Machine learning-Based model for prediction of Narcolepsy Type 1 in Patients with Obstructive Sleep Apnea with Excessive Daytime Sleepiness.

Background: Excessive daytime sleepiness (EDS) forms a prevalent symptom of obstructive sleep apnea (OSA) and narcolepsy type 1 (NT1), while the latter might always be overlooked. Machine learning (ML) models can enable the early detection of these conditions, which has never been applied for diagnosis of NT1. Objective: The study aimed to develop ML prediction models to help non-sleep specialist clinicians identify high probability of comorbid NT1 in patients with OSA early. Methods: Totally, clinical features of 246 patients with OSA in three sleep centers were collected and analyzed for the development of nine ML models. LASSO regression was used for feature selection. Various metrics such as the area under the receiver operating curve (AUC), calibration curve, and decision curve analysis (DCA) were employed to evaluate and compare the performance of these ML models. Model interpretability was demonstrated by Shapley Additive explanations (SHAP). Results: Based on the analysis of AUC, DCA, and calibration curves, the Gradient Boosting Machine (GBM) model demonstrated superior performance compared to other machine learning (ML) models. The top five features used in the GBM model, ranked by feature importance, were age of onset, total limb movements index, sleep latency, non-REM (Rapid Eye Movement) sleep stage 2 and severity of OSA. Conclusion: The study yielded a simple and feasible screening ML-based model for the early identification of NT1 in patients with OSA, which warrants further verification in more extensive clinical practices.

Rashba-splitting-induced topological flat band detected by anomalous resistance oscillations beyond the quantum limit in ZrTe5.

Topological flat bands - where the kinetic energy of electrons is quenched - provide a platform for investigating the topological properties of correlated systems. Here, we report the observation of a topological flat band formed by polar-distortion-assisted Rashba splitting in the three-dimensional Dirac material ZrTe5. The polar distortion and resulting Rashba splitting on the band are directly detected by torque magnetometry and the anomalous Hall effect, respectively. The local symmetry breaking further flattens the band, on which we observe resistance oscillations beyond the quantum limit. These oscillations follow the temperature dependence of the Lifshitz-Kosevich formula but are evenly distributed in B instead of 1/B at high magnetic fields. Furthermore, the cyclotron mass gets anomalously enhanced about 102 times at fields ~ 20 T. Our results provide an intrinsic platform without invoking moiré or order-stacking engineering, which opens the door for studying topologically correlated phenomena beyond two dimensions.

The balance between traffic control and economic development in tourist cities under the context of COVID-19: A case study of Xi'an, China.

Selecting an appropriate intensity of epidemic prevention and control measures is of vital significance to promoting the two-way dynamic coordination of epidemic prevention and control and economic development. In order to balance epidemic control and economic development and suggest scientific and reasonable traffic control measures, this paper proposes a SEIQR model considering population migration and the propagation characteristics of the exposed and the asymptomatic, based on the data of COVID-19 cases, Baidu Migration, and the tourist economy. Further, the factor traffic control intensity is included in the model. After determining the functional relationship between the control intensity and the number of tourists and the cumulative number of confirmed cases, the NSGA-II algorithm is employed to perform multi-objective optimization with consideration of the requirements for epidemic prevention and control and for economic development to get an appropriate traffic control intensity and suggest scientific traffic control measures. With Xi'an City as an example. The results show that the Pearson correlation coefficient between the predicted data of this improved model and the actual data is 0.996, the R-square in the regression analysis is 0.993, with a significance level of below 0.001, suggesting that the predicted data of the model are more accurate. With the continuous rise of traffic control intensity in different simulation scenarios, the cumulative number of cases decreases by a significant amplitude. While balancing the requirements for epidemic prevention and control and for tourist economy development, the model works out the control intensity to be 0.68, under which some traffic control measures are suggested. The model presented in this paper can be used to analyze the impacts of different traffic control intensities on epidemic transmission. The research results in this paper reveal the traffic control measures balancing the requirements for epidemic prevention and control and for economic development.

N-acyl homoserine lactones lactonase est816 suppresses biofilm formation and periodontitis in rats mediated by Aggregatibacter actinomycetemcomitans.

Aims: The current study aimed to explore the adjuvant therapeutic effect of N-acyl homoserine lactones (AHLs)-lactonase est816 on Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) biological behaviors and periodontitis progression. Methods: The inhibitory properties of est816 were detected by live/dead bacterial staining, scanning electron microscope (SEM), crystal-violet staining and reverse-transcription quantitative PCR (RT-qPCR). Biocompatibility of est816 on human gingival fibroblasts (HGFs) and human gingival epithelial cells (HGEs) was evaluated by CCK8 and ELISA. The ligature-induced periodontitis model was established in rats. Micro computed tomography and immunohistochemical and histological staining served to evaluate the effect of est816 on the prevention of periodontitis in vivo. Results: est816 significantly attenuated biofilm formation, reduced the mRNA expression of cytolethal distending toxin, leukotoxin and poly-N-acetyl glucosamine (PNAG) and downregulated expressions of interleukin-6 and tumor necrosis factor-α with low cell toxicity. In vivo investigations revealed est816 decreased alveolar bone resorption, suppressed matrix metalloproteinase-9 expression and increased osteoprotegerin expression. Conclusion: est816 inhibited A. actinomycetemcomitans biofilm formation and virulence release, resulting in anti-inflammation and soothing of periodontitis in rats, indicating that est816 could be investigated in further research on periodontal diseases.

Sudden unexpected death in epilepsy disclosure causes anxiety in patients with epilepsy: a Chinese questionnaire survey.

Background and objective: Sudden unexpected death in epilepsy (SUDEP) has been regarded as a leading cause of premature death in patients with epilepsy (PWE). Although patients, relatives and caregivers have the right to be informed of SUDEP, neurologists prefer not to release the facts for fear of associated anxiety. In the study, a Chinese questionnaire survey was carried out to elucidate effect of SUDEP disclosure on anxiety in PWE and variables determining the anxiety of patients and provided suggestions for SUDEP disclosure. Methods: A survey study in China was conducted. We recruited 305 PWE from 3 tertiary epilepsy centers who attended outpatient clinic from December 2021 to February 2022. Two hundred and thirty-two PWE completed the screening evaluation, survey and Hamilton anxiety rating scale (HAMA) twice with 171 PWE completing third HAMA at follow-up. HAMA scores at baseline, T1, T2 were compared using analysis of variance and dependent samples t-test. The variables related to anxiety were screened out by univariate analysis and used for multivariate logistic regression. Result: We found 127 (54.7%) among the 232 participants experienced anxiety after SUDEP disclosure. HAMA scores at T1 were significantly higher than at baseline and T2, while there was no statistical difference between baseline and T2. Medical insurance, seizure severity, and whether the PWE supported SUDEP being disclosed to their relatives and caregivers only were associated with the occurrence of anxiety. Conclusion: SUDEP disclosures may cause short-term acute anxiety, but have no long-term effects in PWE. Acute anxiety caused by SUDEP disclosure may be more common in PWE with NCMI and severe seizures. Meanwhile, compared with indirect SUDEP disclosure to their relatives and caregivers, direct SUDEP disclosure to PWE reduces the risk of anxiety. Recommendations are provided to avoid anxiety caused by SUDEP disclosure.

Electroclinical Features of Sleep-Related Head Jerk.

STUDY OBJECTIVES: To evaluate clinical and electrophysiological features of sleep-related head jerk (SRHJ) and electromyographic activity of superficial neck muscles during head jerk. METHODS: Totally, 850 cases with video-polysomnography recording were collected, among which 50 presented with SRHJ. In these 50 patients, 15 underwent electromyography (EMG) check on bilateral sternocleidomastoid (SCM) and trapezius muscles as well as chin, while 35 had only chin EMG check. Further, the sensitivity and specificity of the both EMGs were calculated and compared. RESULTS: Six among the 50 SRHJ patients had a primary complaint of involuntary head jerks associated with impaired sleep. Approximately 76.1% of head jerks occurred during REM sleep with the median head jerk index of 5.9/h, 64.5% of which were associated with electroencephalogram arousals and 66.4% with body movements. One patient showed SRHJ predominantly in NREM sleep but also in wakefulness. Surface EMG of SCM/trapezius muscles showed a sensitivity of 92% and a specificity of 97.8%, whereas chin EMG had a sensitivity of 14.5% and a specificity of 98.8%. CONCLUSION: SRHJ was associated with electroencephalogram arousals and might interfere with sleep. Surface EMG of SCM/trapezius muscles exhibited a good accuracy in the revelation of SRHJ.

Berberine attenuates the inflammatory response by activating the Keap1/Nrf2 signaling pathway in bovine endometrial epithelial cells.

Endometritis is a common inflammatory disease that disturbs the rapid development of dairy farming. In the present study, we investigated the anti-inflammatory effects of berberine on the LPS-induced inflammatory response in bovine endometrial epithelial cells (bEECs) and the participation of the Keap1/Nrf2 signaling pathway in this process. Berberine treatment significantly reduced the LPS-induced expression levels of CRP, IL-1ß, IL-6, and TNF-α in bEECs. The Nrf2 signaling pathway in these cells was also activated by berberine. We further evaluated the effects of Nrf2 activators and inhibitors on the downregulation of proinflammatory cytokines. The activator of Nrf2 significantly inhibited the production of these proinflammatory cytokines that was induced by LPS. However, an inhibitor of Nrf2 only partially inhibited the anti-inflammatory effects of berberine on the LPS-induced inflammatory response in bEECs. In conclusion, our findings suggest that berberine exerts anti-inflammatory effects partially by activating the Keap1/Nrf2 signaling pathway.

Higher heating value, exergy, pyrolysis kinetics and thermodynamic analysis of ultrasound-assisted deep eutectic solvent pretreated watermelon rind biomass.

The higher heating value (HHV) and exergy of ultrasound-assisted deep eutectic solvent pretreated watermelon rind (WMR) biomass were investigated. Thereafter, the co-pyrolysis of the WMR biomass and coal blends was studied. The pyrolysis kinetics and thermodynamic parameters of the WMR-coal blends were determined using four isoconversional models (Flynn-Wall-Ozawa, Kissinger-Akahira-Sunose, Friedman and Starink). The HHVs of the pretreated WMR ranged between 12.73 and 19.28 MJ/kg, while the exergy value for the raw and pretreated WMR were 16.08 and 21.55 MJ/kg, respectively. The lower heating value related exergy had the greatest influence on the overall exergy of the WMR. The values of the pre-exponential factor showed variations in wide range, and the change in entropy of the system displayed both negative and positive entropies. The activation energy and enthalpy varied directly with the amount of coal in the blends. Amongst the isoconversional model methods, Friedman model was the best predictor of the kinetic parameters.

Andrographolide attenuates inflammatory response induced by LPS via activating Nrf2 signaling pathway in bovine endometrial epithelial cells.

Endometritis is one of the main causes of bovine infertility, which causes serious economic losses to the industry. The endometrium is the first line of defense against invading microbial pathogens in the uterus. Andrographolide is the primary active component of A. paniculate, and has been shown to have anti-inflammatory and antioxidant effects. However, its effects on the LPS-induced signaling pathway in bovine endometrial epithelial cells (bEECs) have not been reported yet. The aim of this study was to investigate the anti-inflammatory effects and mechanism of andrographolide in the LPS-induced inflammatory response of bEECs. We found that andrographolide strongly reduced LPS-induced NO and iNOS expression. The production of cytokines that were upregulated by LPS was significantly suppressed. To investigate the anti-inflammatory mechanism of andrographolide, we examined the activation of Nrf2. The results shown that andrographolide inhibited the expression of Keap1 but increased the expression of Nrf2. The expression levels of target genes of Nrf2 including Ho-1 and Nqo-1 were increased by andrographolide. Taken together, these results suggest that andrographolide may serve as a candidate to protect against the LPS-induced inflammatory response by inducing Nrf2 activation.

Effects of tri-frequency ultrasound-ethanol pretreatment combined with infrared convection drying on the quality properties and drying characteristics of scallion stalk.

BACKGROUND: Having short drying time and attractive product quality are important in fruit and vegetable dehydration processing. In this work, tri-frequency (20, 40 and 60 kHz) ultrasound-ethanol pretreatment, ultrasound-water pretreatment and ethanol pretreatment were employed before infrared convection drying (ICD) of scallion stalks, which was aimed at improving the drying process and quality of the end products. The mass transfer, drying characteristics (moisture ratio and drying rate and quality properties of scallion (rehydration, color, flavor, optical microscope image, moisture distribution and microbiological quality) were analyzed. RESULTS: All pretreatments have decreased the drying time by 33.34-83.34% compared to the control, while ultrasound-ethanol pretreatment provided the highest time reduction (83.34%). The reason is that the volatility of ethanol have replaced air in the tissue, which produced a better osmotic dehydration effect and the cavitation effect of ultrasound changed the cell function of the material, so that the food tissue was rapidly compressed and expanded, resulting in damage to the cell structure. Ultrasonic-ethanol pretreatment has greatly reduced the water loss and dry matter of fresh scallion, improved the rehydration effect of dried scallion, better retained the color and flavor of scallion and effectively reduced the microbiological quality of the scallion. CONCLUSION: The tri-frequency ultrasound-ethanol pretreatment has effectively improved the drying process and quality characteristics of the dried scallion. Therefore, this research has a great contribution to the drying technology, as evident in the remarkable reduction in drying time and the improvement in the quality of the end product. © 2020 Society of Chemical Industry.