Publications by authors named "Yu Fang"

1,380 Publications

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Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study.

Glob Health Res Policy 2021 Oct 25;6(1):42. Epub 2021 Oct 25.

School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, China.

Background: There is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. This study aims to examine the nationality differences in the practices of PSMA and knowledge, attitudes and practices (KAP) toward antibiotic use, and understand the practices of PSMA among parents of various nationalities in China.

Methods: A cross-sectional study based on a structured questionnaire survey was conducted in Xi'an, Shaanxi Province, China, from September 2018 to October 2018. A total of 299 respondents participated in. The practices of PSMA (a dichotomous variable) and KAP toward antibiotic use (a continuous variable) served as dependent variables. Participant's nationality was regarded as the independent variable. Binary logistic regression and ordinary least square regression were employed to examine the association between parent's nationality and the practices of PSMA, and KAP toward antibiotic use, respectively.

Results: 121 (40.88%) Chinese, 100 (33.76%) other Asians and 75 (25.34%) Occidentals were included in final analysis, with a sample size of 296. Chinese were more likely to practice PSMA (OR = 7.070; 95% CI 1.315, 38.01), with worse knowledge (Coef. = - 0.549; 95% CI - 1.021, - 0.078), attitudes (Coef. = - 3.069; 95% CI - 4.182, - 1.956) and practices (Coef. = - 1.976; 95% CI - 3.162, - 0.790) toward antibiotic use, compared to their Occidental counterparts. The main reasons for the practices of PSMA were enough previous medication experience (80.49%) and same ailments with no need to see a doctor (39.02%), with common symptoms such as fever (60.98%) and cough (58.54%). Purchasing antibiotics at pharmacies (92.08%) and using leftover antibiotics (26.83%) were usual approaches.

Conclusions: The study highlights the gaps in the practices of PSMA and KAP toward antibiotic use among parents of different nationalities. The access to obtain antibiotics from pharmacies reflects the pharmacists' unaware of laws on prescription of antibiotics, fierce competition in the pharmacy market, and the government's lax supervision in China. It suggests the need to improve pharmacists' training, enforce current legislations on pharmacy market regarding the sale of antibiotics, and provide practical and effective educational interventions for residents about antibiotic use.
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http://dx.doi.org/10.1186/s41256-021-00226-yDOI Listing
October 2021

Mechanistic Effects of Aerobic Exercise in Alzheimer's Disease: Imaging Findings From the Pilot FIT-AD Trial.

Front Aging Neurosci 2021 7;13:703691. Epub 2021 Oct 7.

Mayo Clinic Department of Radiology, Rochester, MN, United States.

Despite strong evidence from animal models of Alzheimer's disease (AD) supporting aerobic exercise as a disease-modifying treatment for AD, human mechanistic studies are limited with mixed findings. The objective of this pilot randomized controlled trial was to examine the effects of 6-month aerobic exercise on hippocampal volume, temporal meta-regions of interest (ROI) cortical thickness, white matter hyperintensity (WMH) volume, and network failure quotient (NFQ), measured with MRI, in community-dwelling older adults with AD dementia. Additionally, the relationships between 6- and 12-month changes in MRI biomarkers and the AD Assessment Scale-Cognition (ADAS-Cog) were examined. Sixty participants were randomized, but one was excluded because baseline MRI failed quality control: 38 randomized to cycling and 21 to stretching. The intervention was moderate-intensity cycling for 20-50 mins, three times a week for 6 months. Control was low-intensity stretching. The study outcomes include hippocampal volume, temporal meta-ROI cortical thickness, WMH volume, and NFQ. Outcomes were measured at baseline, 6 months, and 12 months. The sample averaged 77.3 ± 6.3 years old with 15.6 ± 2.9 years of education and 53% men. Both groups experienced significant declines over 6 months in hippocampal volume (2.64% in cycling vs. 2.89% in stretching) and temporal meta-ROI cortical thickness (0.94 vs. 1.54%), and over 12 months in hippocampal volume (4.47 vs. 3.84%) and temporal meta-ROI cortical thickness (2.27 vs. 1.79%). These declines did not differ between groups. WMH volume increased significantly with the cycling group increasing less (10.9%) than stretching (24.5%) over 6 months ( = 4.47, = 0.04) and over 12 months (12.1 vs. 27.6%, = 5.88, = 0.02). NFQ did not change significantly over time. Pairwise correlational analyses showed a significant negative correlation between 6-month changes in hippocampal volume and ADAS-Cog ( = -0.34, < 0.05). To conclude, aerobic exercise may reduce the decline in hippocampal volume and temporal meta-ROI cortical thickness during the intervention period, but the effect sizes are likely to be very small and dose-dependent and reverse once the intervention stops. Aerobic exercise is effective on slowing down WMH progression but has no effect on NFQ. Hippocampal atrophy was associated with cognitive decline during the intervention period. www.ClinicalTrials.gov, identifier: NCT01954550.
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http://dx.doi.org/10.3389/fnagi.2021.703691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530186PMC
October 2021

A Qualitative Study Exploring the Management of Medicine Shortages in the Community Pharmacy of Pakistan.

Int J Environ Res Public Health 2021 Oct 12;18(20). Epub 2021 Oct 12.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China.

Managing medicine shortages consumes ample time of pharmacists worldwide. This study aimed to explore the strategies and resources being utilized by community pharmacists to tackle a typical shortage problem. Qualitative face-to-face interviews were conducted. A total of 31 community pharmacists from three cities (Lahore, Multan, and Dera Ghazi Khan) in Pakistan were sampled, using a purposive approach. All interviews were audio taped, transcribed verbatim, and subjected to thematic analysis. The analysis yielded five broad themes and eighteen subthemes. The themes highlighted (1) the current scenarios of medicine shortages in a community setting, (2) barriers encountered during the shortage management, (3) impacts, (4) corrective actions performed for handling shortages and (4) future interventions. Participants reported that medicine shortages were frequent. Unethical activities such as black marketing, stockpiling, bias distribution and bulk purchasing were the main barriers. With respect to managing shortages, maintaining inventories was the most common proactive approach, while the recommendation of alternative drugs to patients was the most common counteractive approach. Based on the findings, management strategies for current shortages in community pharmacies are insufficient. Shortages would continue unless potential barriers are addressed through proper monitoring of the sale and consumption of drugs, fair distribution, early communication, and collaboration.
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http://dx.doi.org/10.3390/ijerph182010665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8535806PMC
October 2021

Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial.

Antibiotics (Basel) 2021 Sep 23;10(10). Epub 2021 Sep 23.

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China.

Globally, lower respiratory infections (LRTIs) are one of the most common infectious diseases whichaffect majority of the population and as a result of inappropriate antibiotics practices lead to antibiotic resistance (AR). An individual randomized control trial will be conducted in the post-conflict areas of Swat, Pakistan, through a random sampling method. Patients aged > 18 years will be recruited from five community pharmacies and assigned to equally sized groups to receive either pharmacist-led education interventions or usual care with no intervention. A total of 400 (control = 200, study = 200) patients will be included, with prescriptions comprised of antibiotics for LRTIs. The outcomes measured in both groups will be a combination of treatment cure rate and adherence, which will be assessed using the Morisky Medication Adherence Scale and pill count. The trial comprises pharmacist-led educational interventions to improve treatment outcomes for patients with LRTIs. This study might establish the groundwork for pharmaceutical care of LRTIs patients with antibacterial therapy and the future delivery of a care strategy for the improvement of LRTIs treatment outcomes in post-conflict, remote areas of the third world and LMICs.
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http://dx.doi.org/10.3390/antibiotics10101147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8532944PMC
September 2021

Mast Cells Are Identified in the Lung Parenchyma of Wild Mice, Which Can Be Recapitulated in Naturalized Laboratory Mice.

Front Immunol 2021 27;12:736692. Epub 2021 Sep 27.

Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong, SAR, China.

Background: It is well documented that laboratory mice bred and maintained in ultra-hygienic specific pathogen-free (SPF) barriers display reduced richness and complexity of microbiota compared with wild mice. The laboratory mice profoundly lack lung parenchymal mast cells. Hence, we aimed to investigate the lung distribution of mast cells in free-living wild mice.

Methods: Wild house mice were trapped in South-Eastern Norway and Hemtabad, West Bengal, India. C57BL/6 laboratory mice were bred in a purposefully built, closed environment with bedding material obtained from the natural environment in order to normalize the gut microbiota of these laboratory mice to that of the wild mice, and the offspring were collected for study at eight weeks of age.

Results: Mast cells were easily identified at a substantial density in the lung parenchymal tissues of wild mice from both Norway and India, which stands in clear contrast to the rare distribution of lung parenchymal mast cells in the conventional laboratory SPF mice. Consistently, wild mice also expressed higher pulmonary levels of stem cell factor, a critical growth factor for mast cell survival. Higher levels of histamine were recorded in the lung tissues of the wild mice. Interestingly, "naturalized" C57BL/6 laboratory mice which spent their entire life in a semi-natural environment developed lung parenchymal mast cells at an appreciable density.

Conclusion: Our observations support that environmental factors, possibly through modulation of microbiota, may impact the tissue distribution of mast cells in mouse lung parenchyma.
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http://dx.doi.org/10.3389/fimmu.2021.736692DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502827PMC
September 2021

Resonance-Enhanced Two-Photon Absorption and Optical Power Limiting Properties of Three-Dimensional Perylene Bisimide Derivatives.

J Phys Chem B 2021 Oct 12;125(41):11540-11547. Epub 2021 Oct 12.

Key Laboratory of Applied Surface and Colloid Chemistry of Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an 710119, P. R. China.

Push-pull organic structures characterized by an intramolecular charge transfer (ICT) process and π-electron delocalization are potentially interesting luminescent materials. A series of three-dimensional -carborane-containing perylene bisimide derivatives (PBIs) were synthesized, and their optical properties were systematically investigated to illustrate the stereo effect, especially on the two-photon absorption (2PA) and optical power limiting (OPL) properties. Open-aperture Z-scan curves showed that all four PBIs displayed strong and broad two-photon absorptivities based on the resonance-enhanced phenomenon. The maximum degenerate two-photon absorption cross section (δ) increased with the number of PBI substituents. The derivative CB-PBI possessed a δ value of ∼2400 GM at 650 nm, a significant enhancement in comparison with that of the parent PBI (∼719 GM), ascribed to the present stereo effect. When the aromatic-donating units changed from naphthyl and pyrenyl to PBI, the generated multidimensional intramolecular charge transfer (ICT) from the aromatic units to the -carborane cage contributed to the 2PA processes. All of the fluorophores exhibited excellent optical power limiting (OPL) performances as well as a minimum limiting threshold of ∼4.98 mJ/cm for CB-PBI. These significant results not only allow us to get deep insight into the nature of the fundamental stereo effect and nonlinear optical (NLO) response involved but also guide us toward the design of new multifunctional luminescent materials.
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http://dx.doi.org/10.1021/acs.jpcb.1c07296DOI Listing
October 2021

Sequence types 8, 59, and 45 methicillin resistant Staphylococcus aureus as the predominant strains causing skin and soft tissue infections in Taiwan's prisons and jails.

J Microbiol Immunol Infect 2021 Sep 25. Epub 2021 Sep 25.

Department of Clinical Laboratory, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the predominant cause of skin and soft tissue infections (SSTIs), which is a problem in prisons and jails. We conducted this study to understand MRSA molecular characteristics among inmates with SSTIs, and we chose MRSA isolates from a community hospital as a comparison.

Methods: A total of 219 MRSA isolates from three custodial facilities and 134 isolates from a community hospital in Taiwan were collected in the 2017 calendar year. MRSA isolates were investigated molecularly by staphylococcal chromosome cassette mec (SCCmec) type, mupirocin, and chlorhexidine genotypical resistance, and multi-locus sequence typing (ST).

Results: Of the 219 MRSA isolates from custodial facilities, SCCmec IV was the most prevalent type (65.3%), followed by type V (32.4%) and type V (1.8%). Regarding sequence types, ST59 (36.4%), 8 (35.3%), and 45 (17.9%) were the leading three predominant types out of 184 selected MRSA isolates, and ST45 MRSA was more prevalent in custodial facilities (p = 0.019). The antimicrobial resistance rates varied for different MRSA strains, with ST45 MRSA having the lowest rates of resistance to most antimicrobials. Overall, 91.5% of isolates carried mupA gene and 25.8% were positive for qacA/B gene, this was independent of the MRSA sequence types.

Conclusions: ST59, ST8, and ST45 MRSA are the leading three MRSA strains causing SSTIs in Taiwan, 2017, but the molecular distribution varied distinctly between the custodial facilities and hospital settings. The genotypical mupirocin resistance rate is quite high in this study. The frequency of chlorhexidine resistance gene is relatively low, especially in MRSA isolates from custodial facilities.
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http://dx.doi.org/10.1016/j.jmii.2021.08.013DOI Listing
September 2021

Anatomic survey of seeding in Alzheimer's disease brains reveals unexpected patterns.

Acta Neuropathol Commun 2021 Oct 11;9(1):164. Epub 2021 Oct 11.

Center for Alzheimer's and Neurodegenerative Diseases, Peter O'Donnell Jr. Brain Institute, NL10.120, University of Texas Southwestern Medical Center, 6000 Harry Hines Blvd., Dallas, TX, 75390, USA.

Tauopathies are heterogeneous neurodegenerative diseases defined by progressive brain accumulation of tau aggregates. The most common tauopathy, sporadic Alzheimer's disease (AD), involves progressive tau deposition that can be divided into specific stages of neurofibrillary tangle pathology. This classification is consistent with experimental data which suggests that network-based propagation is mediated by cell-cell transfer of tau "seeds", or assemblies, that serve as templates for their own replication. Until now, seeding assays of AD brain have largely been limited to areas previously defined by NFT pathology. We now expand this work to additional regions. We selected 20 individuals with AD pathology of NFT stages I, III, and V. We stained and classified 25 brain regions in each using the anti-phospho-tau monoclonal antibody AT8. We measured tau seeding in each of the 500 samples using a cell-based tau "biosensor" assay in which induction of intracellular tau aggregation is mediated by exogenous tau assemblies. We observed a progressive increase in tau seeding according to NFT stage. Seeding frequently preceded NFT pathology, e.g., in the basolateral subnucleus of the amygdala and the substantia nigra, pars compacta. We observed seeding in brain regions not previously known to develop tau pathology, e.g., the globus pallidus and internal capsule, where AT8 staining revealed mainly axonal accumulation of tau. AT8 staining in brain regions identified because of tau seeding also revealed pathology in a previously undescribed cell type: Bergmann glia of the cerebellar cortex. We also detected tau seeding in brain regions not previously examined, e.g., the intermediate reticular zone, dorsal raphe nucleus, amygdala, basal nucleus of Meynert, and olfactory bulb. In conclusion, tau histopathology and seeding are complementary analytical tools. Tau seeding assays reveal pathology in the absence of AT8 signal in some instances, and previously unrecognized sites of tau deposition. The variation in sites of seeding between individuals could underlie differences in the clinical presentation and course of AD.
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http://dx.doi.org/10.1186/s40478-021-01255-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507321PMC
October 2021

Intracellular Condensates of Oligopeptide for Targeting Lysosome and Addressing Multiple Drug Resistance of Cancer.

Adv Mater 2021 Oct 10:e2104704. Epub 2021 Oct 10.

Key Laboratory of Precise Synthesis of Functional Molecules of Zhejiang Province, School of Science, Westlake University, Institute of Natural Sciences, Westlake Institute for Advanced Study, 18 Shilongshan Road, Hangzhou, Zhejiang Province, 310024, China.

Biomolecular condensates have been demonstrated as a ubiquitous phenomenon in biological systems and play a crucial role in controlling cellular functions. However, the spatiotemporal construction of artificial biomolecular condensates with functions remains challenging and has been less explored. Herein, a general approach is reported to construct biomolecular condensates (e.g., hydrogel) in the lysosome of living cells for cancer therapy and address multiple drug resistance induced by lysosome sequestration. Aromatic-motif-appended pH-responsive hexapeptide (LTP) derived from natural insulin can be uptaken by cancer cells mainly through caveolae-dependent endocytosis, ensuring the proton-triggered phase transformation (solution to hydrogel) of LTP inside the lysosome specifically. Lysosomal hydrogelation further leads to enlargement of the lysosome in cancer cells and increases the permeability of the lysosome, resulting in cancer cell death. Importantly, lysosomal assemblies can significantly improve the efficiency of current chemotherapy drugs toward multidrug resistance (MDR) cells in vitro and in xenograft tumor models. As an example of functional artificial condensates in lysosomes, this work provides a new strategy for controlling functional condensates formation precisely in the organelles of living cells and addressing MDR in cancer therapy.
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http://dx.doi.org/10.1002/adma.202104704DOI Listing
October 2021

Modeling the Percutaneous Absorption of Solvent-Deposited Solids Over a Wide Dose Range.

J Pharm Sci 2021 Oct 7. Epub 2021 Oct 7.

The James L. Winkle College of Pharmacy, The University of Cincinnati. Electronic address:

The transient absorption of two skin care agents, niacinamide (nicotinamide, NA) and methyl nicotinate (MN), solvent-deposited on ex vivo human skin mounted in Franz diffusion cells has been analyzed according to a new variation on a recently published mechanistic skin permeability model (Yu et al. 2020. J Pharm Sci 110:2149-56). The model follows the absorption and evaporation of two components, solute and solvent, and it includes both a follicular transport component and a dissolution rate limitation for high melting, hydrophilic solids deposited on the skin. Explicit algorithms for improving the simulation of transient diffusion of solvent-deposited solids are introduced. The simulations can account for the ex vivo skin permeation time course of both NA and MN over a dose range exceeding 4.5 orders of magnitude. The model allows one to describe on a mechanistic basis why the percutaneous absorption rate of NA is approximately 60-fold lower than that of its lower melting, more lipophilic analog, MN. It furthermore suggests that MN perturbs stratum corneum barrier lipids and increases their permeability while NA does not, presenting a challenge to molecular modelers engaged in simulating biological lipid barriers.
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http://dx.doi.org/10.1016/j.xphs.2021.10.001DOI Listing
October 2021

Fundamentals of Radiation Oncology for Treatment of Vertebral Metastases.

Radiographics 2021 Oct 8:210052. Epub 2021 Oct 8.

From the Department of Radiation Oncology (S.G., S.B., K.K.), Department of Radiology (U.S., F.F.Y., A.A., B.R.S., K.M.R.), and Departments of Orthopaedic Surgery and Neurosurgery (S.V.), The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390; and Rio Grande Urology, El Paso, Tex (J.T.M.).

The fields of both radiology and radiation oncology have evolved considerably in the past few decades, resulting in an increased ability to delineate between tumor and normal tissue to precisely target and treat vertebral metastases with radiation therapy. These scientific advances have also led to improvements in assessing treatment response and diagnosing toxic effects related to radiation treatment. However, despite technological innovations yielding greatly improved rates of palliative relief and local control of osseous spinal metastases, radiation therapy can still lead to a number of acute and delayed posttreatment complications. Treatment-related adverse effects may include pain flare, esophageal toxic effects, dermatitis, vertebral compression fracture, radiation myelopathy, and myositis, among others. The authors provide an overview of the multidisciplinary approach to the treatment of spinal metastases, indications for surgical management versus radiation therapy, various radiation technologies and techniques (along with their applications for spinal metastases), and current principles of treatment planning for conventional and stereotactic radiation treatment. Different radiologic criteria for assessment of treatment response, recent advances in radiologic imaging, and both common and rare complications related to spinal irradiation are also discussed, along with the imaging characteristics of various adverse effects. Familiarity with these topics will not only assist the diagnostic radiologist in assessing treatment response and diagnosing treatment-related complications but will also allow more effective collaboration between diagnostic radiologists and radiation oncologists to guide management decisions and ensure high-quality patient care. RSNA, 2021.
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http://dx.doi.org/10.1148/rg.2021210052DOI Listing
October 2021

An -Carborane Derivative of Perylene Bisimide-Based Thin Film Displaying both Electrochromic and Electrofluorochromic Properties.

ACS Appl Mater Interfaces 2021 Oct 6;13(41):49500-49508. Epub 2021 Oct 6.

Key Laboratory of Applied Surface and Colloid Chemistry of Ministry of Education, School of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi'an 710062, P. R. China.

The widespread application in displays, information encryption, and sensors has boosted studies of electrochromic (EC) systems combining large contrast, fast response, high robustness, and low-cost properties. Herein, we report a film-type new EC system with a non-planar perylene bisimide-carborane derivative (PBI-CB) as the electroactive materials. It was revealed that the film demonstrated outstanding EC properties with response times of 1.18 and 0.94 s for the coloration and bleaching processes, respectively, large transmittance variation around 630 nm (45.7%), and superior stability for more than 200 coloration-bleaching cycles. Moreover, the film also showed precious electrofluorochromic (EFC) properties. The emission around 650 nm at the "on" state could be more than 24.5 times than that at the "off" state, and the response times of the off and on processes could reach 2.2 s and 4.3 s, respectively. Considering the facts that the film was fabricated via simple drop-coating, the EC/EFC operation was performed via a routine three-electrode system and the voltage applied is only -1.3 V, we believe that the EC/EFC system as developed would find applications in smart windows, information encryption, optoelectrical sensing, etc. In addition, the work could also pave the way for developing combined EC/EFC systems via employing known organic fluorophores as the electrochemical active materials, which are not only abundant in numbers but also solution-processable.
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http://dx.doi.org/10.1021/acsami.1c15223DOI Listing
October 2021

In Vitro Human Skin Absorption of Solvent-deposited Solids: Niacinamide and Methyl Nicotinate.

J Pharm Sci 2021 Sep 30. Epub 2021 Sep 30.

The Procter & Gamble Company, Data and Modeling Sciences, Brussels Innovation Center, Belgium.

A quantitative understanding of the dose dependence of topical delivery is important to cosmetic and dermatological product development and to risk assessment for hazardous chemicals contacting the skin. Despite considerable research, predictive capability in this area remains limited. To this end we conducted an experimental skin absorption study of two closely related skin care agents, niacinamide (nicotinamide, NA) and methyl nicotinate (MN), and analyzed the results quantitatively using a transient diffusion model described separately (Yu et al. submitted for publication). Radiolabeled test compounds were solvent-deposited onto ex vivo human skin mounted in Franz diffusion cells over a dose range exceeding 4.5 orders of magnitude, and permeation was measured over a 1-4 day period. At low doses, the permeation rate of NA was approximately 60-fold lower than that of its lower melting, more lipophilic analog, MN; at high doses an even greater difference was observed. The difference can be qualitatively explained based on higher lipid solubility and lower crystallinity of MN relative to NA. Dissolution-limited mass transfer through a lipid layer at the SC surface is suggested. Relevance of the results to practical skin care formulations was confirmed by a parallel study of NA in an o/w emulsion.
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http://dx.doi.org/10.1016/j.xphs.2021.09.040DOI Listing
September 2021

Alterations in the gut microbiome with hemorrhagic transformation in experimental stroke.

CNS Neurosci Ther 2021 Sep 30. Epub 2021 Sep 30.

Department of neurology, Xiangya Hospital Central South University, Changsha, Hunan P.R., China.

Objective: Hemorrhagic transformation (HT) is a life-threatening complication of stroke. Whether changes in gut microbial composition underlie the development of HT remains unknown. This study aimed to investigate whether the gut microbiota is altered in HT rats and examine the association between these changes and inflammatory responses.

Methods: HT was successfully established in rats injected with 50% glucose (6 ml/Kg, i.p.) 15 min before middle cerebral artery occlusion (MCAO, 90 min occlusion) with reperfusion. After 5 days, rats were euthanized, and their brains used to estimate infarct volume. The inflammatory factors, the analysis of gut microbiota, and short-chain fatty acids (SCFA) were assessed.

Results: In contrast with non-HT rats, gut microbiota sequencing showed an elevation in the relative abundance of Proteobacteria and Actinobacteria in HT rats. Total SCFAs, especially butyrate and valeric acid, were significantly lower in the cecal contents of HT rats than in those of non-HT rats. Hyperglycemia-induced HT exacerbation was not observed when rats were treated with antibiotics, suggesting that altered microbiota play a critical role in hyperglycemic HT pathogenesis. Furthermore, rats whose gut was colonized with HT rat microbiota showed increased susceptibility to HT.

Conclusion: This study provides important information about the gut microbiota profiles and SCFA levels of MCAO rats with HT or non-HT. The susceptibility to HT in MCAO rats is associated with inflammation and gut microbiota modulation.
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http://dx.doi.org/10.1111/cns.13736DOI Listing
September 2021

The Genetic Architecture of Depression in Individuals of East Asian Ancestry: A Genome-Wide Association Study.

JAMA Psychiatry 2021 Sep 29. Epub 2021 Sep 29.

23andme, Inc, Sunnyvale, California.

Importance: Most previous genome-wide association studies (GWAS) of depression have used data from individuals of European descent. This limits the understanding of the underlying biology of depression and raises questions about the transferability of findings between populations.

Objective: To investigate the genetics of depression among individuals of East Asian and European descent living in different geographic locations, and with different outcome definitions for depression.

Design, Setting, And Participants: Genome-wide association analyses followed by meta-analysis, which included data from 9 cohort and case-control data sets comprising individuals with depression and control individuals of East Asian descent. This study was conducted between January 2019 and May 2021.

Exposures: Associations of genetic variants with depression risk were assessed using generalized linear mixed models and logistic regression. The results were combined across studies using fixed-effects meta-analyses. These were subsequently also meta-analyzed with the largest published GWAS for depression among individuals of European descent. Additional meta-analyses were carried out separately by outcome definition (clinical depression vs symptom-based depression) and region (East Asian countries vs Western countries) for East Asian ancestry cohorts.

Main Outcomes And Measures: Depression status was defined based on health records and self-report questionnaires.

Results: There were a total of 194 548 study participants (approximate mean age, 51.3 years; 62.8% women). Participants included 15 771 individuals with depression and 178 777 control individuals of East Asian descent. Five novel associations were identified, including 1 in the meta-analysis for broad depression among those of East Asian descent: rs4656484 (β = -0.018, SE = 0.003, P = 4.43x10-8) at 1q24.1. Another locus at 7p21.2 was associated in a meta-analysis restricted to geographically East Asian studies (β = 0.028, SE = 0.005, P = 6.48x10-9 for rs10240457). The lead variants of these 2 novel loci were not associated with depression risk in European ancestry cohorts (β = -0.003, SE = 0.005, P = .53 for rs4656484 and β = -0.005, SE = 0.004, P = .28 for rs10240457). Only 11% of depression loci previously identified in individuals of European descent reached nominal significance levels in the individuals of East Asian descent. The transancestry genetic correlation between cohorts of East Asian and European descent for clinical depression was r = 0.413 (SE = 0.159). Clinical depression risk was negatively genetically correlated with body mass index in individuals of East Asian descent (r = -0.212, SE = 0.084), contrary to findings for individuals of European descent.

Conclusions And Relevance: These results support caution against generalizing findings about depression risk factors across populations and highlight the need to increase the ancestral and geographic diversity of samples with consistent phenotyping.
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http://dx.doi.org/10.1001/jamapsychiatry.2021.2099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482304PMC
September 2021

Chiral Fluorescent Metal-Organic Framework with a Pentanuclear Copper Cluster as an Efficient Luminescent Probe for Dy Ion and Cyano Compounds.

Inorg Chem 2021 Oct 27;60(20):15085-15090. Epub 2021 Sep 27.

College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, Hunan China.

Luminescent probes have been used for the detection of various heavy metals and toxic compounds. A novel sensor with excellent sensitivity and selectivity is in high demand. Herein, we designed and synthesized a three-dimensional copper-organic framework of "pcu" α-Po primitive cubic topology with a Schläfli symbol of {4.4.4.4.4.4.4.4.4.4.4.4.*.*.*}. By taking advantage of metal clusters and a triazole ligand as the metal-organic framework (MOF) components, the newly obtained MOF is stable in various environments and can be potentially used as the sensor. Remarkably, this MOF-based sensor shows high sensitivity and selectivity toward a dysprosium ion (Dy) in a multiple-lanthanide mixed solution. Besides, it exhibits luminescent quenching toward various cyano compounds. This chiral cluster-based network provides a potential luminescent probe for various inorganic and organic compounds with high sensitivity and selectivity.
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http://dx.doi.org/10.1021/acs.inorgchem.1c01349DOI Listing
October 2021

A method for characterizing daily physiology from widely used wearables.

Cell Rep Methods 2021 Aug 29;1(4). Epub 2021 Jul 29.

Department of Mathematics, University of Michigan, Ann Arbor, MI, USA.

Millions of wearable-device users record their heart rate (HR) and activity. We introduce a statistical method to extract and track six key physiological parameters from these data, including an underlying circadian rhythm in HR (CRHR), the direct effects of activity, and the effects of meals, posture, and stress through hormones like cortisol. We test our method on over 130,000 days of real-world data from medical interns on rotating shifts, showing that CRHR dynamics are distinct from those of sleep-wake or physical activity patterns and vary greatly among individuals. Our method also estimates a personalized phase-response curve of CRHR to activity for each individual, representing a passive and personalized determination of how human circadian timekeeping continually changes due to real-world stimuli. We implement our method in the "Social Rhythms" iPhone and Android app, which anonymously collects data from wearable-device users and provides analysis based on our method.
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http://dx.doi.org/10.1016/j.crmeth.2021.100058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462795PMC
August 2021

A case of trichotillomania with binge eating disorder: combined with N-acetylcysteine synergistic therapy.

Ann Gen Psychiatry 2021 Sep 25;20(1):46. Epub 2021 Sep 25.

Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, 2088 Tiaoxi Road, Huzhou, 313000, Zhejiang, China.

Background: Obsessive-compulsive and related disorders (OCRDs) are a group of intractable and chronic mental disorders. Trichotillomania (TTM) is a common type of OCRDs characterized by repetitive hair pulling, driven by escalating tension before the action and during the attempts to resist it. Binge eating disorder (BED) is a common type of eating disorder characterized by recurrent compulsive episodes of binge eating. Both have common psychological processes (tension or impulsion) and pathological manifestations (out of control), but the pathological mechanisms are still unclear and the current clinical treatments are often unsatisfactory for these two disorders.

Case Presentation: A 25-year-old woman with TTM comorbid BED came to our hospital for treatment. She had accepted systematic cognitive behavioral therapy (CBT) and also monotherapy or multidrug therapy with sertraline, fluvoxamine, bupropion, risperidone in full dosage and duration for 2 years, but all of them did not work. We treated this case with N-acetylcysteine (NAC) as a synergist on the basis of recent treatment (fluvoxamine 150 mg/day and bupropion 300 mg/day). The pathological hair plucking behavior and binge eating symptoms were both significantly and rapidly improved, and the follow-up in next 14 weeks showed that the effect was still maintained.

Conclusion: To our knowledge, this may be the first case report of using NAC as a synergist to treat TTM comorbid BED successfully, which suggest that these two disorders may have a common pathophysiological mechanism. Moreover, NAC can be one choice as a synergistic treatment for OCRDs.
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http://dx.doi.org/10.1186/s12991-021-00369-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467022PMC
September 2021

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials.

Neuropsychiatr Dis Treat 2021 15;17:2937-2954. Epub 2021 Sep 15.

Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People's Republic of China.

Background: The obstacle of limb motor caused by stroke, especially the decline of motor function of upper limbs, can directly affect the activities of daily living of stroke patients with hemiplegia. Based on long-term clinical practice, the treatment effect of electrical stimulation methods for stroke limb dysfunction has been widely recognized and supported by authoritative guidelines and systematic reviews. However, which electrical stimulation method is the optimum in the treatment of stroke limb dysfunction is still a controversial issue.

Objective: In this paper, we adopted Network Meta-Analysis (NMA) to rank the priorities of various electrical stimulation methods, so as to select the optimal electrical stimulation method and discuss its rationality in guiding clinical practice.

Methods: We carried out a systematic review by searching a total of 6806 studies from 8 databases and 2 clinical trial registries, and finally screened out 34 studies for further investigation. Then, pairwise meta-analysis and Bayesian network meta-analysis were employed to evaluate the effectiveness and ranking of various interventions. The primary outcome measure was Fugl-Meyer Assessment Upper Extremity (FMA-UE), and the secondary outcome measures were Modified Barthel Index (MBI) and Modified Ashworth Scale (MAS). Finally, the risk of bias, publication bias and sensitivity of the Randomized Controlled Trials (RCTs) were evaluated.

Results: On the basis of comprehensive rehabilitation treatment (RT), the Functional Electrical Stimulation (FES) was superior than other electrical stimulation methods in improving both FMA-UE and MBI. Meanwhile, the results indicated that the Transcutaneous Electrical Acupoint Stimulation (TEAS) was the only electrical stimulation method that showed treatment advantages in reducing MAS.

Conclusion: The study showed that FES had the optimal overall rehabilitation effect on upper limb dysfunction of stroke patients based on the comprehensive RT, while the treatment effect of TEAS on upper limb spasticity after stroke was the most significant.
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http://dx.doi.org/10.2147/NDT.S332967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450164PMC
September 2021

Engineering outer membrane could facilitate better bacterial performance and effectively enhance poly-3-hydroxybutyrate accumulation.

Appl Environ Microbiol 2021 Sep 22:AEM0138921. Epub 2021 Sep 22.

State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi 214122, China.

Poly-3-hydroxybutyrate (PHB) is an environmentally friendly polymer and can be produced in cells after overexpressing the heterologous gene cluster . The biosynthesis of outer membrane (OM) consumes lots of nutrients and influences cell morphology. Here we engineered OM by disrupting all gene clusters relevant to polysaccharide portion of LPS, colanic acid (CA), flagella or/and fimbria in W3110. All these disruptions benefited PHB production. Especially, disrupting all these OM components improved PHB content to 83.0 wt%, while the wild-type control produced only 1.5 wt% PHB. The improvement was mainly due to the LPS truncation to Kdo-lipid A, which facilitated 82.0 wt% PHB with 25-fold larger cell volume; and disrupting CA facilitated 57.8 wt% PHB. In addition, disrupting LPS facilitated advantageous fermentation features including 69.1% less acetate, 550% higher percentage of autoaggregated cells among the total culture cells, 69.1% less biofilm and higher cellular broken ratio. Further detailed mechanism investigations showed that disrupting LPS caused global regulations on envelope and cellular metabolism: (i) sharply decrease of flagella, fimbria and secretions; (ii) more elastic cell; (iii) much more carbon flux towards acetyl-CoA and cofactors supply including NADP, NAD and ATP; (iv) decrease of byproduct acids but increase of γ-aminobutyric acid by activating σ factor. Disrupting CA, flagella and fimbria also improved the levels of acetyl-CoA and cofactors. The results indicated that engineering OM is an effective strategy to enhance PHB production, and highlighted the applicability of OM engineering to increase microbial cell factory performance. Understanding the detailed influence of OM on cell envelope and cellular metabolism is important for optimizing cell factory and many other microorganisms. This study revealed the applicability of remodeling OM to enhance PHB accumulation as representative inclusion bodies. The knowledge generated in this study provided insights concerning the influence and application of OM engineering, and gave essential references for producing other inclusion bodies or chemicals derived from acetyl-CoA or with the need of cofactor NADPH, NADH or ATP supply, and reducing byproduct acids. This study is promising to provide new ideas for the improvement of microbial cell factories.
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http://dx.doi.org/10.1128/AEM.01389-21DOI Listing
September 2021

Comparison of chidamide-contained treatment modalities versus chemotherapy in the second-line treatment for relapsed or refractory peripheral T-cell lymphoma.

Leuk Res 2021 Sep 14;111:106705. Epub 2021 Sep 14.

State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, PR China; Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, PR China. Electronic address:

Peripheral T-cell lymphoma (PTCL) is characterized by an aggressive clinical behavior. Chidamide has been approved for the treatment of relapsed/refractory (R/R) PTCL in China. We compared the efficacy of chidamide-contained regimens with chemotherapy (ChT) in R/R PTCL. Based on the second-line treatments, patients were divided into three groups, including ChT, ChT combined with chidamide (chidamide + ChT) and chidamide combined with or without other targeted agents (targeted therapy) group. Chidamide + ChT group had a better progression-free survival (PFS) compared with targeted therapy group (p = 0.013), and showed a trend towards superior PFS compared with ChT group (p = 0.079). Among patients with high second-line International Prognostic Index (IPI) (3-5), chidamide+ChT group had a longer PFS than ChT group(p = 0.018), and PFS in targeted therapy group was not inferior to that in chidamide+ChT group (p = 0.200). Among patients younger than 60 years, chidamide+ChT group demonstrated a PFS benefit over targeted therapy group (p = 0.010). Among CD30-negative patients, PFS was superior in the chidamide+ChT group compared with ChT group (p < 0.001). Conversely, results observed above were absent in patients with low second-line IPI or patients older than 60 years or CD30-positive patients. Overall, the combination of chidamide and ChT may be an effective treatment strategy for R/R PTCL.
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http://dx.doi.org/10.1016/j.leukres.2021.106705DOI Listing
September 2021

Pan-HDAC (Histone Deacetylase) Inhibitors Increase Susceptibility of Thoracic Aortic Aneurysm and Dissection in Mice.

Arterioscler Thromb Vasc Biol 2021 Nov 16;41(11):2848-2850. Epub 2021 Sep 16.

Department of Physiology and Pathophysiology (S.Z., Z. Liu, N.X., Z. Li, F.Y., Y.F., W.K.), School of Basic Medical Sciences, Peking University, Beijing, China.

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http://dx.doi.org/10.1161/ATVBAHA.121.316808DOI Listing
November 2021

Plasma Neurofilament Light and Future Declines in Cognition and Function in Alzheimer's Disease in the FIT-AD Trial.

J Alzheimers Dis Rep 2021 21;5(1):601-611. Epub 2021 Jul 21.

Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.

Background: Utilities of blood-based biomarkers in Alzheimer's disease (AD) clinical trials remain unknown.

Objective: To evaluate the ability of plasma neurofilament light chain (NfL) to predict future declines in cognition and activities of daily living (ADL) outcomes in 26 older adults with mild-to-moderate AD dementia from the FIT-AD Trial.

Methods: Plasma NfL was measured at baseline and 3 and 6 months. Cognition and ADL were assessed using the AD Assessment Scale-Cognition (ADAS-Cog) and AD Uniform Dataset Instruments and Disability Assessment for Dementia (DAD), respectively, at baseline, 3, 6, 9, and 12 months. Linear mixed effects models were used to examine the associations between baseline or change in plasma NfL and changes in outcomes.

Results: Higher baseline plasma NfL was associated with greater rate of decline in ADAS-Cog from baseline to 6 months (standardized estimate of 0.00462,  = 0.02853) and in ADL from baseline to 12 months (standardized estimate of -0.00284,  = 0.03338). Greater increase in plasma NfL in short term from baseline to 3 months was associated with greater rate of decline in memory and ADL from 3 to 6 months (standardized estimate of -0.04638 [0.003],  = 0.01635; standardized estimate of -0.03818,  = 0.0435) and greater rate of decline in ADL from 3 to 12 month (standardized estimate of -0.01492,  = 0.01082).

Conclusion: This study demonstrated that plasma NfL might have the potential to predict cognitive and function decline up to 12 months. However, future studies with bigger sample sizes need to confirm the findings.
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http://dx.doi.org/10.3233/ADR-210302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8385429PMC
July 2021

Serum Bilirubin Levels and Extent of Symptomatic Intracranial Atherosclerotic Stenosis in Acute Ischemic Stroke: A Cross-Sectional Study.

Front Neurol 2021 26;12:714098. Epub 2021 Aug 26.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

Bilirubin plays a paradoxical role in the pathological mechanism of stroke. To date, few clinical studies have investigated the effect of serum bilirubin on symptomatic intracranial atherosclerotic stenosis (sICAS). This study aims to evaluate the connection between serum bilirubin and sICAS. From September 2015 to May 2020, 1,156 sICAS patients without hepatobiliary diseases admitted to our hospital were included. Patients were distributed into none-mild (0-49%), moderate (50-69%) and severe-occlusion sICAS groups (70-100%) by the degree of artery stenosis. Moderate and severe-occlusion sICAS patients were classified into three groups by the number of stenotic arteries (single-, two- and multiple-vessel stenosis). The relationship between serum bilirubin levels and sICAS was analyzed by logistic regression analysis. In univariable analyses, sICAS patients with severe and multiple atherosclerotic stenoses had lower levels of total bilirubin (Tbil), direct bilirubin (Dbil), and indirect bilirubin (Ibil). In multinomial logistic regression analyses, when compared with the highest tertile of bilirubin, lower levels of Tbil, Dbil, and Ibil showed higher risks of severe-occlusion sICAS (95% CI: 2.018-6.075 in tertile 1 for Tbil; 2.380-7.410 in tertile 1 for Dbil; 1.758-5.641 in tertile 1 for Ibil). Moreover, the logistic regression analyses showed that lower levels of Tbil, Dbil, and Ibil were related to multiple (≥3) atherosclerotic stenoses (95% CI: 2.365-5.298 in tertile 1 and 2.312-5.208 in tertile 2 for Tbil; 1.743-3.835 in tertile 1 and 1.416-3.144 in tertile 2 for Dbil; 2.361-5.345 in tertile 1 and 1.604-3.545 in tertile 2 for Ibil) when compared with tertile 3. Our findings suggest that lower bilirubin levels may indicate severe and multiple intracranial atherosclerotic stenoses.
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http://dx.doi.org/10.3389/fneur.2021.714098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427197PMC
August 2021

KIF2C promotes the proliferation of hepatocellular carcinoma cells and .

Exp Ther Med 2021 Oct 2;22(4):1094. Epub 2021 Aug 2.

Department of General Surgery, The Secondary Hospital of Tianjin Medical University, Tianjin 300211, P.R. China.

Hepatocellular carcinoma (HCC) is one of the most common malignancies with high mortality and morbidity rates. In recent years, HCC targeted therapy has gained increasing attention. Due to the heterogeneity and high metastasis of HCC, more effective therapeutic targets are needed. Kinesin family member 2C (KIF2C), also known as mitotic centromere-associated kinesin, is a microtubule-based motor protein which is involved in a variety of important cellular processes, such as mitosis. The effects of KIF2C on cancer progression and development have been widely studied; however, its potential effects on HCC remains unclear. In the present study, high expression of KIF2C in human HCC tissues was demonstrated using The Cancer Genome Atlas database and immunohistochemistry assays. KIF2C expression was associated with HCC prognosis, including overall survival and disease-free survival. KIF2C expression was also associated with clinical pathological characteristics including the number of tumor nodes (P=0.015) and tumor size (P=0.009). KIF2C knockdown inhibited the proliferation of HCC cells , confirmed by MTT and colony formation assays, and suppressed tumor growth in mice which was confirmed by a xenograft mouse model. Together, the results suggested that KIF2C may serve as a promising therapeutic target for the treatment of HCC.
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http://dx.doi.org/10.3892/etm.2021.10528DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383772PMC
October 2021

Exercise Dose and Aerobic Fitness Response in Alzheimer's Dementia in the FIT-AD Trial.

Int J Sports Med 2021 Sep 7. Epub 2021 Sep 7.

Edison College of Nursing and Health Innovation, Arizona State University, Phoenix, United States.

The purpose of this study was to examine the effects of a 6-month cycling aerobic exercise intervention on cardiorespiratory fitness and the dose-response relationship in community-dwelling older adults with mild-to-moderate Alzheimer's dementia. The FIT-AD trial was a single blind, 2-parallel group, pilot randomized controlled trial. The aerobic exercise group participated in a 6-month, thrice weekly, moderate-vigorous intensity cycling intervention while control group performed stretching. Cardiorespiratory fitness was evaluated by peak oxygen consumption from cardiopulmonary exercise test and peak walking distance from the shuttle walk test and 6-minute walk test. Aerobic exercise dose was calculated using the novel heart rate physical activity score. The aerobic exercise group significantly increased peak oxygen consumption (1.28 ml/kg/min; p=.03) in subgroup who achieved maximal criteria on cardiopulmonary exercise test. Changes in peak oxygen consumption and peak walking distance on the shuttle walk and 6-minute walk tests did not significantly differ between aerobic exercise and stretching groups. Notably, the aerobic exercise dose was strongly and significantly correlated to change in peak oxygen consumption (r=.60; n=16; p=.01), in subset who met maximal test criteria. Emphasis on exercise dose is needed in aerobic exercise programs to maximize cardiorespiratory fitness gains in persons with mild-moderate Alzheimer's dementia.
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http://dx.doi.org/10.1055/a-1639-2307DOI Listing
September 2021

Association of Plasma Metabolic Biomarker Sphingosine-1-Phosphate With Cerebral Collateral Circulation in Acute Ischemic Stroke.

Front Physiol 2021 19;12:720672. Epub 2021 Aug 19.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

The contribution of metabolic profile to the cerebral collateral circulation in acute ischemic stroke (AIS) has not been fully outlined. In this study, we conducted a metabolomic study to assess the relationship between the metabolic biomarkers and the collateral status of AIS. A two-stage study was conducted from September 2019 to June 2021 in our hospital. There were 96 subjects including 66 patients with AIS and 30 healthy controls in the discovery stage and 80 subjects including 53 patients with AIS and 27 healthy controls in the validation stage. Collateral circulation was assessed by the Tan score based on computed tomographic angiography (CTA). Liquid chromatography-tandem mass spectrometry was used to identify differential metabolic markers. Then, an ELISA was employed to detect the plasma levels of sphingosine-1-phosphate (S1P). There were 114 differential metabolites between patients with AIS and control groups and 37 differential metabolites between good collateral circulation (GCC) and poor collateral circulation (PCC) groups. The pathway enrichment analysis revealed that arginine biosynthesis was the only statistically significant pathway between AIS and control groups and sphingolipid metabolism was the only statistically significant pathway between GCC and PCC groups. The differential metabolites sphinganine-1-phosphate (SA1P) and S1P belong to the sphingolipid metabolism. In the discovery stage, when the GCC group was compared with the PCC group, the receiver operating characteristic (ROC) analysis showed that plasma SA1P relative levels demonstrated an area under the curve (AUC) of 0.719 (95% CI: 0.582-0.834), and S1P levels demonstrated an AUC of 0.701 (95% CI: 0.567-0.819). In addition, both plasma SA1P and S1P relative levels showed significant negative correlations with the 90-day modified Rankin Scale (mRS) score. In the validation sample, higher plasma S1P levels were independent predictors of GCC ( = 0.014), and plasma S1P levels demonstrated an AUC of 0.738 (95% CI: 0.599-0.849) to differentiate patients with GCC from patients with PCC. In addition, plasma S1P levels also showed significant negative correlations with the 90-day mRS score. We first illustrated the association between plasma metabolic profiles and cerebral collateral circulation in patients with AIS. Plasma S1P levels might be a potential diagnostic biomarker for predicting collateral circulation status in patients with AIS.
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http://dx.doi.org/10.3389/fphys.2021.720672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8416917PMC
August 2021

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study.

Front Aging Neurosci 2021 13;13:698988. Epub 2021 Aug 13.

The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.

Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment. Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture ( = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event. Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were = 0.28 (adjusted) for males and = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were = 0.22 (adjusted) for individuals 18 to 39 years of age, = 0.31 (adjusted) for individuals 40 to 59 years of age, = 0.28 (adjusted) for those 60 to 79 years of age, and = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted = 0.42), the basal ganglia (adjusted = 0.22), the radiation crown (adjusted = 0.42), the diencephalon (adjusted = 0.20), or multiple partial strokes (adjusted = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, = 0.000). First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions. Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.
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http://dx.doi.org/10.3389/fnagi.2021.698988DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414891PMC
August 2021

Rapid simultaneous acquisition of macromolecular tissue volume, susceptibility, and relaxometry maps.

Magn Reson Med 2021 Sep 4. Epub 2021 Sep 4.

Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA.

Purpose: A major obstacle to the clinical implementation of quantitative MR is the lengthy acquisition time required to derive multi-contrast parametric maps. We sought to reduce the acquisition time for QSM and macromolecular tissue volume by acquiring both contrasts simultaneously by leveraging their redundancies. The joint virtual coil concept with GRAPPA (JVC-GRAPPA) was applied to reduce acquisition time further.

Methods: Three adult volunteers were imaged on a 3 Tesla scanner using a multi-echo 3D GRE sequence acquired at 3 head orientations. Macromolecular tissue volume, QSM, , T , and proton density maps were reconstructed. The same sequence (GRAPPA R = 4) was performed in subject 1 with a single head orientation for comparison. Fully sampled data was acquired in subject 2, from which retrospective undersampling was performed (R = 6 GRAPPA and R = 9 JVC-GRAPPA). Prospective undersampling was performed in subject 3 (R = 6 GRAPPA and R = 9 JVC-GRAPPA) using gradient blips to shift k-space sampling in later echoes.

Results: Subject 1's multi-orientation and single-orientation macromolecular tissue volume maps were not significantly different based on RMSE. For subject 2, the retrospectively undersampled JVC-GRAPPA and GRAPPA generated similar results as fully sampled data. This approach was validated with the prospectively undersampled images in subject 3. Using QSM, , and macromolecular tissue volume, the contributions of myelin and iron content to susceptibility were estimated.

Conclusion: We have developed a novel strategy to simultaneously acquire data for the reconstruction of 5 intrinsically coregistered 1-mm isotropic resolution multi-parametric maps, with a scan time of 6 min using JVC-GRAPPA.
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http://dx.doi.org/10.1002/mrm.28995DOI Listing
September 2021
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