Effects of fecal microbiota transfer on blood pressure in animal models: A systematic review and meta-analysis.

BACKGROUND: Numerous recent studies have found a strong correlation between intestinal flora and the occurrence of hypertension. However, it remains unclear whether fecal microbiota transfer might affect the blood pressure of the host. This study aimed to quantify both associations. METHODS: An electronic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang database, Weipu, Embase, and SinoMed to retrieve relevant studies. The final search was completed on August 22, 2022. Two authors independently applied the inclusion criteria, extracted data, and assessed the risk of bias assessment. All data were analyzed using RevMan 5.4. RESULTS: A total of 5 articles were selected for final inclusion. All studies were assessed as having a high risk of bias according to the SYRCLE risk of bias tool. The meta-analysis results showed that transplantation of fecal bacteria from the hypertensive model can significantly improve the host's systolic pressure (MD = 18.37, 95%CI: 9.74~26.99, P<0.001), and diastolic pressure (MD = 17.65, 95%CI: 12.37~22.93, P<0.001). Subgroup analyses revealed that the increase in systolic pressure in the hypertension model subgroup (MD = 29.56, 95%CI = 23.55-35.58, P<0.001) was more pronounced than that in the normotensive model subgroup (MD = 12.48, 95%CI = 3.51-21.45, P<0.001). CONCLUSION: This meta-analysis suggests a relationship between gut microbiota dysbiosis and increased blood pressure, where transplantation of fecal bacteria from the hypertensive model can cause a significant increase in systolic pressure and diastolic pressure in animal models.

Preoperative slow-wave sleep is associated with postoperative delirium after heart valve surgery: A prospective pilot study.

Postoperative delirium (POD) is a very common neurological complication after valve surgery. Some studies have shown that preoperative sleep disorder is associated with POD, but the correlation between preoperative slow wave sleep (SWS) and POD remains unclear. Therefore, this study aims to identify the correlation between preoperative slow wave sleep and postoperative delirium in patients with heart valve disease. This was a prospective, observational study of elective valve surgery patients admitted to the Heart Medical Center between November 2021 and July 2022. Polysomnography (PSG) was used to monitor sleep architecture from 9:30 p.m. for 1 night before surgery to 6:30 a.m. on the day of surgery. Patients were assessed for postoperative delirium from postoperative day 1 to extubation or day 5 by using the Richmond Agitation/Sedation Scale (RASS) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). A total of 60 elective valve surgery patients were enrolled in this study. Prolonged N1 (11.44%) and N2 (58.62%) sleep, decreased N3 sleep (8.75%) and REM sleep (18.24%) within normal limits were the overall sleep architecture. Compared with patients without POD, patients with POD had less slow wave sleep 1 night before surgery (5.77% vs 10.88%, p < 0.001). After adjusting for confounding factors, slow wave sleep (OR: 0.647, 95% CI 0.493-0.851, p = 0.002) was found to be a protective factor for postoperative delirium. The preoperative SWS is a predictive factor of the POD in patients undergoing valve surgery. But further studies with larger sample sizes are still needed to elucidate the relationship between preoperative slow wave sleep and postoperative delirium.

The efficacy of high-flow nasal cannula (HFNC) versus non-invasive ventilation (NIV) in patients at high risk of extubation failure: a systematic review and meta-analysis.

BACKGROUND: Studies suggest that high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) can prevent reintubation in critically ill patients with a low risk of extubation failure. However, the safety and effectiveness in patients at high risk of extubation failure are still debated. Therefore, we conducted a systematic review and meta-analysis to compare the efficacies of HFNC and NIV in high-risk patients. METHODS: We searched eight databases (MEDLINE, Cochrane Library, EMBASE, CINAHL Complete, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, and Chinese Biological Medical Database) with reintubation as a primary outcome measure. The secondary outcomes included mortality, intensive care unit (ICU) length of stay (LOS), incidence of adverse events, and respiratory function indices. Statistical data analysis was performed using RevMan software. RESULTS: Thirteen randomized clinical trials (RCTs) with 1457 patients were included. The HFNC and NIV groups showed no differences in reintubation (RR 1.10, 95% CI 0.87-1.40, I2 = 0%, P = 0.42), mortality (RR 1.09, 95% CI 0.82-1.46, I2 = 0%, P = 0.54), and respiratory function indices (partial pressure of carbon dioxide [PaCO2]: MD - 1.31, 95% CI - 2.76-0.13, I2 = 81%, P = 0.07; oxygenation index [P/F]: MD - 2.18, 95% CI - 8.49-4.13, I2 = 57%, P = 0.50; respiratory rate [Rr]: MD - 0.50, 95% CI - 1.88-0.88, I2 = 80%, P = 0.47). However, HFNC reduced adverse events (abdominal distension: RR 0.09, 95% CI 0.04-0.24, I2 = 0%, P < 0.01; aspiration: RR 0.30, 95% CI 0.09-1.07, I2 = 0%, P = 0.06; facial injury: RR 0.27, 95% CI 0.09-0.88, I2 = 0%, P = 0.03; delirium: RR 0.30, 95%CI 0.07-1.39, I2 = 0%, P = 0.12; pulmonary complications: RR 0.67, 95% CI 0.46-0.99, I2 = 0%, P = 0.05; intolerance: RR 0.22, 95% CI 0.08-0.57, I2 = 0%, P < 0.01) and may have shortened LOS (MD - 1.03, 95% CI - 1.86-- 0.20, I2 = 93%, P = 0.02). Subgroup analysis by language, extubation method, NIV parameter settings, and HFNC flow rate revealed higher heterogeneity in LOS, PaCO2, and Rr. CONCLUSIONS: In adult patients at a high risk of extubation failure, HFNC reduced the incidence of adverse events but did not affect reintubation and mortality. Consequently, whether or not HFNC can reduce LOS and improve respiratory function remains inconclusive.

A Comparison of the Microstructure, Mechanical Properties, and Corrosion Resistance of the K213 Superalloy after Conventional Casting and Selective Laser Melting.

K213 superalloy was fabricated by conventional casting and selective laser melting (SLM). The microstructures of the two samples were examined, and the mechanical properties and corrosion resistance of these two kinds of K213 alloy were comparatively studied. The results show that segregation of Ti occurs at the grain boundaries of the as-cast alloy, resulting in the formation of MC carbide. Many microcracks were formed in the SLM sample. Premature fracture of the as-cast alloy is caused by the precipitation of the harmful phase (Ti, Mo, Nb)C (MC). The MC carbides and microcracks in the as-cast and SLM alloys, respectively, induce tensile fracture. In comparison, the strength of the SLM sample is greater, while the elongation of the as-cast sample is greater. The oxidation resistance of the SLM sample is better at a high temperature of 800 °C. This is due to the relatively uniform composition and microstructure of the SLM alloy. However, the corrosion rate of the SLM alloy is accelerated during the electrochemical immersion corrosion process due to the existence of microcracks.

Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis.

Background: Postoperative delirium (POD) is an acute brain dysfunction that is frequently observed in patients undergoing cardiac surgery. Increasing evidence indicates POD is related to higher mortality among cardiac surgical patients, but the results remain controversial. Moreover, a quantitative evaluation of the influence of POD on hospital days, intensive care unit (ICU) time, and mechanical ventilation (MV) time has not been performed. Objective: This study aimed to evaluate the correlation between POD and outcomes in patients undergoing cardiac surgery by a systematic review and meta-analysis. Materials and methods: A total of 7 electronic databases (Cochrane Library, PubMed, EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National Knowledge Infrastructure) were searched from January 1980 to July 20, 2021, with language restrictions to English and Chinese, to estimate the impact of the POD on outcome in patients who underwent cardiac surgery. The meta-analysis was registered with PROSPERO (Registration: CRD42021228767). Results: Forty-two eligible studies with 19785 patients were identified. 3368 (17.0%) patients were in the delirium group and 16417 (83%) were in the non-delirium group. The meta-analysis showed that compared to patients without POD, patients with POD had 2.77-fold higher mortality (OR = 2.77, 95% CI 1.86-4.11, P < 0.001), 5.70-fold higher MV (>24h) rate (OR = 5.70, 95% CI 2.93-11.09, P < 0.001); and longer MV time (SMD = 0.83, 95% CI 0.57-1.09, P < 0.001), ICU time (SMD = 0.91, 95% CI 0.60-1.22, P < 0.001), hospital days (SMD = 0.62, 95% CI 0.48-0.76, P < 0.001). Conclusion: The synthesized evidence suggests that POD is causally related to the increased risk of mortality, prolonged length of ICU and hospital stay, and a longer duration of MV time. Future research should focus on the interventions for POD, to reduce the incidence. Systematic review registration: [www.crd.york.ac.uk/PROSPERO], identifier [CRD42021228767].

Meta-Analysis: Shouldn't Prophylactic Corticosteroids be Administered During Cardiac Surgery with Cardiopulmonary Bypass?

Background: Corticosteroids can effectively inhibit systemic inflammation induced by cardiopulmonary bypass. Recently clinical trials and meta-analyses and current guidelines for cardiac surgery do not support corticosteroids prophylaxis during cardiac surgery because of an increase in myocardial infarction and no benefit for patients. The aim of this study is to determine whether specific corticosteroids dose ranges might provide clinical benefits without increasing myocardial infarction. Methods: The PubMed, Web of Science, Embase, Clinical Trials, and Cochrane databases were searched for randomized controlled trials (RCTs) published before August 1, 2021. Results: 88 RCTs with 18,416 patients (17,067 adults and 1,349 children) were identified. Relative to placebo and high-dose corticosteroids, low-dose corticosteroids (≤20 mg/kg hydrocortisone) during adult cardiac surgery did not increase the risks of myocardial infarction (odds ratio [OR]: 0.96, 95% confidence interval [CI]: 0.43-2.17; p = 0.93). However, low-dose corticosteroids were associated with lower risks of atrial fibrillation (OR: 0.58, 95% CI: 0.44-0.76; p < 0.0001) and kidney injury (OR: 0.29, 95% CI: 0.09-0.96; p = 0.04). Furthermore, low-dose corticosteroids significantly shortened the mechanical ventilation times (mean difference [MD]: -2.74 h, 95% CI: -4.14, -1.33; p = 0.0001), intensive care unit (ICU) stay (MD: -1.48 days, 95% CI: -2.73, -0.22; p = 0.02), and hospital stay (MD: -2.29 days, 95% CI: -4.51, -0.07; p = 0.04). Conclusion: Low-dose corticosteroids prophylaxis during cardiac surgery provided significant benefits for adult patients, without increasing the risks of myocardial infarction and other complications.

Predictive Value of Increased Perioperative Heart Rate for All-Cause Mortality After Cardiac Surgery: A Systematic Review and Meta-Analysis.

Background: Accumulated studies have revealed that heart rates are associated with all-cause mortality in cardiac surgery patients, but the results remain controversial. This meta-analysis aimed to evaluate the predictive value of increased perioperative heart rate for all-cause mortality after cardiac surgery. Methods: We searched PubMed, Embase, Web of Science, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases for studies from inception to October 11, 2021. Two researchers independently screened the studies. Titles, authors, publication years, and hazard ratios were extracted. We used a random-effects model to combine the HRs and 95% confidence intervals. Several subgroup analyses were conducted. Statistical significance was set at p < .05. Results: Eleven studies were included in the meta-analysis of 33,849 patients and 3166 (9.4%) deaths. The HR of higher perioperative heart rates was 2.09 (95% CI 1.53-2.86, p < .001, I2 = 81%). The HR with a 10-bpm increase in preoperative heart rate was 1.19 (95% CI 1.11-1.26, p < .001, I2 = 51%). Subgroup analysis showed patients with higher preoperative heart rates had an HR of 1.88 (95% CI 1.51-2.34, p < .001, I2 = 0%), and patients with a higher postoperative heart rate had an HR of 2.29 (95% CI 1.28- 4.09, p < .0001, I2 = 91%) compared to patients with lower postoperative heart rates. Conclusion: Increased perioperative heart rate is associated with all-cause mortality in patients undergoing cardiac surgery.

Emotion Understanding Correlates With Parental Emotional Expressivity in Chinese Youths With Hearing Loss and Typical Hearing.

This study aimed at examining the differences between Chinese youths with hearing loss (HL) and with typical hearing (TH) in emotion understanding (EU), parental emotional expressivity, and the associations between EU and parental emotional expressivity. The participants were 282 youths with HL (14.58 ± 3.42 years old) and 350 youths with TH (11.69 ± 2.49 years old). EU was measured by four visual-mode tasks, of which two involve language comprehension while the others do not. Parents reported positive and negative emotional expressivity on the Self-Expressiveness in the Family Questionnaire. Covariates were controlled for including socioeconomic status, parent gender, youth gender, age, intelligence, and teacher-reported comprehension difficulties. Results showed that the four EU tasks were more challenging for the youths with HL than for the youths with TH. The interaction effect of the two groups × 4 tasks was not significant, suggesting that the differences between the two groups of youths in EU were generally similar across the four tasks. The parents of the youths with HL did not differ from the parents of the youths with TH in how often they displayed positive and negative emotional expressivity. Multigroup regression analyses revealed that negative emotional expressivity was negatively related to EU in the youths with HL but not in the youths with TH. However, these two regression coefficients were not significantly different. Positive emotional expressivity was not related to EU in either group. In conclusion, this study extends the knowledge about the EU of Chinese youths with HL and emotion-related socialization of the parents of these youths.

Reshaping cell line development and CMC strategy for fast responses to pandemic outbreak.

The global pandemic outbreak COVID-19 (SARS-COV-2), has prompted many pharmaceutical companies to develop vaccines and therapeutic biologics for its prevention and treatment. Most of the therapeutic biologics are common human IgG antibodies, which were identified by next-generation sequencing (NGS) with the B cells from the convalescent patients. To fight against pandemic outbreaks like COVID-19, biologics development strategies need to be optimized to speed up the timeline. Since the advent of therapeutic biologics, strategies of transfection and cell line selection have been continuously improved for greater productivity and efficiency. NGS has also been implemented for accelerated cell bank testing. These recent advances enable us to rethink and reshape the chemistry, manufacturing, and controls (CMC) strategy in order to start supplying Good Manufacturing Practices (GMP) materials for clinical trials as soon as possible. We elucidated an accelerated CMC workflow for biologics, including using GMP-compliant pool materials for phase I clinical trials, selecting the final clone with product quality similar to that of phase I materials for late-stage development and commercial production.

The effect of Eurotium cristatum (MF800948) fermentation on the quality of autumn green tea.

Autumn green tea (AT) has poor taste quality for its strong astringency. This study aims to improve the taste quality as well as the aroma of AT by Eurotium cristatum (MF800948) fermentation and to produce a fermented autumn green tea (FT). Results showed that the aroma quality of AT was improved, and the content of terpene alcohols that impart characteristic flowery aroma to FT significantly increased. The umami intensity of FT was comparable to that of AT while the astringency tasted much weaker mainly due to the oxidation of the catechins. The results also confirmed that theabrownins exhibited strong umami taste, not astringent taste. Finally, a metabolic map was analyzed to show the effect of E. cristatum (MF800948) on the quality of AT, and to visualize the changes of differential compounds in AT and FT. The work provides insights into the quality improvement of autumn green tea.

Symptoms of post-traumatic stress disorder and associated risk factors in type A aortic dissection.

BACKGROUND: Surgery is the primary option of acute type A aortic dissection (AAAD) treatment. However, the unique traumatic stress of cardiovascular disease and surgery brings physical and psychological suffering to the patients and causes post-traumatic stress disorder (PTSD). The aim of this study was to investigate the rate of PTSD in AAAD patients after surgery and identify the risk factors of this complication. METHODS: A prospective cohort design was used. All patients who underwent AAAD surgery from September 2017 to June 2019 were included. Resilience, anxiety, and depression level were assessed before patients discharged from the hospital. Additionally, the PTSD symptoms were assessed three months after discharge from hospital. The data were analyzed by SPSS 24.0 (IBM, Armonk, NY, USA) and P<0.05 was considered as statistically significant. RESULTS: Two hundred and twenty-four patients were included in this study. The incidence of PTSD was 21.4%. Symptoms were highly prevalent with reexperience and increased alertness. "Primary or below" AAAD patients had a significantly higher score in "increased alertness" (P<0.05). Depressive symptoms (B=1.621, ß=0.398, P<0.001), female gender (B=-7.539, ß=-0.311, P<0.001) were the risk factors associated with PTSD, while optimism (B=-0.920, ß=-0.169, P=0.012) was the protective factor in AAAD patients. CONCLUSIONS: AAAD patients exhibited high prevalence of PTSD, which was highly prevalent with reexperience and increased alertness. Higher depressive level, female gender, and lower optimism were associated with higher risk of PTSD. The findings suggest that medical staff should assess the psychological health status of AAAD patients timely and identify high-risk patients early to improve the outcome.

Psychometric properties of the short-form UCLA Loneliness Scale (ULS-8) among Chinese adolescents.

Loneliness is prevalent and severe among adolescents, indicating the need for a reliable, valid, and concise instrument for detecting adolescent loneliness. This study aims to examine the psychometric properties of the Chinese version of the short-form UCLA Loneliness Scale (ULS-8) among Chinese adolescents.Computer-assisted self-interviewing was used to complete the questionnaire among 3480 junior or senior high school students aged 10 to 19 years. Construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). To test the concurrent validity and convergent validity of the scale, a single loneliness item and variables such as depression, suicidal ideation, and quality of interpersonal relationships were used. For reliability, Cronbach alpha and test-retest correlation were computed.Construct validity and internal consistency showed that the ULS-6, which excluded 2 reverse-scored items from the ULS-8, had stronger psychometric properties than the ULS-8. The convergent validity and concurrent validity were also supported by the study results. The overall Cronbach α of the ULS-6 was 0.878 and the test-retest reliability coefficient was 0.663.The ULS-6 showed satisfactory reliability and validity in this study, suggesting that this instrument can be used in the measurement of loneliness among Chinese adolescents.

Upregulated proteins associated with fibroin synthesis in posterior silk glands of Antheraea pernyi fifth instar larvae.

Antheraea pernyi is a typical wild silkworm with larval silk glands specific for the synthesis and secretion of silk proteins. We examined changes in the protein profile in the posterior section of the silk glands on days 1 and 4 of the last larval instar. Two-dimensional gel electrophoresis over the pH range of 4-7 followed by silver staining revealed about 350 protein spots. Twenty-three proteins upregulated on day 4 were analyzed using matrix-assisted laser desorption/ionization time-of-flight/time-of-flight (MALDI-TOF/TOF). Search for homologous sequences in NCBI databases identified seven proteins probably involved in the regulation of transcription, translation, and general cell metabolism. Among these, glutathione S-transferase theta (GSTT) and ribosomal protein L8 (RPL8) were selected for investigations at the mRNA level. Real-time quantitative PCR showed that the expression of GSTT peaked on day 4, whereas that of RPL8 peaked on day 3, confirming the upregulation of these proteins during the last larval instar. These results show that expressions of GSTT and RPL8 may play a role in fibroin synthesis in A. pernyi.