Conectar
by Xuying Zhang, Johanna Mainzer, Isabella Giambra, Tong Yin, Petra Engel, Hannah Hümmelchen, Henrik Wagner, Axel Wehrend, Christiane Egerer, Katharina Gerhards, Gerald Reiner, Sven König
Long tails trigger tail biting in pigs and increase the risk of flystrike infections in sheep. Tail docking has been a common management practice in both species for decades, but increasingly conflicts with legal animal welfare guidelines. Sustainable solutions require breeding strategies targeting shorter tails. In consequence, the aims were to conduct whole-genome sequencing (WGS)-based genome-wide association studies (GWAS) and comparative genomic analyses (CGA) to explore functional elements influencing tail traits. Phenotypically divergent experimental populations of pigs and sheep were established through unified selection and mating experiments. Tail traits included tail length (TL) measured at birth, and tail abnormalities (TA) assessed radiographically at 14 weeks of age. WGS-based GWAS identified a significant locus on SSC18 in pigs and suggestive loci for TL in both species, which, together with previously reported loci for TA, were further analyzed by CGA. The genomic windows of the significant locus on SSC18 in pigs and the TL GWAS locus on OAR4 in sheep were found to be conserved, harboring six common genes with predicted functional variants. These variants were jointly associated with TL (Plm ) in both species in linear regression models adjusted for sex, age of the dam, body length, and body weight. In other GWAS locus windows (±1 Mb), species-specific TL candidate genes were identified in sheep (HOXB13, MUC5B, EPB41L3, MTCL1, PIEZO2, MPPE1, and LOXHD1) and in pigs (KNL1, DISP2, SPRED1, TGFB2, and HAND1), each harboring associated putative functional variants. For TA, sheep-specific candidates (PGM2, LRRC66, CRACD, LOC105601916, and SH2D4B) and pig-specific candidates (MYOT, TMCO6, and PCDHAC2) were revealed using logistic regression models (Pglm ). GO analyses of candidate genes predicted shared biological processes between sheep and pigs, whereas pathway analyses indicated that common carbohydrate metabolism pathways, along with species-specific immune and inflammatory signaling, and pig-specific TGF-β signaling and endochondral ossification, may contribute to tail length variation and abnormalities. These findings provided deeper insights into the genetic basis of differential embryonic tail morphogenesis and perinatal tail development across species.by Job Kasule, Julius L. Tonzel, Natalie Burns, Tyler Hamby, Roger Ying, Grace Mirembe, Immaculate Nakabuye, Hannah Kibuuka, Margaret Yacovone, Betty Mwesigwa, Trevor A. Crowell, for the Multinational Observational Cohort of HIV and other Infections (MOCHI) Study Group
BackgroundPeople with behavioral vulnerability to HIV face barriers to healthcare engagement that may impede uptake of non-pharmaceutical and other interventions to prevent COVID-19. Understanding COVID-19 knowledge, attitudes, and practices in this population can inform disease prevention efforts during future pandemics.
Materials and methodsFrom October 2022 to September 2024, we enrolled participants aged 14–55 years without HIV who endorsed recent sexually transmitted infection, injection drug use, transactional sex, condomless sex, and/or anal sex with male partners. At enrollment, we collected socio-behavioral data, including assessments of COVID-19 knowledge, attitudes, and practices. Robust Poisson regression with purposeful variable selection was used to estimate prevalence ratios with 95% confidence intervals for factors associated with COVID-19 preventive practices.
ResultsAmong 418 participants, 228 (56.9%) were female, the median age was 21 years (interquartile range 19−24), and 362 (84.9%) reported sex work. Knowledge about SARS-CoV-2 transmission routes was high (95.4%) but lower for the consequences of genetic variants (48.5%−69.7%) and possibility for asymptomatic infection or transmission (66.7%−80.8%). Handwashing was practiced by 90.8% of participants in the preceding month, whereas mask-wearing (76.5%), avoiding symptomatic people (73.7%), and any history of COVID-19 vaccination (46.9%) were less prevalent. Males were more likely to report avoiding symptomatic people (adjusted prevalence ratio 1.16 [95% confidence interval 1.03–1.31]) and COVID-19 vaccination (1.30 [1.05–1.60]). Enrollment during the BQ.1/BQ.1.1 Omicron wave was associated with less mask-wearing (0.81 [0.67–0.99]) but more vaccination (1.59 [1.29–1.95]).
DiscussionWe observed variable COVID-19 knowledge and attitudes among Ugandan adolescents and adults with little impact on COVID-19 preventive practices. Efforts to address suboptimal uptake of disease preventive practices during this and future disease outbreaks will require more than just improving knowledge.
Postoperative sleep disturbance (PSD) is a common complication following major surgery, occurring in 15%–72% of patients. PSD poses a significant threat to both postoperative recovery and long-term outcome, leading to elevated risks of cognitive decline, pain sensitivity and cardiovascular events in patients. The current pharmacological treatments for PSD are typically reactive, administered only after symptoms have manifested, highlighting a critical unmet need for effective prophylactic strategies during the perioperative period. Recently, an increasing number of studies have demonstrated the effect of esketamine on preventing PSD, but their findings are inconsistent. This protocol outlines a systematic review and meta-analysis to examine the effect of perioperative esketamine on the prevention of PSD.
A comprehensive search will be conducted in MEDLINE (via Ovid), EMBASE (via Ovid), the Cochrane Central Register of Controlled Trials (via Ovid), PubMed and Web of Science by two authors independently. The search terms will comprise indexed and free-text terms to encompass the concepts of esketamine and PSD. The primary outcome is the incidence of PSD at postoperative days 1, 3 and 7. Two authors will independently conduct study screening, data extraction and risk of bias assessment with the Cochrane Collaboration’s tool. RevMan V.5.4.1 and Stata V.17.0 software will be used to conduct the statistical analysis. Subgroup analysis, sensitivity analysis and assessment of publication bias will be performed to verify the strength of our conclusions. Finally, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to recommend evidence quality.
Ethical approval is not required for this study. The findings will be presented at national or international conferences and submitted to a peer-reviewed journal.
CRD420251232636.
To assess the levels of knowledge, attitudes and practices (KAP) toward skin cancer prevention among Malaysian adults and to examine differences in KAP across socio-demographic groups.
Cross-sectional online survey.
Community-based study conducted in Malaysia using social media recruitment.
A total of 386 adults aged ≥18 years residing in Malaysia. Most participants were young adults (86.3%), female (55.4%) and of Chinese ethnicity (65.5%). Healthcare professionals were excluded.
Primary outcomes were levels of knowledge, attitude and preventive practices toward skin cancer, measured using the validated KAP-SC-Q (Knowledge, Attitude and Practice of Skin Cancer Questionnaire) and categorised as poor, moderate or good. Secondary outcomes included differences in KAP across socio-demographic and clinical characteristics, analysed using independent t-tests and 2 tests.
Over half of participants demonstrated poor knowledge of skin cancer (56.0%) and the vast majority showed inadequate preventive practices (84.2%), while attitudes toward skin cancer were predominantly positive (62.4%). Significant differences in mean KAP scores and categorical levels were observed across several socio-demographic variables. Participants with tertiary education had higher knowledge (14.32 vs 12.61) and attitude scores (20.01 vs 15.95; p
Malaysian adults exhibited limited knowledge and very poor preventive practices toward skin cancer despite generally positive attitudes. These findings highlight substantial gaps between awareness and behaviour and support the need for targeted public health interventions to correct misconceptions, improve risk perception especially in high-risk groups and promote effective ultraviolet protection behaviours.
by Peiling Zuo, Huanhuan Zhu, Chunying Sun, Xiaohan Ma, Sheng Chen, Rong Tang, Tong Wu, Ding Zhang, Xiao Tang, Wenquan Lv, Wenzhong Chen, Xiawei Wei, Encun Hou, Minsheng Wu, Minghe Jiang
BackgroundEvidence indicates that the Endothelial Activation and Stress Index (EASIX) is a predictor of mortality in endothelium-related conditions; however, its association with mortality risk in atrial fibrillation (AF) remains uncertain. Accordingly, this study examines the relationship between EASIX and mortality risk among patients with AF.
MethodsThis retrospective analysis utilized data from the Medical Information Marketplace in Intensive Care IV (MIMIC-IV) database, which includes critically ill patients diagnosed with AF. To examine the association between EASIX scores and mortality, Kaplan–Meier survival analysis, Cox proportional hazards models, and restricted cubic spline regression were applied to evaluate the relationship between EASIX and all-cause mortality. Subgroup analyses were conducted to explore potential interactions with key patient characteristics, and sensitivity analyses were performed to further confirm the robustness of the results.
ResultsA total of 3,193 patients were included in the analysis. KM survival analysis showed that elevated EASIX levels were associated with a higher risk of both in-hospital and ICU mortality. After adjusting for potential confounders, increased EASIX levels remained significantly associated with in-hospital mortality [HR, 1.09 (95% CI 1.03, 1.15), P = 0.0002] and ICU mortality [HR, 1.10 (95% CI 1.04, 1.17), P = 0.0002]. Stratified analyses revealed a significant interaction between sepsis, respiratory failure, and EASIX in relation to both in-hospital and ICU mortality. To evaluate the robustness of the findings, a sensitivity analysis was performed. After additionally adjusting for metoprolol and heparin as covariates, patients in the highest EASIX group continued to demonstrate the greatest mortality risk: the HR for in-hospital death was 2.08 (95% CI: 1.51–2.85), and the HR for ICU death was 1.83 (95% CI: 1.21–2.65).
ConclusionElevated EASIX levels correlate with higher mortality rates, underscoring its potential as an accessible tool for identifying high-risk patients and informing clinical decisions. However, further studies are needed to explore the underlying mechanisms and validate its applicability across diverse patient populations.
by Dandan Feng, Yakun Song, Zuqi Wu, Wuruo Liu, Yuting Pu, Yangcan Gao, Yuying Sun, Jiquan Zhang
Trypsin, a canonical serine protease in crustaceans, plays a crucial role in ontogeny and antibacterial defense. Whether these biological functions correlate with its catalytic characteristics remains unresolved in the freshwater shrimp Neocaridina denticulata sinensis. To address this gap, we characterized a trypsin gene from N. denticulata sinensis (NdTryp) and assessed both its biological roles and its prospective utility. NdTryp was predominantly expressed in the hepatopancreas, where it localized to storage cells (R-cells) and tubule-lining epithelial cells (ECTs). Across development, NdTryp transcripts were essentially absent during early embryogenesis but rose sharply at late stages, temporally coincident with hatching and the onset of feeding. After a challenge with Vibrio parahaemolyticus, the expression of NdTryp was induced, with the expression level significantly increased relative to the baseline expression level. RNA interference-mediated knockdown rendered shrimp more susceptible to infection and was accompanied by extensive hepatopancreatic injury, including epithelial detachment and disruption of the basement membrane. Biochemically, recombinant NdTryp (rNdTryp) displayed proteolytic activity over a broad temperature and pH span. Activity was differentially tuned by metal ions, with several divalent cations producing marked enhancement, whereas ferric iron exerted strong inhibition. Overall, our results showed that NdTryp functions as a multifunctional protease involved in both late embryonic development and innate antimicrobial defense. Furthermore, the robust stability of rNdTryp underscores its potential as an aquafeed additive and candidate for enzymatic biotransformation.Despite international efforts to address women’s long-term health and well-being, significant gaps in sexual and reproductive health (SRH) services and non-communicable diseases (NCDs) prevention remain, particularly in low-and-middle-income countries (LMICs).
We analysed data from 726 278 women aged 15–49 from six national surveys (2017–2021, Benin, Cameroon, Gabon, India, Madagascar and Mauritania) on unmet needs for NCD prevention (blood pressure, glucose, cervical cancer screening) and SRH services (contraception, antenatal, postnatal care). Unmet needs prevalence was calculated as the percentage of participants with specific unmet needs and estimated across demographics and socioeconomic groups using multivariable logistic regression models.
Unmet needs were strikingly high for NCD prevention: 36.6% for blood pressure, 70.0% for blood glucose and 98.5% for cervical cancer screening. In contrast, unmet needs for contraception, antenatal care and postnatal care were relatively lower: 7.5%, 14.5% and 14.5%, respectively. Significant variations were observed across countries. India had the lowest unmet needs for SRH services: 6.7% for contraception, 13.1% for antenatal care and 13.1% for postnatal care. Gabon had lower unmet needs for prenatal (16.8%) and postnatal care (14.8%) compared with other African countries and the lowest unmet need for cervical screening at 84.7% (95% confidential interval 83.1% to 86.2%), over 10 percentage points lower than others. Furthermore, socioeconomic factors like higher education, better economic status, healthcare access, insurance and internet use significantly lowered unmet needs, especially for antenatal and postnatal care. Employed women had higher unmet needs for antenatal (35.7%) and postnatal (37.3%) care than unemployed women (28.1%, 27.8%) but lower for NCDs prevention (98.9%, 71.8%) under two definitions than unemployed women (99.3%, 79.2%).
This study highlights the urgent need to address high unmet needs for NCD prevention among women in LMICs, particularly cervical cancer screening. Unmet SRH needs are also a major concern, given significant disparities across countries. Especially, governments should prioritise measures to focus on vulnerable groups.
The aim of this study was to develop a predictive model of nutritional risk in elderly CAPI patients through retrospective cross-sectional data, to identify core predictors applicable to community/nursing home settings, and to validate the predictive augmentation of the combined Braden Score and Nutritional Blood Indicator in hospitalised patients, to provide a basis for stratified nutritional risk management. A retrospective study was conducted to include 424 elderly CAPI patients. They were divided into two groups according to NRS2002 score. Demographic parameters, physiological function parameters and blood parameters were collected. All above indicators of the patients with CAPI were analysed to explore their correlation with nutritional risk. Among 424 participants, 294 patients (69.34%) were at nutritional risk. Independent risk factors identified were aged ≥ 70 years, reduced intake in the last week, and decrease in BMI, Braden score, ALB (albumin), and PA (prealbumin) levels. The AUCs of the first four parameters mentioned above and all the above parameters were 0.816 and 0.872, respectively. The value of aged ≥ 70 years, reduced intake in the past week, BMI, and Braden score in combination to predict and assess nutritional risk is high, which can be used to predict nutritional risk for elderly patients with CAPI who are at home or in nursing homes. The combination of the above parameters combined with albumin and prealbumin has an even higher predictive value in elderly patients hospitalised with CAPI.
by Hongfei Yang, Chao Sun, Ya Li, You Zhou, Rui Wang, Yingxue Li
ObjectiveThe triglyceride-glucose index and estimated glucose disposal rate serve as notable surrogate markers of insulin resistance, demonstrating established links to cardio-cerebrovascular disease. However, their combined prognostic value in predicting cardio-cerebrovascular disease outcomes remains unexplored. The current investigation examined the interaction between the TyG (triglyceride–glucose index) index and eGDR (estimated glucose disposal rate) concerning the danger of cardiovascular disease within a clinical population.
MethodsThis investigation employed data sourced from the China Health and Retirement Longitudinal Study (CHARLS). The median TyG index and eGDR scores were used to stratify the participants into 4 categories: low TyG/high eGDR, high TyG/high eGDR, low TyG/low eGDR, and high TyG/low eGDR. Clinical characteristics across groups were systematically compared. Cox proportional hazards regression models evaluated the distinct and interconnected associations of the TyG index and eGDR with the risk of cardio-cerebrovascular disease, with multiplicative and additive interaction effects subsequently assessed through formal interaction analysis.
ResultsThe final study cohort comprised 7,330 participants, with 1,336 individuals (18.2%) developing cardio-cerebrovascular disease during the 9-year follow-up. Stratification using median thresholds (TyG: 8.59; eGDR: 10.55 mg/kg/min) yielded four groups: low TyG/high eGDR (n = 2,991), high TyG/high eGDR (n = 1,375), low TyG/low eGDR (n = 1,372), and high TyG/low eGDR (n = 2,292). Multivariable-adjusted Cox regression analyses revealed markedly increased risks of cardio-cerebrovascular disease among the various exposure groups when contrasted with the low TyG/high eGDR reference: high TyG/high eGDR (HR: 1.31, 95%CI: 1.10–1.57, ppp Conclusion
The TyG index and eGDR demonstrate independent associations with cardio-cerebrovascular disease risk, while their combined assessment reveals synergistic predictive capacity. Combined assessment of the two allows for further accurate stratification of the population based on insulin resistance and improved prediction of cardio-cerebrovascular disease.
by Lin Zhang, Feng Luo, Yalin Chai, Lijie Sun, Xuan Wang, Le Yin, Congjuan Luo
Acute kidney injury (AKI) remains a major clinical challenge due to its high morbidity and mortality, with ischemia-reperfusion injury (IRI) as one of its primary causes. Severe IRI-associated AKI (IRI-AKI) can progress to irreversible renal failure, yet no effective therapies are currently available. Ferroptosis, an iron-dependent regulated cell death, has recently been implicated in the pathogenesis of IRI-AKI. Moreover, IL-22 may alleviate AKI by modulating the ferroptosis process through regulation of the P62-Keap1-Nrf2 signaling axis. In this study, we examined the protective role of the immune cytokine interleukin-22 (IL-22) in IRI-AKI and its mechanistic association with ferroptosis. Using a murine IRI model and an HK-2 cell hypoxia/reoxygenation system, we systematically assessed the impact of IL-22 treatment. IL-22 administration significantly enhanced renal function, reduced histological injury, and limited both reactive oxygen species accumulation and ferroptotic cell death. Further mechanistic studies demonstrated that IL-22 suppresses ferroptosis in vitro through an Nrf2-dependent mechanism and is associated with activation of the P62-Keap1-Nrf2 signaling pathway. These findings offer experimental evidence supporting IL-22 as a potential therapy for IRI-AKI and highlight ferroptosis modulation as a promising therapeutic strategy.by Chunqing Yang, Qingjie Xue, Yu Feng, Wenjun Ding, Ying Lu, Qinqin Wang
Conventional dendritic cells (cDCs) are pivotal antigen-presenting cells (APCs) with critical roles in immune regulation, yet their subset classification remains ambiguous due to phenotypic overlap with macrophages and monocytes, particularly in the spleen. This study employed multi-parametric flow cytometry and clodronate liposome (CL) depletion to systematically re-evaluate splenic CD11chighMHCIIhigh cDCs in C57BL/6 mice. We identified three novel subsets: (1) a tissue-resident T-cell zone macrophage (TZM)-like population (F4/80inter-lowCX3CR1+MERTK+) constituting 0.59% of cDC2s with >10-fold CL-depletion resistance (p high APC subset (CCR2 ⁻ Ly6C⁻) accounting for 2.7% of cDC2s with CL-sensitivity; (3) unconventional CD4⁺CD8α⁺ hybrids present in 2.57% of cDC2 and some cDC1s. These findings demonstrate unprecedented cDC plasticity driven by microenvironmental signals, revising conventional classification frameworks and proposing new targets for DC-based immunotherapies in autoimmunity and cancer. Our phenotypic mapping provides a foundational framework for future functional investigations into these novel subsets.Although female smoking prevalence in China remains low, emerging evidence suggests that social acceptance may be increasing, with tobacco marketing increasingly targeting women. This study explored women’s smoking behaviours, motivations and societal perceptions toward this in urban China.
Between May and October 2019, 28 semistructured focus groups were conducted in Beijing, Changsha and Shenzhen with 288 participants: 12 groups of female smokers, 6 of female former smokers, 6 of female never-smokers and 4 of men. Participants were recruited both online and offline, and smoking status was verified with a carbon monoxide monitor. Discussions were transcribed verbatim and analysed thematically using dual coding.
Four themes emerged. First, while stigma against female smoking persisted, social acceptance is growing, especially among younger generation. Second, three initiation stages were identified: adolescence, early career and post-retirement, often triggered by peer influence, occupational stress and life transitions. Third, many female smokers concealed their behaviour, reflecting tension between shifting descriptive norms and enduring injunctive norms, which may contribute to underreporting in surveillance data. Fourth, misconceptions about smoking harms and quitting were common, with most women who smoke relying on willpower and showing limited interest in cessation support; pregnancy was one of the few strong motivators for quitting.
Findings suggest gradual normalisation of female smoking in urban China, driven by evolving gender roles and targeted marketing. Public health responses should prioritise gender-specific health education, strengthen promotion of cessation services and tighten restrictions on tobacco marketing towards women to prevent future increases in female smoking.
Although topical oxygen therapy (TOT) is a promising treatment for chronic wounds, its clinical efficacy and safety remain to be rigorously established. We conducted a two-arm randomised controlled trial to evaluate the efficacy and safety of TOT for treating chronic wounds by a commercially available portable continuous diffusion of oxygen (CDO) system. Eighty-eight patients were allocated to the TOT (n = 44) or moist wound therapy (MWT) (n = 44) group for a 28-day intervention period, followed by standardised MWT for unhealed wounds until the 12-week endpoint. Eighty-eight patients were allocated to either the TOT group (n = 44) or the standard MWT group (n = 44) for 28 days (or until wound closure) and were followed for up to 12 weeks. Wound area, depth, pH, healing rate and healing time were assessed weekly for 28 days or until 12 weeks. Any adverse event was observed at the same time. At day 28, the TOT group demonstrated significantly greater reductions in wound area and depth compared with the MWT group (p < 0.05). The wound bed pH in the TOT group was lower than the MWT group at day 14 and 28. Although the healing rate was higher in the TOT group than in the MWT group at day 28 (45.5% vs. 11.4%, p < 0.001), the healing rate in both groups was similar at week 12 (95.5% vs. 90.9%, p = 0.536). The healing time of the TOT group was shorter than that of the MWT group at week 12 by 13.5 days (95% CI: 6.74–15.40; p = 0.004). No TOT-related adverse events were reported. These findings indicate that portable TOT can significantly accelerate wound healing, particularly by improving wound bed pH that could facilitate subsequent healing processes in patients with chronic wounds.
The aim in this human trial is to compare the efficacy and safety of polygalacturonic–caprylic acid (PG–CAP) ointment to MediHoney in chronic wounds at three international medical centres. In this prospective open-label study, patients with chronic full-thickness wounds were randomised to daily treatment with PG–CAP ointment or MediHoney. Assessments were obtained weekly for 6 weeks. The validated Pressure Ulcer Scale for Healing (PUSH) score was used to track healing. Efficacies were compared using the Wilcoxon rank-sum test for continuous variables and chi-square or Fisher's exact test for categorical variables. Twenty-six patients with chronic wounds were included. Baseline characteristics were comparable between the groups; however, the history of diabetes mellitus was higher in the PG–CAP group (p = 0.011). All 13 PG–CAP patients showed improvement (100%), compared to only 69% of the 13 MediHoney patients (p = 0.023). Half of the failures in the MediHoney arm were associated with death (15%). No failures, adverse events or deaths occurred in the PG–CAP arm. PG–CAP wound ointment is a novel combination of two plant-based compounds that pose minimal risk of promoting antimicrobial resistance, was highly effective for eradicating wound-pathogen biofilms in vitro and promoted chronic wound healing in vivo with minimal inflammatory reactions. Our findings support PG–CAP as safe, noninferior and possibly more effective than MediHoney in healing chronic contaminated wounds.
by Congli Jia, Fu Yang, Yingchun Li
ObjectiveThis study aimed to identify diagnostic biomarkers for keloid and explore potential therapeutic agents from traditional Chinese medicine (TCM) by integrating network pharmacology approaches. Specifically, we sought to uncover key molecular targets for Aloe vera and validate their roles in keloid pathogenesis.
MethodsWe integrated keloid transcriptome datasets (GSE218007 and GSE237752) by merging GEO data, and identifying differentially expressed genes (DEGs). Functional enrichment analysis (GO, GSEA) and machine learning approaches were applied to select diagnostic biomarkers. Candidate genes were validated via Receiver Operating Characteristic (ROC) curves in training and independent cohorts (GSE44270). PPI networks and Cytohubba algorithms identified hub genes, while TCMSP-screened compounds from Aloe vera were docked with targets using molecular docking.
Results91 Identified DEGs enriched in fibrosis-related pathways. Machine learning prioritized two diagnostic biomarkers: AMPH and TNFRSF9 (AUC > 0.85 in training/testing). PPI analysis revealed IL6 as a hub gene. Aloe vera-derived quercetin targeted HAS2 and IL6 (both P Conclusion
AMPH and TNFRSF9 are promising diagnostic biomarkers for keloid, while quercetin from Aloe vera targets HAS2 and IL6, offering therapeutic potential. The dual role of IL6 underscores its centrality in keloid pathogenesis, connecting bioinformatics predictions with TCM pharmacology. This study provides a foundation for clinical prediction and targeted treatment strategies.
The treatment of chronic wounds in the Aged is often difficult. Masquelet technique is used for the treatment of infected large segmental bone defects as it provides an adequate blood supply for bone and soft tissue reconstruction. In this study, a two-stage wound management strategy was used, consisting of covering the initial wound with bone cement and skin grafting under induced membranes. From September 2020 to September 2022, 20 Aged patients with chronic refractory wounds of the lower extremities with exposed bone or tendons were recruited in the Department of Wound Repair Surgery of the Second Affiliated Hospital of Wenzhou Medical University. Each patient was reconstructed according to a two-stage process. In the first stage, while treating the patient's underlying disease, several debridements were first performed on the wound; subsequently, the Masquelet technique was applied to seal the wound with antibiotic bone cement. Four to 6 weeks later, the second stage was initiated—after confirming the sufficient formation of wound induced membranes, the bone cement was removed, and free skin grafts were finally used to cover the chronic refractory wounds on the extremities. The area of the defects ranged from 4.5 × 3.0 cm to 15.0 × 6.0 cm, and all soft tissue defects were associated with tendon or bone exposure. After the surgery, patients attended regular outpatient visits and were followed up by telephone and video to observe the healing of the wounds and whether there were any complications in the donor site. The Lower Extremity Function Scale (LEFS) score was used to evaluate the functional recovery of the lower extremities. We found that all implants survived without necrosis or infection. All 20 cases were followed up regularly after surgery for 3 to 12 months, with a mean of 7.6 months. In the first stage, Induced Membranes induction was performed 1–4 times, with an average of (1.3 ± 0.7) times, and in the second stage, free skin grafting was performed on the induction membrane, and all 20 cases of skin grafting survived without necrosis or infection; the appearance and texture of the skin in the grafted area were satisfactory, and the postoperative LEFS score was (69.83 ± 10.82). Finally, our strategy for the management of chronic refractory wounds in the Aged can achieve satisfactory clinical results, reduce surgical risk, be simple and reliable, and be an effective addition to the repair modality.
by Wen-Qi Hou, Yu-Xin Li, Ming-Fei Luo, Wen-Ying Zhou, Mai Lu
Due to the diversification of media functions of mobile phones, users can make calls and access the internet simultaneously, which has significantly increased the usage time of mobile phones. The exposure dose of the users in the combined electromagnetic fields (EMF) should be further quantified to better evaluate the public exposure safety. Different from most conventional EMF safety studies that only focus on a single frequency, this work not only discusses the mobile phone simultaneously operated in fourth-generation (4G) and fifth-generation (5G) mobile communications radiation impact on users, but also verifies that the miniaturized mobile phone multiple-input multiple-output (MIMO) antenna array can significantly reduce the specific absorption rate (SAR) absorbed by users. In this article, a miniaturized mobile phone MIMO antenna array is employed as the radiation source, and multi-pose human models are established to simulate the practical utilization of a smartphone. A systematic analysis of the SAR absorbed by the human model is conducted in both single and combined EMF scenarios. The results indicate that the peak SAR in various tissues under multi-frequency exposure is 1.02 to 15.85 times higher than that under single-frequency exposure.The objective of this study was to determine the association between viral subtype/clade and disease severity.
Multicentre retrospective cohort study.
This study used data from the Global Influenza Hospital Surveillance Network (GIHSN). The dataset comprised hospitalised influenza patients with viral sequencing data across 14 countries, collected from August 2022 through October 2023.
A total of 761 hospitalised patients were enrolled during the study period, and 745 patients were included in the analysis. We excluded patients with missing data on explanatory or outcome variables, those infected with viral clades represented by fewer than 11 sequences, and those enrolled at study sites contributing fewer than 5 patients.
Disease severity was defined by admission to intensive care unit (ICU), receipt of non-invasive oxygen supplementation, 3-variable definition (ICU, mechanical ventilation or death) or 4-variable definition (3-variable plus oxygen supplementation).
Outcomes were analysed in association with subtype or clade using the mixed-effects logistic regression models, adjusting for age group, sex, underlying medical conditions, influenza vaccination status, antiviral use, country income level and epidemic period, while study site was included as a random effect.
745 patients were included: 263 A(H1N1)pdm09, 380 A(H3N2), 102 B/Victoria. A(H1N1)pdm09 infection was associated with increased odds of ICU admission (adjusted ORs (aORs) 2.5, 95% CI 1.1 to 5.8) compared with A(H3N2). 6B.1A.5a.2a.1 clade of A(H1N1)pdm09 was associated with increased severity compared with 6B.1A.5a.2a clade (aOR 3.0, 95% CI 1.0 to 9.5) and (aOR 5.4, 95% CI 1.6 to 18.3) for the 3-variable and 4-variable definitions respectively. Among A(H3N2), the (3C.2a1b.2a.)2b clade showed a trend toward increased severity using the 4-variable definition compared with the 2a.1b clade (aOR 2.9, 95% CI 0.8 to 10.0).
This analysis highlights the differential impact of influenza subtypes and clades on disease severity in hospitalised patients. Future research should investigate the role of specific viral mutations of these clades in modulating immune evasion or disease severity. These findings reinforce the GIHSN’s critical role in global surveillance. Ongoing genomic surveillance is crucial for understanding the clinical impact of emerging influenza variants and informing public health responses.
Early detection of carotid plaque prevents stroke and myocardial infarction. Individuals with fatty liver might be at an increased risk of developing carotid plaque, yet limited access to carotid artery ultrasound underscores the need for predictive models.
We aimed to construct six predictive models for males and females separately to predict carotid plaque among individuals with fatty liver disease.
A cross-sectional study.
We included 8361 participants aged ≥40 years (4871 males; 3490 females) with fatty liver who underwent at least one health check-up between 1 January 2020 and 31 December 2023.
The sex-stratified dataset was randomly divided into 70% training and 30% internal testing datasets. With 24 potential predictors, we applied four machine learning (ML) algorithms and two conventional logistic regression (LR) models: stepwise LR and LR based on ML-selected features (LR-ML) to develop sex-specific carotid plaque prediction models. The performances were evaluated by area under the receiver operating characteristic curve (AUC), sensitivity, specificity, precision, F1-score, accuracy, calibration curve and decision curve analysis.
Carotid plaque was determined when the local carotid intima-media thickness was ≥1.5 mm in any of the arterial segments.
Four predictors (age, hypertension, total bilirubin, total cholesterol and white blood cell count) in males and three (age, systolic blood pressure and fasting blood glucose) in females were identified by consensus across the four ML algorithms and subsequently used to construct LR models. Among all 4 ML and two LR models, the gradient boosting machine model demonstrated the best overall performance in males (AUC=0.773, 95% CI 0.749 to 0.797), while the LR-ML model was optimal in females (AUC=0.817, 95% CI 0.791 to 0.843). Calibration and decision curve analyses further demonstrated satisfactory agreement and higher net benefit across sexes. Risk stratification identified distinct low-, intermediate- and high-risk groups with progressively higher observed prevalence of carotid plaque (20.25%, 48.58% and 69.41% in males; 15.28%, 50.89% and 66.56% in females).
Our findings highlight significant sex differences in practical carotid plaque prediction, providing crucial insights for public health implications in the early identification and risk assessment of carotid plaque among individuals with fatty liver.
by Yonggang Chen, Jintai Luo, Yingying Zheng, Xiaomei Jiang, Zixiang Yang, Xiaobing Liu
BackgroundDiabetic kidney disease (DKD) poses a significant health burden with inadequate diagnostic sensitivity. This study develops non-invasive biomarkers by integrating urinary and renal single-cell sequencing with machine learning.
MethodsThis study analyzed DKD single-cell and bulk transcriptomic data from public repositories. We established a computational pipeline to distinguish kidney-originating cells in urinary sediments, enabling the identification of injury-associated gene signatures. These signatures were refined using machine learning to develop a diagnostic model, which was validated in independent cohorts. The biomarkers were further verified in DKD renal tissues at single-cell resolution and across multiple nephropathies. Functional and spatial analyses confirmed biological relevance using transcriptomic and histological validation.
ResultsSingle-cell analysis of 2,089 urine-derived cells identified eight renal cell types, including injured proximal tubule cells (Inj-PTC) showing upregulated injury markers (HAVCR1, VCAM1) and enriched apoptotic/TGF-β pathways. A machine learning-selected biomarker panel (PDK4, RHCG, FBP1) demonstrated strong diagnostic value (area under the curve, AUC > 0.9), with consistent downregulation across multiple chronic kidney diseases. PDK4 and FBP1 were specifically suppressed in DKD renal Inj-PTC (p Conclusions
This study identifies a three-gene biomarker panel (PDK4, RHCG, FBP1) as a promising non-invasive diagnostic tool for DKD. While demonstrating excellent diagnostic performance. It represents a tubular injury-associated gene signature that is detectable in urinary cells and shows strong association with DKD in transcriptomic datasets, presenting a promising candidate for a non-invasive diagnostic assay.
FreshRSS 