MRI of kidney size matters.

OBJECTIVE: To highlight progress and opportunities of measuring kidney size with MRI, and to inspire research into resolving the remaining methodological gaps and unanswered questions relating to kidney size assessment. MATERIALS AND METHODS: This work is not a comprehensive review of the literature but highlights valuable recent developments of MRI of kidney size. RESULTS: The links between renal (patho)physiology and kidney size are outlined. Common methodological approaches for MRI of kidney size are reviewed. Techniques tailored for renal segmentation and quantification of kidney size are discussed. Frontier applications of kidney size monitoring in preclinical models and human studies are reviewed. Future directions of MRI of kidney size are explored. CONCLUSION: MRI of kidney size matters. It will facilitate a growing range of (pre)clinical applications, and provide a springboard for new insights into renal (patho)physiology. As kidney size can be easily obtained from already established renal MRI protocols without the need for additional scans, this measurement should always accompany diagnostic MRI exams. Reconciling global kidney size changes with alterations in the size of specific renal layers is an important topic for further research. Acute kidney size measurements alone cannot distinguish between changes induced by alterations in the blood or the tubular volume fractions-this distinction requires further research into cartography of the renal blood and the tubular volumes.

The non-covalent and covalent interactions of whey proteins and saccharides: influencing factor and utilization in food.

During the application of Whey proteins (WPs), they often have complex interactions with saccharides (Ss), another important biopolymer in food substrate. The texture and sensory qualities of foods containing WPs and Ss are largely influenced by the interactions of WPs-Ss. Moreover, the combination of WPs and Ss is possible to produce many excellent functional properties including emulsifying properties and thermal stability. However, the interactions between WPs-Ss are complex and susceptible to some processing conditions. In addition, with different interaction ways, they can be applied in different fields. Therefore, the non-covalent interaction mechanisms between WPs-Ss are firstly summarized in detail, including electrostatic interaction, hydrogen bond, hydrophobic interaction, van der Waals force. Furthermore, the existence modes of WPs-Ss are introduced, including complex coacervates, soluble complexes, segregation, and co-solubility. The covalent interactions of WPs-Ss in food applications are often formed by Maillard reaction (dry or wet heat reaction) and occasionally through enzyme induction. Then, two common influencing factors, pH and temperature, on non-covalent/covalent bonds are introduced. Finally, the applications of WPs-Ss complexes and conjugations in improving WP stability, delivery system, and emulsification are described. This review can improve our understanding of the interactions between WPs-Ss and further promote their wider application.

Using celluloses to reinforce the optimized alginate film in wet state: Effect of cellulose types and cooking treatment.

Alginate (Alg) as co-extruded casing is of interest to the meat industry as replacers for natural sausage casing. However, these studies on the mechanical reinforcement of Alg-based film are still limited in the wet state (e.g. co-extrusion process). In this work, Alg-D with the highest viscosity-average molecular weight (1.12 × 105) was selected from four types of alginates based on the results of the viscosity of Alg solutions and film strength. Next, three celluloses (cellulose nanocrystals (CNC), cellulose nanofibers (CNF) and microfibrillated fiber (MFC)) were added to the Alg-D matrix at different concentrations. SEM showed that the cross section of the Alg-based films became more compact and uniform when the size of celluloses decreased. The tensile test revealed that the strength (TS) of Alg-based films exhibited an initial increase followed by a subsequent drop as the cellulose content rose. The best mechanical strengthening effect was the Alg-CNC film (1.16 MPa), which increased by 93.33 % compared with that of pure Alg. Cooking treatment could further enhance this trend. The opacity increased gradually with the increase of cellulose content, while these films were still transparent enough for food packaging. These findings would have potential applications in food packaging, especially co-extruded sausage casings.

SIRT1 exerts protective effects by inhibiting endoplasmic reticulum stress and NF-κB signaling pathways.

Silent information regulator two homolog 1 (SIRT1), an NAD + -dependent histone deacetylase, plays a pivotal regulatory role in a myriad of physiological processes. A growing body of evidence suggests that SIRT1 can exert protective effects in metabolic disorders and neurodegenerative diseases by inhibiting endoplasmic reticulum (ER) stress and the nuclear factor-κB (NF-κB) inflammatory signaling pathway. This review systematically elucidates the molecular mechanisms and biological significance of SIRT1 in regulating ER stress and the NF-κB pathway. On one hand, SIRT1 can deacetylate key molecules in the ER stress pathway, such as glucose-regulated protein 78 (GRP78), X-box binding protein 1 (XBP1), PKR-like ER kinase (PERK), inositol-requiring enzyme 1α (IRE1α), and activating transcription factor 6 (ATF6), thereby alleviating ER stress. On the other hand, SIRT1 can directly or indirectly remove the acetylation modification of the NF-κB p65 subunit, inhibiting its transcriptional activity and thus attenuating inflammatory responses. Through these mechanisms, SIRT1 can ameliorate insulin resistance in metabolic diseases, exert cardioprotective effects in ischemia-reperfusion injury, and reduce neuronal damage in neurodegenerative diseases. However, it is important to note that while these findings are promising, the complex nature of the biological systems involved warrants further investigation to fully unravel the intricacies of SIRT1's regulatory mechanisms. Nevertheless, understanding the regulatory mechanisms of SIRT1 on ER stress and the NF-κB pathway is of great significance for expanding our knowledge of the pathogenesis of related diseases and exploring new preventive and therapeutic strategies targeting SIRT1.

Experimental study on the impact of functional training on the agility quality of young athletes

At present, there is a lack of relevant literature on functional training for young athletes aged 10-12 years old in China. This project plans to combine functional training with sports training classes. Through 40 young athletes aged 10-12 years old, the impact of functional training on 10-12-year-oldathletes is systematically studied. Effects on agility in age-old athletes and exploring its causes. This article uses expert interview methods, experimental methods, mathematical statistics and other methods to analyze the survey results. Before the experiment begins, general information about the research subjects is collected, and then they are divided into experimental groups and control groups, and then a difference analysis is performed to determine the differences between the two groups. After 12 weeks of experimental intervention, the sensitivity quality evaluation indicators of the two groups of students were compared. Results: There was a very significant difference in the experimental group's scores on the hexagonal reaction ball test before and after the experiment (P<0.01), with an improvement rate of 10.8%; the difference between the control group's scores on the hexagonal reaction ball test before and after the experiment was statistically significant (P<0.01). Significance (P<0.05), the average improvement was 4.0%. There was a very significant difference (P<0.01) in the performance of the experimental group in the 4×10m return run before and after the experiment, with an improvement rate of 11.7%; in the control group, there was a significant difference in the 4×10m return run before and after the experiment. The difference was statistically significant (P<0.05), and the average progress rate was 8.0%... (AU)

Construction of phenolic acids grafted chitosan bioactive microspheres to reduce oxidation and iron absorption in meat digestion.

Although iron in meat is an important trace element for human diet, its presence also induces postprandial oxidative stress and aggravates the condition of patients with iron overload. To overcome this situation, a type of new tunable Fe-absorption bioactive materials was constructed in this study. First, four phenolic acids (Caffeic acid, Gallic acid, Protocatechuic acid, Chlorogenic acid) were grafted onto chitosan. Then, the copolymers were prepared into micron-level microspheres by emulsification method, which were characterized in adsorption isotherms (Langmuir model), swelling behavior and digestion characteristics. In order to verify the practical application effect of microspheres, Protocatechuic acid grafted chitosan microspheres as the representative were used in sirloin powder to observe their effects in vitro digestion and rat experiment. In the present study, microspheres were innovatively applied in meat consumption, which significantly inhibited the oxidation of meat in the process of digestion and effectively controlled the iron absorption. These results are expected to play an important role in promoting the healthy consumption of meat around the world, improving gastrointestinal redox status through dietary assistance, and treating diseases related to iron overload.

Adjustable strength and toughness of dual cross-linked nanocellulose films via spherical cellulose as soft-phase.

Nanocellulose films possess numerous merits ascribing to their inherent biocompatibility, non-toxic and biodegradability properties. The potential for practical applications would be improved if their mechanical strength and toughness requirements could be met simultaneously. Herein, dual cross-linked nanocellulose (DC) film was fabricated by the treatments of chemical and physical cross-linking, which was mechanically superior to pure nanocellulose (CNF) films. To further increase the toughness of DC films, spherical cellulose (Sph) was incorporated into DC film (DC-Sph film), and analyzed under different humidity conditions (RH) (from 10 % to 90 %). The changes of functional groups of CNF, DC and DC-Sph films were detected by FTIR and XPS spectrum. The epichlorohydrin and Sph content were optimized, followed by the investigation of RH on the toughness of films. The highest tensile strength (146.6 ± 4.6 MPa) was obtained in DC film at 50 % RH, while the DC-Sph film showed the largest toughness (40.3 ± 3.7 kJ/m2) at 70 % RH. Furthermore, the possible toughening mechanism of DC-Sph film was also discussed.

Noninvasive Assessment of Diabetic Kidney Disease With MRI: Hype or Hope?

Owing to the increasing prevalence of diabetic mellitus, diabetic kidney disease (DKD) is presently the leading cause of chronic kidney disease and end-stage renal disease worldwide. Early identification and disease interception is of paramount clinical importance for DKD management. However, current diagnostic, disease monitoring and prognostic tools are not satisfactory, due to their low sensitivity, low specificity, or invasiveness. Magnetic resonance imaging (MRI) is noninvasive and offers a host of contrast mechanisms that are sensitive to pathophysiological changes and risk factors associated with DKD. MRI tissue characterization involves structural and functional information including renal morphology (kidney volume (TKV) and parenchyma thickness using T1- or T2-weighted MRI), renal microstructure (diffusion weighted imaging, DWI), renal tissue oxygenation (blood oxygenation level dependent MRI, BOLD), renal hemodynamics (arterial spin labeling and phase contrast MRI), fibrosis (DWI) and abdominal or perirenal fat fraction (Dixon MRI). Recent (pre)clinical studies demonstrated the feasibility and potential value of DKD evaluation with MRI. Recognizing this opportunity, this review outlines key concepts and current trends in renal MRI technology for furthering our understanding of the mechanisms underlying DKD and for supplementing clinical decision-making in DKD. Progress in preclinical MRI of DKD is surveyed, and challenges for clinical translation of renal MRI are discussed. Future directions of DKD assessment and renal tissue characterization with (multi)parametric MRI are explored. Opportunities for discovery and clinical break-through are discussed including biological validation of the MRI findings, large-scale population studies, standardization of DKD protocols, the synergistic connection with data science to advance comprehensive texture analysis, and the development of smart and automatic data analysis and data visualization tools to further the concepts of virtual biopsy and personalized DKD precision medicine. We hope that this review will convey this vision and inspire the reader to become pioneers in noninvasive assessment and management of DKD with MRI. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

Quality Information Detection of Agaricus bisporus Based on a Portable Spectrum Acquisition Device.

As one of the most popular edible fungi in the market, the quality of Agaricus bisporus will determine its sales volume. Therefore, to achieve rapid and nondestructive testing of the quality of Agaricus bisporus, this study first built a portable spectrum acquisition device for Agaricus bisporus. The Ocean Spectromeper was used to calibrate the spectral data of the device, and the linear regression analysis method was combined to analyze the two. The results showed that the Pearson correlation coefficient of significance between the two was 0.98. Then, the spectral data of Agaricus bisporus were collected, the spectral characteristic wavelength of Agaricus bisporus was extracted by the SPA and PCA algorithms, and the moisture content and whiteness prediction models based on a BP neural network and PLSR, respectively, were built. The parameters of the BP neural network model were optimized by SSA. The R2 values for the final moisture content and the predicted whiteness were 0.95 and 0.99, and the RMSE values were 5.04% and 0.60, respectively. The results show that the portable spectral acquisition and analysis device can be used for the accurate and rapid quality detection of Agaricus bisporus.

Gentiopicroside-Loaded Chitosan Nanoparticles Inhibit TNF-α-Induced Proliferation and Inflammatory Response in HaCaT Keratinocytes and Ameliorate Imiquimod-Induced Dermatitis Lesions in Mice.

Purpose: In this study, we aimed to report the biological characteristics of the first successful synthesis of gentiopicroside-loaded chitosan nanoparticles and to evaluate the therapeutic effects and preliminary mechanisms of gentiopicrin-loaded chitosan on psoriasis-like cell and mouse models. Methods: Gentiopicroside-loaded chitosan nanoparticles (CHI-GEN) were prepared, and their biological characteristics were evaluated. HaCaT keratinocytes were stimulated with TNF-α to establish a psoriatic keratinocyte model. MTT assay and flow cytometry were used to measure cell viability and apoptosis, respectively. mRNA levels of K17, VEGF A, and IL-6 and IL-23A were detected using qRT-PCR. These tests were used to preliminarily assess the effects of CHI-GEN on keratinocyte proliferation and inflammation. Imiquimod was used to construct a psoriasis-like mice model. The severity of psoriasis was scored based on the psoriasis area severity index (PASI), H&E staining was used to observe the histological changes and the level of inflammation and cell proliferation of skin lesions was evaluated by measuring the mRNA levels of K17, IL-23A, and IL-17A using qRT-PCR. Results: The average particle size of CHI-GEN nanoparticles was approximately 100 nm, and the zeta potential was 2.69 ± 0.87 mV. The cumulative release was 67.2% in solutions of pH 5.5 at 24 h. GEN reduced TNF-α-induced excessive proliferation of HaCaT keratinocytes and downregulated mRNA levels of K17, VEGF A, and inflammatory cytokines IL-6 and IL-23A, which was more obvious in the CHI-GEN treatment group. Additionally, CHI-GEN significantly improved the severity of skin lesions in psoriasis-like mice and downregulated the mRNA expressions of IL-6, IL-23A, and IL-17A in mice skin lesions. Conclusion: In conclusion, we successfully prepared gentiopicrin-chitosan nanoparticles. Our results show that these nanoparticles have anti-psoriasis activity, inhibits keratinocyte proliferation and improves symptoms in psoriasis model mice and can be used to develop an effective strategy for the treatment of psoriasis.

Diagnostic and prognostic performance of renal compartment volume and the apparent diffusion coefficient obtained from magnetic resonance imaging in mild, moderate and severe diabetic kidney disease.

Background: Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD). There are unmet needs for noninvasive diagnosis and prognosis prediction of DKD in clinical practice. This study examines the diagnostic and prognostic value of magnetic resonance (MR) markers of renal compartment volume and the apparent diffusion coefficient (ADC) for mild, moderate, and severe DKD. Methods: This study was registered at the Chinese Clinical Trial Registry Center (registration number: ChiCTR-RRC-17012687). Sixty-seven DKD patients were prospectively randomly enrolled and underwent clinical examination and diffusion-weighted magnetic resonance imaging (DW-MRI). Patients with comorbidities that affected renal volumes or components were excluded. Ultimately, 52 DKD patients were included in the cross-sectional analysis. The ADC in the renal cortex (ADCcortex), ADC in the renal medulla (ADCmedulla) and difference between ADCcortex and ADCmedulla (ΔADC) were measured using a twelve-layer concentric objects (TLCO) approach. Renal compartment volumes of the parenchyma and pelvis were derived from T2-weighted MRI. Due to lost contact or ESRD diagnosed before follow-up (n=14), only 38 DKD patients remained for follow-up (median period =8.25 years) to investigate the correlations between MR markers and renal outcomes. The primary outcomes were the composite of doubling of the primary serum creatinine concentration or ESRD. Results: ADCcortex presented superior performance in discriminating DKD with normal and declined estimated glomerular filtration rate (eGFR) over ADCmedulla, ΔADC and renal compartment volumes with an AUC of 0.904 (sensitivity of 83% and specificity of 91%) and was moderately correlated with the clinical biomarkers eGFR and proteinuria (P<0.05). The Cox survival analysis demonstrated that ADCcortex rather than ΔADC is a predictor of renal outcomes with a hazard ratio of 3.4 (95% CI: 1.1-10.2, P<0.05) independent of baseline eGFR and proteinuria. Conclusions: ADCcortex is a valuable imaging marker for the diagnosis and prediction of renal function decline in DKD.

Factors associated with euphoria in a large subset of cases using propofol sedation during gastrointestinal endoscopy.

Background: The utilization of Propofol, a widely used intravenous sedative or anesthetic, is characterized by its quick onset, predictable control, and fleeting half-life during both general anesthesia and intensive care unit sedation. Recent evidence, however, has highlighted propofol's propensity to induce euphoria, particularly in patients undergoing painless procedures such as gastrointestinal or gastric endoscopy. Given its widespread use in patients undergoing such procedures, this study aims to investigate the clinical evidence and factors that may influence propofol-induced euphoria in these settings. Methods: The Addiction Research Center Inventory-Chinese Version (ARCI-CV) scale was administered to 360 patients undergoing gastric or gastrointestinal endoscopy using propofol as a sedative. Patient characteristics including past medical history, depression, anxiety, alcohol abuse, and sleep disturbance were recorded through history taking and assessment using various questionnaires prior to the examination. The euphoric and sedative statuses were assessed at 30 min and 1 week post-examination. Results: The experimental results of a survey of 360 patients who underwent gastric or gastrointestinal endoscopy using propofol showed that the mean Morphine-Benzedrine Group (MBG) score before the procedure and after 30 min of the procedure was 4.23 and 8.67, respectively. The mean Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score before the procedure and after 30 min of the procedure was 3.24 and 6.22, respectively. These results showed that both MBG and PCAG scores increased significantly after the procedure. Certain factors, such as dreaming, propofol dose, duration of anesthesia, and etomidate dose, were all correlated with MBG both at 30 min and 1 week after the examination. In addition, etomidate had an effect of decreasing MBG scores and increasing PCAG scores both at 30 min and 1 week after the examination. Conclusion: Taken together, propofol may elicit euphoria and potentially contribute to propofol addiction. There are several risk factors for the development of propofol addiction, including dreaming, propofol dose, duration of anesthesia, and etomidate dose. These findings suggest that propofol may have a euphoric effect and may have the potential for drug addiction and abuse.

A Chromosome-level Genome Assembly and Evolution Analysis of Andrena camellia (Hymenoptera: Andrenidae).

Andrena camellia, an effective pollinator of the economicallysignificant crop Camellia oleifera, can withstand the toxic pollen of C. oleifera, making A. camellia a crucial for resource conservation and cultivation of C. oleifera. In this study, the whole genome of A. camellia was sequenced on the Oxford Nanopore platform. The assembled genome size was 340.73 Mb including 50 scaffolds (N50=47.435 Mb) and 131 contigs (N50=17.2 Mb). A total of 11, 258 protein-coding genes were annotated, in addition, 1,104 non-coding RNAs were identified. Further analysis that some chromosomes of A. camellia have a high level of synteny with those of Apis mellifera, Osmia bicornis and Andrena minutula. Thus, our reported genome of A. camellia serves as a valuable resource for studying species evolution, behavioral biology, and adaption to toxic pollen of C. oleifera.

Identification of oestrus cows based on vocalisation characteristics and machine learning technique using a dual-channel-equipped acoustic tag.

Timely and accurate detection of oestrus in cows is an essential element of the good management of dairy farms. At present, the detection of cows in oestrus by acoustic means is impeded by the problems of filtering, incomplete feature selection, and poor recognition accuracy. To overcome these difficulties, this study proposes a sound detection method for cows in oestrus based on machine learning technology using an optimal feature combination and an optimal time window. Firstly, a dual-channel sound detection tag consisting of a unidirectional microphone and an omnidirectional microphone (OM) was developed. The Least Mean Squares adaptive algorithm based on wavelet thresholds was used to filter the signals from the OM, and the dual-channel endpoint detection algorithm was used to identify the lowing of individual cows. The Friedman analysis was then used to select the sound features with significant differences before and after oestrus in terms of time, frequency, and cepstrum, and these were used to determine the most acceptable feature combination. We then analysed the effects of Back Propagation Neural Network (BPNN), Cartesian Regression Tree, Support Vector Machine, and Random Forest classification on the accuracy, precision, sensitivity, specificity, and F1 score of oestrus discrimination. Different time windows were used, and the discrimination performance of these algorithms was evaluated using the Area under Receiver Operating Characteristic Curve to find the most satisfactory match between the time window and the recognition algorithm. The dual-channel acoustic tag's accuracy, precision, sensitivity, and specificity results were 91.25, 98.83, 91.75, and 83.68%, respectively. BPNN with the 70 ms time window and the feature combination (spectral roll-off + spectral flatness + Mel-Frequency Cepstrum Coefficients) was confirmed as the most suitable oestrus recognition method. The average accuracy, precision, sensitivity, specificity, and F1 score of this method were 97.62, 98.07, 97.17, 97.19, and 97.63%, respectively. Based on these results, the approach was shown to be a feasible means of oestrus detection in dairy cows. Based on its ability to differentiate cows and its consistency, it was demonstrated that sound has the potential to replace accelerometers as an early indicator of oestrus in dairy cows.

Effects of different cooking methods on physicochemical, textural properties of yak meat and its changes with intramuscular connective tissue during in vitro digestion.

The effects of vacuum cooking (VC), traditional cooking (TC), and high-pressure cooking (HPC) on the physicochemical properties and texture of yak meat and the digestibility of yak meat and intramuscular connective tissue (IMCT) were investigated. Compared with VC treatment, TC and HPC treatment significantly increased meat cooking loss and meat hardness (P < 0.05). Meanwhile, the carbonyl content of yak meat of TC and HPC was 3.73 nmol/mg protein, and the free sulfhydryl content was 7.93 nmol/mg protein, indicating that more protein was oxidized at higher temperatures. Oxidative aggregation of proteins caused by cooking reduced meat digestibility by about 25%. However, cooking reduced the undigested residue of IMCT and promoted its digestion. Principal component analysis showed that the physicochemical, texture, oxidation, and protein digestibility of TC and HPC meat were similar but significantly different from VC meat.

In Vivo CaV3 Channel Inhibition Promotes Maturation of Glucose-Dependent Ca2+ Signaling in Human iPSC-Islets.

CaV3 channels are ontogenetically downregulated with the maturation of certain electrically excitable cells, including pancreatic ß cells. Abnormally exaggerated CaV3 channels drive the dedifferentiation of mature ß cells. This led us to question whether excessive CaV3 channels, retained mistakenly in engineered human-induced pluripotent stem cell-derived islet (hiPSC-islet) cells, act as an obstacle to hiPSC-islet maturation. We addressed this question by using the anterior chamber of the eye (ACE) of immunodeficient mice as a site for recapitulation of in vivo hiPSC-islet maturation in combination with intravitreal drug infusion, intravital microimaging, measurements of cytoplasmic-free Ca2+ concentration ([Ca2+]i) and patch clamp analysis. We observed that the ACE is well suited for recapitulation, observation and intervention of hiPSC-islet maturation. Intriguingly, intraocular hiPSC-islet grafts, retrieved intact following intravitreal infusion of the CaV3 channel blocker NNC55-0396, exhibited decreased basal [Ca2+]i levels and increased glucose-stimulated [Ca2+]i responses. Insulin-expressing cells of these islet grafts indeed expressed the NNC55-0396 target CaV3 channels. Intraocular hiPSC-islets underwent satisfactory engraftment, vascularization and light scattering without being influenced by the intravitreally infused NNC55-0396. These data demonstrate that inhibiting CaV3 channels facilitates the maturation of glucose-activated Ca2+ signaling in hiPSC-islets, supporting the notion that excessive CaV3 channels as a developmental error impede the maturation of engineered hiPSC-islet insulin-expressing cells.

Using celluloses in different geometries to reinforce collagen-based composites: Effect of cellulose concentration.

Cellulose is frequently used to strengthen biocomposite films, but few literature systematically deliberates the effects of concentration of celluloses in different geometries on the reinforcement of these composites. Here we prepared three types of celluloses, including rod-like cellulose nanocrystalline (CNC), long-chain cellulose nanofiber (CNF) and microscopic cellulosic fines (CF). The effect of concentration of the three celluloses was examined on the barrier properties to water and light, thermostability, microstructure, and mechanical properties of collagen (COL) films. The addition of celluloses increased the watertightness and thermostability of composite films. Besides, FTIR showed a increased hydrogen bonding for COL/CNF and COL/CNC composite films, but decrease for COL/CF composites. As the concentration of CF and CNF increased, the strength of composites improved. The TS for COL/CNF (124 MPa) and COL/CF composites (113 MPa) were largely increased, compared with that of collagen ones (90 MPa). Considering the factors of crystallinity, hydrogen bonding, and interfacial tortuosity, COL/CNF composites possessed better mechanical behaviors than that of COL/CF and COL/CNC composites. Furthermore, Halpin-Kardos and Ouali models well predicted the modulus of COL/CNF composites when CNF was below and above percolation threshold (2.7 wt%), respectively.

Preoperative plasma visfatin may have a dual effect on the occurrence of postoperative delirium.

Background: Visfatin is considered to be a "novel pro-inflammatory cytokine." Neuroinflammatory response is one of the important mechanisms of postoperative delirium (POD). The relationship between preoperative plasma visfatin and POD is unclear. Objective: To investigate the relationship between preoperative plasma visfatin concentrations and POD (primary outcome) in older hip fracture patients and to explore whether it affects POD through inflammatory factors. Materials and methods: This prospective cohort study enrolled 176 elderly patients who were scheduled for hip fracture surgery. Preoperative plasma was collected on the morning of surgery, and visfatin levels were measured. Interleukin (IL)-1 and IL-6 were measured using patients' plasma collected on the first day after surgery. We used the 3-min diagnostic interview for Confusion Assessment Method-defined delirium (3D-CAM) twice daily within the 2 days after surgery to assess whether POD had occurred. Restricted cubic splines and piecewise regression were used to explore the relationship between preoperative plasma visfatin concentrations and POD, and further mediation analysis was used to verify whether visfatin plays a role in POD through regulating inflammatory factors. Results: The incidence of POD was 18.2%. A J-shaped association was observed between preoperative plasma visfatin levels and POD. The risk of POD decreased within the lower visfatin concentration range up to 37.87 ng/ml, with a hazard ratio of 0.59 per 5 ng/ml [odds ratio (OR) = 0.59, 95% confidence interval (CI) = 0.37-0.95], but the risk increased above this concentration (P for non-linearity < 0.001, with a hazard ratio of 1.116 per 10 ng/ml; OR = 1.10, 95% CI = 1.02-1.23). Mediation effect analysis showed that when the plasma visfatin concentration was higher than 37.87 ng/ml, the effect of visfatin on POD was mediated by IL-6 (p < 0.01). A significant indirect association with postoperative plasma IL-6 was observed between preoperative plasma visfatin and POD (adjusted ß = 0.1%; 95% CI = 4.8∼38.9%; p < 0.01). Conclusion: Visfatin is the protective factor in POD when the preoperative plasma visfatin concentration is below 37.87 ng/ml, but when it exceeds 37.87 ng/ml, the visfatin concentration is a risk factor for POD, which is mediated by postoperative plasma IL-6. The results suggest that preoperative visfatin may have a dual effect on the POD occurrence. Clinical trial registration: [www.ClinicalTrials.gov], identifier [ChiCTR21 00052674].