Patients with Rett syndrome (RTT) show severe difficulties with communication, social withdrawl, and learning. Music-based interventions improve social interaction, communication skills, eye contact, ...and physical skills and reduce seizure frequency in patients with RTT. This study aimed to investigate the mechanism by which music-based interventions compromise sociability impairments in mecp2 null/y mice as an experimental RTT model. Male mecp2 null/y mice and wild-type mice (24 days old) were randomly divided into control, noise, and music-based intervention groups. Mice were exposed to music or noise for 6 h/day for 3 consecutive weeks. Behavioral patterns, including anxiety, spontaneous exploration, and sociability, were characterized using open-field and three-chamber tests. BDNF, TrkB receptor motif, and FNDC5 expression in the prefrontal cortex (PFC), hippocampus, basal ganglia, and amygdala were probed using RT-PCR or immunoblotting. mecp2 null/y mice showed less locomotion in an open field than wild-type mice. The social novelty rather than the sociability of these animals increased following a music-based intervention, suggesting that music influenced the mecp2-deletion-induced social interaction repression rather than motor deficit. Mechanically, the loss of BDNF signaling in the prefrontal cortex and hippocampal regions, but not in the basal ganglia and amygdala, was compromised following the music-based intervention in mecp2 null/y mice, whereas TrkB signaling was not significantly changed in either region. FNDC5 expression in the prefrontal cortex region in mecp2 null/y mice also increased following the music-based intervention. Collective evidence reveals that music-based interventions improve mecp2-loss-induced social dysfunction. BDNF and FNDC5 signaling in the prefrontal cortex region mediates the music-based-intervention promotion of social interactions. This study gives new insight into the mechanisms underlying the improvement of social behaviors in mice suffering from experimental Rett syndrome following a music-based intervention.
BACKGROUND—Substantial infective endocarditis (IE)–related morbidity and mortality may occur even after successful treatment. However, no previous study has explored long-term hard end points (ie, ...stroke, myocardial infarction, heart failure, cardiovascular death) in addition to all-cause mortality in IE survivors.
METHODS AND RESULTS—A nationwide population-based cohort study was conducted among IE survivors identified with the use of the Taiwan National Health Insurance Research Database during 2000 to 2009. IE survivors were defined as those who survived after discharge from first hospitalization with a diagnosis of IE. A total of 10 116 IE survivors were identified. IE survivors were matched to control subjects without IE at a 1:1 ratio through the use of propensity scores. The primary outcomes were stroke, myocardial infarction, readmission for heart failure, and sudden cardiac death or ventricular arrhythmia. The secondary outcomes were repeat IE and all-cause mortality. Compared with the matched cohort, IE survivors had higher risks of ischemic stroke (adjusted hazard ratio aHR, 1.59; 95% confidence interval CI, 1.40–1.80), hemorrhagic stroke (aHR, 2.37; 95% CI, 1.90–2.96), myocardial infarction (aHR, 1.44; 95% CI, 1.17–1.79), readmission for heart failure (aHR, 2.24; 95% CI, 2.05–2.43), sudden death or ventricular arrhythmia (aHR, 1.69; 95% CI, 1.44–1.98), and all-cause death (aHR, 2.27; 95% CI, 2.14–2.40). Risk factors for repeat IE were older age, male sex, drug abuse, and valvular replacement after an initial episode of IE.
CONCLUSION—Despite treatment, the risk of long-term major adverse cardiac events was substantially increased in IE survivors.
Chronic kidney disease (CKD) is a public health problem and its prevalence has increased worldwide; patients are commonly unaware of the condition. The present study aimed to investigate whether ...exhaled breath ammonia via vertical-channel organic semiconductor (V-OSC) sensor measurement could be used for rapid CKD screening. We enrolled 121 CKD stage 1–5 patients, including 19 stage 1 patients, 26 stage 2 patients, 38 stage 3 patients, 21 stage 4 patients, and 17 stage 5 patients, from July 2019 to January 2020. Demographic and laboratory data were recorded. The exhaled ammonia was collected and rapidly measured by the V-OSC sensor to correlate with kidney function. Results showed no significant difference in age, sex, body weight, hemoglobin, albumin level, and comorbidities in different CKD stage patients. Correlation analysis demonstrated a good correlation between breath ammonia and blood urea nitrogen levels, serum creatinine levels, and estimated glomerular filtration rate (eGFR). Breath ammonia concentration was significantly elevated with increased CKD stage compared with the previous stage (CKD stage 1/2/3/4/5: 636 ± 94; 1020 ± 120; 1943 ± 326; 4421 ± 1042; 12781 ± 1807 ppb, p < 0.05). The receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.835 (p < 0.0001) for distinguishing CKD stage 1 from other CKD stages at 974 ppb (sensitivity, 69%; specificity, 95%). The AUC was 0.831 (p < 0.0001) for distinguishing between patients with/without eGFR < 60 mL/min/1.73 m2 (cutoff 1187 ppb: sensitivity, 71%; specificity, 78%). At 886 ppb, the sensitivity increased to 80% but the specificity decreased to 69%. This value is suitable for kidney function screening. Breath ammonia detection with V-OSC is a real time, inexpensive, and easy to administer measurement device for screening CKD with reliable diagnostic accuracy.
This paper explores how information is shared across the vertical and horizontal boundaries of government agencies. Different types of information sharing are identified and discussed in terms of ...their strengths and encountered challenges. Centralized types of information sharing are found as a primary strategy adopted to facilitate interagency information sharing in the two dimensions. Particularly, influential determinants from type comparisons and government agencies are identified and discussed regarding what agencies may take into considerations when selecting certain types of information sharing. While there is no single type of information sharing that can satisfy all the needs and concerns of government agencies, most agencies still simultaneously employ several types of information sharing in different circumstances. A competition-and-cooperation relationship exists among the different types of information sharing in both dimensions. The paper suggests that a balance between centralized and decentralized types of information sharing should be achieved to obtain advantages and diminish disadvantages. The similarities and differences between the types in the two dimensions are also compared and discussed. Lastly, the conclusion outlines the contribution and limitation of the current research and suggests future studies of the current work.
•Centralized types of information sharing are found as a primary adopted strategy.•Types of information sharing in the vertical dimension are discussed.•Types of information sharing in the horizontal dimension are discussed.•A competition-and-cooperation relationship exists among the different types.•A balance between centralization and decentralization is discussed.
We report on a ∼5σ detection of polarized 3–6 keV X-ray emission from the supernova remnant Cassiopeia A (Cas A) with the Imaging X-ray Polarimetry Explorer (IXPE). The overall polarization degree of ...1.8% ± 0.3% is detected by summing over a large region, assuming circular symmetry for the polarization vectors. The measurements imply an average polarization degree for the synchrotron component of ∼2.5%, and close to 5% for the X-ray synchrotron-dominated forward shock region. These numbers are based on an assessment of the thermal and nonthermal radiation contributions, for which we used a detailed spatial-spectral model based on Chandra X-ray data. A pixel-by-pixel search for polarization provides a few tentative detections from discrete regions at the ∼ 3σ confidence level. Given the number of pixels, the significance is insufficient to claim a detection for individual pixels, but implies considerable turbulence on scales smaller than the angular resolution. Cas A's X-ray continuum emission is dominated by synchrotron radiation from regions within ≲1017 cm of the forward and reverse shocks. We find that (i) the measured polarization angle corresponds to a radially oriented magnetic field, similar to what has been inferred from radio observations; (ii) the X-ray polarization degree is lower than in the radio band (∼5%). Since shock compression should impose a tangential magnetic-field structure, the IXPE results imply that magnetic fields are reoriented within ∼1017 cm of the shock. If the magnetic-field alignment is due to locally enhanced acceleration near quasi-parallel shocks, the preferred X-ray polarization angle suggests a size of 3 × 1016 cm for cells with radial magnetic fields.
An elevated level of serum C-reactive protein (CRP) is widely considered an indicator of an underlying inflammatory disease and a long-term prognostic predictor for dialysis patients. This ...cross-sectional cohort study was designed to assess the correlation between the level of high-sensitivity CRP (HS-CRP) and the outcome of peritoneal dialysis (PD) patients.
A total of 402 patients were stratified into 3 tertiles (lower, middle, upper) according to serum HS-CRP level and and followed up from October 2009 to September 2011. During follow-up, cardiovascular events, infection episodes, technique failure, and mortality rate were recorded.
During the 24-month follow-up, 119 of 402 patients (29.6%) dropped out from PD, including 28 patients (7.0%) who died, 81 patients (20.1%) who switched to hemodialysis, and 10 patients (2.5%) who underwent kidney transplantation. The results of Kaplan-Meier analysis and log-rank test demonstrated a significant difference in the cumulative patient survival rate across the 3 tertiles (the lowest rate in upper tertile). On multivariate Cox regression analysis, only higher HS-CRP level, older age, the presence of diabetes mellitus (DM), lower serum albumin level, and the occurrence of cardiovascular events during follow-up were identified as independent predictors of mortality. Every 1 mg/L increase in HS-CRP level was independently predictive of a 1.4% increase in mortality. Multivariate Cox regression analysis also showed that higher HS-CRP level, the presence of DM, lower hemoglobin level, lower serum albumin level, higher dialysate/plasma creatinine ratio, and the occurrence of infective episodes and cardiovascular events during follow-up were independent predictors of technique failure.
The present study shows the importance of HS-CRP in the prediction of 2-year mortality and technique survival in PD patients independent of age, diabetes, hypoalbuminemia, and the occurrence of cardiovascular events.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective Factors associated with testicular torsion (TT) and consequent orchiectomy in patients presenting to pediatric emergency departments (PEDs) with scrotal pain (SP) are not well described. We ...report the factors predicting TT and consequent orchiectomy in children with SP. Methods The data on patients (aged ≤18 years) who presented with SP to PEDs at 4 branches of the Chang Gung Hospital through 10 years were analyzed. Results In all, 256 pediatric patients presented with SP. Their mean age was 11.60 ± 4.61 years and 72.7% (n = 186) were aged 10 to 18 years. The pain was left-sided in 54.7% (n = 140) and the interval between SP onset and PED arrival was 22.45 ± 31.27 hours. Overall, 84 (32.8%) patients needed surgery and 72 (28.1%) had TT. Of the patients with TT, 28 (38.9%) patients needed an orchiectomy. After analysis, TT and consequent orchiectomy were associated with a longer interval between SP onset and PED arrival, absent of testicular ultrasonic blood flow, interval between SP onset and surgery of more than 24 hours, and a high degree of TT. None of them experienced recurrent SP symptoms or TT again. Conclusions The rate of TT in patients presenting to PEDs with an SP was 28.1%, and 38.9% of the patients with TT needed an orchiectomy. Early diagnosis and intervention helped to prevent subsequent orchiectomy in pediatric patients with TT.
The microstructure and surface properties of the optimal nanostructured-gold (ONG) film were characterized using scanning electron microscopy, transmission electron microscopy, X-ray diffraction, ...nanoindentation and static contact angle evaluation in the present study. A three-dimensional model of human liver was reconstructed using magnetic resonance imaging to simulate the thermomechanical performance of the ONG film by means of finite element model analysis. Moreover, a monopolar electrosurgical unit equipped with needle type uncoated stainless steel (U-SS) and ONG film coated stainless steel (ONG-SS) electrodes was used to investigate the thermal distribution in the liver of rats. Experimental results showed that the temperature decreased significantly when using the ONG-SS electrode. The ONG-SS electrode also created a relatively small thermal injury area and lateral thermal effect. Furthermore, thermography indicated that the ONG-SS electrode exhibited a significantly lower surgical temperature as compared with the U-SS electrode during electrosurgery process in rats. Therefore, it could be demonstrated that the ONG-SS electrode is a promising biomedical device for reducing excessive thermal injury and decreasing adherence tissue in electrosurgery.
•The nano-Au coated electrode possessed a well hydrophilicity surface.•The temperature decreased significantly in the nano-Au coated electrode.•The nano-Au coated electrode created a relatively small thermal injury area and lateral thermal effect.
•In this 2-year cohort that included cases of 127 trauma-related deaths in a trauma center in central Taiwan, 8 (6.3%), 8 (6.3%), and 111 (87.4%) deaths were categorized as definite preventable, ...potentially preventable, and non-preventable, respectively, based on trauma and injury severity score (TRISS) and the opinion of a panel.•Among the definite preventable and potentially preventable deaths, pre-defined categories of inadequate infection prevention/control, delayed treatment, delayed diagnosis, and technical error were identified in six (37.5%), five (31.2%), three (18.8%), and two (12.5%) cases, respectively.•The quality of postoperative care is as important as timely diagnosis and treatment for the prevention of trauma-related deaths.
The preventable death rate (PDR) is an important parameter in the quality assurance of traumatic care. Medical errors or untimely management may occur during stressful trauma care, resulting in preventable deaths. We aimed to develop an applicable PDR model in a trauma center in middle Taiwan.
We identified adult trauma-related deaths which occurred from January 1, 2018 to December 31, 2019 at our hospital. Patients with a trauma and injury severity score (TRISS) <75% or ≥75% but with a chance of preventability, as determined by a trauma surgeon, were discussed by a panel comprising an emergency physician and surgeons specializing in different fields of medicine. Deaths were subsequently classified as definitely preventable (DP), potentially preventable (PP), or non-preventable (NP). Causes of DP or PP deaths were categorized as delayed diagnosis, delayed treatment, technical error, or inadequate infection prevention/control. The relationship between the time and cause of preventable deaths was also analyzed.
This study included 127 trauma-related deaths, of which 39 were discussed by the panel. Eight patients (6.3%) were categorized as DP, eight (6.3%) as PP, and 111 (87.4%) as NP. Among patients with preventable deaths, inadequate infection prevention/control, delayed treatment, delayed diagnosis, and technical error were identified in six (37.5%), five (31.2%), three (18.8%), and two (12.5%) patients, respectively. Four patients in the inadequate infection prevention/control group (4/6, 66.7%) died of aspiration pneumonia during the recovery phase.
A PDR evaluation model was developed and revealed that postoperative care is as important as a timely diagnosis and treatment to avoid preventable deaths following trauma.
PDF
