The experimental design of postmortem studies: the effect size and statistical power

Plasma Biomarker Screening Based on Proteomic Signature of Patients with Resistant Hypertension

Resistant hypertension (RH) poses a significant health challenge, yet its underlying pathogenesis remains unclear. This study employs untargeted proteomic techniques to analyze the plasma of patients with RH and controlled hypertension (CH), identifying 157 differentially expressed proteins, with TGFB1 emerging as a key candidate. Through gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, Protein-Protein Interaction Networks (PPI) topological analysis, TGFB1's differential regulation in RH is established. ELISA verification solidifies TGFB1's role, marking it as a potential biological target for early RH diagnosis and treatment. The study underscores the importance of proteomic approaches in enhancing our understanding of RH and improving therapeutic strategies. These findings carry implications for advancing RH diagnostics and treatment modalities, addressing a critical gap in current knowledge.

Intimate relationships regulate female brain activity in a competitive context: evidence from EEG and functional connectivity analysis

Competition is common in life, and intimate relationships are essential. Understanding how intimate relationships impact an individual's competitive process is crucial. This study explored the impact of competitor gender on female competition using electroencephalography analysis. The results revealed that females exhibited a smaller median of the absolute value of reaction time difference (DRT) between their partners and their competitors when their partners were absent compared to when their partners were present. Additionally, females showed greater average amplitudes of N2 posterior contralateral component (N2pc) and Late Positive Potential (LPP), increased activation of the alpha frequency band, and enhanced theta frequency band functional connectivity between the central parietal lobe and occipital lobe. Furthermore, when competing with individuals of the same gender as opposed to individuals of the opposite gender, females exhibited greater average amplitudes of percentage of wins and N2pc. A significant negative correlation was noted between the DRT and the average wave amplitudes of N2pc and LPP. These findings suggest that females are more engaged in competitive tasks when partners are not present and have improved decision-making when competing with same-gender individuals. This study provides evidence for the influence of lovers on female competition, helping females adapt to social competition and promoting healthy relationships.

Physical activity changes and related factors in chronic heart failure patients during the postdischarge transition period: a longitudinal study

BACKGROUND

Physical activity (PA) is essential and effective for chronic heart failure (CHF) patients. A greater understanding of the longitudinal change in PA and its influencing factors during the postdischarge transition period may help create interventions for improving PA. The aims of this study were (1) to compare the change in PA, (2) to examine the influencing factors of PA change, and (3) to verify the mediating pathways between influencing factors and PA during the postdischarge transition period in CHF patients.

METHODS

A total of 209 CHF patients were recruited using a longitudinal study design. The Chinese version of the International Physical Activity Questionnaire (IPAQ), Patient-reported Outcome Measure for CHF (CHF-PRO), and the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart) were used to assess PA, CHF-related symptoms, and kinesiophobia. The IPAQ score was calculated (1) at admission, (2) two weeks after discharge, (3) two months after discharge, and (4) three months after discharge. Two additional questionnaires were collected during admission. Generalized estimating equation (GEE) models were fitted to identify variables associated with PA over time. We followed the STROBE checklist for reporting the study.

RESULTS

The PA scores at the four follow-up visits were 1039.50 (346.50-1953.00) (baseline/T1), 630.00 (1.00-1260.00) (T2), 693.00 (1-1323.00) (T3) and 693.00 (160.88-1386.00) (T4). The PA of CHF patients decreased unevenly, with the lowest level occurring two weeks after discharge, and gradually improving at two and three months after discharge. CHF-related symptoms and kinesiophobia were significantly associated with changes in PA over time. Compared with before hospitalization, an increase in CHF-related symptoms at two weeks and two months after discharge was significantly associated with decreased PA. According to our path analysis, CHF-related symptoms were positively and directly associated with kinesiophobia, and kinesiophobia was negatively and directly related to PA. Moreover, CHF-related symptoms are indirectly related to PA through kinesiophobia.

CONCLUSION

PA changed during the postdischarge transition period and was associated with CHF-related symptoms and kinesiophobia in CHF patients. Reducing CHF-related symptoms helps improve kinesiophobia in CHF patients. In addition, the reduction in CHF-related symptoms led to an increase in PA through the improvement of kinesiophobia.

TRIAL REGISTRATION

The study was registered in the Chinese Clinical Trial Registry (11/10/2022 ChiCTR2200064561 retrospectively registered).

Favoritism or bias? Cooperation and competition under different intergroup relationships: evidence from EEG hyperscanning

Cooperation and competition are the most common forms of social interaction in various social relationships. Intergroup relationships have been posited to influence individuals' interpersonal interactions significantly. Using electroencephalography hyperscanning, this study aimed to establish whether intergroup relationships influence interpersonal cooperation and competition and the underlying neural mechanisms. According to the results, the in-group Coop-index is better than the out-group, whereas the out-group Comp-index is stronger than the in-group. The in-group functional connectivity between the frontal-central region and the right temporoparietal junction in the β band was stronger in competition than cooperation. The out-group functional connectivity between the frontal-central region and the left temporoparietal junction in the α band was stronger in cooperation than competition. In both cooperation and competition, the in-group exhibited higher interbrain synchronization between the prefrontal cortex and parietal region in the θ band, as well as between the frontal-central region and frontal-central region in the α band, compared to the out-group. The intrabrain phase-locking value in both the α and β bands can effectively predict performance in competition tasks. Interbrain phase-locking value in both the α and θ bands can be effectively predicted in a performance cooperation task. This study offers neuroscientific evidence for in-group favoritism and out-group bias at an interpersonal level.

Fukuchi-Manabe Score for Infection Control Measures During the Very Early COVID-19 Pandemic Period When Access to Reverse Transcription-Polymerase Chain Reaction Testing Was Poor in Japan: A Single-Center Observational Prospective Cohort Study

BACKGROUND

During the early stages of the COVID-19 pandemic in Japan, access to reverse transcription-polymerase chain reaction (RT-PCR) testing was limited. All patients with COVID-19 required hospitalization, and isolation of suspected COVID-19 patients had not yet been implemented. With the recently acquired evidence on COVID-19, it is important to develop a risk stratification system for isolation rooms in the context of limited resources for better resource management.

OBJECTIVE

This study aimed to develop and validate a COVID-19 risk-scoring strategy, the Fukuchi-Manabe score, to safely stratify and manage isolation rooms, personal protective equipment (PPE), and RT-PCR testing in the context of limited RT-PCR testing and a short supply of PPE.

METHODS

This single-center prospective study consecutively enrolled suspected COVID-19 adult inpatients between March 1 and August 31, 2020. The primary and secondary outcomes were a positive RT-PCR test and the occurrence of nosocomial infections during the study period, respectively. Factors related to patient history, symptoms, chest computed tomography findings, and laboratory data suggestive of COVID-19 were scored, totaled, and divided into four categories ("probable," "possible," "less likely," and "non-suspicious") based on the likelihood of COVID-19. Sensitivity, specificity, and positive and negative predictive values were evaluated for each probability category.

FINDINGS

Twenty of 224 inpatients were positive on the RT-PCR test, including 18 "probable" patients (90.0%), one "possible" patient, and one "less likely" patient. The area under the curve (AUC) (95% confidence interval: 0.841-0.977), sensitivity, and specificity were 0.909, 90.0%, and 80.4%, respectively. The positive and negative predictive values and accuracy for the "probable" category were 0.90, 0.80, and 0.82, respectively. The mean and standard deviation of AUCs, validated by bootstrap analysis, were 0.910±0.034. No nosocomial infections were observed.

CONCLUSION

The Fukuchi-Manabe score will be helpful when other novel pathogens emerge in the future before the availability of genetic testing methods.

Romantic relationships attenuated competition between lovers: evidence from brain synchronization

Competition is an essential component of social interaction and is influenced by interpersonal relationships. This study is based on social exchange theory and explores the relationship between brain synchronization and competition in the binary system of romantic relationships through electroencephalogram hyperscanning technology. The results found that females had a greater win rate in the romantic and friend groups. During the early stage (0-200 ms), when the competitive target appeared, the stranger group exhibited greater interbrain synchronicity in the Alpha frequency band. However, during the later stage (600-800 ms), the romantic group showed higher Alpha band interbrain synchrony when the competitive target appeared. Significant interbrain synchronizations were observed in the Theta frequency band of the stranger and friend groups at 400-600 ms and 800-1000 ms. Moreover, these interbrain synchronizations were significantly positively correlated with the winning rates of females in the competition. These findings suggest a close relationship between interpersonal coordination and interbrain synchronization. Furthermore, romantic relationships reduce participants' willingness to compete, affecting their attention regulation, emotional processing, and goal orientation, thus influencing competition. This study investigated the impact of romantic relationships on competition, providing a theoretical foundation for promoting the positive and healthy development of romantic relationships.

Immunogenetics of autism spectrum disorder: A systematic literature review

The aetiology of autism spectrum disorder (ASD) is complex and, partly, accounted by genetic factors. Nonetheless, the genetic underpinnings of ASD are poorly defined. The presence of immune dysregulations in autistic individuals, and their families, supports a role of the immune system and its genetic regulators. Albeit immune responses belong either to the innate or adaptive arms, the overall immune system genetics is broad, and encompasses a multitude of functionally heterogenous pathways which may have different influences on ASD. Hence, to gain insights on the immunogenetic underpinnings of ASD, we conducted a systematic literature review of previous immune genetic and transcription studies in ASD. We defined a list of immune genes relevant to ASD and explored their neuro-immune function. Our review confirms the presence of immunogenetic variability in ASD, accounted by inherited variations of innate and adaptive immune system genes and genetic expression changes in the blood and post-mortem brain of autistic individuals. Besides their immune function, the identified genes control neurodevelopment processes (neuronal and synaptic plasticity) and are highly expressed in pre/peri-natal periods. Hence, our synthesis bolsters the hypothesis that perturbation in immune genes may contribute to ASD by derailing the typical trajectory of neurodevelopment. Our review also helped identifying some of the limitations of prior immunogenetic research in ASD. Thus, alongside clarifying the neurodevelopment role of immune genes, we outline key considerations for future work into the aetiology of ASD and possible novel intervention targets.

Neuroprotective role for RORA in Parkinson's disease revealed by analysis of post-mortem brain and a dopaminergic cell line

Parkinson's disease (PD) is almost twice as prevalent in men, which has largely been attributed to neuroprotective effect of oestradiol in women. RORA (retinoic acid receptor-related orphan receptor alpha) regulates the transcription of central aromatase, the enzyme responsible for local oestradiol synthesis, simultaneously, RORA expression is regulated by sex hormones. Moreover, RORA protects neurones against oxidative stress, a key mechanism contributing to the loss of dopaminergic neurones in PD. Therefore, we hypothesized that there would be sex differences in RORA expression in the substantia nigra pars compacta (SNpc), which could contribute to sex differences observed in PD prevalence and pathogenesis. In a case control study, qPCR and western blot analyses were used to quantify gene and protein expression in the SNpc of post-mortem brains (n = 14 late-stage PD and 11 age and sex matched controls). The neuroprotective properties of a RORA agonist were then investigated directly using a cell culture toxin-based model of PD coupled with measures of viability, mitochondrial function and apoptosis. RORA was expressed at significantly higher levels in the SNpc from control females' brains compared to males. In PD, we found a significant increase in SNpc RORA expression in male PD compared to female PD. Treatment with a RORA agonist showed a significant neuroprotection in our cell culture model of PD and revealed significant effects on intracellular factors involved in neuronal survival and demise. This study is the first to demonstrate a sex specific pattern of RORA protein and gene expression in the SNpc of controls post-mortem human brains, and to show that this is differentially altered in male and female PD subjects, thus supporting a role for RORA in sex-specific aspects of PD. Furthermore, our in vitro PD model indicates mechanisms whereby a RORA agonist exerts its neuroprotective effect, thereby highlighting the translational potential for RORA ligands in PD.

Quantitative proteomics of tau and Aβ in detergent fractions from Alzheimer's disease brains

The two hallmarks of Alzheimer's disease (AD) are amyloid-β (Aβ) plaques and neurofibrillary tangles marked by phosphorylated tau. Increasing evidence suggests that aggregating Aβ drives tau accumulation, a process that involves synaptic degeneration leading to cognitive impairment. Conversely, there is a realization that non-fibrillar (oligomeric) forms of Aβ mediate toxicity in AD. Fibrillar (filamentous) aggregates of proteins across the spectrum of the primary and secondary tauopathies were the focus of recent structural studies with a filament structure-based nosologic classification, but less emphasis was given to non-filamentous co-aggregates of insoluble proteins in the fractions derived from post-mortem human brains. Here, we revisited sarkosyl-soluble and -insoluble extracts to characterize tau and Aβ species by quantitative targeted mass spectrometric proteomics, biochemical assays, and electron microscopy. AD brain sarkosyl-insoluble pellets were greatly enriched with Aβ₄₂ at almost equimolar levels to N-terminal truncated microtubule-binding region (MTBR) isoforms of tau with multiple site-specific post-translational modifications (PTMs). MTBR R3 and R4 tau peptides were most abundant in the sarkosyl-insoluble materials with a 10-fold higher concentration than N-terminal tau peptides. This indicates that the major proportion of the enriched tau was the aggregation-prone N-terminal and proline-rich region (PRR) of truncated mixed 4R and 3R tau with more 4R than 3R isoforms. High concentration and occupancies of site-specific phosphorylation pT₁₈₁ (~22%) and pT₂₁₇ (~16%) (key biomarkers of AD) along with other PTMs in the PRR and MTBR indicated a regional susceptibility of PTMs in aggregated tau. Immunogold labelling revealed that tau may exist in globular non-filamentous form (N-terminal intact tau) co-localized with Aβ in the sarkosyl-insoluble pellets along with tau filaments (N-truncated MTBR tau). Our results suggest a model that Aβ and tau interact forming globular aggregates, from which filamentous tau and Aβ emerge. These characterizations contribute towards unravelling the sequence of events which lead to end-stage AD changes.

Predictors of Readmission After Pulmonary Resection in Patients With Lung Cancer: A Systematic Review and Meta-analysis

Objective: Postoperative readmissions are considered an indicator of healthcare quality. The purpose of this study was to assess the factors associated with readmission following pulmonary resection for lung cancer. Methods: A comprehensive search was performed in PubMed, Web of science, the Cochrane Library, and databases of CNKI and Wanfang. We collected the factors associated with readmission following pulmonary resection from the included studies, and data analysis was conducted with STATA SE12.0 software. Results: A total of 11 studies (386 012 participants) were included. The meta-analysis results showed that age (standardized mean difference [SMD] = 0.093), male sex (odds ratio [OR] = 1.260), Charlson score (SMD = 1.408), forced expiratory volume in 1 second predicted (SMD = -0.203), congestive heart failure (OR = 1.708), peripheral vascular disease (OR = 1.436), and histology (OR = 0.804) were associated with readmission (P < .05), while hypertension was not. Patients with postoperative empyema, pneumonia, air leak, and arrhythmia (all P < .05) had higher odds of hospital readmission. Conclusion: The predictive factors for readmission can help in establishing individualized discharge and follow-up plans and programs for reducing hospital readmissions after pulmonary resection in patients with lung cancer.

At the Interface of Life and Death: Post-mortem and Other Applications of Vaginal, Skin, and Salivary Microbiome Analysis in Forensics

Microbial forensics represents a promising tool to strengthen traditional forensic investigative methods and fill related knowledge gaps. Large-scale microbiome studies indicate that microbial fingerprinting can assist forensics in areas such as trace evidence, source tracking, geolocation, and circumstances of death. Nevertheless, the majority of forensic microbiome studies focus on soil and internal organ samples, whereas the microbiome of skin, mouth, and especially vaginal samples that are routinely collected in sexual assault and femicide cases remain underexplored. This review discusses the current and emerging insights into vaginal, skin, and salivary microbiome-modulating factors during life (e.g., lifestyle and health status) and after death (e.g., environmental influences and post-mortem interval) based on next-generation sequencing. We specifically highlight the key aspects of female reproductive tract, skin, and mouth microbiome samples relevant in forensics. To fill the current knowledge gaps, future research should focus on the degree to which the post-mortem succession rate and profiles of vaginal, skin, and saliva microbiota are sensitive to abiotic and biotic factors, presence or absence of oxygen and other gases, and the nutrient richness of the environment. Application of this microbiome-related knowledge could provide valuable complementary data to strengthen forensic cases, for example, to shed light on the circumstances surrounding death with (post-mortem) microbial fingerprinting. Overall, this review synthesizes the present knowledge and aims to provide a framework to adequately comprehend the hurdles and potential application of vaginal, skin, and salivary post-mortem microbiomes in forensic investigations.

Endocannabinoid system alterations in Alzheimer's disease: A systematic review of human studies

Studies investigating alterations of the endocannabinoid system (ECS) in Alzheimer's disease (AD) in humans have reported inconsistent findings so far. We performed a systematic review of studies examining alterations of the ECS specifically within humans with AD or mild cognitive impairment (MCI), including neuroimaging studies, studies of serum and cerebrospinal fluid biomarkers, and post-mortem studies. We attempted to identify reported changes in the expression and activity of: cannabinoid receptors 1 and 2; anandamide (AEA); 2-arachidonoylglycerol (2-AG); monoacylglycerol lipase (MAGL); fatty acid amide hydrolase (FAAH); and transient receptor potential cation channel V1 (TRPV1). Twenty-two studies were identified for inclusion. Mixed findings were reported for most aspects of the ECS in AD, making it difficult to identify a particular profile of ECS alterations characterising AD. The included studies tended to be small, methodologically heterogeneous, and frequently did not control for important potential confounders, such as pathological progression of AD. Eight studies correlated ECS alterations with neuropsychometric performance measures, though studies infrequently examined behavioural and neuropsychiatric correlates. PROSPERO database identifier: CRD42018096249.

Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study

The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. The median curvilinear distance along the skin from the pigmented border to the digital nerves of the index, middle, ring and little fingers was 1.4 mm. In the thumb, this distance was 2.4 and 3.7 mm on the radial and ulnar sides, respectively. The digital nerve was located 2.4 mm deep to the skin in all fingers. The median angle to the nerve from the skin at the pigmented border was 30°. These dimensions differed in the thumb compared with the rest of the fingers. We conclude that the pigmented border of digits is a reliable anatomical landmark to locate digital nerves.

Animal Models in Forensic Science Research: Justified Use or Ethical Exploitation?

A moral dilemma exists in biomedical research relating to the use of animal or human tissue when conducting scientific research. In human ethics, researchers need to justify why the use of humans is necessary should suitable models exist. Conversely, in animal ethics, a researcher must justify why research cannot be carried out on suitable alternatives. In the case of medical procedures or therapeutics testing, the use of animal models is often justified. However, in forensic research, the justification may be less evident, particularly when research involves the infliction of trauma on living animals. To determine how the forensic science community is dealing with this dilemma, a review of literature within major forensic science journals was conducted. The frequency and trends of the use of animals in forensic science research was investigated for the period 1 January 2012-31 December 2016. The review revealed 204 original articles utilizing 5050 animals in various forms as analogues for human tissue. The most common specimens utilized were various species of rats (35.3%), pigs (29.3%), mice (17.7%), and rabbits (8.2%) although different specimens were favored in different study themes. The majority of studies (58%) were conducted on post-mortem specimens. It is, however, evident that more needs to be done to uphold the basic ethical principles of reduction, refinement and replacement in the use of animals for research purposes.

Evaluation of postmortem biochemical markers: Completeness of data and assessment of implication in the field

Throughout the years an increase has been observed in research output on biochemical markers for determining the postmortem interval (PMI). However, to date, a complete overview is missing on the results of postmortem biochemical markers (PBM's) for PMI estimation. In this paper, literature was reviewed in order to identify the knowledge lacunae of PBM research from a practical point of view. A three-step approach was undertaken in order to achieve the set goal. Literature was collected, the PBM's were evaluated for completeness by means of a scorings index based on set criteria, and PBM's were subsequently evaluated in light of the Daubert &Frye criteria for scientific evidence in court. Seven PBM's were found to be well investigated, from which potassium had the highest completion score. However, none of these PBM's could be qualified as suitable for court evidence. Further, this study revealed that the majority of PBM's (94%) is not well investigated. Consequently, these PBM's did not meet Daubert &Frye criteria. In order to improve the assessment for use of PBM's as evidence in court regarding PMI estimation, PBM's should be investigated more thoroughly and data should be made readily available.