Multidimensional assessment of adverse events of bupropion: A large-scale data analysis from the FAERS database

OBJECTIVE

Bupropion, a monocyclic antidepressant, aids in smoking cessation, treats major depression, and prevents severe depression in seasonal affective disorder patients. Yet, its adverse reactions remain insufficiently studied.

METHODS

All data from the raw data packages for 78 quarters from the 1st quarter of 2004 to the 2nd quarter of 2023 were extracted from the FDA Adverse Event Reporting System (FAERS) database and imported into the SAS9.4 software for data cleaning and analysis. The Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS) methods were used to analyze drug adverse events and assess their compliance with various screening criteria.

RESULTS

The results showed a total of 36,862 reports related to Bupropion use, identifying 364 positive reaction terms (PT) covering 23 System Organ Classes (SOCs). In addition to known side effects, some new potential adverse reactions were found, such as Stool analysis abnormal, Oculocephalogyric reflex absent, Suspected suicide, and so on. At the same time, reactions like Encephalopathy neonatal, Hyponatraemic coma, and Electrocardiogram QRS complex prolonged were prominently ranked. Notably, occurrences such as Urine amphetamine positive and Amphetamines positive were relatively high, suggesting extra caution for these potential adverse reactions during clinical use of Bupropion.

CONCLUSION

These findings highlight the potential health risks of long-term Bupropion use, especially concerning efficacy, positive drug tests, and suicidal tendencies. Therefore, it is recommended to monitor and assess patients using Bupropion more stringently to use this therapeutically potential drug more safely and effectively.

Smoking may increase the usage of antidepressant: evidence from genomic perspective analysis

This study uses the two-sample Mendelian randomization (TSMR) method to explore the causal relationships between smoking initiation (SMKI), never smoking (NSMK), past tobacco smoking (PTSMK), and the usage of antidepressants (ATD). Single-nucleotide polymorphisms (SNPs) with genome-wide significance (P < 5E-08) related to SMKI, NSMK, and PTSMK were selected from the genome-wide association study (GWAS) database as instrumental variables (IVs). The main method, inverse variance weighted (IVW), was utilized to investigate the causal relationship. The results demonstrated a positive causal relationship between SMKI and ATD use, where SMKI leads to an increase in ATD use. Conversely, NSMK and PTSMK showed a negative causal relationship with ATD use, meaning that NSMK and PTSMK lead to a reduction in ATD use. Additionally, sensitivity analysis showed that the results of this study were robust and reliable. Using the TSMR method and from a genetic perspective, this study found that SMKI leads to an increase in ATD use, while NSMK and PTSMK reduce ATD use.

Analysis of antimicrobial drug usage in psychiatric specialized hospitals during the pandemic in China

BACKGROUND

This study aims to compare antimicrobial drug usage in our hospital to Jiangsu Province and China from 2020 to 2022 during the pandemic. The ultimate goal is to improve the rational use of antimicrobials in psychiatric hospitals.

RESEARCH DESIGN AND METHODS

A detailed analysis was performed using data from the National Antimicrobial Drug Clinical Application Monitoring Network. Several parameters were studied: the rate of antimicrobial drug use, number and types of drugs used, the rate of combined use, rate of microbiological examinations, drug use intensity, and cumulative Defined Daily Doses (DDDs).

RESULTS

From 2020 to 2022, our hospital's antimicrobial drug usage rate (5.59% in 2020, 6.0% in 2021, 5.0% in 2022) was consistently lower than Jiangsu Province and China, displaying a decreasing trend. The average number of drug types and the combined drug use rate were higher in 2020 but fell below those in Jiangsu Province and China in 2021 and 2022. Our microbiological examination rate (70%-100%) consistently surpassed that of Jiangsu Province and China. Furthermore, our Antimicrobial Usage Density (AUD, 2.82-3.07) and cumulative DDDs (9956.21 -14,267.91) were notably lower. While AUD remained stable, DDDs showed a decreasing trend. The most dominant drug in DDDs was cefditoren, a third-generation cephalosporin.

CONCLUSIONS

During the pandemic years, our hospital not only met the requirements for antimicrobial drug usage, microbiological examination, AUD, and cumulative DDDs when compared to Jiangsu Province and China but also demonstrated a consistent year-by-year decrease in drug usage and DDDs. This underscores our hospital's effective progress in maintaining rational antimicrobial drug use.

Unveiling potential adverse events associated with escitalopram oxalate: A real-world analysis based FDA adverse event reporting system database

OBJECTIVE

The study aimed to conduct a multidimensional evaluation of potential adverse events (AEs) of escitalopram oxalate based on the FDA adverse event reporting system (FAERS) database.

METHODS

This study utilized the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma-poisson shrinker (MGPS) to mine and analyze data from the FAERS database from the first quarter of 2004 to the second quarter of 2023.

RESULTS

There was a total of 19,854 AE reports related to escitalopram oxalate, extracting 625 preferred terms (PTs), and covering 27 system organ classes (SOCs). The results showed that the number of reports by females was significantly higher than males, accounting for 57.68%. The reporting number was higher in 2018 and 2019, accounting for 9.50% and 10.18% of the total reports, respectively. The main reporters were consumers and other health professionals, accounting for 26.99% and 26.75% respectively. The majority of the reports were primarily from the United States. Newly emerging AE signals such as intentional overdose (n = 691, ROR 8.51, PRR 8.45, IC 3.05, Empirical Bayesian Geometric Mean (EBGM) 8.35), suicide attempt (n = 665, ROR 8.58, PRR 8.52, IC 3.06, EBGM 8.42), serum serotonin (n = 5, ROR 1044.78, PRR 1044.71, IC 2.56, EBGM 392.39), anti-actin antibody positive (n = 5, ROR 626.87, PRR 626.83, IC 2.56, EBGM 313.91), among others, were not mentioned in the drug's label.

CONCLUSION

While escitalopram oxalate has clear benefits in the treatment of depression and other mental health disorders, the presence of AEs also suggests risks associated with its use. Particularly concerning are risks of suicide and changes in serum serotonin levels.

Mining and analysis of security alert signals of valbenazine based on the Food and Drug Administration Adverse Event Reporting System database

BACKGROUND

Valbenazine is used for tardive movement disorders in adults. Current studies on its safety are mostly from clinical trials and small case reports, limiting information on rare adverse reactions. This study investigated valbenazine-related adverse event (AE) risk signals using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.

METHODS

Valbenazine AEs data were collected from the FAERS database from 2017 Q2 to 2023 Q1, employing methods like reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network, and empirical Bayesian geometric mean.

RESULTS

After data cleaning and drug screening, there were 20,837 AEs primarily suspecting valbenazine, involving 26 system organ classes and 125 AEs related to valbenazine at the preferred terms level. AEs related to valbenazine were mainly concentrated in nervous system disorders, general disorders and administration site conditions, and psychiatric disorders. Eye disorders and gastrointestinal disorders are new AEs not labeled in the valbenazine instructions. In addition, some new potential AE signals were found, such as Tardive dyskinesia and eyelid function disorder.

CONCLUSION

The common AEs of valbenazine in the real world are consistent with the instructions, but there are some newly discovered suspicious AEs.

Highly homogeneous and stable single-walled carbon nanotubes dispersion modified by polyvinylpyrrolidone and alkanolamine in water

A novel noncovalent surface modification of commercial single-walled carbon nanotubes (SWCNTs) was successfully carried out by using ball grinding technology between SWCNTs and mixed dispersants (polyvinylpyrrolidone (PVP) and alkanolamine), affording a highly homogeneous and stable PA-SWCNTs dispersion in water. The homogeneous dispersibility and long storage stability were systematically investigated by transmittance spectroscopy, absorption spectroscopy, zeta potential analyzer, sedimentation photo and transmittance electron microscopy. Under the optimized conditions, the PA-SWCNTs dispersion modified with 0.7 wt% PVP and 0.25 wt% alkanolamine under the condition of total 6 h ball grinding time using paint shaker can be easily well-dispersed in water and has good storage stability, and no sedimentation is observed more than one month. From an industrial perspective, this method is green and easy to operate in industry.

Causal relationship between diabetes and depression: A bidirectional Mendelian randomization study

OBJECTIVE

This study explores the causal relationship between diabetes and depression using a two-sample Mendelian Randomization (TSMR) method.

METHODS

The study selected single nucleotide polymorphisms (SNPs) closely associated with diabetes and depression in European populations from the Genome-Wide Association Study (GWAS) database, to serve as instrumental variables (IVs). The main evaluation method was inverse variance weighted analysis (IVW), supplemented by verification using Weighted median, Weighted mode, and MR Egger methods. The Odds Ratio (OR) and 95 % Confidence Interval (CI) were used as the main evaluation indicators, along with sensitivity analysis.

RESULTS

This study found a negative correlation between diabetes and depression, suggesting that diabetes may reduce the risk of depression [IVW(FE): OR: 0.901, 95 % CI: 0.823 to 0.987; P = 0.025 < 0.05]. This finding was further confirmed by the Weighted median [OR: 0.844, 95 % CI: 0.730 to 0.974; P = 0.021 < 0.05] and Weighted mode method [OR: 0.766, 95 % CI: 0.637 to 0.921; P = 0.006 < 0.05]. However, the reverse showed no causal relationship between depression and diabetes (P > 0.05). Sensitivity analysis found no pleiotropy, and there were no large influences from individual SNPs on the result's robustness; the results are stable and reliable.

CONCLUSION

For the first time, this study using TSMR analysis found a negative correlation between diabetes and the risk of depression onset in European populations, suggesting that diabetes might reduce the risk of depression. But as the mechanisms are still unclear, these findings warrant further study.

Dual oxidase 2 (duox 2) participates in the intestinal antibacterial innate immune responses of Procambarus clarkii by regulating ROS levels

Dual oxidase (Duox) a member of the nicotinamide adenine dinucleotide phosphate oxidase (NOX) family can induce the production of reactive oxygen species (ROS). In vertebrates, the duox gene was indicated to be associated with the mucosal immunity. The roles of the duox gene in invertebrates were mainly studied in insects for the function of maintaining intestinal flora balance. In recent years, some studies have reported that Duox is involved in regulating the production of ROS and plays an important role in defending against the intestinal pathogen infection. However, the molecular mechanism has not been fully illuminated. In this study, a duox 2 involved in the production of H2O2 was identified for the first time in P. clarkii. Mature Pc-Duox 2 is a 7-transmembrane protein molecule that includes PHD, FAD, and NAD domains. Pc-duox 2 was mainly expressed in hemocytes and intestinal tissue. Its expression levels were obviously upregulated after intramuscular or oral infection with V. harveyi. In the RNAi assay, the upregulated trends of H2O2 and total ROS levels in crayfish intestine were significantly suppressed when Pc-duox 2 was knocked down. Compared with the slightly affected SOD activity, the upregulated CAT activity was suppressed more obviously in the crayfish intestine. Furthermore, Pc-duox 2 had an important effect on the maintenance of the structural stability of crayfish the intestine. Further research revealed that the knockdown of Pc-duox 2 could cause an obvious suppression in the upregulated levels of Toll signalling pathway-related genes, including Pc-toll 1, Pc-toll 3, Pc-dorsal, Pc-ALF 5, Pc-crustin 1, and Pc-lysozyme. Ultimately, these changes triggered the accelerated death of crayfish. Overall, we speculated that Pc-duox 2 played an important role in antibacterial innate immunity in the crayfish intestine by regulating the total ROS level.

Investigating the Mechanism of Chufan Yishen Formula in Treating Depression through Network Pharmacology and Experimental Verification

Objective: To investigate the antidepressant effect and potential mechanism of the Chufan Yishen Formula (CFYS) through network pharmacology, molecular docking, and experimental verification. Methods: The active ingredients and their target genes of CFYS were identified through Traditional Chinese Medicine Systems Pharmacology (TCMSP) and TCM-ID. We obtained the differentially expressed genes in patients with depression from the GEO database and screened out the genes intersecting with the target genes of CFYS to construct the PPI network. The key pathways were selected through STRING and KEGG. Then, molecular docking and experimental verification were performed. Results: A total of 113 effective components and 195 target genes were obtained. After intersecting the target genes with the differentially expressed genes in patients with depression, we obtained 37 differential target genes, among which HMOX1, VEGFA, etc., were the key genes. After enriching the differential target genes by KEGG, we found that the "chemical carcinogenesis-reactive oxygen species" pathway was the key pathway for the CFYS antidepressant effect. Besides, VEGFA might be a key marker for depression. Experimental verification found that CFYS could significantly improve the behavioral indicators of rats with depression models, including improving the antioxidant enzyme activity and increasing VEGFA levels. The results are consistent with the network pharmacology analysis. Conclusions: CFYS treatment for depression is a multicomponent, multitarget, and multipathway complex process, which may mainly exert an antidepressant effect by improving the neuron antioxidant stress response and regulating VEGFA levels.

Deciphering the Enhancing Impact of Exogenous Brassinolide on Physiological Indices of Melon Plants under Downy Mildew-Induced Stress

Melon (Cucumis melo L.) is a valuable horticultural crop of the Cucurbitaceae family. Downy mildew (DM), caused by Pseudoperonospora cubensis, is a significant inhibitor of the production and quality of melon. Brassinolide (BR) is a new type of phytohormone widely used in cultivation for its broad spectrum of resistance- and defense-mechanism-improving activity. In this study, we applied various exogenous treatments (0.5, 1.0, and 2.0 mg·L-1) of BR at four distinct time periods (6 h, 12 h, 24 h, and 48 h) and explored the impact of BR on physiological indices and the genetic regulation of melon seedling leaves infected by downy-mildew-induced stress. It was mainly observed that a 2.0 mg·L-1 BR concentration effectively promoted the enhanced photosynthetic activity of seedling leaves, and quantitative real-time polymerase chain reaction (qRT-PCR) analysis similarly exhibited an upregulated expression of the predicted regulatory genes of photosystem II (PSII) CmHCF136 (MELO3C023596.2) and CmPsbY (MELO3C010708.2), thus indicating the stability of the PSII reaction center. Furthermore, 2.0 mg·L-1 BR resulted in more photosynthetic pigments (nearly three times more than the chlorophyll contents (264.52%)) as compared to the control and other treatment groups and similarly upregulated the expression trend of the predicted key enzyme genes CmLHCP (MELO3C004214.2) and CmCHLP (MELO3C017176.2) involved in chlorophyll biosynthesis. Meanwhile, the maximum contents of soluble sugars and starch (186.95% and 164.28%) were also maintained, which were similarly triggered by the upregulated expression of the predicted genes CmGlgC (MELO3C006552.2), CmSPS (MELO3C020357.2), and CmPEPC (MELO3C018724.2), thereby maintaining osmotic adjustment and efficiency in eliminating reactive oxygen species. Overall, the exogenous 2.0 mg·L-1 BR exhibited maintained antioxidant activities, plastid membranal stability, and malondialdehyde (MDA) content. The chlorophyll fluorescence parameter values of F0 (42.23%) and Fv/Fm (36.67%) were also noticed to be higher; however, nearly three times higher levels of NPQ (375.86%) and Y (NPQ) (287.10%) were observed at 48 h of treatment as compared to all other group treatments. Increased Rubisco activity was also observed (62.89%), which suggested a significant role for elevated carbon fixation and assimilation and the upregulated expression of regulatory genes linked with Rubisco activity and the PSII reaction process. In short, we deduced that the 2.0 mg·L-1 BR application has an enhancing effect on the genetic modulation of physiological indices of melon plants against downy mildew disease stress.

Mining and analysis of adverse event signals of Cariprazine based on the real-world data of FAERS database

OBJECTIVE

This study aims to analyze the adverse events (AEs) of Cariprazine based on the FAERS database, providing evidence for its safety surveillance.

METHODS

For signal quantification of Cariprazine-related AEs, we used disproportionality analysis including the Ratio of Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms.

RESULTS

We selected Cariprazine-related AE reports from the FAERS database from the fourth quarter of 2015 to the first quarter of 2023, and performed a detailed data analysis. Out of a total of 12,278,580 case reports, 3659 were found to be directly related to Cariprazine. We identified 140 Preferred Terms (PT) to describe these AEs, finding that they involved 27 organ systems. Specifically, AEs related to eye disorders such as Cataract cortical, Cataract nuclear, Accommodation disorder, Lenticular opacities, Oculogyric crisis, Dyschromatopsia were not explicitly mentioned in the drug's leaflet, indicating the presence of new ADR signals.

CONCLUSION

Analysis of the FAERS database identified AEs associated with Cariprazine, notably in eye disorders not previously documented in the drug's official leaflet. These findings emphasize the need for continuous post-market surveillance and awareness among healthcare professionals regarding potential new ADR signals.

Terahertz dynamic multichannel holograms generated by spin-multiplexing reflective metasurface

In recent years, metasurfaces have attracted considerable interest for their unprecedented capabilities to manipulate intensity, phase, and polarization of an electromagnetic wave. Although metasurface-based wavefront modulation has achieved numerous successful results, implementation of multifunctional devices in a single metasurface still meet significant challenges. Here, a novel multilayer structure is designed using properties of vanadium dioxide (VO2). Propagation phase and geometric phase are introduced in this structure to achieve multichannel holographic imaging in terahertz band. When the temperature is above 68°C, VO2 becomes a metal and it plays a role in wavefront modulation for terahertz wave. The left-handed channel realizes a hologram letter L and the right-handed channel realizes a hologram letter R. When the temperature is below 68°C, VO2 changes to an insulator, and electromagnetic wave is controlled by gold structures embedded inside a VO2 film. In this case, hologram number 2 is realized in the left-handed channel and hologram number 6 appears in the right-handed channel. Our structure has advantages of low crosstalk, multiple channels, and large bandwidth. This novel design paves a new road for multichannel imaging and information encryption.

The correlation of Esketamine with specific adverse events: a deep dive into the FAERS database

Analyzing the vast data from FAERS database to evaluate the association between Esketamine and specific adverse events to guide clinical practice and regulatory decisions. Data related to Esketamine adverse events from 2019 Q1 to 2023 Q1 were collected from FAERS database. After data standardization, various signal quantification technologies, such as ROR, PRR, BCPNN, and MGPS, were employed to identify and evaluate adverse reaction signals closely related to the use of Esketamine comprehensively. A total of 5061 reports with Esketamine as the primary suspected drug were obtained, identifying 117 adverse reaction terms (PT) involving 27 system organ class (SOC) categories. Apart from the adverse events already mentioned in the drug's instructions, this study identified some new, clinically valuable potential AE signals, such as Flashback, Tachyphylaxis, and Autoscopy. In addition, high-ranking results included euphoric mood, feeling of relaxation, and feeling drunk. Notably, the occurrence frequencies of suicidal ideation and suicide attempt were relatively high, so clinicians should be particularly vigilant about these potential adverse reactions when using Esketamine. Moreover, since this drug is administered as a nasal spray, issues such as drug monitoring procedure incorrectly performed and nasal discomfort may arise. This study underscores the potential adverse reactions and risks of Esketamine in clinical applications, especially regarding long-term efficacy, addiction risks, and suicidal risks.

Adverse events of epidiolex: A real-world drug safety surveillance study based on the FDA adverse event reporting system (FAERS) database

Epidiolex, the first FDA-approved drug with cannabis extract, treats Dravet and Lennox-Gastaut syndromes. Using data from the FAERS database between 2018 and 2023, this study analyzed 13,275 Epidiolex-related adverse events. Through computational methods (ROR, PRR, BCPNN, EBGM), we found that real-world adverse reactions largely align with those in Epidiolex's drug leaflet. However, Seizure cluster, Blood ketone body decrease, Cortical visual impairment, Hyperactive pharyngeal reflex, and Poverty of speech emerged as potential new side effects not previously listed, warranting further attention for drug safety.

Relationship Between Sphingomyelin and Risk of Alzheimer's Disease: A Bidirectional Mendelian Randomization Study

Background

Alzheimer's disease (AD) is a complex neurodegenerative disorder whose etiology involves multiple genetic and environmental factors. Sphingomyelin (SM) is a type of sphingolipid found in cell membranes, and recent evidence suggests a potential link between SM and AD. However, the nature of this relationship remains unclear.

Objective

To elucidate the potential causal relationship between SM levels and the risk of developing AD using a two-sample Mendelian randomization approach.

Methods

The study utilized data extracted from the genome wide association study database. The primary analysis method was the inverse variance weighted (IVW) method, which was supplemented by weighted median, weighted mode, and MR Egger methods. The study specifically investigated the bidirectional causal relationship between SM and AD, evaluating odds ratios (OR) with a 95% confidence interval (95% CI).

Results

Elevated levels of SM were found to be a risk factor for AD, as shown by IVW(MRE) [OR: 1.001, 95% CI: 1.000 to 1.002; p = 0.020 < 0.05], IVW(FE) [OR: 1.001, 95% CI: 1.001 to 1.002; p = 3.36e-07 < 0.05], and MR Egger. Conversely, AD was demonstrated to lead to an increase in SM levels [IVW(MRE): OR: 5.64e+08, 95% CI: 1.69e+05 to 1.89e+12; p = 1.14e-06 < 0.05], with consistent findings across the IVW(FE), MR Egger, weighted median, and weighted mode methods.

Conclusions

The study establishes a bidirectional positive correlation between SM and AD. Increased SM levels are associated with a higher risk of developing AD, and the presence of AD can further elevate SM levels, potentially exacerbating the disease's progression.

The expression of immune related genes and potential regulatory mechanisms in schizophrenia

OBJECTIVE

This study aimed to investigate the role of immune dysfunction in the pathogenesis of schizophrenia through single-cell transcriptome and bulk RNA data analyses.

METHODS

The single-cell RNA sequencing (scRNA-seq) was selected to assess the cellular composition and gene expression profiles of the brain tissue. Further, bulk RNA sequencing data was utilized to corroborate findings from the single-cell analyses and provide additional insights into the molecular changes associated with the disease. Gene-drug interaction data was also included to identify potential therapeutic drugs targeting these dysregulated immune-related genes in schizophrenia.

RESULTS

We discovered significant differences in cellular composition within schizophrenia tissue, including increased infiltration of fibroblasts, horizontal basal cells, monocytes, mesenchymal cells, and smooth muscle cells. The investigation of immune-related genes revealed significantly different expression of genes such as S100A2, CCL14, IGHA1, BPIFA1, GDF15, IL32, BPIFB2, HLA-DRA, S100A8, PTX3, TPM2, TNFRSF12A, GREM1 and others. These genes possibly contribute to the progression of schizophrenia through various pathways such as humoral immune response, IL-17 signaling pathway, adaptive immune response, antigen processing and presentation, and gut IgA production. Our findings also suggest possible transcriptional regulation in schizophrenia's immune dysfunction by transcription factors in monocytes, neutrophils, endothelial cells, and epithelial cells. Lastly, potential therapeutic drugs were identified through gene-drug interaction data, such as those targeting HLA-A and HLAB.

CONCLUSION

The cellular heterogeneity and immune-related gene dysregulation play important roles in schizophrenia, which provides a foundation for understanding the pathogenesis and developing new treatment methods.

Causal relationships between dietary habits and five major mental disorders: A two-sample Mendelian randomization study

OBJECTIVE

To explore the causal relationship between dietary habits and five major mental disorders using the two-sample Mendelian randomization (MR) analysis.

METHODS

This study was based on the summary data of the genome-wide association study (GWAS) on diet and five major mental disorders in the European population. The genetic locus data of five major mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia) from those who never eat eggs, dairy, wheat, and sugar were used. Two-sample MR analysis was conducted to evaluate the causal relationship between diet and five major mental disorders.

RESULTS

This study revealed a causal relationship between "Never eat Wheat products" and all five types of mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), demonstrating a significant negative correlation (P < 0.05). However, no significant causal relationship was observed between "Never eat Sugar or foods/drinks containing sugar" and any of the five mental disorders (P > 0.05). Furthermore, the study found that the statement "Never eat eggs, dairy, wheat, sugar: I eat all of the above" had a causal relationship with mania, bipolar disorder, and manic depression, showing a significant positive correlation (P < 0.05). However, this statement did not exhibit a significant causal relationship with depression and schizophrenia (P > 0.05).

CONCLUSION

There was a negative correlation between never eating wheat products and the five mental disorders (mania, bipolar disorder, manic depression, depression, schizophrenia), indicating that never eating wheat products may reduce the risk of mental disorders.

Causal relationship between sex hormone-binding globulin and major depression: A Mendelian randomization study

OBJECTIVE

This study aimed to explore the causal relationship between sex hormone-binding globulin (SHBG) and major depression using two-sample Mendelian randomization (MR) studies.

METHODS

Based on the genome-wide association study (GWAS) summary data of SHBG and major depression in the European population, which included 214,989 female SHBG samples, 185,221 male SHBG samples, and 500,199 major depression samples, we used genetic factors as instrumental variables to conduct two-sample MR analyses. We used methods including inverse variance weighted (IVW), weighted median, weighted mode, and MR Egger to evaluate the bidirectional causal relationship between SHBG and major depression.

RESULTS

The results showed that there was a causal relationship between female SHBG and major depression, which was positively correlated. The ORs were 1.056 (95% CI: 1.005-1.109, p = 0.031) for the weighted median and 1.067 (95% CI: 1.012-1.126, p = 0.021) for the weighted mode. There was no significant effect of male SHBG on major depression (p > 0.05), and there was no significant effect of major depression on female SHBG (p > 0.05). Major depression was negatively correlated with male SHBG, indicating that major depression could lead to a decrease in male SHBG. The OR was 0.954 (95% CI: 0.916-0.993, p = 0.023) for IVW.

CONCLUSION

Female SHBG was positively correlated with the risk of major depression, however, major depression was found to be negatively correlated with serum SHBG levels in men, indicating that SHBG plays distinct roles in patients with major depression of different genders.

Optical reflective metasurfaces enable spin-decoupled OAM and focusing

Due to the physically unrestricted set of orthogonally helical modes of orbital angular momentum (OAM), it has contributed significantly to wireless communication and information capacity. Meanwhile, focusing has important applications in fields such as super-resolution microscopic imaging and optical integration. Plasmonic metasurfaces have a powerful ability to modulate electromagnetic (EM) waves, and diversified functionalities in them are strongly desired. As of today, few plasmonic metasurfaces are reported which have multi-function in a single flat device. Herein, by fine-tuning the geometric dimensions and orientation angle of the meta-atom, the geometric phase is combined with the propagation phase to produce an independent phase response when left-handed circular polarization (LCP) and right-handed circular polarization (RCP) waves illuminate the metasurface. This paper presents three plasmonic metasurfaces, and each of them implements multiple functions on a single plasmonic metasurface. Firstly, normal reflection of OAM and a focused beam is achieved. Secondly, we realize anomalous reflection of OAM by convolving a gradient sequence and implement computational focusing at any point. Finally, addition theorem is adopted to implement the above two functions, and this design contains normal and inclined output beams. Our work provides novel approaches for the integration of multifunctional EM modulation.

[Correlation between malnutrition and delirium in elderly patients with severe pneumonia undergoing invasive mechanical ventilation]

OBJECTIVE

To investigate the relationship between malnutrition and delirium and its effect on prognosis in elderly patients with severe pneumonia undergoing invasive mechanical ventilation.

METHODS

A prospective observational study was conducted. Patients with severe pneumonia aged ≥ 60 years old who underwent invasive mechanical ventilation admitted to department of critical care medicine of the Second People's Hospital of Lianyungang from January 2021 to December 2022 were enrolled. The confusion assessment method (CAM) was used to evaluate the delirium of the patients in intensive care unit (ICU). The score of CAM ≥ 1 was defined as delirium. Mini nutritional assessment short-form (MNA-SF) was used to assess the nutritional status of patients, and MNA-SF score ≤ 7 was defined as malnutrition. Patients were divided into delirium group and non-delirium group according to whether delirium occurred. The differences in clinical indicators, length of ICU stay, duration of mechanical ventilation and wake-up time after drug withdrawal were compared between the two groups. After 28 days of short-term follow-up, the patients were divided into death group and survival group, and the differences in the incidence of delirium and malnutrition between the two groups were compared. Binary multivariate Logistic regression analysis was used to screen the risk factors for delirium in elderly patients with severe pneumonia undergoing invasive mechanical ventilation. Kaplan-Meier survival curve was used to analyze the effect of delirium on prognosis.

RESULTS

A total of 132 elderly patients with severe pneumonia undergoing invasive mechanical ventilation were enrolled, of whom 98 survived and 34 died within 28 days, with a mortality of 25.76%. The incidence of malnutrition and delirium in the death group was significantly higher than that in the survival group (61.76% vs. 37.76%, 64.71% vs. 26.53%, both P < 0.05), and the MNA-SF score was significantly lower than that in the survival group (6.32±1.80 vs. 8.72±2.23, P < 0.01). Procalcitonin (PCT), interleukin-6 (IL-6) and blood lactic acid (Lac) in the death group were significantly higher than those in the survival group [PCT (μg/L): 4.47 (2.69, 10.39) vs. 2.77 (1.28, 5.94), IL-6 (ng/L): 204.08 (126.12, 509.85) vs. 120.46 (60.67, 290.99), Lac (mmol/L): 5.14 (2.75, 8.60) vs. 3.13 (2.16, 4.30), all P < 0.05], and the wake-up time after drug withdrawal was significantly longer than that in the survival group (minutes: 33.94±8.51 vs. 28.92±7.03, P < 0.01). Among 132 elderly patients with severe pneumonia undergoing invasive mechanical ventilation, 48 patients had delirium during ICU stay, and 84 patients did not have delirium. The incidence of delirium was 36.36%. The 28-day mortality in the delirium group was significantly higher than that in the non-delirium group (45.83% vs. 14.29%, P < 0.01), and the MNA-SF score was significantly lower than that in the non-delirium group (6.46±1.77 vs. 9.05±2.15, P < 0.01), the length of ICU stay, duration of mechanical ventilation, and wake-up time after drug withdrawal were also significantly longer than those in the non-delirium group [length of ICU stay (days): 13.40±9.59 vs. 10.06±7.81, duration of mechanical ventilation (hours): 197.06±89.80 vs. 138.81±82.30, wake-up time after drug withdrawal (minutes): 35.85±7.01 vs. 26.99±6.12, all P < 0.05]. Binary multivariate Logistic regression analysis showed that malnutrition [odds ratio (OR) = 7.527, 95% confidence interval (95%CI) was 2.585-21.917], Lac (OR = 5.345, 95%CI was 1.733-16.483), wake-up time after drug withdrawal (OR = 6.653, 95%CI was 2.021-21.904) were independent risk factors for delirium during ICU stay in elderly patients with severe pneumonia undergoing invasive mechanical ventilation (all P < 0.01). Kaplan-Meier survival analysis showed that the 28-day cumulative survival rate of patients in the delirium group was significantly lower than that in the non-delirium group (54.17% vs. 85.71%), and the difference was statistically significant (Log-Rank test: χ2 = 16.780, P < 0.001).

CONCLUSIONS

The risk factors for delirium in elderly patients with severe pneumonia undergoing invasive mechanical ventilation during ICU stay include malnutrition, Lac, and wake-up time after drug withdrawal. The occurrence of delirium is closely related to poor prognosis.

Bidirectional causal association between ischemic stroke and five mental disorders

OBJECTIVE

To explore the bidirectional causal association between ischemic stroke and five mental disorders from a genetic perspective using two-sample Mendelian randomization (TSMR).

METHODS

Single-nucleotide polymorphisms (SNPs) associated with ischemic stroke were obtained from the genome-wide association study (GWAS) database, and those closely related to the exposure phenotype and satisfying the three core assumptions of Mendelian randomization were selected as instrumental variables (IVs). The main TSMR analysis was conducted using the inverse variance-weighted (IVW) method, and the robustness of the results was assessed using the weighted median, weighted mode, and MR Egger methods. Heterogeneity test, pleiotropy test, and sensitivity analysis were also conducted to further ensure the accuracy and stability of the research results.

RESULTS

This study found a positive correlation between ischemic stroke and depression [IVW method (FEM): OR = 1.002, 95%CI: 1.000-1.003, P = 0.023<0.05], but no significant causal association with schizophrenia, bipolar disorder, insomnia, or anxiety (P > 0.05). Reverse TSMR analysis showed no causal association between depression, schizophrenia, bipolar disorder, insomnia, anxiety, and ischemic stroke (P > 0.05).

CONCLUSION

This study used TSMR to demonstrate from a genetic perspective that there is a positive correlation between ischemic stroke and depression, which increases the risk of depression. Proactive intervention for ischemic stroke might reduce the risk of depression.

Causal relationship between schizophrenia and sex hormone binding globulin: A Mendelian randomization study

OBJECTIVE

The underlying etiology of schizophrenia is still not fully understood, and recent studies have pointed to a potential link between hormonal factors and the risk of developing this condition. Sex Hormone-Binding Globulin (SHBG) is a protein that regulates the bioavailability of sex hormones. However, the causal relationship between SHBG levels and schizophrenia remains unclear, this study aimed to investigate the causal relationship based on two-sample Mendelian randomization (MR) analysis.

METHODS

This study was based on the summary data of genome-wide association studies (GWAS) of schizophrenia and SHBG in European populations. Two-sample MR was applied, and genetic factors were used as instrumental variables, and the causal relationship between schizophrenia and SHBG was assessed.

RESULTS

We selected 79 single nucleotide polymorphisms with genome-wide significance from the schizophrenia GWAS as instrumental variables. The inverse variance weighting (IVW) method results showed that there is a causal relationship and a positive correlation between schizophrenia and female SHBG, with an odds ratio (OR) of 1.024 (95%CI: 1.007-1.042, P = 0.005), and this result was further confirmed by the Weighted median odds ratio (OR) of 1.032 (95%CI: 1.016-1.048, P = 5.58E-05) and the Weighted mode of 1.035 (95%CI: 1.004-1.067, P = 0.028). Schizophrenia and male SHBG also have a causal relationship and a positive correlation, with an odds ratio (OR) of 1.027 (95%CI: 1.007-1.047, P = 0.008).

CONCLUSION

This study found a positive correlation between schizophrenia and SHBG in both men and women through MR analysis, indicating that the level of SHBG may be elevated in patients with schizophrenia, regardless of gender.

RNA-Seq Identified Putative Genes Conferring Photosynthesis and Root Development of Melon under Salt Stress

Melon is an important fruit crop of the Cucurbitaceae family that is being cultivated over a large area in China. Unfortunately, salt stress has crucial effects on crop plants and damages photosynthesis, membranal lipid components, and hormonal metabolism, which leads to metabolic imbalance and retarded growth. Herein, we performed RNA-seq analysis and a physiological parameter evaluation to assess the salt-induced stress impact on photosynthesis and root development activity in melon. The endogenous quantification analysis showed that the significant oxidative damage in the membranal system resulted in an increased ratio of non-bilayer/bilayer lipid (MGDG/DGDG), suggesting severe irregular stability in the photosynthetic membrane. Meanwhile, root development was slowed down by a superoxidized membrane system, and downregulated genes showed significant contributions to cell wall biosynthesis and IAA metabolism. The comparative transcriptomic analysis also exhibited that major DEGs were more common in the intrinsic membrane component, photosynthesis, and metabolism. These are all processes that are usually involved in negative responses. Further, the WGCN analysis revealed the involvement of two main network modules: the thylakoid membrane and proteins related to photosystem II. The qRT-PCR analysis exhibited that two key genes (MELO3C006053.2 and MELO3C023596.2) had significant variations in expression profiling at different time intervals of salt stress treatments (0, 6, 12, 24, and 48 h), which were also consistent with the RNA-seq results, denoting the significant accuracy of molecular dataset analysis. In summary, we performed an extensive molecular and metabolic investigation to check the salt-stress-induced physiological changes in melon and proposed that the PSII reaction centre may likely be the primary stress target.

Practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals during COVID-19 pandemic in Wuxi, China

Objective

To study the practice of pharmaceutical services in internet-based psychiatric hospitals, and to analyze the prescriptions to ensure the safety and efficacy of internet-based medication in Wuxi, China.

Methods

All 1,259 internet-based prescriptions from our hospital in 2022 were collected, and data on patients' age, gender, diagnosis, medications used, medication types, dosage forms, rationality of medication use, and reasons for irrationality were analyzed through descriptive statistics.

Results

In the electronic prescriptions of internet-based psychiatric hospitals, females accounted for the majority (64.50%), with a female-to-male ratio of 1.82:1. Middle-aged and young adults accounted for the majority of patients (57.50%). There were 47 diagnosed diseases involved, with 89 types of medications used and 1,938prescriptions issued. Among them, there were 78 types of western medicine with 1,876 prescriptions (96.80%), and 11 types of traditional Chinese medicine with 62 prescriptions (3.20%). The main medications used were anti-anxiety and antidepressant medications (44.94%) and psychiatric medications (42.21%). The dosage forms were all oral, with tablets (78.53%), capsules (17.54%), and solution preparations (2.17%) being the top three in frequency. According to the prescription review results, the initial pass rate of internet-based system review was 64.26%. After intervention by the internet-based system and manual review by pharmacist reviewers, the final pass rate of internet-based prescriptions reached 99.76%.

Conclusion

The practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals could significantly improve medication rationality, which fills the research gap in this field. In addition, it promotes the transformation of pharmaceutical service models.

Dual-Mode Undistorted Visual Fluorescent Sensing Strategy through Manipulating the Coffee-Ring Effect on Microfluidic Paper-Based Chip

To overcome the insufficient sensitivity due to distortion of the fluorescent images by mobile devices, we first developed a novel dual-mode strategy for undistorted visual fluorescent sensing on μPAD by technically manipulating the coffee-ring effect of the fluid sample. Based on the manipulating coffee-ring effect, we divided the horizontal direction of the resulting fluorescence image into 600 pixels and obtained more accurate quantitative information to avoid image distortion. The bovine serum albumin-stabilized gold nanoclusters-copper ion complex was used as the fluorescent probe, combined with a small imaging box and a smartphone, to achieve a rapid testing of histidine in human urine. The output image was analyzed in dual mode: RGB numerical analysis in pixel units and the direct measurement of the fluorescent strips length (limit of detection (LOD) is 0.021 and 0.5 mM, respectively), and improved antidistortion for visual fluorescent sensing. This strategy can overcome the distortion of a smartphone-visualized fluorescent image and shows great potential for rapid and convenient analysis.

[Development and validation of a mechanical power-oriented nomogram model for predicting the risk of weaning failure in mechanically ventilated patients: an analysis using the data from MIMIC-IV]

OBJECTIVE

To develop and validate a mechanical power (MP)-oriented nomogram prediction model of weaning failure in mechanically ventilated patients.

METHODS

Patients who underwent invasive mechanical ventilation (IMV) for more than 24 hours and were weaned using a T-tube ventilation strategy were collected from the Medical Information Mart for Intensive Care-IV v1.0 (MIMIC-IV v1.0) database. Demographic information and comorbidities, respiratory mechanics parameters 4 hours before the first spontaneous breathing trial (SBT), laboratory parameters preceding the SBT, vital signs and blood gas analysis during SBT, length of intensive care unit (ICU) stay and IMV duration were collected and all eligible patients were enrolled into the model group. Lasso method was used to screen the risk factors affecting weaning outcomes, which were included in the multivariate Logistic regression analysis. R software was used to construct the nomogram prediction model and build the dynamic web page nomogram. The discrimination and accuracy of the nomogram were assessed by receiver operator characteristic curve (ROC curve) and calibration curves, and the clinical validity was assessed by decision curve analysis (DCA). The data of patients undergoing mechanical ventilation hospitalized in ICU of the First People's Hospital of Lianyungang City and the Second People's Hospital of Lianyungang City from November 2021 to October 2022 were prospectively collected to externally validate the model.

RESULTS

A total of 3 695 mechanically ventilated patients were included in the model group, and the weaning failure rate was 38.5% (1 421/3 695). Lasso regression analysis finally screened out six variables, including positive end-expiratory pressure (PEEP), MP, dynamic lung compliance (Cdyn), inspired oxygen concentration (FiO2), length of ICU stay and IMV duration, with coefficients of 0.144, 0.047, -0.032, 0.027, 0.090 and 0.098, respectively. Logistic regression analysis showed that the six variables were all independent risk factors for predicting weaning failure risk [odds ratio (OR) and 95% confidence interval (95%CI) were 1.155 (1.111-1.200), 1.048 (1.031-1.066), 0.968 (0.963-0.974), 1.028 (1.017-1.038), 1.095 (1.076-1.113), and 1.103 (1.070-1.137), all P < 0.01]. The MP-oriented nomogram prediction model of weaning failure in mechanically ventilated patients showed accurate discrimination both in the model group and external validation group, with area under the ROC curve (AUC) and 95%CI of 0.832 (0.819-0.845) and 0.879 (0.833-0.925), respectively. Furthermore, its predictive accuracy was significantly higher than that of individual indicators such as MP, Cdyn, and PEEP. Calibration curves showed good correlation between predicted and observed outcomes. DCA indicated that the nomogram model had high net benefits, and was clinically beneficial.

CONCLUSIONS

The MP-oriented nomogram prediction model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning.

Molecular cloning and functional characterization of peroxiredoxin 4 (prx 4) in freshwater crayfish, Procambarus clarkii

Peroxiredoxin (Prx), which is a newly discovered member of the antioxidant protein family, performs important biological functions in intracellular signal transduction. In the present study, a peroxiredoxin 4 gene was cloned from crayfish for the first time and named Pc-prx 4. According to the amino acid sequence signature, Pc-Prx 4 was identified as the typical 2-Cys Prx molecule, which possessed two conserved cysteines (Cys98 and Cys219). Time-course expression patterns post V. harveyi infection revealed that Pc-prx 4 was likely related to crayfish innate immune defense responses. In particular, the highest fold upregulation of the Pc-prx 4 mRNA transcript reached approximately 170 post V. harveyi infection in the crayfish hepatopancreas. The results of the mixed functional oxidase assay showed that rPc-Prx 4^△ could resist the damaging effect of reactive oxygen species generated from the thiol/Fe³⁺/O₂^- reaction system to some extent. In addition, the results of the RNAi assay revealed that the crayfish survival rate was obviously increased post injection of V. harveyi when Pc-prx 4 was knocked down. Further study revealed that both hemolymph melanization and PO activity were strengthened to different degrees in the RNAi assay. Therefore, we speculated that the increase in the crayfish survival rate was likely due to the increase in hemolymph melanization. The obviously reinforced hemolymph melanization was directly caused by the upregulation of hemolymph PO activity, which was induced by the knockdown of Pc-prx 4. However, further studies are still indispensable for illuminating the molecular mechanism of Pc-prx 4 in the crayfish innate immune defense system.

Application of "Internet +" pharmaceutical consultation services in psychiatric hospital during the epidemic

This study explored the application value of "Internet +" pharmacy service on psychiatric hospital during the COVID-19 epidemic. During the epidemic, as of December 31, 2020, the number of online pharmacist consultations increased to 149 cases (82.78 %). At the same time, patients had various types of consultation questions, mainly involving adverse drug reactions, drug selection, usage and dosage, persistence of long-term medication, drug distribution, etc. Due to the particularity of psychiatric hospital, pharmaceutical consultation services mainly focus on nervous system drugs. The results indicated that the demand for "Internet +" pharmaceutical consultation services has increased significantly during the COVID-19 epidemic.

Design, fabrication, and evaluation of a large-area hybrid solar simulator for remote sensing applications

Solar irradiance variations have a direct effect on the accuracy and repeatability of identifying spectral signatures in the remote sensing field experiments. Solar simulators have been deployed to allow for testing under controlled and reproducible laboratory conditions. However, it is difficult and expensive to make a large-area solar simulation with the appropriate spectral content and spatial uniformity of irradiance. In this study, a hybrid solar simulator has been designed and constructed to provide large-area illumination for remote sensing simulation applications. A design method based on the two-phase genetic algorithm is proposed to improve the performance of the spectral match and spatial uniformity, which no longer relies on the traditional trial-and-error technique. The first phase is used to determine the most appropriate configuration of different lamps in order to represent the solar spectrum. The second phase is to accommodate an optimal placement of the multiple sources to achieve irradiance uniformity. Both numerical simulations and experiments were performed to verify the performances. The results showed that the solar simulator provided a good spectral match and spatial irradiance for simulating the variations in direct normal irradiance at different solar zenith angles. In addition, the modular design makes it possible to adjust irradiance on the target area without altering the spectral distribution. This work demonstrates the development and measurement of a hybrid solar simulator with a realizable optimal configuration of multiple lamps, and offers the prospect of a scalable, large-area solar simulation.

Establishment and application value of a novel prescription medication abuse monitoring model for psychiatric hospitals

Objective

To construct a prescription medication abuse (PMA) monitoring model for psychiatric hospitals and to assess its applicability.

Methods

A PMA monitoring working group was established to guide the formulation of a PMA monitoring system, which included three active real-time monitoring modes and one retrospective analysis monitoring mode. The effect of the established system was analyzed.

Results

In 2021, 35 cases of effective PMA were reported, which was a significant increase compared to two cases identified through passive monitoring mode in the preceding year. Most of the reported cases were based on active real-time monitoring mode. Among them, 21 cases (60.00%) were identified during the diagnosis and treatment of medicine and nursing; 3 cases (8.57%) were reported based on drug concentration detection technology; and 5 cases (14.29%) were reported by the laboratory department during PMA screening. Besides, 6 cases (17.14%) were reported according to the retrospective analysis of the hospital information system. The majority of prescription medication abusers were adolescents under the age of 18 (12 cases, 34.29%). Overall, there were 27 cases of class II psychotropic prescription medications, accounting for 77.14%.

Conclusion

The combined PMA monitoring model can effectively improve the quality of PMA monitoring and provide a basis for the supervision of higher-level regulatory authorities.

Artificial intelligence-based full aortic CT angiography imaging with ultra-low-dose contrast medium: a preliminary study

OBJECTIVES

To further reduce the contrast medium (CM) dose of full aortic CT angiography (ACTA) imaging using the augmented cycle-consistent adversarial framework (Au-CycleGAN) algorithm.

METHODS

We prospectively enrolled 150 consecutive patients with suspected aortic disease. All received ACTA scans of ultra-low-dose CM (ULDCM) protocol and low-dose CM (LDCM) protocol. These data were randomly assigned to the training datasets (n = 100) and the validation datasets (n = 50). The ULDCM images were reconstructed by the Au-CycleGAN algorithm. Then, the AI-based ULDCM images were compared with LDCM images in terms of image quality and diagnostic accuracy.

RESULTS

The mean image quality score of each location in the AI-based ULDCM group was higher than that in the ULDCM group but a little lower than that in the LDCM group (all p < 0.05). All AI-based ULDCM images met the diagnostic requirements (score ≥ 3). Except for the image noise, the AI-based ULDCM images had higher attenuation value than the ULDCM and LDCM images as well as higher SNR and CNR in all locations of the aorta analyzed (all p < 0.05). Similar results were also seen in obese patients (BMI > 25, all p < 0.05). Using the findings of LDCM images as the reference, the AI-based ULDCM images showed good diagnostic parameters and no significant differences in any of the analyzed aortic disease diagnoses (all K-values > 0.80, p < 0.05).

CONCLUSIONS

The required dose of CM for full ACTA imaging can be reduced to one-third of the CM dose of the LDCM protocol while maintaining image quality and diagnostic accuracy using the Au-CycleGAN algorithm.

KEY POINTS

• The required dose of contrast medium (CM) for full ACTA imaging can be reduced to one-third of the CM dose of the low-dose contrast medium (LDCM) protocol using the Au-CycleGAN algorithm. • Except for the image noise, the AI-based ultra-low-dose contrast medium (ULDCM) images had better quantitative image quality parameters than the ULDCM and LDCM images. • No significant diagnostic differences were noted between the AI-based ULDCM and LDCM images regarding all the analyzed aortic disease diagnoses.

Development and validation of a mechanical power-oriented prediction model of weaning failure in mechanically ventilated patients: a retrospective cohort study

OBJECTIVE

To develop and validate a mechanical power (MP)-oriented prediction model of weaning failure in mechanically ventilated patients.

DESIGN

A retrospective cohort study.

SETTING

Data were collected from the large US Medical Information Mart for Intensive Care-IV (MIMIC-IV) V.1.0, which integrates comprehensive clinical data from 76 540 intensive care unit (ICU) admissions from 2008 to 2019.

PARTICIPANTS

A total of 3695 patients with invasive mechanical ventilation for more than 24 hours and weaned with T-tube ventilation strategies were enrolled from the MIMIC-IV database.

PRIMARY AND SECONDARY OUTCOME

Weaning failure.

RESULTS

All eligible patients were randomised into development cohorts (n=2586, 70%) and validation cohorts (n=1109, 30%). Multivariate logistic regression analysis of the development cohort showed that positive end-expiratory pressure, dynamic lung compliance, MP, inspired oxygen concentration, length of ICU stay and invasive mechanical ventilation duration were independent predictors of weaning failure. Calibration curves showed good correlation between predicted and observed outcomes. The prediction model showed accurate discrimination in the development and validation cohorts, with area under the receiver operating characteristic curve values of 0.828 (95% CI: 0.812 to 0.844) and 0.833 (95% CI: 0.809 to 0.857), respectively. Decision curve analysis indicated that the predictive model was clinically beneficial.

CONCLUSION

The MP-oriented model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning.

Targeting p53-MDM2 interaction by small-molecule inhibitors: learning from MDM2 inhibitors in clinical trials

p53, encoded by the tumor suppressor gene TP53, is one of the most important tumor suppressor factors in vivo and can be negatively regulated by MDM2 through p53–MDM2 negative feedback loop. Abnormal p53 can be observed in almost all tumors, mainly including p53 mutation and functional inactivation. Blocking MDM2 to restore p53 function is a hotspot in the development of anticancer candidates. Till now, nine MDM2 inhibitors with different structural types have entered clinical trials. However, no MDM2 inhibitor has been approved for clinical application. This review focused on the discovery, structural modification, preclinical and clinical research of the above compounds from the perspective of medicinal chemistry. Based on this, the possible defects in MDM2 inhibitors in clinical development were analyzed to suggest that the multitarget strategy or targeted degradation strategy based on MDM2 has the potential to reduce the dose-dependent hematological toxicity of MDM2 inhibitors and improve their anti-tumor activity, providing certain guidance for the development of agents targeting the p53–MDM2 interaction.

Identifying Endogenous Cellular Proteins Destabilizing the Propagation of Swi1 Prion upon Overproduction

(1) Background: Numerous prions exist in the budding yeast, including [SWI+], the prion form of Swi1-a subunit of the chromatin-remodeling complex SWI/SNF. Despite decades of research, the molecular mechanisms underlying prion initiation and propagation are not fully understood. In this study, we aimed to identify endogenous cellular proteins that destabilize [SWI+]. (2) Methods: We screened the MoBY-ORF 2.0 library for proteins that destabilize [SWI+] upon overproduction. We further explored the effects of the identified candidates against other yeast prions and analyzed their potential prion-curing mechanisms. (3) Results: Eighty-two [SWI+] suppressors were identified, and their effects were shown to be [SWI+]-specific. Interestingly, a few documented [SWI+] suppressors were not among the identified hits. Further experiments indicate that, for some of these [SWI+] suppressors, their overproduction, and thus their prion-curing activities, are regulated by environmental conditions. Bioinformatics analyses show that our identified [SWI+] suppressors are involved in diverse biological functions, with gene ontology term enrichments specifically for transcriptional regulation and translation. Competition for Swi1 monomers between [SWI+] and Swi1 interactors, including the SWI/SNF complex, is a potential prion-curing mechanism. (4) Conclusions: We identified a number of [SWI+]-specific suppressors that highlight unique features of [SWI+] in maintaining its self-perpetuating conformations.

Role and Mechanism of Ferroptosis in Neurological Diseases

Background

Ferroptosis, as a new form of cell death, is different from other cell deaths such as autophagy or senescence. Ferroptosis involves in the pathophysiological progress of several diseases, including cancers, cardiovascular diseases, nervous system diseases, and kidney damage. Since oxidative stress and iron deposition are the broad pathological features of neurological diseases, the role of ferroptosis in neurological diseases has been widely explored.

Scope of review

Ferroptosis is mainly characterized by changes in iron homeostasis, iron-dependent lipid peroxidation, and glutamate toxicity accumulation, of which can be specifically reversed by ferroptosis inducers or inhibitors. The ferroptosis is mainly regulated by the metabolism of iron, lipids and amino acids through System Xc⁻, voltage-dependent anion channels, p53, p62-Keap1-Nrf2, mevalonate and other pathways. This review also focus on the regulatory pathways of ferroptosis and its research progress in neurological diseases.

Major conclusions

The current researches of ferroptosis in neurological diseases mostly focus on the key pathways of ferroptosis. At the same time, ferroptosis was found playing a bidirectional regulation role in neurological diseases. Therefore, the specific regulatory mechanisms of ferroptosis in neurological diseases still need to be further explored to provide new perspectives for the application of ferroptosis in the treatment of neurological diseases.

Reevaluation of adverse drug reactions of psychiatric drugs under the chinese drug volume-based procurement policy

Background

The "4 + 7" volume-based procurement is a "large group purchase" led by the Chinese government, with the aim of reducing the price of medicines by trading volume for price. Although the "4 + 7" drugs had passed the national consistency evaluation, the adverse drug reactions need to be further evaluated to ensure the safety of the "4 + 7" drugs with low prices. We aimed to analyze the occurrence characteristics and related influencing factors of adverse reactions of psychiatric drugs under the chinese drug volume-based procurement policy(4 + 7 policy), and provide references for clinical medication.

Methods

137 cases of adverse drug reactions of four psychotropic drugs reported under the "4 + 7" policy in Wuxi Mental Health Center in 2020 were collected. The gender and age of patients, related "4 + 7" drugs, involving organs / systems, clinical manifestations, distribution of new / serious adverse reactions, clinic outcomes were analyzed.

Results

Among the 137 cases of adverse drug reactions, the incidence of adverse drug reactions was the highest in patients aged 61–70 (25.38%). Mainly involved 4 "4 + 7" psychiatric drugs, of which olanzapine tablets caused the most adverse reactions (54, 39.24%). The adverse reactions mainly involved the digestive system, nervous system, cardiovascular system, blood and lymphatic system, among which the digestive system was the most common (61, 44.53%). A total of 8 cases (6.16%) of new and 26 cases of serious adverse reactions were reported, all of which led to the prolongation of disease course. Except for the transient side effects, most of that were improved or cured with no death, disability or teratogenicity after stopping or reducing the dose with symptomatic treatment.

Conclusion

Since more and more drugs will be included in "4 + 7" for clinic, clinical pharmacists should strengthen the publicity and training of the knowledge of "4 + 7" drugs, strengthen the monitoring of adverse drug reactions, and provide timely feedback to the clinic, in order to achieve early prevention, early identification, timely diagnosis and reasonable intervention of the adverse drug reactions under the context of "4 + 7" policy.

Designing an ultra-thin and wideband low-frequency absorber based on lumped resistance

Traditional absorbers are mostly limited by their large size and high profile, which renders them unfavorable for practical devices. To solve this problem, we design and test an ultra-thin metamaterial absorber (UTMA). The top layer of the metamaterial absorber is designed as a patterned combination of split ring and metal strips, so that its resonant frequency point is in the target low frequency. Meanwhile, ohmic loss is enhanced by loading lumped resistance in the gap of the meta-surface to improve the absorb efficiency (> 90%) and to expand the working bandwidth (1.24-3.14 GHz). Moreover, the total thickness of the absorber is 9 mm (0.037λwith respect to the lowest operating frequency). The working mechanism of UTMA is analyzed based on the equivalent media theory, surface current and electric field energy distribution. The experimental results are in good agreement with the simulation, which verifies the feasibility of the design. In this work, the metamaterial absorber is designed to meet the target requirements from three performance indexes: low frequency, ultra-thin, and wideband, leading to the prospect of broad applications in the military and civil fields.

[Diagnostic value of mechanical power in patients with moderate to severe acute respiratory distress syndrome: an analysis using the data from MIMIC-III]

OBJECTIVE

To explore the diagnostic value of mechanical power (MP) in patients with moderate to severe acute respiratory distress syndrome (ARDS) based on the Medical Information Mart for Intensive Care-IIIv1.4 (MIMIC-III v1.4).

METHODS

The information of ARDS patients undergoing invasive mechanical ventilation for no less than 48 hours who were hospitalized at Beth Israel Deaconess Medical Center in Boston, Massachusetts from June 2001 to October 2012 in the MIMIC-III v1.4 were collected. The demographics of patients, disease severity scores, ARDS etiology, prognostic indicators, pre-ventilation arterial blood gas analysis and respiratory parameters within 48 hours of ventilation were extracted. According to the lowest oxygenation index (PaO₂/FiO₂) before ventilation, the patients were divided into mild to moderate ARDS group (> 150 mmHg, 1 mmHg≈0.133 kPa) and moderate to severe ARDS group (≤ 150 mmHg), and the differences in baseline characteristics between the two groups were compared. The independent predictors associated with the severity of ARDS were analyzed using Logistic regression. The receiver operator characteristic curve (ROC curve) was plotted. The area under ROC curve (AUC) was calculated to evaluate the diagnostic value of MP for moderate to severe ARDS. The Youden index was used to determine the diagnostic threshold of MP for moderate to severe ARDS. According to the cut-off value of MP based on Youden index, all ARDS patients were divided into high and low MP groups. Kaplan-Meier survival curve was used to analyze the 28-day survival status of patients.

RESULTS

A total of 403 ARDS patients were enrolled in the study, including 107 subjects with mild to moderate ARDS and 296 with moderate to severe ARDS. There were significant differences in age, sequential organ failure assessment (SOFA) score, the lowest PaO₂/FiO₂ before ventilation, the last PaO₂/FiO₂ before ventilation, 28-day mortality, the length of intensive care unit (ICU) stay, duration of mechanical ventilation, lung dynamic compliance (Cdyn) in the second 24 hours of ventilation and positive end-expiratory pressure (PEEP), plateau pressure (Pplat), driving pressure (ΔP), respiratory rate (RR), lung static compliance (Cst), MP, inspired fraction of oxygen (FiO₂) within 48 hours of ventilation between the two groups. After adjusting variables such as age, SOFA score, the last PaO₂/FiO₂ before ventilation, and related respiratory mechanics parameters, multivariate Logistic regression analysis showed that higher ΔP, PEEP and MP, and lower last PaO₂/FiO₂ before ventilation were independently associated with moderate to severe ARDS [odds ratio (OR) and 95% confidence interval (95%CI) was 1.137 (1.032-1.252), 1.333 (1.139-1.561), 1.102 (1.030-1.179), and 0.996 (0.993-0.998), respectively, all P < 0.01]. The ROC curve analysis showed that the best cut-off value of MP for the diagnosis of moderate to severe ARDS was 18.1 J/min with sensitivity of 81.42% and specificity of 60.75%, and the AUC was 0.745 (95%CI was 0.690-0.799). According to the cut-off value of MP obtained by ROC curve, all ARDS patients were divided into high MP group (> 18.1 J/min) and low MP group (≤ 18.1 J/min). The Kaplan-Meier survival curve showed that the 28-day cumulative survival rate in the high MP group was significantly lower than that in the low MP group (73.8% vs. 85.1%; Log-Rank test: χ² = 5.660, P = 0.017).

CONCLUSIONS

MP is an independent predictor of the severity of ARDS, and it can be used to diagnose moderate to severe ARDS.

Interleukin enhancer binding factor 2 (IEBF 2) was involved in the regulation of the antibacterial immune reactions in fresh water crayfish, Procambarus clarkii

Although interleukin and interleukin analogues which play important immunomodulatory roles in mammals have not yet been reported in invertebrates, interleukin enhancer binding factor (IEBF) which acts as a transcription factor has been recently studied in several crustaceans and it may be involved in innate immune defence against pathogens. In this study, an IEBF 2 homologue was identified in the fresh water crayfish, Procambarus clarkii. The significantly changed expression levels of Pc-iebf 2 after bacterial challenge revealed the possibility of its participation in defence against bacterial infection. The results of an RNAi assay showed that the crayfish survival rate was obviously decreased after dsIEBF 2 injection, compared with the control groups. And S. aureus proliferation was obviously enhanced at 24 and 48 h post bacterial injection, when Pc-iebf 2 was knocked down. The possible molecular mechanisms for the innate immune regulation functions of Pc-IEBF 2 were also investigated. We speculated that Pc-IEBF 2 plays an important role in defending against bacterial infection in crayfish. It could regulate some innate immune responses by affecting the Toll signalling pathway, melanisation, and cell apoptosis.

Effect of beinaglutide treatment on weight loss in Chinese patients with type 2 diabetes mellitus and overweight/obesity

OBJECTIVE

To evaluate the effect of beinaglutide on weight loss and plasma protein patterns of inflammation/obesity relevant cytokines and biomarkers.

METHODS

This study involved 36 adult patients with a body mass index (BMI) of ≥ 24 kg/m2 and T2DM. Beinaglutide was administered for three months. Changes in body weight, fasting plasma glucose (FPG) level, 2 h postprandial plasma glucose (2h-PG) level, glycosylated hemoglobin (HbA1c) level, BMI and visceral and subcutaneous fat areas were measured at baseline and after three months of treatment. In addition, relevant inflammation/obesity cytokines and biomarkers were measured.

RESULTS

After three months, beinaglutide treatment led to significant changes, including in body weight, BMI, FPG level, HbA1c level, visceral and subcutaneous fat areas. In addition, serpin E1, leptin, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) also decreased significantly. The plasma protein concentrations of CRP (Log2 transformed) were found to be positively correlated with the percentage of weight loss (R = 0.514 and p-value = 0.021).

CONCLUSION

Beinaglutide treatment resulted in weight loss, plasma glucose control and anti-inflammatory effects in patients with T2DM and overweight/obesity.

Ultra-thin and broadband surface wave meta-absorber

Perfect absorbers are highly desired in many engineering and military applications, including radar cross section (RCS) reduction, cloaking devices, and sensor detectors. However, most types of present absorbers can only absorb space propagation waves, but absorption for surface waves has not been researched intensively. Surface waves are easily excited on the interfaces between metal and dielectrics for electronic devices, which decreases their working performances due to the electromagnetic disturbances. Thus, it is of great significance to design appropriate absorbers to dissipate undesirable surface waves. Here, we propose the concept of a surface wave absorber, analyze its working principle, and prove its good performances experimentally. To demonstrate our concept, we design and fabricate a realistic surface wave absorber that is fixed on a metal surface. Experiments are performed to verify its electromagnetic characteristics. The results show that our designed meta-absorber can achieve an excellent surface wave absorption within a wide frequency window (5.8-11.2 GHz) and exhibit a very high efficiency over than 90%, but only with the thickness of 1 mm (0.028 λ). Our device can help to solve the issues of absorption at large angles, and it can find wide applications in large antenna array design and other communication systems.

A novel and sensitive method for determination of amisulpride in human plasma by two-dimensional liquid chromatography

A novel and sensitive heart-cutting two-dimensional liquid chromatography with ultraviolet detection method (2D-LC-UV) was developed and validated for determination of amisulpride in human plasma. The 2D-LC system consists of a first dimensional (¹ D) LC column and a middle transfer column as well as a second-dimensional (² D) LC column. After simple protein precipitation, the sample was directly injected into the introduction valve of the 2D-LC system. The ¹ D column, playing a role of primary separation and preconcentration for complex plasma matrices, transferred the targets to the intermediate column. Following capture of targets on the middle column online, the analytes were transferred to the ² D separation column by a six-port valve. The ² D column, avoiding interference from the plasma matrix, completed further separation and quantification. An assistant pump was optimized for primary enrichment as well as final elution in the heart-cutting mode. The analytical time of amisulpride was 7.401 min. The accuracy was between 0.48 and 8.49%, while the intra- and inter-day precisions ranged from 0.9 to 3.1% and from 1.7% to 3.3%, respectively. The linear range of amisulpride was 48.15-2,407.59 ng/ml, while the extraction recovery was 98.7-101.3%. The strategy established in the study, which was successfully applied to therapeutic drug monitoring of amisulpride for routine clinical detection, displays high sensitivity, good repeatability, convenience and low cost.