.

Introduction: Inflammatory and thrombotic biomarkers are simple prognostic indicators of adverse clinical outcomes in patients with ischemic stroke (IS). However, isolated assessment of inflammatory or thrombus biomarkers in patients with IS is limited in clinical practice. Methods: This study aimed to evaluate the predictive value of a novel, simplified thrombo-inflammatory prognostic score (TIPS) that combines both inflammatory and thrombus biomarkers in the early phase of IS and to identify high-risk patients at the time of admission. The study population comprised 915 patients with a primary diagnosis of IS in the emergency departments of five grade A tertiary hospitals in China. Results: Patients were divided into two groups based on the modified Rankin Scale (mRS): <3 and ≥3. TIPS with a value of "2" indicates biomarkers for high inflammation and thrombosis, "1" represents a biomarker, and "0" signals the absence of a biomarker. Multivariate logistic regression analysis was employed to identify the association between TIPS and clinical outcomes. TIPS was an independent predictor of unfavorable functional outcomes and mortality. It had a superior predictive value for clinical outcomes compared to the National Institutes of Health Stroke Scale (NIHSS) (effect ratio, 37.5%), D-dimer (effect ratio, 12.5%), and neutrophil-to-lymphocyte ratio (effect ratio, 25%). Conclusion: The survival probability of TIPS with a score of 0 is twice as high as that of TIPS with a score of 2. The survival rate for TIPS with a score of 1 is one time higher than that for TIPS with a score of 2. The predictive value of TIPS for unfavorable functional outcomes is represented by an AUC of 0.653. TIPS is associated with an increased risk of death and unfavorable functional outcomes in patients with IS and may be a useful tool for identifying high-risk patients at the time of admission.

Coronary Artery Tree Description and Lesion Evaluation (CatLet) score for functional evaluation of coronary stenosis: a comparison study with pressure wire fractional flow reserve.

Background: Pressure wire fractional flow reserve (FFR) and its derivatives, such as quantitative flow ratio (QFR), computational pressure flow-derived FFR (caFFR), coronary angiography-derived FFR (FFRangio), and computed tomography-derived FFR (FFRCT), have been validated for identifying functionally significant stenosis and guiding revascularization strategy. The limitations of using these methods include the side effects of hyperemia-induced agents, additional costs, and vulnerability to microvascular resistance. FFR is related both to the degree of a stenotic coronary artery and to its subtended myocardial territory. Coronary Artery Tree Description and Lesion Evaluation (CatLet) score (also known as Hexu) is a product of the degree of a stenosis and the weighting of the affected coronary artery (myocardial territory). Hence, we hypothesized that the CatLet score could predict hemodynamically significant coronary stenosis. Methods: We retrospectively enrolled consecutive patients with stable coronary artery disease. They attended Sichuan Science City Hospital with at least one lesion of 50-90% diameter stenosis in a coronary artery of 2 mm or larger. FFR measurement was obtained during invasive coronary angiography. The CatLet score was obtained by multiplying a fixed value of 2.0 (for non-occlusive lesions) and the weight of the affected coronary artery. The primary endpoint was the CatLet score's diagnostic accuracy in identifying hemodynamically significant coronary stenosis, with a pressure wire FFR of ≤0.80 being used as reference. Results: We analyzed the FFR and CatLet scores from 206 vessels in 175 patients with stable coronary disease and intermediate coronary lesions. The per-vessel analysis revealed an overall good correlation between the CatLet score and the FFR [r=-0.61; 95% confidence interval (95% CI): -0.69 to -0.52; P<0.01]. We also noted a significant CatLet score-FFR correlation for each of the left anterior descending artery (LAD), left circumflex (LCX), and right coronary artery (RCA). With a CatLet score ≥10 as a predictor of FFR ≤0.80, the overall diagnostic accuracy included a sensitivity of 78.80% (95% CI: 67.00-87.90%), a specificity of 85.00% (95% CI: 78.00-90.50%), a positive likelihood ratio of 5.25, a negative likelihood ratio of 0.25, and an area under the curve of 0.90 (95% CI: 0.85-0.94). Equivalent vessel-specific results were also achieved for each of the LAD, LCX, and RCA. Conclusions: The CatLet score, solely based on visual estimation of the results of coronary angiography, demonstrated good diagnostic performance with respect to myocardial ischemia. Its clinical values in guiding revascularization warrant further investigation.

BMX deletion mitigates neuroinflammation induced by retinal ischemia/reperfusion through modulation of the AKT/ERK/STAT3 signaling cascade.

Aims: Retinal ischemia/reperfusion (I/R) injury is implicated in the etiology of various ocular disorders. Prior research has demonstrated that bone marrow tyrosine kinase on chromosome X (BMX) contributes to the advancement of ischemic disease and inflammatory reactions. Consequently, the current investigation aims to evaluate BMX's impact on retinal I/R injury and clarify its implied mechanism of action. Main methods: This study utilized male and female systemic BMX knockout (BMX-/-) mice to conduct experiments. The utilization of Western blot assay and immunofluorescence labeling techniques was employed to investigate variations in the expression of protein and tissue localization. Histomorphological changes were observed through H&E staining and SD-OCT examination. Visual function changes were assessed through electrophysiological experiments. Furthermore, apoptosis in the retina was identified using the TUNEL assay, as well as the ELISA technique, which has been utilized to determine the inflammatory factors level. Key findings: Our investigation results revealed that the knockdown of BMX did not yield a significant effect on mouse retina. In mice, BMX knockdown mitigated the negative impact of I/R injury on retinal tissue structure and visual function. BMX knockdown effectively reduced apoptosis, suppressed inflammatory responses, and decreased inflammatory factors subsequent to I/R injury. The outcomes of the current investigation revealed that BMX knockdown partially protected the retina through downregulating phosphorylation of AKT/ERK/STAT3 pathway. Significance: Our investigation showed that BMX-/- reduces AKT, ERK, and STAT3 phosphorylation, reducing apoptosis and inflammation. Thus, this strategy protected the retina from structural and functional damage after I/R injury.

WNT2B activates macrophages via NF-κB signaling pathway in inflammatory bowel disease.

Inflammation is a significant pathological manifestation of inflammatory bowel disease (IBD), yet its mechanism has remained unclear. Although WNT2B is enriched in the intestinal inflammatory tissue of IBD patients, the specific mechanism of WNT2B in the formation of intestinal inflammation remains unclear. This study was aimed to investigate whether macrophages expressing WNT2B can aggravate intestinal tissue inflammation. Samples were collected from both normal individuals and patients with IBD at multiple colon sites. Macrophages were identified using tissue immunofluorescence. IκB kinase (IKK)-interacting protein (IKIP), which interacts with WNT2B, was found by protein cross-linking and protein mass spectrometry. The expression of WNT2B, IKIP, the NF-κB pathway, and downstream molecules were analyzed. An acute colitis model of C57BL/6J mice was established using an adeno-associated virus (AAV)-mediated WNT2B knockdown system and 3% dextran sulfate sodium (DSS). The degree of intestinal inflammation in mice was assessed upon WNT2B knockdown in macrophages. Macrophages expressing WNT2B were found to be enriched in the colitis tissues of IBD patients. WNT2B in macrophages activated the NF-κB pathway and enhanced the expression of downstream inflammatory cytokines. By competitively binding IKIP, WNT2B reduced the binding of IKIP to IKKß and promoted the activation of the NF-κB pathway. Using an AAV-mediated WNT2B knockdown system, WNT2B expression in intestinal macrophages was suppressed, leading to a reduction in intestinal inflammation. WNT2B activated the NF-κB pathway and enhanced the expression of downstream inflammatory cytokines by competitively binding to IKIP, potentially contributing to colon inflammatory injury in IBD.

The Accuracy of Guided Implant Surgery With Different Fields of View of Cone-Beam Computerized Tomography.

Although a smaller size field of view (FOV) of cone-beam computerized tomography (CBCT) reduces radiation exposure, its effect on the accuracy of static computer-aided implant surgery (s-CAIS) remains unknown. This study aimed to evaluate the impact of the size of FOV on the accuracy of s-CAIS and to investigate if the arch affects this effect. A total of 32 implant sites on 8 identical scannable models (maxillae and mandibles) were randomly allocated to 2 FOV sizes: test (5 × 5 cm) and control (10 × 10 cm). All models were scanned with an intraoral scanner (IOS). With the registration of the surface scan and CBCT image, a prosthetic-driven implant position was planned. Following the fabrication of surgical templates, a single-blinded surgeon placed all implants with the fully guided s-CAIS protocol. IOS captured the implant positions with the scan body attached. Implant-planning software measured the angular deviation, 3-dimensional (3D) deviation at the crest, and 3D deviation at the apex between preplanned and actual implant positions. Two-way analysis of variance was used to analyze the effect of FOV and arch on the deviations. The size of FOV did not show a significant effect (P > .198) on angular deviation, 3D deviation at the crest, or 3D deviation at the apex. No significant difference was found when comparing the effect of the size of FOV between the maxillary and mandibular implants. In conclusion, the use of small FOV CBCT demonstrated comparable accuracy of s-CAIS to the use of medium FOV CBCT.

Fluorescence sensor based on optimized quantum yield manganese-carbon polymer dots and smartphone-integrated sensing platform for tetracycline detection.

The one-step synthesis of Mn-doped carbon quantum dots (Mn-CPDs) with a high quantum yield (QY = 45%) is reported using the microwave-assisted method. Subsequently, Mn-CPDs were successfully combined with Eu3+ ions to construct an Eu3+@Mn-CPDs fluorescence sensor. The presence of tetracycline (TC) induced a transition of fluorescence emission from blue (434 nm) to red (618 nm), and a robust linear relationship was observed between the ratio of F618 nm / F434 nm and the TC concentration (5 - 50 nmol/L), with a limit of detection (LOD) of 5.76 nmol/L. The underlying mechanism of Eu3+@Mn-CPDs and TC sensing is unveiled as a synergistic effect involving inner filter effect (IFE) and concurrent interactions. Notably, the smartphone-integrated sensing platform based on Eu3+@Mn-CPDs enables rapid and quantitative TC detection within a short time (< 30 s) by monitoring fluorescence color changes, achieving high-detection sensitivities (with a LOD of 6.18 nmol/L). This versatile and efficient sensing platform demonstrates its potential for the determination of TC concentrations in milk, honey, and tap water samples.

Solid-state high harmonic spectroscopy for all-optical band structure probing of high-pressure quantum states.

High pressure has triggered various novel states/properties in condensed matter, as the most representative and dramatic example being near-room-temperature superconductivity in highly pressured hydrides (~200 GPa). However, the mechanism of superconductivity is not confirmed, due to the lacking of effective approach to probe the electronic band structure under such high pressures. Here, we theoretically propose that the band structure and electron-phonon coupling (EPC) of high-pressure quantum states can be probed by solid-state high harmonic generation (sHHG). This strategy is investigated in high-pressure Im-3m H3S by the state-of-the-art first-principles time-dependent density-functional theory simulations, where the sHHG is revealed to be strongly dependent on the electronic structures and EPC. The dispersion of multiple bands near the Fermi level is effectively retrieved along different momentum directions. Our study provides unique insights into the potential all-optical route for band structure and EPC probing of high-pressure quantum states, which is expected to be helpful for the experimental exploration of high-pressure superconductivity in the future.

A commentary regarding the article 'A meta-analysis of atrial septal defect closure in patients with severe pulmonary hypertension: Is there a room for poking holes amidst debate?'

Atrial septal defects (ASD) are a common congenital heart defect. The majority of patient with ASDs often follow an uncomplicated course of events. However, a proportion of patients with ASDs, may have their condition complicated by pulmonary hypertension (PH), with a subsequent significant impact on management, morbidity, and mortality. The presence of PH influences the suitability for defect closure. Suitability for ASD closure when PVR is between 2.3 and 4.6 WU (PVRi 4-8 WU/m2) is not straightforward and clinical decision-making is individualized. Considerations include, whether to intervene with a complete defect closure, fenestrated closure or the 'treat and repair' strategy. However, it is difficult to determine the outcomes for ASD closure in patients with moderately-to-severely elevated PVR. A "treat and repair strategy" might be an option. In addition, the patient should be carefully selected by the observation of PVR change through vasoreactivity and balloon occlusion tests, and then closure should be considered. For patients with a predictable poor prognosis, research on the risk assessment of ASD closure in patients with PAH will be needed for a more individualized treatment plan.

Detection of 14 sulfonate esters impurities of active pharmaceutical ingredients based on GC-MS/MS and LC-MS/MS / 药学学报

Two methods including gas chromatography tandem mass spectrometry (GC-MS/MS) and high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS) were established to detect common alkyl sulfonates and aryl sulfonates genotoxic impurities. Four alkyl sulfonates and methyl benzenesulfonate were determined by GC-MS/MS using butyl methanesulfonate as the internal standard, the chromatographic column was HP-5MS UI (30 mm × 0.25 mm, 0.25 µm), the carrier gas was helium, the flow rate was 1.0 mL·min-1 in a constant flow mode, the sample inlet temperature was set to 250 ℃, the split ratio was 10∶1, and the initial temperature of the heating program was 80 ℃, maintained for 1 minute, and then increased to 240 ℃ at a heating rate of 30 ℃·min-1 for 2 minutes. The mass spectrometry detector was an electron bombardment ion source (EI source), the data collection condition was multi reaction monitoring mode (MRM), and method validation using the raw material of clinical drug citalopram hydrobromide as a sample. The results showed that the linear range of four alkyl sulfonates and methyl benzenesulfonate were good at 3-50 ng·mL-1 and 9-150 ng·mL-1, with a correlation coefficient of r > 0.999, The spiked recovery was 80%-120%. The detection limits were 1 and 3 ng·mL-1; Ten aryl sulfonates determined by LC-MS/MS, the chromatographic column was CSH Fluoro phenyl (100 mm × 2.1 mm, 1.7 µm), the mobile phase was methanol (B)-5 mmol·L-1 ammonium formate (D), with a flow rate of 0.2 mL·min-1, and gradient elution was performed. The gradient program (T/% B) was set as 0/20, 25/90, 35/90, 42/20. The mass spectrometer detector was electro spray ionization with positive ionization mode (ESI+), the data collection was in dynamic multi reaction monitoring mode (dMRM), and the method was validated using the raw material of the clinical drug citalopram hydrobromide as a sample. The results showed that the linear range of aryl sulfonates were good at 9-2 000 ng·mL-1, 3-100 ng·mL-1 and 0.9-30 ng·mL-1, respectively. The correlation coefficient r > 0.999, the spiked recovery was 80%-120%. The detection limits were 30, 1 and 0.3 ng·mL-1. Two detection methods did not detect potential sulfonate genotoxicity impurities in the above APIs. The established analytical methods are reliable and effective, which can provide reference for drug quality control and detection.

Enhancing Emergency Nurses' Disaster Nursing Ability and Psychological Resilience: A Randomized Controlled Trial.

Objective: This study aimed to investigate emergency nurses' disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses. Methods: A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses' disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses' Disaster Nursing Ability Assessment Scale were used in the survey. Results: There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05). Conclusion: The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.

Prognostic accuracy of SOFA, MEWS, and SIRS criteria in predicting the mortality rate of patients with sepsis: A meta-analysis.

BACKGROUND: In recent years, some studies classified patients with sepsis and predicted their mortality by using some evaluation scales. Several studies reported significant differences in the predictive values of several tools, and the non-uniformity of the cut-off value. OBJECTIVE: To determine and compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) score, Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS) criteria in predicting the mortality of patients with sepsis. METHODS: This study comprised of systematic literature review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Embase, Web of Science and Cochrane Library databases from their establishment to July 31, 2022. The research articles published in the index journals provide sufficient data (true positive, false positive, true negative, and false negative results) for patients with sepsis. The combined sensitivity and specificity of the 95% confidence interval (CI) were calculated using the bivariate random effect model (BRM). The hierarchical overall subject working characteristics (HSROC) curve was drawn to evaluate the accuracy of the overall prognosis. RESULTS: Data of 55 088 patients from 32 studies were included in this meta-analysis. SOFA had an intermediate sensitivity of 0.73 (95% CI: 0.67-0.78) and a specificity of 0.70 (0.63-0.76). SIRS criteria had the highest sensitivity of 0.75 (0.66-0.82) and the lowest specificity of 0.40 (0.29-0.52). MEWS had the lowest sensitivity of 0.49 (0.40-0.59) and the highest specificity of 0.82 (0.78-0.86). CONCLUSIONS: Among SOFA, MEWS, and SIRS criteria, SOFA showed moderate sensitivity and specificity for predicting mortality in patients with sepsis, the highest sensitivity of SIRS and the strongest specificity of MEWS for predicting mortality in patients with sepsis. The future research direction is to combine the relevant indicators of MEWS and SIRS to develop a measurement tool with high reliability and validity. RELEVANCE TO CLINICAL PRACTICE: The review provides useful insights into the prognostic accuracy of different assessment tools in predicting mortality in sepsis patients, which will help clinicians choose the most appropriate tool for early identification and treatment of sepsis. The findings may also contribute to the development of more accurate and reliable prognostic models for sepsis.

[Saikosaponin D regulates apoptosis and autophagy of pancreatic cancer Panc-1 cells via Akt/mTOR pathway].

This study aims to investigate the effect and mechanism of saikosaponin D on the proliferation, apoptosis, and autophagy of pancreatic cancer Panc-1 cells. The cell counting kit(CCK-8) was used to examine the effects of 7, 10, 13, 16, 19, 22, 25, and 28 µmol·L~(-1) saikosaponin D on the proliferation of Panc-1 cells. Three groups including the control(0 µmol·L~(-1)), low-concentration(10 µmol·L~(-1)) saikosaponin D, and high-concentration(16 µmol·L~(-1)) saikosaponin D groups were designed. The colony formation assay was employed to measure the effect of saikosaponin D on the colony formation rate of Panc-1 cells. The cells treated with saikosaponin D were stained with hematoxylin-eosin(HE), and the changes of cell morphology were observed. Hoechst 33258 fluorescent staining was used to detect the effect of saikosaponin D on the cell apoptosis. The autophagy staining assay kit with MDC was used to examine the effect of saikosaponin D on the autophagy of Panc-1 cells. Western blot and immunocytochemistry(ICC) were employed to examine the effect of saikosaponin D on the expression levels and distribution of B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), cysteine-aspartic acid protease-3(caspase-3), cleaved caspase-3, autophagy-associated protein Beclin1, microtubule-associated protein light chain 3(LC3), protein kinase B(Akt), phosphorylated protein kinase B(p-Akt), mammalian target of rapamycin(mTOR), and phosphorylated mammalian target of rapamycin(p-mTOR). The results showed that compared with the control group, saikosaponin D decreased the proliferation rate of Panc-1 cells in a dose-dependent and time-dependent manner. The colony formation rate of the cells significantly decreased after saikosaponin D treatment. Compared with the control group, the cells treated with saikosaponin D became small, accompanied by the formation of apoptotic bodies. The saikosaponin D groups showed increased apoptosis rate and autophagic vesicle accumulation. Compared with the control group, saikosaponin D up-regulated the expression of Bax, cleaved caspase3, Beclin1, LC3Ⅱ/LC3Ⅰ and down-regulated the expression of Bcl-2, caspase-3, p-Akt/Akt, and p-mTOR/mTOR. In addition, these proteins mainly existed in the cytoplasm. In conclusion, saikosaponin D can inhibit the proliferation and induce the apoptosis and autophagy of Panc-1 cells via inhibiting the Akt/mTOR pathway.

MOF-Enhanced Chiral ECL Recognition System: Dual-Function in Phenylalanine Enantiomer Detection and Coreaction Acceleration.

The accurate discernment and separation of chiral isomers with high precision remain a significant challenge in various industries and biological fields. In this investigation, an electrochemiluminescent (ECL) chiral recognition platform was devised to ascertain the presence of phenylalanine (Phe). Notably, a homochiral [Ni2(l-asp)2(bipy)] (Ni-LAB) was established as a dual-function coreactant accelerator and chiral recognition substrate. Ni-LAB facilitates the reaction between the coreactant (K2S2O8) and the luminescent entity 3,4,9,10-perylenetetracar-boxylic-l-cysteine (PTCA-cys), thereby enhancing the ECL luminescence efficiency and improving the sensitivity of the chiral sensor. The chiral recognition potential of Ni-LAB was assessed to differentiate between Phe chiral isomers, and the underlying mechanism was comprehensively elucidated. This system exhibited remarkable proficiency in detecting Phe enantiomers and precisely differentiating a single Phe enantiomer within a mixture, showcasing exceptional levels of selectivity, stability, and reproducibility. This study paves the way for the development of advanced chiral recognition systems, potentially revolutionizing the field of chiral sensing and discrimination.

Chiral Discrimination of Penicillamine Enantiomers: The Role of Aggregation-Caused Quenching in Achieving High Selectivity.

The recognition and separation of chiral isomers are of great importance in both industrial and biological applications. In this study, a chiral recognition system based on electrochemiluminescence was established for the detection of penicillamine (PA) enantiomers. The system utilized a homochiral [Zn2(BDC)(d-lac)] (Zn-BL) platform for the uniform distribution of Ru(bpy)32+ nanoparticles, effectively mitigating aggregation-caused quenching. The chiral recognition ability of Zn-BL was tested to distinguish between PA enantiomers, and the results indicated a substantial increase in the chiral electrochemiluminescence (ECL) signal when l-PA was present, in contrast to d-PA. The mechanism underlying ECL chiral discrimination was investigated using water contact angle measurements, DFT calculations, and electrochemical characterization. The system exhibited high selectivity, stability, and reproducibility for PA enantiomer detection. Furthermore, the proposed method can accurately identify one enantiomer of PA in a mixture. This study provides a reliable and sensitive approach for achieving the highly selective detection of chiral molecules.

Periodontal Regeneration with Amnion-Chorion Membrane on Root Surface: A Retrospective Case Series.

This retrospective case series investigated the clinical and radiographic outcomes in 19 intrabony defects treated with periodontal regenerative therapy utilizing a combined approach. Placing an amnion-chorion membrane (ACM) as a biologic modifier on the root surface of the periodontally diseased tooth, combined with bone substitutes and an additional ACM as a barrier membrane, the treated sites were examined 8 to 24 months after the therapy. The preoperative (baseline) mean probing pocket depth (PPD) was 7.21 ± 1.08 mm, and the mean clinical attachment level (CAL) was 7.68 ± 1.49 mm. A mean PPD reduction of 4.05 ± 1.22 mm, CAL gain of 3.68 ± 1.34 mm, and 73.91% ± 22.02% of bone fill were recorded postoperatively. Without any adverse events, root-surface application of ACM as a biologic material in periodontal regenerative therapy could be a safe and cost-effective approach.

Utilizing directional preference in the management of cervicogenic headache: a case series.

BACKGROUND/PURPOSE: Headaches are among the most common complaints requiring medical care, and annual expenditures for this condition are estimated to be 14 billion US dollars. The International Headache Society (IHS) describes cervicogenic headache (CGH) as a secondary type of headache emanating from the cervical spine which may be referred to one or more regions of the head and/or face. Mechanical Diagnosis and Therapy (MDT) is an approach shown to be effective in the management of spinal musculoskeletal disorders; however, there is limited evidence as to its efficacy in the management of CGH. The purpose of this case series was to examine the MDT approach in the assessment, classification, and management of a sample of patients experiencing cervicogenic headache. CASE DESCRIPTION: This study was a prospective case series. Following IRB approval, 15 patients meeting the study inclusion criteria were recruited from a hospital-based outpatient physical therapy clinic. All subjects received a physical therapy examination by a Diploma trained MDT clinician which included but was not limited to patient self-report forms and the testing of repeated end range movements. The Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), Headache Disability Index (HDI), Yellow Flag Risk Form (YFRF), Cervical Flexion Rotation Test (CFRT), and the Craniocervical Flexion Test (CCFT) were administered at the initial visit, 5th visit, and 10th visit or discharge, whichever occurred first. The NPRS, NDI, and HDI were re-administered at a 3 month follow up. Following the initial examination, patients were classified into the MDT categories of derangement, dysfunction, postural, or 'other' and then received intervention based on directional preference. OUTCOMES: Fifteen subjects (mean age, 45.9 years; F = 11, M = 4; symptom duration, 44.3 months; average visits, 8.8) received an examination and intervention and completed follow-up outcome measures. Based on MDT classification criteria, all 15 subjects in this case series were classified as derangements. A non-parametric Friedman test of Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation differences among repeated measures was conducted on all outcome measures revealing statistically significant improvements in NPRS (p < .01), NDI(p < .01), and HDI (p < .01) scores at visit 10 and 3 month follow up. The mean change scores exceeded the minimal clinical important difference (MCID) for NPRS (4.2), NDI (7.6), and HDI (28.5). CCFT scores improved significantly from the initial examination to visit 5 (p < .01) and YFRF scores improved significantly between visits 5 and 10 (p < .01). DISCUSSION/CONCLUSION: The diagnosis of CGH is difficult to determine based on pathoanatomical assessment. This case series suggests that the patient's response to repeated end range movements may indicate a directional preference for manual procedures and exercises which may be used in management of musculoskeletal conditions such as CGH.

Preventive therapeutic effect of Lactobacillus-fermented black wolfberry juice on sodium dextran sulfate-induced ulcerative colitis in mice.

In this study, male mice were treated with fermented and unfermented Lactobacillus plantarum, Lactobacillus bulgaricus, and Lactobacillus rhamnosus black wolfberry juice (10 mL/kg/day) for 40 days, and their prophylactic effects on ulcerative colitis (UC) induced by dextran sodium sulfate were investigated. The intervention of black wolfberry juice reduced the levels of pro-inflammatory cytokines and increased the content of anti-inflammatory cytokines in the serum and colon. In addition, the pathological changes in colon tissue were alleviated, the expression of Bcl-2 protein in the colon was enhanced, and the intestinal microbiota of the mice was regulated, with an increase in Bacteroidetes and a decrease in Helicobacter. These results suggested that black wolfberry juice had an anti-UC function and Lactobacillus fermentation enhanced the anti-inflammatory effect of black wolfberry juice by modulating the intestinal microbiota.

The prevalence of anxiety and depression in cardiac arrest survivors: A systematic review and meta-analysis.

OBJECTIVE: This systematic review aimed to identify the prevalence of anxiety and depression in cardiac arrest (CA) survivors. METHODS: A systematic review and network meta-analysis was performed on observational studies in adult cardiac arrest survivors with psychiatric disorders from PubMed, Embase, Cochrane Library and Web of Science. In the meta-analysis, we combined the prevalence quantitatively and analyzed the subgroup based on the classification indexes. RESULTS: We identified 32 articles that met the inclusion criteria. Regarding anxiety,the pooled prevalence was 24% (95% CI, 17-31%) and 22% (95% CI, 13-26%) in short-term and long-term respectively. The subgroup analysis showed that the pooled incidence in in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrests (OHCA) survivors was 14.0% (95%CI, 9.0-20.0%) and 28.0% (95%CI, 20.0-36.0%) for short-term anxiety.The incidence of anxiety measured by, Hamilton Anxiety Rating Scale(HAM-A) and State-Trait Anxiety Inventory(STAI) was higher than other tools(P < 0.01). Regarding depression,the data analysis showed that the pooled incidence of short-term and long-term depression was 19% (95% CI, 13-26%) and 19% (95% CI, 16-25%), respectively. The subgroup analysis showed that the incidence of short-term and long-term depression was 8% (95% CI, 1-19%) and 30% (95% CI, 5-64%) for IHCA survivors, and was 18% (95% CI, 11-26%) and 17% (95% CI, 11-25%) for OHCA survivors. The incidence of depression measured by Hamilton Depression Rating Scale(HDRS) and Symptom check list-90(SCL-90) was higher than other assessment tools(P < 0.01). CONCLUSIONS: The meta-analysis indicated a high prevalence of anxiety and depression in CA survivors, and those symptoms persisted 1 year or more after CA. Evaluation tool is an important factor affecting the measurement results.

Comparison of In Vitro Biofilm Formation on Titanium and Zirconia Implants.

Background: Peri-implant diseases are emerging issues in contemporary implant dentistry. As biofilms play a critical role in peri-implant diseases, the characteristic of resisting bacterial adhesion would be ideal for dental implants. The aims of the study were to compare titanium (Ti) and zirconia (Zr) implants regarding the amount of biofilm formation at different time frames and assess the distribution of biofilm on different aspects of dental implants. Methods: Biofilm was developed on Ti and Zr dental implants with a peri-implant-related multispecies model with Streptococcus oralis, Actinomyces naeslundii, Veillonella dispar, and Porphyromonas gingivalis, for 3 and 14 days. Quantitative assessment was performed with the measurement of total bacterial viability (colony forming units, CFU/mg). Scanning electron microscopy (SEM) was used to evaluate biofilm formation on different aspects of the implants. Results: Three-day-old biofilm on Ti implants was significantly higher than that on Zr implants (p < 0.001). The Ti and Zr groups were not significantly different for 14-day-old biofilm. SEM images demonstrated that 3-day-old biofilm on Zr implants was sparse while biofilm growth was more pronounced for 3-day-old biofilm on Ti implants and 14-day-old biofilm groups. It appeared that less biofilm formed on the valley compared to the thread top for 3-day-old biofilm on Zr implants. Differences between the valley and the thread top became indistinguishable with the development of mature biofilm. Conclusion: While early formed biofilms show greater accumulation on Ti implants compared to Zr implants, older biofilms between the two groups are comparable. The distribution of biofilms was not uniform on different areas of implant threads during early biofilm development.