Lung Epithelium Releases Growth Differentiation Factor 15 in Response to Pathogen-mediated Injury.

GDF15 (growth differentiation factor 15) is a stress cytokine with several proposed roles, including support of stress erythropoiesis. Higher circulating GDF15 levels are prognostic of mortality during acute respiratory distress syndrome, but the cellular sources and downstream effects of GDF15 during pathogen-mediated lung injury are unclear. We quantified GDF15 in lower respiratory tract biospecimens and plasma from patients with acute respiratory failure. Publicly available data from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were reanalyzed. We used mouse models of hemorrhagic acute lung injury mediated by Pseudomonas aeruginosa exoproducts in wild-type mice and mice genetically deficient for Gdf15 or its putative receptor, Gfral. In critically ill humans, plasma levels of GDF15 correlated with lower respiratory tract levels and were higher in nonsurvivors. SARS-CoV-2 infection induced GDF15 expression in human lung epithelium, and lower respiratory tract GDF15 levels were higher in coronavirus disease (COVID-19) nonsurvivors. In mice, intratracheal P. aeruginosa type II secretion system exoproducts were sufficient to induce airspace and plasma release of GDF15, which was attenuated with epithelial-specific deletion of Gdf15. Mice with global Gdf15 deficiency had decreased airspace hemorrhage, an attenuated cytokine profile, and an altered lung transcriptional profile during injury induced by P. aeruginosa type II secretion system exoproducts, which was not recapitulated in mice deficient for Gfral. Airspace GDF15 reconstitution did not significantly modulate key lung cytokine levels but increased circulating erythrocyte counts. Lung epithelium releases GDF15 during pathogen injury, which is associated with plasma levels in humans and mice and can increase erythrocyte counts in mice, suggesting a novel lung-blood communication pathway.

Impact of Bullying Victimization on Chinese College Students' Suicidal Tendency: The Moderating Effect of Teachers' Emotional Support and Family Support.

Objective: To explore the influence of bully victims on the suicidal tendencies of college students, and the moderating role of teacher emotional support and family support in the relationship between bully victims and college students' suicidal tendencies, in order to provide a reference for the effective intervention of college students' suicide behavior. Methods: Based on a survey of 15,560 college students. Multiple stepwise regression and Interaction analysis explore the impact of the bully victimization on college students' suicidal tendencies and the moderating role of family support and teacher emotional support in the relationship between the bully victim and college students' suicidal tendencies. Results: This study found that the Suicidal Tendencies score of college students was 19.79 points, indicating that some college students have a risk of suicidal tendencies; secondly, verbal bullying (ß = 0.084, P <0.001), physical bullying (ß = 0.222, P <0.001) and social relationship bullying (ß = 0.122, P <0.001) have a positive and significant impact on the suicidal tendencies of college students; in addition, family support and teacher emotional support have a significant regulatory effect on the bully victim and college students Suicidal Tendencies and family support. The regulating effect was significantly higher than that of teacher emotional support. Conclusion: Chinese college students have the risk of suicidal tendencies; peer bullying victimization is an important reason for affecting college students' suicidal tendencies, teacher emotional support is a protective factor for bully victims to affect college students' suicidal tendencies, and family support has a significant moderating effect on the bully victim and college students' suicidal tendencies. Therefore, it is necessary to actively adopt home-school linkage and home-school communication to reduce campus violence and increase the psychological resilience of college students.

Research on collaborative development mechanism of multiple stakeholders in medical institutions based on rough set.

Reducing doctor-patient conflict is an important part of coordinating doctor-patient disputes and easing doctor-patient relationship, which is conducive to building a harmonious medical environment and promoting the healthy development of medical undertakings. This paper constructs a multi-decision-maker mixed conflict model based on rough set theory, puts forward the matrix operation expression of the conflict degree theory in the Pawlak model, and gives a more objective and scientific evaluation function. Combined with hot issues of doctor-patient conflict, the proposed multi-decision-maker mixed conflict model is applied to doctor-patient conflict, examines the doctor-patient relationship in the medical institution system from multiple internal perspectives, and calculates feasible solutions in the conflict system. The results show that high medical quality, high standardize medication, high institutional efficiency, high staff efficiency, high hospital benefits, high hospital revenue, medium employee development, medium equipment development, or high medical quality, high standardize medication, high institutional efficiency, medium staff efficiency, medium hospital benefits, high hospital revenue, high employee development, and high equipment development are important conditions for building a harmonious medical environment and reducing doctor-patient conflicts.

External validation of the SYNTAX score II 2020 in patients with chronic renal insufficiency.

BACKGROUND: The SYNTAX score Ⅱ 2020 (SSⅡ-2020) was created as a customized decision-making tool for individuals diagnosed with complex coronary artery disease (CAD). Nevertheless, there has been a scarcity of research investigating the long-term predictive significance of SSⅡ-2020 for patients with both CAD and chronic renal insufficiency (CRI) who undergo percutaneous coronary intervention (PCI). AIMS: We sought to showcase the prognostic capacity of SSII-2020 in evaluating long-term all-cause mortality (ACM) within this high-risk patient cohort. METHODS: A retrospective cohort comprising 1156 individuals diagnosed with CRI and exhibiting left main CAD, three-vessel CAD or both was included in this investigation. We categorized participants into three groups based on the optimal SSII-2020 threshold for predicting long-term ACM, determined using the X-tile software. RESULTS: At the median follow-up duration of 6.3 years, the ACM rates were determined to be 10% in the low, 17% in the moderate, and 28% in the high SSII-2020 groups (p < 0.001). Employing multivariate Cox regression analysis, it was observed that the high SSII-2020 group exhibited a 3.289-fold increased risk of ACM (95% confidence interval [CI]: 2.229-4.856, p < 0.001) compared with the low SSII-2020 group, whereas the high SSII-2020 group displayed a 1.757-fold (95% CI: 1.190-2.597, p = 0.005) in comparison to the median SSII-2020 groups. Compared with SSII, the SSII-2020 had an incremental value for predicting 7-year ACM (C-index: 0.662 vs. 0.534, p = 0.007; IDI: 0.016, p < 0.001). CONCLUSIONS: SSII-2020 enhances long-term ACM prediction, facilitates improved risk stratification, and improves clinical utility for PCI patients with complex CAD and CRI.

Pathways of Media Contact to Health Literacy in Middle-Aged and Older People: The Chain Mediation Effect of Perceived Social Support and Self-Efficacy.

Objective: To understand the status of media exposure, social support, self-efficacy, and health literacy among middle-aged and older adults in China, and explore the impact path of media exposure on the health literacy of this population, providing a reference for promoting their physical and mental health. Methods: From July to November 2022, a multi-stage random sampling method was employed to survey 16,938 Chinese middle-aged and older adults aged 46 and above. Structural equation modeling and statistical analysis were conducted using LISREL 8.8 and Mplus 8.3 software. Results: The average score for media exposure among Chinese middle-aged and older adults was (18.55±5.36), perceived social support was (60.68±12.51), self-efficacy was (28.76±5.40), and health literacy was (35.49±6.05). Statistical results revealed that media exposure has a positive impact on the health literacy of middle-aged and older adults, with a direct effect of 0.091 (p < 0.001). Mediation analysis showed that media exposure can affect the health literacy of this population through the independent mediating effects of perceived social support (ß = 0.013, p < 0.001) and self-efficacy (ß = 0.029, p < 0.001), as well as through a chain mediation effect involving perceived social support and self-efficacy (ß = 0.015, p < 0.001). Conclusion: As a pathway for health information dissemination, media exposure plays a crucial role in the intervention of health literacy among middle-aged and older adults. Perceived social support and self-efficacy not only have independent mediating effects but also significant chain mediating effects in the relationship between media exposure and health literacy among this population. Therefore, improving the health literacy of middle-aged and older people can be popularized through media and improved in a multi-path, all-round, and precise way with the help of related technologies and social forces from which media literacy can be improved.

Middle-aged and older people's preference for medical-elderly care integrated institutions in China: a discrete choice experiment study.

BACKGROUND: With the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years. OBJECTIVES: To explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions. METHODS: In this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants' willingness to pay for each attribute was also calculated. RESULTS: Data from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: ß = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: ß = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for "poor service quality" and "low medical technology level," respectively, to receive "moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and "high medical technology level" (p = 0.005, 95% CI 852 ~ 4824). CONCLUSIONS: The state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly. PUBLIC CONTRIBUTION: The design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.

Pyroptosis-related signatures predict immune characteristics and prognosis in IPF.

The purpose of this work was to use integrated bioinformatics analysis to screen for pyroptosis-related genes (PRGs) and possible immunological phenotypes linked to the development and course of IPF. Transcriptome sequencing datasets GSE70866, GSE47460 and GSE150910 were obtained from GEO database. From the GSE70866 database, 34 PRGs with differential expression were found in IPF as compared to healthy controls. In addition, a diagnostic model containing 4 genes PRGs (CAMP, MKI67, TCEA3 and USP24) was constructed based on LASSO logistic regression. The diagnostic model showed good predictive ability to differentiate between IPF and healthy, with ROC-AUC ranging from 0.910 to 0.997 in GSE70866 and GSE150910 datasets. Moreover, based on a combined cohort of the Freiburg and the Siena cohorts from GSE70866 dataset, we identified ten PRGs that might predict prognosis for IPF. We constructed a prognostic model that included eight PRGs (CLEC5A, TREM2, MMP1, IRF2, SEZ6L2, ADORA3, NOS2, USP24) by LASSO Cox regression and validated it in the Leuven cohort. The risk model divided IPF patients from the combined cohort into high-risk and low-risk subgroups. There were significant differences between the two subgroups in terms of IPF survival and GAP stage. There is a close correlation between leukocyte migration, plasma membrane junction, and poor prognosis in a high-risk subgroup. Furthermore, a high-risk score was associated with more plasma cells, activated NK cells, monocytes, and activated mast cells. Additionally, we identified HDAC inhibitors in the cMAP database that might be therapeutic for IPF. To summarize, pyroptosis and its underlying immunological features are to blame for the onset and progression of IPF. PRG-based predictive models and drugs may offer new treatment options for IPF.

A cross-sectional study: family communication, anxiety, and depression in adolescents: the mediating role of family violence and problematic internet use.

OBJECTIVE: The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role. METHODS: The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence. RESULTS: The results indicate that family communication was significantly and negatively related to family violence (ß = -.494, p < 0.001), problematic internet use (ß = -.056, p < .05), depression (ß = -.076, p < .01), and anxiety (ß = -.071, p < .05). And the finds also indicate that family violence mediated the relationships between family communication and depression (ß = -.143, CI: -.198 -.080), and between family communication and anxiety (ß = -.141; CI: -.198 -.074). Chain indirect effects between family communication and depression (ß = -.051; CI: -.081 -.030) or anxiety (ß = -.046; CI: -.080 -.043) via family violence and then through problematic internet use were also found in the present study. CONCLUSIONS: In conclusion, positive family communication is crucial in reducing anxiety and depression in adolescents. Moreover, problematic internet use and family violence mediate the effects of positive family communication on anxiety and depression. Therefore, improving family communication and promoting interventions aimed at reducing family violence and problematic internet use can help reduce anxiety and depression in adolescents, thus promoting their healthy development.

The Effect of Teacher Discrimination Behavior on Adolescent Suicidal Ideation: A Cross-Sectional Survey.

Introduction:  Suicidal ideation and suicidal behavior, as the most severe psychological and behavioral problems among adolescents, bring not only significant damage to individual social functioning but also cause enormous economic and social pressure, which will ultimately be detrimental to social development and social stability. This paper aimed to explore the potential relationship between teacher discrimination behavior, peer bullying victimization, anxiety disorders, and adolescent suicidal ideation based on the Vulnerability-Stress Model. Methods:  From September to November 2022, our research team surveyed 21,017 junior high school students from 12 secondary schools in ten cities in China. Mplus 8.3 software was used to analyze the pathways of teacher discrimination behavior on adolescent suicidal ideation. Results:  The results showed that teacher preference had a significant negative effect on suicidal ideation, and teacher prejudice significantly positively affected suicidal ideation. Mediation test results indicated that there were significant independent mediating effects of peer bullying victimization and anxiety disorders between teacher discrimination behavior and adolescents' suicidal ideation, as well as significant chain mediating effects. Conclusion:  Secondary school teachers should improve their self-quality and pay more attention to adolescents' suicidal ideation. Teachers are expected to put love into their education, respect and trust each student, and attend to their emotional needs unbiasedly. Educators should develop targeted prevention and intervention measures according to the actual situation of school bullying and also strengthen adolescents' life-value education to improve the psychological quality of adolescents and create a healthy campus atmosphere.

Long noncoding RNA H19 regulates degeneration and regeneration of injured peripheral nerves.

Our previous studies have shown that long noncoding RNA (lncRNA) H19 is upregulated in injured rat sciatic nerve during the process of Wallerian degeneration, and that it promotes the migration of Schwann cells and slows down the growth of dorsal root ganglion axons. However, the mechanism by which lncRNA H19 regulates neural repair and regeneration after peripheral nerve injury remains unclear. In this study, we established a Sprague-Dawley rat model of sciatic nerve transection injury. We performed in situ hybridization and found that at 4-7 days after sciatic nerve injury, lncRNA H19 was highly expressed. At 14 days before injury, adeno-associated virus was intrathecally injected into the L4-L5 foramina to disrupt or overexpress lncRNA H19. After overexpression of lncRNA H19, the growth of newly formed axons from the sciatic nerve was inhibited, whereas myelination was enhanced. Then, we performed gait analysis and thermal pain analysis to evaluate rat behavior. We found that lncRNA H19 overexpression delayed the recovery of rat behavior function, whereas interfering with lncRNA H19 expression improved functional recovery. Finally, we examined the expression of lncRNA H19 downstream target SEMA6D, and found that after lncRNA H19 overexpression, the SEMA6D protein level was increased. These findings suggest that lncRNA H19 regulates peripheral nerve degeneration and regeneration through activating SEMA6D in injured nerves. This provides a new clue to understand the role of lncRNA H19 in peripheral nerve degeneration and regeneration.

Research on the Cooperative Governance Path of Multiple Stakeholders in Doctor-Patient Disputes under the Environment of Information Asymmetry.

The number of doctor-patient conflicts and disputes in China has been increasing recently. In order to solve the current social problems of the tense doctor-patient relationship and frequent medical disputes, this article, based on grounded theory, uses qualitative analysis software to conduct grounded coding on 622 cases of doctor-patient disputes randomly selected by stratification. After successively adopting open, axial, and selective coding, the relationship structure between the causes and development of medical disputes is summarized. Furthermore, this relationship structure can be used to analyze further and discuss the causes of doctor-patient disputes from the perspective of multiple co-governance and the governance framework of doctor-patient disputes. Finally, it reminds us of the need to standardize government's regulatory responsibilities, promote the equal distribution of medical resources, strengthen the communication awareness between doctors and patients, reduce the information asymmetry between doctors and patients, and build a preventive mechanism-oriented multi-subject collaborative governance path to promote the relationship between doctors and patients in China. We provide relevant countermeasures and suggestions for harmonious development and the smooth resolution of doctor-patient conflicts.

The influence of internet use frequency, family atmosphere, and academic performance on adolescent depression: Based on the chain mediating effect of self-adjustment and campus deviant behavior.

Introduction: Depression has become a prominent psychological problem among young people. The purpose of this study was to investigate the potential relationship between the frequency of Internet use, family atmosphere, academic performance, self-adjustment, campus deviant behavior, and depressive symptoms among adolescents. Methods: Based on the survey data of the fifth wave (2017~2018) and the sixth wave (2019~2020) of the China Family Panel Studies (CFPS), this study used LISREL8.8 software to analyze 1,577 10~15 data on adolescents. Results: In this study, the mean score of self-adjustment was 42.40 (SD = 6.79), the mean score of campus deviant behavior was 12.59 (SD = 4.00), the mean score of depressive symptoms in 2018 was 11.88 (SD = 3.04), and the mean score of depressive symptoms in 2020 was 7.64 (SD = 2.20). Secondly, the frequency of Internet use had no direct effect on the depressive symptoms of adolescents, family atmosphere was negatively correlated with depressive symptoms (p < 0.005), and academic performance was positively correlated with depressive symptoms (p < 0.005). Depressive symptoms in 2020 had a direct effect (ß = 0.37, p < 0.001), and also had a negative effect on depressive symptoms in 2020, with a total effect of-0.07 (p < 0.001); self-adjustment had no direct effect on depressive symptoms in adolescents in 2018, However, the total effect was -0.14 (p < 0.001), which had a significant positive effect on 2020 depressive symptoms, and the total effect was 0.18 (p < 0.001), and self-adjustment had a significant negative effect on adolescent campus deviant behavior (ß = -0.38, p < 0.001); in addition, the frequency of Internet use, family atmosphere, and academic performance all had indirect effects on adolescents' 2020 depressive symptoms, with total effects of -0.60, 0.01, and 0.02 (p < 0.001), respectively. This study also found depressive symptoms in adolescents have a certain persistence in time. Discussion: Based on this study, it is necessary to pay more attention to the depression of adolescents, strengthen the training of self-adjustment, improve the anti-frustration ability and psychological resilience, and reduce the campus deviant behavior of adolescents. It is recommended to try to start from emotional self-adjustment to promote the personality health of adolescents.

Homozygous mutation in DNAAF4 causes primary ciliary dyskinesia in a Chinese family.

Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder that affects the structure and function of motile cilia, leading to classic clinical phenotypes, such as situs inversus, chronic sinusitis, bronchiectasis, repeated pneumonia and infertility. In this study, we diagnosed a female patient with PCD who was born in a consanguineous family through classic clinical manifestations, transmission electron microscopy and immunofluorescence staining. A novel DNAAF4 variant NM_130810: c.1118G>A (p. G373E) was filtered through Whole-exome sequencing. Subsequently, we explored the effect of the mutation on DNAAF4 protein from three aspects: protein expression, stability and interaction with downstream DNAAF2 protein through a series of experiments, such as transfection of plasmids and Co-immunoprecipitation. Finally, we confirmed that the mutation of DNAAF4 lead to PCD by reducing the stability of DNAAF4 protein, but the expression and function of DNAAF4 protein were not affected.

The influence of academic pressure on adolescents' problem behavior: Chain mediating effects of self-control, parent-child conflict, and subjective well-being.

As a negative social issue, teenagers' problem behavior not only affects individuals' physical and mental health and social function development but is also not conducive to social harmony and stability. This study mainly discusses the influence of academic pressure on adolescents' problem behavior, and the potential relationship between these and academic pressure, examining issues such as self-control, parent-child conflict, and subjective well-being. The data were collected from the fifth wave of the China Family Panel Studies (2017-2018). The data of 2,465 teenagers aged 10-15 were analyzed by LISREL8.8 software. The results show that academic pressure positively affects adolescents' deviant behavior. The mediation model finds that parent-child conflict and self-control play a direct mediating role between academic pressure and adolescents' behavioral problems. Parent-child conflict, self-control, and subjective well-being have important chain mediation effects between academic pressure and adolescents' problem behavior. Therefore, in order to reduce the risk of such problems, it is necessary to further strengthen individuals' ability to maintain self-control, promote or cultivate adolescents' character strengths, create a harmonious family atmosphere, reduce the probability of parent-child conflict, and increase the subjective well-being of teenagers.

Influence of perceived importance of the internet on life satisfaction and health of the older people: An analysis based on intermediary and moderating effects.

With the global growth of the aging population, healthy aging and active aging has become an important goal for the future social development of all countries. The purpose of this study is to explore the potential relationships between the older people's perceived importance of the Internet, family atmosphere, behavioral independence, life satisfaction, and health. The data come from the China Family Panel Studies' fourth wave (2015-2016) and fifth wave (2017-2018) investigations. According to an analysis of data of 5,948 people over 60 years old performed using LISREL 8.8 software, the selected cases answered the same questions about the perceived importance of the Internet, life satisfaction, and health status in two waves of surveys. The results show that life satisfaction and self-rated health have cross influences, while at the same time both are persistent in the time baseline, and family atmosphere and behavioral independence play an important intermediary role. Therefore, strengthening parent-child interaction, promoting parent-child relationships, and improving behavioral independence can effectively improve the life satisfaction and health status of the older people.

Influence of Heat Stress on Intestinal Epithelial Barrier Function, Tight Junction Protein, and Immune and Reproductive Physiology.

The potential threat of global warming in the 21st century is on the ecosystem through many aspects, including the negative impact of rising global temperature on the health of humans and animals, especially domestic animals. The damage caused by heat stress to animals has been more and more significant as the worldwide climate continues to rise, along with the breeding industry's expanding scale and stocking density, and it has become the most important stress-causing factor in southern China. In this review, we described the effects of heat stress on animal immune organs and immune system. The much-debated topic is how hyperthermia affects the tight junction barrier. Heat stress also induces inflammation in the body of animals causing low body weight and loss of appetite. This review also discussed that heat stress leads to hepatic disorder, and it also damages the intestine. The small intestine experiences ischemia, and the permeability of the intestine increases. Furthermore, the oxidative stress and mitogen-activated protein kinase (MAPK) pathways have a significant role in stress-induced cellular and organ injury. The study has shown that MAPK activity in the small intestine was increased by heat stress. Heat stress caused extreme small intestine damage, enhanced oxidative stress, and activated MAPK signaling pathways.

Corrigendum: Efficacy and Safety of Shenqu Xiaoshi Oral Liquid Compared With Domperidone Syrup in Children With Functional Dyspepsia.

[This corrects the article DOI: 10.3389/fphar.2022.831912.].

Biomarker interaction selection and disease detection based on multivariate gain ratio.

BACKGROUND: Disease detection is an important aspect of biotherapy. With the development of biotechnology and computer technology, there are many methods to detect disease based on single biomarker. However, biomarker does not influence disease alone in some cases. It's the interaction between biomarkers that determines disease status. The existing influence measure I-score is used to evaluate the importance of interaction in determining disease status, but there is a deviation about the number of variables in interaction when applying I-score. To solve the problem, we propose a new influence measure Multivariate Gain Ratio (MGR) based on Gain Ratio (GR) of single-variate, which provides us with multivariate combination called interaction. RESULTS: We propose a preprocessing verification algorithm based on partial predictor variables to select an appropriate preprocessing method. In this paper, an algorithm for selecting key interactions of biomarkers and applying key interactions to construct a disease detection model is provided. MGR is more credible than I-score in the case of interaction containing small number of variables. Our method behaves better with average accuracy [Formula: see text] than I-score of [Formula: see text] in Breast Cancer Wisconsin (Diagnostic) Dataset. Compared to the classification results [Formula: see text] based on all predictor variables, MGR identifies the true main biomarkers and realizes the dimension reduction. In Leukemia Dataset, the experiment results show the effectiveness of MGR with the accuracy of [Formula: see text] compared to I-score with accuracy [Formula: see text]. The results can be explained by the nature of MGR and I-score mentioned above because every key interaction contains a small number of variables in Leukemia Dataset. CONCLUSIONS: MGR is effective for selecting important biomarkers and biomarker interactions even in high-dimension feature space in which the interaction could contain more than two biomarkers. The prediction ability of interactions selected by MGR is better than I-score in the case of interaction containing small number of variables. MGR is generally applicable to various types of biomarker datasets including cell nuclei, gene, SNPs and protein datasets.

Efficacy and Safety of Shenqu Xiaoshi Oral Liquid Compared With Domperidone Syrup in Children With Functional Dyspepsia.

Background: Treatment of functional dyspepsia (FD) in children is generally symptomatic and unsatisfactory. Traditional Chinese medicines, such as Shenqu Xiaoshi Oral Liquid (SXOL), have been recommended to alleviate dyspeptic symptoms. However, evidence of their safety and efficacy remains limited to date. AIM: To assess whether 2 weeks of therapy with SXOL was non-inferior to domperidone syrup in children with FD. Methods: In this randomized, double-blind, double-simulated, non-inferiority, multi-center clinical trial, we recruited children (3-14 years) with FD according to the Rome IV criteria from 17 tertiary medical centers across China. Patients were randomly allocated (1:1) to receive SXOL or domperidone syrup for 2 weeks. We compared the participants' clinical scores from both groups based on the severity and frequency of dyspepsia symptoms according to Rome IV criteria (0, 1, 2, and 4 weeks after randomization). The primary endpoint was the total response rate, which was defined as the proportion of patients with a decrease of 30% or more in the FD symptoms clinical score from baseline, at the end of the 2-weeks treatment. A non-inferiority margin of -10% was set. Secondary endpoints and adverse events were assessed. This trial is registered with www.Chictr.org.cn, number ChiCTR1900022654. Results: Between February 2019 and March 2021, a total of 373 patients were assessed for eligibility, and 356 patients were enrolled and randomized. The clinical response rate at week two was similar for SXOL [118 (83.10%) of 142] and domperidone [128 (81.01%) of 158]; difference 2.09; 95% CI -6.74 to 10.71, thereby establishing non-inferiority. The total FD symptom scores were significantly improved in the two groups at 1-, 2-, and 4-weeks follow-up periods (p < 0.005). The decrease in symptom score compared with the baseline were similar between these two groups. Over the total study period, 10 patients experienced at least one treatment-related adverse event [six (3.37%)] in the SXOL group, four [(2.25%) in the domperidone group], although no serious adverse event was noted. Conclusion: Treatment with SXOL effectively improves dyspeptic symptoms and is well tolerated. In addition, it is not inferior to domperidone syrup and leads to sustained improvement in Chinese children with FD.