Objective
To evaluate the efficacy of prednisolone in the treatment of medication‐overuse headache (MOH) using data from a multicenter prospective registry (Registry for Load and Management of ...Medication Overuse Headache RELEASE).
Background
The treatment of MOH is challenging, especially when withdrawal headache manifests during the cessation of overused medication. Although systemic corticosteroids have been empirically used to reduce withdrawal headaches, their efficacy on the long‐term outcomes of MOH has not been documented.
Methods
This was a post hoc analysis of the RELEASE study. The RELEASE is an ongoing multicenter observational cohort study in which patients with MOH have been recruited from seven hospitals in Korea since April 2020. Clinical characteristics, disease profiles, treatments, and outcomes were assessed at baseline and specific time points. We analyzed the effect of prednisolone on MOH reversal at 3 months.
Results
Among the 309 patients enrolled during the study period, prednisolone was prescribed to 59/309 (19.1%) patients at a dose ranging from 10 to 40 mg/day for 5–14 days; 228/309 patients (73.8%) completed the 3‐month follow‐up period. The MOH reversal rates at 3 months after baseline were 76% (31/41) in the prednisolone group and 57.8% (108/187) in the non‐prednisolone group (p = 0.034). The effect of steroids remained significant (adjusted odds ratio 2.78, 95% confidence interval 1.27–6.1, p = 0.010) after adjusting for the number of monthly headache days at baseline, mode of discontinuation of overused medication, use of early preventive medications, and the number of preventive medications combined.
Conclusions
Although our observational study could not draw a definitive conclusion, prednisolone may be effective in the treatment of MOH.
Identification of EGFR mutations is critical to the treatment of primary lung cancer and brain metastases (BMs). Here, we explored whether radiomic features of contrast-enhanced T1-weighted images ...(T1WIs) of BMs predict EGFR mutation status in primary lung cancer cases. In total, 1209 features were extracted from the contrast-enhanced T1WIs of 61 patients with 210 measurable BMs. Feature selection and classification were optimized using several machine learning algorithms. Ten-fold cross-validation was applied to the T1WI BM dataset (189 BMs for training and 21 BMs for the test set). Area under receiver operating characteristic curves (AUC), accuracy, sensitivity, and specificity were calculated. Subgroup analyses were also performed according to metastasis size. For all measurable BMs, random forest (RF) classification with RF selection demonstrated the highest diagnostic performance for identifying EGFR mutation (AUC: 86.81). Support vector machine and AdaBoost were comparable to RF classification. Subgroup analyses revealed that small BMs had the highest AUC (89.09). The diagnostic performance for large BMs was lower than that for small BMs (the highest AUC: 78.22). Contrast-enhanced T1-weighted image radiomics of brain metastases predicted the EGFR mutation status of lung cancer BMs with good diagnostic performance. However, further study is necessary to apply this algorithm more widely and to larger BMs.
Objective
To characterize the clinical features of patients with medication‐overuse headache (MOH) according to the class of acute medications being overused.
Background
MOH is a common global health ...problem, severely disabling the majority of the patients affected. Although various medications can cause MOH, whether clinical features differ according to the overused medication type remains unclear.
Methods
We analyzed data from a multicenter cross‐sectional study in neurology clinics in Korea from April 2020 to June 2021.
Results
Among 229 eligible patients, MOH was documented in patients who overused multiple drug classes (69/229, 30.1%; most frequent occurrence), triptans (50/229, 21.8%), non‐opioid analgesics (48/229, 21.0%), and combination‐analgesics (40/229, 17.4%). Patients who overused multiple drug classes reported more frequent use of acute medications (median 25th–75th percentiles: 25.0 15.0–30.0 vs. 17.5 10.0–25.5 days/month, p = 0.029) and fewer crystal‐clear days (0.0 0.0–9.5 vs. 9.0 0.0–10.0 days/month, p = 0.048) than those who overused triptans. Patients who overused multiple drug classes also reported shorter intervals from chronic daily headache to the onset of MOH than patients who overused combination‐analgesics (0.6 0.2–1.9 vs. 2.4 0.7–5.4 years, p = 0.001) or non‐opioid analgesics (1.5 0.6–4.3 years, p = 0.004). Patients who overused multiple drug classes reported more emergency room visits (1.0 0.0–1.0 visits/year) than those who overused combination‐analgesics (0.0 0.0–1.0, p = 0.024) or non‐opioid analgesics (0.0 0.0–1.0, p = 0.030). Patients who overused triptans reported fewer headache days (21.0 20.0–30.0 vs. 30.0 20.5–30.0 days/month, p = 0.008) and fewer severe headache days (7.0 4.0–10.0 vs. 10.0 5.0–15.0 days/month, p = 0.017) than those who overused non‐opioid analgesics.
Conclusions
Some clinical characteristics of MOH significantly differed according to the class of overused medications. The findings from this study may contribute to the understanding of the clinical characteristics and pathophysiology of MOH.
Aim: We investigated the effects of metabolic syndrome (MetS) and its components, including a body shape index (ABSI), on increased arterial stiffness measured using the cardio-ankle vascular index ...(CAVI) according to sex and age strata.Methods: A total of 7127 asymptomatic Korean participants aged 21–90 years (men, 69.4%) were included. Age–sex-specific increased CAVI was defined as having the highest quartile of CAVI in each age group.Results: The CAVI increased with age and was higher in men. MetS was associated with an increased risk of high CAVI by 1.30 times in men and 1.45 times in women. The risk of high CAVI with an increasing MetS risk score was greater in women. MetS was significantly associated with increased CAVI in men only aged 51–70 years and in women aged ≥ 51 years, and the size of association increased with age (odds ratio (OR) of 1.41 in 51–70 years vs. OR of 2.96 in ≥ 71 years of women). Among MetS components, triglyceride (men, all ages), hypertension (men, 51–70 years; women, ≤ 70 years), glucose intolerance (men, 51–70 years; women, ≥ 51 years), and HDL-cholesterol (women, ≥ 71 years) were associated with increased CAVI.Unlike increased waist circumference (WC), increased ABSI revealed an association with high CAVI. MetS diagnosed with ABSI instead of WC was more significantly associated with increased CAVI in all age–sex groups. Conclusion: The association of MetS and its components with increased CAVI differed with age and sex, which might provide a new insight for the management of MetS risk factors to promote vascular health.
Applying soil amendments such as biochar has been proposed as a means to improve soil properties and reduce greenhouse gas emission from agricultural soils. The objective of this study was to ...evaluate and compare the effects of biochar and straw application on rice yield, select soil properties, global warming potential (GWP), and greenhouse gas intensity (GHGI) over the 3-year period. The study treatments included control (CN), barley straw biochar (BC, 2,000 kg ha
−1
), barley straw (BS, 2,000 kg ha
−1
), and BC+BS (each 1,000 kg ha
−1
). During the rice-growing season, significant interactive effects of BC and BS treatment were observed in major soil properties. The average rice yields in BC, BS, and BC+BS treatments increased by 4.6%, 4.7%, and 18.7%, compared with CN treatment, respectively. Also, BC+BS treatment produced relatively stable yield during the 3-year study. Both BC and BS applications, either alone or in combination, lowered soil bulk density values compared to the CN treatment. Further, BC application produced a low total CH
4
flux than other treatments. The total produced GWP over the 3 years occurred in the order: BS ≧ CN > BC+BS > BC treatment. These results clearly demonstrate the advantages of biochar and straw applications in improving rice yield and soil fertility while reducing GWP and GHGI.
Mechanosensory feedback from the digestive tract to the brain is critical for limiting excessive food and water intake, but the underlying gut-brain communication pathways and mechanisms remain ...poorly understood
. Here we show that, in mice, neurons in the parabrachial nucleus that express the prodynorphin gene (hereafter, PB
neurons) monitor the intake of both fluids and solids, using mechanosensory signals that arise from the upper digestive tract. Most individual PB
neurons are activated by ingestion as well as the stimulation of the mouth and stomach, which indicates the representation of integrated sensory signals across distinct parts of the digestive tract. PB
neurons are anatomically connected to the digestive periphery via cranial and spinal pathways; we show that, among these pathways, the vagus nerve conveys stomach-distension signals to PB
neurons. Upon receipt of these signals, these neurons produce aversive and sustained appetite-suppressing signals, which discourages the initiation of feeding and drinking (fully recapitulating the symptoms of gastric distension) in part via signalling to the paraventricular hypothalamus. By contrast, inhibiting the same population of PB
neurons induces overconsumption only if a drive for ingestion exists, which confirms that these neurons mediate negative feedback signalling. Our findings reveal a neural mechanism that underlies the mechanosensory monitoring of ingestion and negative feedback control of intake behaviours upon distension of the digestive tract.
The gut microbiome can influence the development of tumours and the efficacy of cancer therapeutics
; however, the multi-omics characteristics of antitumour bacterial strains have not been fully ...elucidated. In this study, we integrated metagenomics, genomics and transcriptomics of bacteria, and analyses of mouse intestinal transcriptome and serum metabolome data to reveal an additional mechanism by which bacteria determine the efficacy of cancer therapeutics. In gut microbiome analyses of 96 samples from patients with non-small-cell lung cancer, Bifidobacterium bifidum was abundant in patients responsive to therapy. However, when we treated syngeneic mouse tumours with commercial strains of B. bifidum to establish relevance for potential therapeutic uses, only specific B. bifidum strains reduced tumour burden synergistically with PD-1 blockade or oxaliplatin treatment by eliciting an antitumour host immune response. In mice, these strains induced tuning of the immunological background by potentiating the production of interferon-γ, probably through the enhanced biosynthesis of immune-stimulating molecules and metabolites.
Nonalcoholic fatty liver disease (NAFLD) is a condition characterized by hepatic accumulation of excess lipids. T cells are commonly classified into various subsets based on their surface markers ...including T cell receptors, type of antigen presentation and pathophysiological functions. Several studies have implicated various T cell subsets and natural killer (NK) cells in the progression of NAFLD. While NK cells are mainly components of the innate hepatic immune system, the majority of T cell subsets can be part of both the adaptive and innate systems. Several studies have reported that various stages of NAFLD are accompanied by the accumulation of distinct T cell subsets and NK cells with different functions and phenotypes observed usually resulting in proinflammatory effects. More importantly, the overall stimulation of the intrahepatic T cell subsets is directly influenced by the homeostasis of the gut microbiota. Similarly, NK cells have been found to accumulate in the liver in response to pathogens and tumors. In this review, we discussed the nature and pathophysiological roles of T cell subsets including γδ T cells, NKT cells, Mucosal-associated invariant T (MAIT) cells as well as NK cells in NAFLD.
Two-dimensional (2D) piezoelectric hexagonal boron nitride nanoflakes (h-BN NFs) were synthesized by a mechanochemical exfoliation process and transferred onto an electrode line-patterned plastic ...substrate to characterize the energy harvesting ability of individual NFs by external stress. A single BN NF produced alternate piezoelectric output sources of ∼50 mV and ∼30 pA when deformed by mechanical bendings. The piezoelectric voltage coefficient (g 11) of a single BN NF was experimentally determined to be 2.35 × 10–3 V·m·N–1. The piezoelectric composite composed of BN NFs and an elastomer was spin-coated onto a bulk Si substrate and then transferred onto the electrode-coated plastic substrates to fabricate a BN NFs-based flexible piezoelectric energy harvester (f-PEH) which converted a piezoelectric voltage of ∼9 V, a current of ∼200 nA, and an effective output power of ∼0.3 μW. This result provides a new strategy for precisely characterizing the energy generation ability of piezoelectric nanostructures and for demonstrating f-PEH based on 2D piezomaterials.
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