Temperature and adaptive immunity

Analysis of predictors of fever after aortic valve replacement: Diabetic patients are less likely to develop fever after aortic valve replacement, a single-centre retrospective study

BACKGROUND

Postoperative temperature dysregulation affects the length of hospital stay and prognosis. This study evaluated the factors that influence the occurrence of fever in patients after aortic valve replacement surgery.

METHODS

Eighty-seven consecutive patients who underwent aortic valve replacement surgery were included. Patients' age, sex and body mass index; presence of diabetes mellitus; operation time; blood loss; blood transfusion volume; preoperative and postoperative laboratory findings; presence or absence of oral function management; and fever >38°C were retrospectively analysed through univariate and multiple logistic regression analyses.

RESULTS

Among the variables, only diabetes mellitus status was significantly associated with fever ⩾38°C. Postoperatively, patients with diabetes mellitus were significantly less likely to develop fever above 38°C and a fever rising to 38°C.

CONCLUSIONS

This study shows that the presence of comorbid diabetes mellitus decreases the frequency of developing fever >38°C after aortic valve replacement surgery.

The Combined Effects of High Temperatures and Ozone Pollution on Medical Emergency Calls - Jinan City, Shandong Province, China, 2013-2019

What is already known about this topic?

Studies have extensively documented the separate and independent effects of extreme temperature and ozone on morbidity and mortality associated with respiratory and circulatory diseases.

What is added by this report?

The study revealed a significant association between elevated temperature, ozone pollution, and the combined effect of high temperature and ozone pollution with an increased risk of all-cause medical emergency calls (MECs) and MECs specifically related to neurological diseases.

What are the implications for public health practice?

Interventional measures should be implemented to mitigate exposure to high temperatures and ozone levels. Specifically, during the warm season, it is crucial for relevant authorities to focus on disseminating scientific information regarding the health impacts of elevated temperatures and ozone pollution. Additionally, timely public health advisories should be issued to alert the public effectively.

Magnetically controlled drug delivery and hyperthermia effects of core-shell Cu@Mn3O4 nanoparticles towards cancer cells in vitro

Recent increase in the integration of nanotechnology and nanosciences to the biomedical sector fetches the human wellness through the development of sustainable treatment methodologies for cancerous tumors at all stages of their initiation and progression. This involves the development of multifunctional theranostic probes that effectively support for the early cancer diagnosis, avoiding non-target cell toxicity, controlled and customized anticancer drug release etc. Therefore, to advance the field of nanotechnology-based sustainable cancer treatment, we fabricated and tested the efficacy of anticancer drug-loaded magnetic hybrid nanoparticles (NPs) towards in vitro cell culture systems. The developed conjugate of NPs was incorporated with the functions of both controlled drug delivery and heat-releasing ability using Mn3O4 (manganese oxide) magnetic core with Cu shell encapsulated within trimethyl chitosan (TMC) biopolymer. On characterization, the Cu@Mn3O4-TMC NPs were confirmed to have an approximate size of 130 nm with full agglomeration (as observed by the HRTEM) and crystal size of 92.95 ± 18.38 nm with tetragonal hausmannite phase for Mn3O4 spinel structure (XRD). Also, the UV-Vis and FTIR analysis provided the qualitative and quantitative effects of 5-fluororacil (5-Fu) anticancer drug loading (max 68 %) onto the Cu@Mn3O4-TMC NPs. The DLS analysis indicated for the occurrence of no significant changes to the particle size (around 100 nm) of Cu@Mn3O4-TMC due to the solution dispersion thereby confirming for the aqueous stability of developed NPs. In addition, the magnetization values of Cu@Mn3O4-TMC NPs were measured to be 34 emu/g and a blocking temperature of 42 K. Further tests of magnetic hyperthermia by the Cu@Mn3O4-TMC/5-Fu NPs provided that the heat-releasing capacity (% ΔT at 15 min) increases with that of increased frequency, i.e. 28 % (440 Hz) > 22.6 % (240 Hz) > 18 % (44 Hz), and the highest specific power loss (SPL) value observed to be 488 W/g for water. Moreover, the 5-Fu drug release studies indicate that the release is high at a pH of 5.2 and almost all the loaded drug is getting delivered under the influence of the external magnetic field (430 Hz) due to the influence of both Brownian-rotation and Néel relaxation heat-mediated mechanism. The pharmacokinetic drug release studies have suggested for the occurrence of more than one model, i.e. First-order, Higuchi (diffusion), and Korsemeyer-Peppas (non-Fickian), in addition to hyperthermia. Finally, the in vitro cell culture systems (MCF-7 cancer and MCF-10 non-cancer) helped to differentiate the physiological changes due to the effects of hyperthermia and 5-Fu drug individually and as a combination of both. The observed differences of cell viability losses among both cell types are measured and discussed with the expression of heat shock proteins (HSPs) by the MCF-10 cells as against the MCF-7 cancer cells. We believe that the results generated in this project can be helpful for the designing of new cancer therapeutic models with nominal adverse effects on healthy normal cells and thus paving a way for the treatment of cancer and other deadly diseases in a sustainable manner.

Effects of anesthetic depth on perioperative T lymphocyte subsets in patients undergoing laparoscopic colorectal cancer surgery: a prospective, parallel-controlled randomized trial

BACKGROUND

During the perioperative period, the surgical stress response induced by surgical trauma tends to cause a decrease in peripheral lymphocytes. Anesthetics could reduce the stress response during surgery and prevent sympathetic nerve overexcitation. The goal of this study was to investigate how BIS-guided anesthetic depth affected peripheral T lymphocytes in patients undergoing laparoscopic colorectal cancer surgery.

METHODS

A total of 60 patients having elective laparoscopic colorectal cancer surgery were randomly assigned and analyzed (n = 30 for deep general anesthesia, BIS 35, n = 30 for light general anesthesia, BIS 55). Blood samples were collected immediately before anesthesia induction and immediately after operation, 24 h and 5 days postoperatively. The CD4+/CD8 + ratio, T lymphocyte subsets (including CD3 + T cells, CD4 + T cells, and CD8 + T cells), and natural killer (NK) cells were analyzed by flow cytometry. Serum interleukin-6 (IL-6), interferon -ɣ (IFN-ɣ), and vascular endothelial growth factor-α (VEGF-α) were also measured.

RESULTS

The CD4+/CD8 + ratio decreased 24 h after surgery in two groups, but the reduction did not differ between the two groups (P > 0.05). The concentration of IL-6 and the numerical rating scale (NRS) score in the BIS 55 group were significantly higher than that in the BIS 35 group 24 h after surgery (P = 0.001). There were no intergroup differences in CD3 + T cells, CD4 + T cells, CD8 + T cells, NK cells, VEGF-α, or the IFN-ɣ. Statistical analyses showed no differences between the two groups in the incidence of fever and surgical site infection during hospitalization.

CONCLUSIONS

Despite the fact that patients in deep general anesthesia group had low levels of the IL-6 24 h after surgery, the deep general anesthesia was not associated to a positive effect on patients' peripheral T lymphocytes during colorectal cancer surgery. We found no evidence that peripheral T lymphocyte subsets and natural killer cells were affected by the targeting a BIS of either 55 or 35 in patients undergoing laparoscopic colorectal cancer surgery in this trial.

TRIAL REGISTRATION

ChiCTR2200056624 ( www.chictr.org.cn ).

Nanocomposite Hydrogels as Functional Extracellular Matrices

Over recent years, nano-engineered materials have become an important component of artificial extracellular matrices. On one hand, these materials enable static enhancement of the bulk properties of cell scaffolds, for instance, they can alter mechanical properties or electrical conductivity, in order to better mimic the in vivo cell environment. Yet, many nanomaterials also exhibit dynamic, remotely tunable optical, electrical, magnetic, or acoustic properties, and therefore, can be used to non-invasively deliver localized, dynamic stimuli to cells cultured in artificial ECMs in three dimensions. Vice versa, the same, functional nanomaterials, can also report changing environmental conditions-whether or not, as a result of a dynamically applied stimulus-and as such provide means for wireless, long-term monitoring of the cell status inside the culture. In this review article, we present an overview of the technological advances regarding the incorporation of functional nanomaterials in artificial extracellular matrices, highlighting both passive and dynamically tunable nano-engineered components.

The impact of stress and anesthesia on animal models of infectious disease

Stress and general anesthesia have an impact on the functional response of the organism due to the detrimental effects on cardiovascular, immunological, and metabolic function, which could limit the organism's response to an infectious event. Animal studies have formed an essential step in understanding and mitigating infectious diseases, as the complexities of physiology and immunity cannot yet be replicated in vivo. Using animals in research continues to come under increasing societal scrutiny, and it is therefore crucial that the welfare of animals used in disease research is optimized to meet both societal expectations and improve scientific outcomes. Everyday management and procedures in animal studies are known to cause stress, which can not only cause poorer welfare outcomes, but also introduces variables in disease studies. Whilst general anesthesia is necessary at times to reduce stress and enhance animal welfare in disease research, evidence of physiological and immunological disruption caused by general anesthesia is increasing. To better understand and quantify the effects of stress and anesthesia on disease study and welfare outcomes, utilizing the most appropriate animal monitoring strategies is imperative. This article aims to analyze recent scientific evidence about the impact of stress and anesthesia as uncontrolled variables, as well as reviewing monitoring strategies and technologies in animal models during infectious diseases.

Influence of Perioperative Anesthesia on Cancer Recurrence: from Basic Science to Clinical Practice

PURPOSEOF REVIEW

In this review, we will summarize the effects of these perioperative anesthetics and anesthetic interventions on the immune system and tumorigenesis as well as address the related clinical evidence on cancer-related mortality and recurrence.

RECENT FINDINGS

Cancer remains a leading cause of morbidity and mortality worldwide. For many solid tumors, surgery is one of the major therapies. Unfortunately, surgery promotes angiogenesis, shedding of circulating cancer cells, and suppresses immunity. Hence, the perioperative period has a close relationship with cancer metastases or recurrence. In the perioperative period, patients require multiple anesthetic management including anesthetics, anesthetic techniques, and body temperature control. Preclinical and retrospective studies have found that these anesthetic agents and interventions have complex effects on cancer outcomes. Therefore, well-planned, prospective, randomized controlled trials are required to explore the effects of different anesthetics and techniques on long-term outcomes after cancer surgery. Due to the conflicting effects of anesthetic management on cancer recurrence, further preclinical and clinical trials are required and beneficial to the development of systemic cancer therapies.

The lagged effect and attributable risk of apparent temperature on hand, foot, and mouth disease in Changsha, China: a distributed lag non-linear model

Hand, foot, and mouth disease (HFMD) is the leading Category C infectious disease affecting millions of children in China every year. In the context of global climate change, the understanding and quantification of the impact of weather factors on human health are particularly critical to the development and implementation of climate change adaptation and mitigation strategies. The aim of this study was to quantify the attributable burden of a combined bioclimatic indicator (apparent temperature) on HFMD and to identify temperature-specific sensitive populations. A total of 123,622 HFMD cases were included in the study. The non-linear relationship between apparent temperature and the incidence of HFMD was approximately M-shaped, with hot weather being more likely to be attributable than cold conditions, of which moderately hot accounting for the majority of cases (21,441, 17.34%). Taking the median apparent temperature (19.2 °C) as reference, the cold effect showed a short acute effect with the highest risk on the day of lag 0 (RR = 1.086, 95% CI: 1.024 ~ 1.152), whereas the hot effect lasted longer with the greatest risk at a lag of 7 days (RR = 1.081, 95% CI: 1.059 ~ 1.104). Subgroup analysis revealed that males, children under 3 years old, and scattered children tended to be more vulnerable to HFMD in hot weather, while females, those aged 3 ~ 5 years, and nursery children were sensitive to cold conditions. This study suggests that high temperatures have a greater impact on HFMD than low temperatures as well as lasting longer, of particular concern being moderately high temperatures rather than extreme temperatures. Early intervention takes on greater importance during cold days, while the duration of HFMD intervention must be longer during hot days.

How Climate Change May Threaten Progress in Neonatal Health in the African Region

Climate change is likely to have wide-ranging impacts on maternal and neonatal health in Africa. Populations in low-resource settings already experience adverse impacts from weather extremes, a high burden of disease from environmental exposures, and limited access to high-quality clinical care. Climate change is already increasing local temperatures. Neonates are at high risk of heat stress and dehydration due to their unique metabolism, physiology, growth, and developmental characteristics. Infants in low-income settings may have little protection against extreme heat due to housing design and limited access to affordable space cooling. Climate change may increase risks to neonatal health from weather disasters, decreasing food security, and facilitating infectious disease transmission. Effective interventions to reduce risks from the heat include health education on heat risks for mothers, caregivers, and clinicians; nature-based solutions to reduce urban heat islands; space cooling in health facilities; and equitable improvements in housing quality and food systems. Reductions in greenhouse gas emissions are essential to reduce the long-term impacts of climate change that will further undermine global health strategies to reduce neonatal mortality.

The impact of meteorological factors on COVID‐19 of California and its lag effect

As of March 30, 2021, COVID‐19 has been circulating globally for more than 1 year, posing a huge threat to the safety of human life and property. Understanding the relationship between meteorological factors and the COVID‐19 can provide positive help for the prevention and control of the global epidemic. We take California as the research object, use Geodetector to screen out the meteorological factors with the strongest explanatory power for the epidemic, then use partial correlation analysis to study the correlation between the two, and finally construct a distributed lag non‐linear model (DLNM) to further explore the relationship between the dominant factor and COVID‐19 and its lag effect. It turns out that temperature has a greater impact on COVID‐19 and the two have a significant negative correlation. When the temperature is lower than 50°F, it has a significant promotion effect on the epidemic, and the relative risk (RR) increases approximately exponentially as the temperature decreases. The delayed effect of the cold effect on the epidemic can be as long as 15 days. This study has shown that more attention should be paid to epidemic prevention and control when the temperature is low, and the delay effect of temperature on the spread of the epidemic cannot be ignored.

The mortality burden of nervous system diseases attributed to ambient temperature: A multi-city study in China

BACKGROUNDS

Studies on the association between ambient temperature and human mortality have been widely reported, focusing on common diseases such as cardiopulmonary diseases. However, multi-city studies on the association between both high and low temperatures and mortality of nervous system diseases were scarce, especially on the evidence of vulnerable populations.

METHODS

Weekly meteorological data, air pollution data and mortality data of nervous system were collected in 5 cities in China. A quasi-Poisson regression with distributed lag non-linear model (DLNM) was applied to quantify the association between extreme temperatures and mortality of nervous system diseases. Multivariate meta-analysis was applied to estimate the pooled effects at the overall levels. The attributable fractions (AFs) were calculated to assess the mortality burden attributable to both high and low temperatures. Stratified analyses were also performed by gender and age-groups through the above steps.

RESULTS

A total of 12,132 deaths of nervous system diseases were collected in our study. The overall minimum mortality temperature was 23.9 °C (61.9th), the cumulative relative risks of extreme heat and cold for nervous system diseases were 1.33(95%CI: 1.10, 1.61) and 1.47(95%CI: 1.27, 1.71). The mortality burden attributed to non-optimal temperatures accounted for 29.54% (95%eCI: 13.45%, 40.52%), of which the mortality burden caused by low temperature and high temperature accounted for 25.89% (95%eCI: 13.03%, 34.36%) and 3.65% (95%eCI: 0.42%, 6.17%), respectively. The mortality burden attributable to ambient temperature was higher in both males and the elderly (>74 years old), with the AF of 31.85% (95%eCI: 20.68%, 39.88%) and 31.14% (95%eCI: -6.83%, 49.51%), respectively.

CONCLUSIONS

The non-optimal temperature can increase the mortality of nervous system diseases and the males and the elderly over 74 years have the highest attributable burden. The findings add the evidence of vulnerable populations of nervous system diseases against ambient temperatures.

Immune response in acute respiratory syndrome induced by the new coronavirus

Coronaviruses (CoVs) belong to the family Coronaviridae, which are enveloped and have a single-stranded RNA genome. The new coronavirus (SARS-CoV-2) is the seventh known coronavirus that can infect humans and cause serious illness, such as acute respiratory syndrome. The coronaviruses already identified have contributed to the understanding of the clinical manifestations caused by SARS-CoV-2, as well as their associations with the immune system. The aim of the present study was to carry out a narrative review of the literature on the host's immune response to infection by the new coronavirus. The review contains basic and summarized information on the main mechanisms involved in the immune response to SARS-CoV-2. The characteristics of the infection were considered according to the following: from the initial contact with the host through binding to angiotensin-converting enzyme 2 (ACE-2); the recognition of the pathogen by innate immunity cells; its containment mechanisms, including the production of effector cytokines and chemokines important in the development of the inflammatory process; and the participation of the complement system until the activation of the adaptive immune response. The probable occurrence of a host dysfunctional immune response and the escape mechanisms of the virus were also addressed. Despite numerous studies on the pathogenesis of SARS-CoV-2 infection, knowledge about the host's immune response in COVID-19 is not fully understood. The present work established the relationship between the new coronavirus and the immune system, but further studies are needed for all the mechanisms of the process to be elucidated.

Survival at 30 days in elderly patients with hip fracture surgery who were exposed to hypothermia: Survival study

The effect of hypothermia as a mortality risk factor at 30 days in the elderly who had hip fracture (HF) surgery is still controversial because it may be due to a set of poorly identified factors. In this study, we aim to determine if exposure to intra and immediate postoperative hypothermia increases the incidence of mortality at 30 days in elderly patients who had HF surgery.Survival study in the elderly who had HF surgery with and without exposure to hypothermia. Sociodemographic, anesthetic and surgical factors were collected. The temperature of the rectum was measured at the end of the surgery and in the recovery room. The effect of hypothermia was analyzed by the incidence of mortality at 30 days. Other results were considered, such as, surgical site infection (SSI), blood transfusions, and influence of implants used in the 30-day mortality.Three hundred eighty five subjects were eligible, to include 300. Inadvertent hypothermia was 12%, the 30-day overall mortality was 9% and in subjects with hypothermia it was 25% (P = .002). Subjects with hypothermia had a higher risk of SSI (relative risk 4.2, 95% confidence interval 1.3-13.6, P = .03) and receive more transfusions (relative risk 3.6, 95% confidence interval 2.0-6.5, P < .001).Elderly subjects with HF exposed to hypothermia who undergo hip hemiarthroplasty and who receive 2 or more blood transfusions during their treatment, are at greater risk of dying after 30 days of the surgery. Hypothermia, as a possible causative factor of mortality, should continue to be studied.

Temperature Plays an Essential Regulatory Role in the Tumor Immune Microenvironment

In recent years, emerging immunotherapy has been included in various malignant tumor treatment standards. Temperature has been considered to affect different pathophysiological reactions such as inflammation and cancer for a long time. However, in tumor immunology research, temperature is still rarely considered a significant variable. In this review, we discuss the effects of room temperature, body temperature, and the local tumor temperature on the tumor immune microenvironment from multiple levels and perspectives, and we discuss changes in the body's local and whole-body temperature under tumor conditions. We analyze the current use of ablation treatment-the reason for the opposite immune effect. We should pay more attention to the therapeutic potential of temperature and create a better antitumor microenvironment that can be combined with immunotherapy.

Effects of Different Ambient Temperatures on Caecal Microbial Composition in Broilers

Short-term or acute temperature stress affect the immune responses and alters the gut microbiota of broilers, but the influences of long-term temperature stress on stress biomarkers and the intestinal microbiota remains largely unknown. Therefore, we examined the effect of three long-term ambient temperatures (high (HC), medium (MC), and low (LC) temperature groups) on the gene expression of broilers’ heat shock proteins (Hsps) and inflammation – related genes, as well as the caecal microbial composition. The results revealed that Hsp70 and Hsp90 levels in HC group significantly increased, and levels of Hsp70, Hsp90, IL-6, TNF-α, and NFKB1 in LC group were significantly higher than in MC group (p < 0.05). In comparison with the MC group, the proportion of Firmicutes increased in HC and LC groups, while that of Bacteroidetes decreased in LC group at phylum level (p < 0.05). At genus level, the proportion of Escherichia/Shigella, Phascolarctobacterium, Parabacteroides,and Enterococcus increased in HC group; the fraction of Faecalibacterium was higher in LC group; and the percentage of Barnesiella and Alistipes decreased in both HC and LC groups (p < 0.05). Functional analysis based on communities’ phylogenetic investigation revealed that the pathways involved in environmental information processing and metabolism were enriched in the HC group. Those involved in cellular processes and signaling, metabolism, and gene regulation were enriched in LC group. Hence, we conclude that the long-term temperature stress can greatly alter the intestinal microbial communities in broilers and may further affect the host’s immunity and health.

The Combined Effects of Fine Particulate Matter and Temperature on Preterm Birth in Seoul, 2010-2016

Background: Preterm birth contributes to the morbidity and mortality of newborns and infants. Recent studies have shown that maternal exposure to particulate matter and extreme temperatures results in immune dysfunction, which can induce preterm birth. This study aimed to evaluate the association between fine particulate matter (PM_2.5) exposure, temperature, and preterm birth in Seoul, Republic of Korea. Methods: We used 2010–2016 birth data from Seoul, obtained from the Korea National Statistical Office Microdata. PM_2.5 concentration data from Seoul were generated through the Community Multiscale Air Quality (CMAQ) model. Seoul temperature data were collected from the Korea Meteorological Administration (KMA). The exposure period of PM_2.5 and temperature were divided into the first (TR1), second (TR2), and third (TR3) trimesters of pregnancy. The mean PM_2.5 concentration was used in units of ×10 µg/m³ and the mean temperature was divided into four categories based on quartiles. Logistic regression analyses were performed to evaluate the association between PM_2.5 exposure and preterm birth, as well as the combined effects of PM_2.5 exposure and temperature on preterm birth. Result: In a model that includes three trimesters of PM_2.5 and temperature data as exposures, which assumes an interaction between PM_2.5 and temperature in each trimester, the risk of preterm birth was positively associated with TR1 PM_2.5 exposure among pregnant women exposed to relatively low mean temperatures (<3.4 °C) during TR1 (OR 1.134, 95% CI 1.061–1.213, p < 0.001). Conclusions: When we assumed the interaction between PM_2.5 exposure and temperature exposure, PM_2.5 exposure during TR1 increased the risk of preterm birth among pregnant women exposed to low temperatures during TR1. Pregnant women should be aware of the risk associated with combined exposure to particulate matter and low temperatures during TR1 to prevent preterm birth.

A Tangled Threesome: Circadian Rhythm, Body Temperature Variations, and the Immune System

Simple Summary

In mammals, including humans, the body temperature displays a circadian rhythm and is maintained within a narrow range to facilitate the optimal functioning of physiological processes. Body temperature increases during the daytime and decreases during the nighttime thus influencing the expression of the molecular clock and the clock-control genes such as immune genes. An increase in body temperature (daytime, or fever) also prepares the organism to fight aggression by promoting the activation, function, and delivery of immune cells. Many factors may affect body temperature level and rhythm, including environment, age, hormones, or treatment. The disruption of the body temperature is associated with many kinds of diseases and their severity, thus supporting the assumed association between body temperature rhythm and immune functions. Recent studies using complex analysis suggest that circadian rhythm may change in all aspects (level, period, amplitude) and may be predictive of good or poor outcomes. The monitoring of body temperature is an easy tool to predict outcomes and maybe guide future studies in chronotherapy.

Abstract

The circadian rhythm of the body temperature (CRBT) is a marker of the central biological clock that results from multiple complex biological processes. In mammals, including humans, the body temperature displays a strict circadian rhythm and has to be maintained within a narrow range to allow optimal physiological functions. There is nowadays growing evidence on the role of the temperature circadian rhythm on the expression of the molecular clock. The CRBT likely participates in the phase coordination of circadian timekeepers in peripheral tissues, thus guaranteeing the proper functioning of the immune system. The disruption of the CRBT, such as fever, has been repeatedly described in diseases and likely reflects a physiological process to activate the molecular clock and trigger the immune response. On the other hand, temperature circadian disruption has also been described as associated with disease severity and thus may mirror or contribute to immune dysfunction. The present review aims to characterize the potential implication of the temperature circadian rhythm on the immune response, from molecular pathways to diseases. The origin of CRBT and physiological changes in body temperature will be mentioned. We further review the immune biological effects of temperature rhythmicity in hosts, vectors, and pathogens. Finally, we discuss the relationship between circadian disruption of the body temperature and diseases and highlight the emerging evidence that CRBT monitoring would be an easy tool to predict outcomes and guide future studies in chronotherapy.

Neuropeptide Y Is an Immunomodulatory Factor: Direct and Indirect

Neuropeptide Y (NPY), which is widely distributed in the nervous system, is involved in regulating a variety of biological processes, including food intake, energy metabolism, and emotional expression. However, emerging evidence points to NPY also as a critical transmitter between the nervous system and immune system, as well as a mediator produced and released by immune cells. In vivo and in vitro studies based on gene-editing techniques and specific NPY receptor agonists and antagonists have demonstrated that NPY is responsible for multifarious direct modulations on immune cells by acting on NPY receptors. Moreover, via the central or peripheral nervous system, NPY is closely connected to body temperature regulation, obesity development, glucose metabolism, and emotional expression, which are all immunomodulatory factors for the immune system. In this review, we focus on the direct role of NPY in immune cells and particularly discuss its indirect impact on the immune response.

Association between diurnal temperature range and outpatient visits for hand, foot, and mouth disease in Hefei, China: a distributed lag nonlinear analysis

We aimed to quantify the relationship between the outpatient visits of hand, foot, and mouth disease (HFMD) and diurnal temperature range (DTR). The data of daily HFMD outpatient visits and meteorological parameters were obtained. A distributed lag nonlinear model combined with generalized linear model was used to estimate simultaneously nonlinear and delayed effects between DTR and daily HFMD outpatient visits after controlling confounding factors. A total of 15,275 HFMD visits were enrolled. DTR was significantly associated with HFMD outpatient visits in children. High DTR (P₇₅: 11.4 °C) and extreme DTR (P₉₅: 15.3 °C) were compared with 8.5 °C, and HFMD visits increased by a maximum of 3.93% (95% CI: 1.82 to 6.07%) and 4.47% (95% CI: 0.45 to 8.65%) in single-day lag effect, respectively. Furthermore, the extreme DTR effect decreased with the lag time and lasted for 10 days. Cumulative lag effects with markedly increasing percent of visits are over 64.88%. Furthermore, the effects were most pronounced among female children and children aged 0-2 years. Our study suggested that DTR changes were associated with HFMD outpatient visits, and populations of female and aged 0-2 years were more sensitive.

Metabolic response to maxillofacial trauma revisited: A retrospective study

Purpose:

Management of a trauma patient aims at stabilization or resuscitation and revival from critical condition resulting from various sequences of systemic pathophysiological responses in the body. Hematological changes are the first signs reflecting the homeostasis mechanisms starting in the body after injury. The aim of the current study is to evaluate the physiological changes following maxillofacial trauma and extrapolate the findings to understand the posttrauma responses.

Patients and Method:

This is a retrospective study involving 192 subjects divided into two groups, trauma group and control group. In both the groups, baseline vitals and complete blood picture were recorded for comparison. In trauma group, the recordings were made within 24 h after maxillofacial injury.

Results:

All the parameters were analyzed using SPSS version 18. Independent sample t-test was used to assess the nature of data distribution and statistical significance was considered only at P value < 0.05. On comparison of complete blood picture mean values of hemoglobin (13.63 vs 12.18), RBC count (4.51 vs 4.10), WBC count (8835.48 vs 8336.56) were seen to be higher in trauma patients compared to control subjects. The mean bleeding times are almost equal (2.35 vs 2.47) but the clotting times (5.42 vs 5.26), random blood glucose (94.78 vs 90.13), and blood urea (27.14 vs 26.30) were marginally higher in trauma group but were statistically insignificant. The mean value of serum creatinine (0.84 vs 0.80) was comparatively higher in trauma patients and was statistically significant. Study of vitals revealed that mean systolic blood pressures were almost equal (120.65 vs 121.08) in both the groups. The mean diastolic blood pressures (79.46 vs 88.49) and oxygen saturation (93.73 vs 98.86) in trauma patients are comparatively reduced. The mean values of temperature (99.30 vs 98.50) and pulse rate (102.38 vs 97.14) were on relatively higher side in trauma group compared with control group.

Summary and Conclusion:

Using basic blood parameters and vitals in the present study, the compensatory mechanisms happening in the body after maxillofacial trauma can be seen. These changes although significant on side by side comparison can still fall within the normal physiological range provided by various diagnostic setups. Hence, the need for maxillofacial surgeon to be sensitive to minor variations in these aspects to ensure safety of the patient cannot be overemphasized.