Function Test Results Research Articles

Association of the psoas muscle index with the survival of patients on a waiting list for lung transplantation: a Japanese single-institution study.

Some predictive markers of death have been reported for patients on the waiting list for lung transplantation (LTx). We assessed whether or not the preoperative psoas muscle index (PMI) correlates with waitlist mortality. In 81 patients with end-stage lung disease on the waiting list for LTx between 2011 and 2020 at Osaka University Hospital, we examined the association between baseline characteristics, including the diagnosis, respiratory function test results, blood collection items, steroid use, and psoas muscle mass on computed tomography, and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models. Thirty-three patients (41%) died during follow-up. Univariate and multivariate analyses showed that patients with a low PMI had a higher rate of death during follow-up than those with a high PMI (p < 0.0001 and 0.0002, respectively). In addition, a diagnosis of interstitial pneumonia (hazard ratio 3.30, 95% confidence interval 1.52-7.17, p = 0.0025) and low albumin level (hazard ratio 2.21, 95% confidence interval 1.02-4.80, p = 0.0449) were also significant predictors of survival. A low PMI at registration is associated with a decreased survival time among LTx candidates and it may be a predictive factor of mortality in patients waiting for LTx.

Evaluation of the autonomic nervous system in patients with essential tremor

BackgroundEssential tremor (ET) is a prevalent movement disorder that may be linked to neurodegenerative changes. It is marked by a mix of motor and non-motor symptoms, which include disturbances in the autonomic nervous system. Aim of the study: We aimed to assess autonomic dysfunction in individuals with essential tremor. Thirty patients with essential tremor (Group 1) and 30 age and sex-matched healthy subjects as the control group (Group 2) were recruited. Comprehensive medical and neurological examinations were conducted on all participants, followed by electrophysiological assessments of autonomic function, including heart rate variability (HRV) tests (E/I ratio, Valsalva ratio, 30:15 ratio), adrenergic tests (blood pressure responses to active standing and sustained hand grip), and sympathetic skin response (SSR) tests. Finally, the results of these tests were classified according to the Ewing classification of autonomic failure. Results: The study revealed significant differences between ET patients and the control group. Heart rate variability tests showed a marked difference between the groups. Adrenergic tests, measuring sympathetic innervation, also displayed a significant difference. The sudomotor function test exhibited noteworthy differences in onset latencies and amplitudes in the palm and sole, with ET patients showing prolonged onset latencies and decreased amplitudes. Moreover, the study found a significant correlation between disease severity and autonomic function test results and the Ewing score. Conclusion: The study highlights the presence of autonomic dysfunction in essential tremor patients, with disease severity being associated with the level of autonomic affection, as evidenced by various autonomic function tests and the Ewing score.

Features of mild duration asthma diagnostics in childbearing aged females

Asthma diagnostics especially of it’s mild forms, is considered to be a serious problem within primary health care unit due to the absence of exact evaluation algorithm of subjective, clinical and functional manifestations. Objective. The goal of our study was to create recommendation on early asthma diagnostics in childbearing aged females, based on particular analysis of complaints, clinical and functional test results and to make them available to all primary medical care units. Materials and methods. 2460 females of childbearing age with various severity of asthma duration were studied with complex of clinic and functional methods. Results. Patients with various grades of asthma severity could be compliant free, same time the can appear signs of bronchial obstruction during auscultation. The marked discordance leads to mismatch in therapy administration. PEF50 decrease while initial spirometry and its’ increase after probe with bronchodilator is considered to be the earliest sign of bronchial obstruction. Asthma diagnostics at prehospital stage is to based upon complete chart collection, complaints analysis, auscultation signs while forced expiration as well as on spirography data on volume and forced expiration dynamics and PEF50. Conclusion. Results of large population study on clinical feature of asthma duration and functional diagnostics of mild asthma duration could be recommended for primary health care physicians as method of early asthma diagnostics and therapy administration

OGBN P32 Outcomes of patient with Biliary Dyskinesia undergoing laparoscopic cholecystectomy - A multicentre cohort study

Abstract Background Biliary dyskinesia (BD) is a benign disorder characterized by recurrent episodes of biliary pain in the absence of gallstones on ultrasound, normal liver function tests and an ejection fraction (EF) of &amp;lt;35% on hepatobiliary iminodiacetic acid (HIDA) scan. Laparoscopic cholecystectomy (LC) remains the only known effective treatment for BD. However, many surgeons are reluctant to offer LC in such patients due to the fear of non-resolution of symptoms. Our aim was to analyse the outcome of patients who underwent LC for BD in terms of resolution of the biliary symptoms. Methods Multicentre retrospective cohort study of patients who have BD proven on HIDA scan from January 2015 to December 2022. BD was defined as EF ≤35% on HIDA scan. Those with EF ≤35% but had evidence of gallstones, microlithiasis or post op leak were excluded from the study. Electronic case notes were reviewed for demographic details, duration of symptoms, body mass index (BMI), liver function test (LFT), radiological investigations, endoscopy report and histopathology results of cholecystectomy. Rome IV criteria of functional gastrointestinal (GI) disorders was used to confirm symptoms were biliary in origin. Results Of the 222 patients who had HIDA scan, 35 (15.7%) patients had BD. 26 (74.2%) were female and median age was 42 years (IQR 33-55). Median time from the onset of symptoms and HIDA scan was 18 months. 19 (54.2%) patients had LC preformed, 9 (25.7%) were discharged with decision of LC not required, 4 (11.4 %) had no further review and 2 (5.7%) still having LC under consideration. Histopathology of LC was, chronic inflammation in 10 (52.6%), cholesterosis in 3 (15.8%) and 4 (20.1%) had normal gallbladder. 13 (68.4%) patients who underwent LC were symptom free 12 months post-surgery. Conclusions BD although painful and potentially lifestyle limiting, does not progress to more serious consequences if untreated. Diagnosis is usually difficult, and patients go through extensive investigations before they have HIDA scan. LC improves the symptoms in two thirds of patients and should be offered to all patients with BD with appropriate counselling.

Efficacy of triple targeted therapy against chronic rhinosinusitis in children with cystic fibrosis (case series)

Introduction. Chronic rhinosinusitis (CRS) with underlying cystic fibrosis (CF) is one of the most challenging inflammatory diseases of the paranasal sinuses (PNS). The treatment of CF in general and CF-associated CRS in particular keeps developing exponentially: special drug delivery systems have been invented, drugs purpose-developed for the treatment of patients with CF (dornase alfa) are used, and radicality of surgical intervention is increasing. In recent years, CF innovative targeted therapy has been introduced. It aims to improve the course of the bronchopulmonary infectious and inflammatory process, nutritional status and pancreatic function, but its efficacy in relation to the PNS condition is still insufficiently studied.Aim. To evaluate the efficacy of ivacaftor/elexacaftor/tezacaftor therapy for CF sinonasal manifestations in children and to determine possible parallels of the CRS course vs other characteristics of the CF course.Materials and methods. A total of 15 children with CF receiving triple targeted therapy were included in the first series of observations. Computed tomography (CT) scans were assessed using the Lund-Mackay scores (LMS) before and 7.6 ± 3.0 months after starting the therapy. In addition, the changes in sweat chloride levels and pulmonary function test results were taken into account. The control group included 11 patients with comparable initial radiographic data who did not receive such therapy.Results and discussion. The treatment group showed a significant improvement in the PNS condition in the form of a decrease in the LMS scores from 15.6 ± 4.5 to 2.1 ± 3.0 (p = 0.001) with inhomogeneous changes vs different PNS groups. A certain parallelism between changes in the CT view and the level of sweat chlorides and pulmonary function test results was reported. In the control group, a nonsignificant deterioration in the course of CRS was observed (from 12.3 ± 6.3 to 14.6 ± 4.9 scores according to LMS; p = 0.108).Conclusions. The study demonstrated high efficacy of CF triple targeted therapy with ivacaftor/elexacaftor/tezacaftor in relation to the severe CRS with a rapid onset of effect in the form of PNS pneumatization restoration according to CT findings.

Hepatitis E Virus Infection Caused Elevation of Alanine Aminotransferase Levels in a Patient with Chronic Hepatitis B and Choledocholithiasis

Hepatitis E virus (HEV) genotypes 3 and 4 are zoonotic strains that are primarily transmitted through the consumption of undercooked pork or game meat. They also cause asymptomatic infections, acute hepatitis, acute-on-chronic liver failure, chronic hepatitis, and extrahepatic manifestations. Here, we report a man in his 80s who had chronic hepatitis B, took entecavir for it, and presented with higher levels of alanine aminotransferase (ALT) and jaundice. An abdominal computed tomography scan revealed choledocholithiasis with cholecystolithiasis. Although endoscopic papillary balloon dilatation was performed for the removal of a common bile duct stone, the abnormal liver function tests, including jaundice, were prolonged. After other viral hepatitis and other causes of the liver injury were ruled out, as his serum was positive for immunoglobulin A anti-HEV and HEV genotype 3b RNA, we diagnosed him as having acute hepatitis E. In this case, with chronic hepatitis B and a common bile duct stone, the prolonged abnormal results for the liver function tests seemed to be caused by HEV infection. In conclusion, in cases with high ALT levels after removing choledocholithiasis, other factors, including HEV infection, should be considered to determine the cause of abnormal liver function test results. The further examination of hepatitis D virus infection and high ALT levels may be needed in HBV-infected individuals.

Bronchodilator responsiveness in children with primary ciliary dyskinesia.

Reversible airway obstruction is common in children with primary ciliary dyskinesia. However, the diagnostic value of adding bronchodilator (BD) response testing to routine spirometry is unclear. This is a retrospective analysis of pulmonary function test results obtained from children with primary ciliary dyskinesia seen as outpatients at the Hospital for Sick Children, Toronto. Spirometry results were collected for every appointment with BD response testing ("Visit", with pre-BD and post-BD measurements) as well as for the previous ("Baseline") and following ("Follow-up") encounters. A positive BD response was seen in 86 out of 474 (18.1%) of the pulmonary function tests from 82 children with primary ciliary dyskinesia. BD responsiveness was associated with a significant absolute change (±sd) in % predicted forced expiratory volume in 1 s (FEV1) from Baseline to Visit pre-BD (-6.5±10.3%, p<0.001), but not from Baseline to Follow-up (0.4±10.8, p=0.757). Antimicrobial therapy was initiated more commonly following a Visit with a positive BD response (OR 3.8, 95% CI 2.2-6.6) compared to no BD response. Children with a positive BD response had a greater annual decline in FEV1 % predicted compared to those with no BD response (-0.9% per year versus -0.5% per year, p<0.001). The annual decline in FEV1 % predicted was greater in children with multiple compared to one measured positive BD responses (-1.3% per year versus -0.6% per year, p<0.001) and in those not treated with antibiotic therapy following a positive BD response compared to those treated with antibiotics (-1.1% versus -0.6%, p<0.001). A positive BD response in children with primary ciliary dyskinesia may help identify those at risk for accelerated lung disease progression.

Description of clinical and genetic features of 122 patients included in the Spanish Pompe registry

Pompe disease is a rare genetic disorder with an estimated prevalence of 1:60.000. The two main phenotypes are Infantile Onset Pompe Disease (IOPD) and Late Onset Pompe Disease (LOPD). There is no published data from Spain regarding the existing number of cases, regional distribution, clinical features or, access and response to the treatment. We created a registry to collect all these data from patients with Pompe in Spain. Here, we report the data of the 122 patients registered including nine IOPD and 113 LOPD patients. There was a high variability in how the diagnosis was obtained and how the follow-up was performed among different centres. Seven IOPD patients were still alive being all treated with enzymatic replacement therapy (ERT) at last visit. Ninety four of the 113 LOPD patients had muscle weakness of which 81 were receiving ERT. We observed a progressive decline in the results of muscle function tests during follow-up. Overall, the Spanish Pompe Registry is a valuable resource for understanding the demographics, patient's journey and clinical characteristics of patients in Spain. Our data supports the development of agreed guidelines to ensure that the care provided to the patients is standardized across the country.

HBV pregenome RNA as a predictor of spontanous HBeAg seroconversion in HBeAg-positive chronic hepatitis B patients

BackgroundPrevious studies have indicated that HBV pregenome RNA (HBV pgRNA) could predict HBeAg seroconversion among the chronic hapatitis B (CHB) patients treated with pegylated interferon (Peg-IFN) or nucleos(t)ide analogues (NAs). However, the data about the prediction of HBV pgRNA for spontaneous HBeAg seroconversion is limited.MethodsOne hundred thirteen CHB patients with HBeAg-positive in the immune active phase were followed up for 76 weeks without antiviral treatment. Based on the laboratory test results of liver function, HBeAg, anti-HBe, and HBV DNA at week 76, patients were assigned to two groups: spontaneous HBeAg seroconversion (group A, n = 18) and non-spontaneous HBeAg seroconversion group. Among the latter group, 36 patients were selected as controls (group B, n = 36).ResultsAt week 12, between group A and group B, there was a significant difference in the level of HBV pgRNA (group A 6.35 ± 1.24 log10 copies/ml and group B 7.52 ± 0.79 log10 copies/ml, P = 0.001), and the difference enlarged at week 28. The receiver operating characteristic curves (AUROCs) of the HBV pgRNA level and the ∆HBV pgRNA at week 28 were 0.912 (P = 0.001, 95% CI: 0.830–0.994), and 0.934 (P = 0.001, 95% CI: 0.872–0.996), respectively. The optimal cutoffs of HBV pgRNA and the reduction from baseline (∆HBV pgRNA) at week 28 for spontaneous HBeAg seroconversion prediction were 5.63 log10 copies/ml and 1.85 log10 copies/ml, respectively. The positive predictive value and negative predictive value of HBV pgRNA and ∆HBV pgRNA at week 28 were 86.7% and 87.2%, 87.5% and 89.5%, respectively. And the combination of the HBV pgRNA level and the HBV pgRNA decreased could provide better prediction.ConclusionsHBV pgRNA is a sound predictor for spontaneous HBeAg seroconversion among the CHB patients in immune active phase. Dynamic monitoring of HBV pgRNA is helpful for clinical treatment decision.

Typical and atypical chest pain: an equivocal and dangerous definition

Abstract Background The traditional classification of stable chest pain into typical, atypical and non anginal1 is equivocal and can lead to doctor's decisions and patient's perception that do not correspond to the real importance of the clinical picture. Methods In the last 15 years, 3,588 outpatients, aged &amp;gt;35 years (mean 64±9, female 55%) were evaluated for stable chest pain reported for more than 48 hours. We excluded 290 patients with a history of myocardial infarction or angina pectoris, heart failure, valve diseases or any other major cardiovascular event, or ECG signs of recent ischemia. In the other 3,298 cases we applied the traditional classification of chest pain. All patients were evaluated for the presence of HEART score risk factors² (smoking, obesity, family history of cardiovascular events, hypertension, diabetes, hypercholesterolemia) as well as age. All patients with typical or atypical angina and those with non-anginal pain according to the physician's judgment were evaluated with one or more functional cardiovascular tests (exertion test, nuclear stress tests, stress echo).A follow-up was performed at 6 months and 1 year, for the detection of major cardiovascular events (cardiovascular death, non-fatal heart attack, revascularization, stroke) and non-cardiovascular mortality. Results Table 1 shows the results of chest pain classification and positive functional test. Table 2 shows major events at one year of follow-up stratified according to the initial assessment of chest pain. Table 3 stratifies the events according to the extent of the risk factors and age. It is evident that a positive functional test is also present in 10% of patients with atypical pain and in 4% of those with non-anginal pain. Patients with typical pain undergo revascularization more frequently (39%). The peculiarity of our study is that the prognosis and rate of events do not differ in terms of clinical and ischemic burden among the 3 groups at 1 year of follow-up, except when patients are stratified by risk burden and for age (Table 4). About 1% of patients had a clinical event regardless of the type of pain and the presence of ischemia and 87% of the events involved patients with ≥ 3 risk factors or heavy smokers. Nine percent of all heavy smokers aged &amp;lt;65 years had a major event and are the highest risk group with a peak of 12.5% in those with atypical pain. Conclusions The traditional classification of stable chest pain should be abandoned, as it does not correlate with actual disease burden and prognosis, that appears to be linked to the burden of cardiovascular risk and above all to smoking in patients &amp;lt; 65 years of age, rather than to the clinical and ischemic burden. It will be necessary to evaluate whether the anatomical burden for the search of high-risk coronary lesions improves the prognosis with added value with respect to the treatment of risk factors³.Picture 1Picture 2

Differences in diagnostic yield of invasive coronary function testing between high and low volume centres, in patients with angina and no obstructive coronary artery disease

Abstract Introduction Coronary angiograms for stable angina frequently show no obstructive coronary artery disease (ANOCA). A large proportion of ANOCA patients have underlying coronary vasomotor dysfunction. They can be divided into different endotype subgroups, according to their invasive coronary function test (CFT) results. A complete CFT in the studied cohort consists of both spasm provocation with acetylcholine as well as testing physiology of the microcirculation with adenosine and bolus thermodilution. There is a high prevalence of vasomotor dysfunction in our tertiary, high volume CFT centre where &amp;gt;100 CFT s are performed each year. No data is available yet on the prevalence in low volume centres. Purpose To compare CFT results of patients who underwent complete CFT in a high volume centre versus low volume centres. Methods We included all consecutive patients from the pilot version of a prospective national registry of coronary function tests in the Netherlands (NL-CFT) who underwent a complete standardized CFT between February 2019 and January 2023 (n=593). We compared CFT diagnosis (endotypes) in high versus low volume centres by acetylcholine spasm provocation and adenosine bolus thermodilution test results. A high volume CFT centre was defined as performing more than 100 CFT’s per year. Coronary microvascular dysfunction (CMD) was defined as a coronary flow reserve CFR &amp;lt;2 and/or index of microvascular resistance IMR ≥25. Coronary vasomotor dysfunction was present when epicardial or microvascular spasm was diagnosed, when CFR and/or IMR was abnormal, or when both parts of the CFT were abnormal. We expect to be able to present expanded data on approximately 1000 patients with complete CFTs around the ESC congress. Results Currently, 593 patients underwent complete CFT (83% female, mean age 60 ± 9.5 years). The high volume centre performed 307 (52%) of all CFTs in the studied period. The four low volume centres combined performed the other 286 (48%). A total of 461 (78%) of patients had coronary vasomotor dysfunction. Prevalence of coronary vasomotor dysfunction was significantly higher in a high volume centre compared to low volume centres (88% vs 66% p&amp;lt;0.001). Coronary spasm was present in 84% of CFTs in a high volume centre: 54% isolated and 30% combined with CMD. Isolated CMD was present in 4% and only 12% had a normal CFT. In low volume centres coronary spasm was present in 54% of patients: 36% isolated and 19% combined with CMD. Isolated CMD was present in 12% and 34% of all performed CFT’s was normal. Conclusions In this pilot data of NL-CFT, a large prospective registry, 593 patients underwent complete CFT. We show that the prevalence of coronary vasomotor dysfunction is significantly higher in a high volume CFT centre compared to low volume centres. Vasospasm is the predominant endotype, either isolated or combined with CMD. Nevertheless, prevalence of vasomotor dysfunction in low volume centres is still high and warrants attention.Distribution of endotypes

A Computational Study into the Mechanism of B−B Bond Cleavage in a Magnesium(II) Diboranate Complex

AbstractThe breaking of the asymmetric B−B bond within a MgII diboranate complex, [Mg](pinBB(nBu)pin) when [(MeBDIDipp)Mg]≡[Mg], in the presence of DMAP (4‐dimethylaminopyridine), is analyzed with DFT (Density Functional Theory) and NBO (Natural Bond Orbital) methods. The formation of a magnesium‐boryl species, [Mg](Bpin)(DMAP)], which exhibits boron “umpolung” nucleophilic behaviour, is explored through “inner” and “outer” sphere mechanisms, alongside a spontaneous base capture pathway. Charges, bond occupancies, Frontier Orbitals and a steric parameter are used to rationalise the mechanistic features of the system, as well as various reactivity observations. Functional testing results and attempts to model unusual 11B NMR data are also reported.

An explainable artificial intelligence framework for risk prediction of COPD in smokers

BackgroundSince the inconspicuous nature of early signs associated with Chronic Obstructive Pulmonary Disease (COPD), individuals often remain unidentified, leading to suboptimal opportunities for timely prevention and treatment. The purpose of this study was to create an explainable artificial intelligence framework combining data preprocessing methods, machine learning methods, and model interpretability methods to identify people at high risk of COPD in the smoking population and to provide a reasonable interpretation of model predictions.MethodsThe data comprised questionnaire information, physical examination data and results of pulmonary function tests before and after bronchodilatation. First, the factorial analysis for mixed data (FAMD), Boruta and NRSBoundary-SMOTE resampling methods were used to solve the missing data, high dimensionality and category imbalance problems. Then, seven classification models (CatBoost, NGBoost, XGBoost, LightGBM, random forest, SVM and logistic regression) were applied to model the risk level, and the best machine learning (ML) model’s decisions were explained using the Shapley additive explanations (SHAP) method and partial dependence plot (PDP).ResultsIn the smoking population, age and 14 other variables were significant factors for predicting COPD. The CatBoost, random forest, and logistic regression models performed reasonably well in unbalanced datasets. CatBoost with NRSBoundary-SMOTE had the best classification performance in balanced datasets when composite indicators (the AUC, F1-score, and G-mean) were used as model comparison criteria. Age, COPD Assessment Test (CAT) score, gross annual income, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), anhelation, respiratory disease, central obesity, use of polluting fuel for household heating, region, use of polluting fuel for household cooking, and wheezing were important factors for predicting COPD in the smoking population.ConclusionThis study combined feature screening methods, unbalanced data processing methods, and advanced machine learning methods to enable early identification of COPD risk groups in the smoking population. COPD risk factors in the smoking population were identified using SHAP and PDP, with the goal of providing theoretical support for targeted screening strategies and smoking population self-management strategies.

Assessing the relationship between organ function test results and COVID-19 severity

A number of recent reports have indicated the association of COVID-19 with multiple organ failure and the need to clarify the relationship between organ testing parameters and disease progression. Therefore, this study aimed to determine the degree of abnormal organ function test parameters and its correlation with COVID-19 severity. A cross-sectional study was conducted among COVID-19 patients admitted at Sanaka hospital, India, from August to September 2020. A total of 100 qRT-PCR-confirmed COVID-19 patients divided into groups with mild or severe cases were enrolled. The data from venous blood samples for liver, renal, cardiac and inflammatory test parameters were included from the Sanaka hospital laboratory database. Biochemical prognostic tests were carried out using a clinical automated ERBA analyzer, cardiac markers were estimated with Enzyme Linked Fluorescent Assay. The Pearson correlation analysis was used to analyze the data. Aspartate/Alanine aminotransferases and alkaline phosphatase activity, creatinine, urea and troponin levels were higher in the confirmed positive cases of COVID-19. Significantly higher levels of troponin, D-dimer and C reactive protein (CRP) were found in patients with severe COVID form compared to a mild one. A strong positive correlation between elevated D-dimer and Ferritin with CRP level was revealed in this group of patients. It was concluded that the positive relationship between serum D-dimer, ferritin levels and CRP level in patients can be considered a stable indicator of disease severity. Keywords: COVID-19, CRP, D-dimer, ferritin, liver function test, renal function test

Huaier improves the efficacy of anti-PD-L1 Ab in the treatment of hepatocellular carcinoma by regulating tumor immune microenvironment

BackgroundCombination therapy is an effective method for augmenting the efficacy of immune checkpoint inhibitors (ICIs). Huaier is a commonly used Chinese patent medicine with substantial antitumor effects. The combination of Huaier and ICIs may increase the efficacy of ICIs against hepatocellular carcinoma (HCC). MethodsThe major components of Huaier were detected by high-performance liquid chromatography-mass spectrometry. The optimal antitumor dose of Huaier was investigated in H22-bearing mice. Next, Huaier was combined with anti-CD8α antibody (Ab) or anti-PD-L1 Ab to observe the antitumor effect. The safety of these combination drugs was evaluated through blood biochemical tests and hematoxylin and eosin staining of histological sections. RT-qPCR, immunohistochemistry, flow cytometry, and transcriptome sequencing were performed to investigate the potential action mechanism of anti-PD-L1 Ab combined with Huaier against HCC. ResultsHPLC-MS/MS identified 333 components of Huaier, including carboxylic acids and derivatives, thienothiophenes, phenols, flavonoids and so on. Huaier exhibited significant antitumor effects, with the strongest effect noted at a dose of 4 g/kg. Huaier boosted CD8+ T cells infiltration into the tumor. Next, CD8+ T cells were depleted by with anti-CD8α Ab, and the antitumor effect of Huaier was suppressed. Flow cytometry results revealed that CD8+ T cells were reduced in the Huaier+anti-CD8α Ab group, with the antitumor effect of this group being inhibited. This indicated that CD8+ T cells were key players in the antitumor activity of Huaier. Meanwhile, Huaier inhibited microvessel density (MVD), downregulated vascular endothelial growth factor A (VEGFA), and upregulated PD-L1 in tumor tissues. Finally, Huaier combined with anti-PD-L1 Ab exhibited a greater antitumor effect in the H22-bearing mice. And the results of liver and kidney function tests and histological section analysis unveiled that the safety of these drugs was excellent. According to the transcriptome sequencing results, Huaier combined with anti-PD-L1 Ab possibly exerted anti-HCC effects through immunomodulation, immune response, and so on. ConclusionsHuaier exhibited a significant antitumor effect. It promoted CD8+ T cells infiltration, upregulated PD-L1 expression, downregulated VEGFA expression, and inhibited MVD, thereby playing a significant antitumor immunoregulatory effect. The combination of Huaier and anti-PD-L1 Ab has significant antitumor effects, and this regimen has good safety. Therefore, Huaier combined with anti-PD-L1 Ab is a promising therapeutic approach against HCC.

Sudoscan as substitute for quantitative sudomotor axon reflex test in composite autonomic scoring scale and its correlation with composite autonomic symptom scale 31 in type 2 diabetes

ObjectiveThis study aims to evaluate the feasibility of substituting electrochemical skin conductance measurement using SUDOSCAN for sudomotor function testing in the Composite Autonomic Scoring Scale (CASS) and to correlate the results with the Composite Autonomic Symptom Scale 31 (COMPASS 31) among patients with type 2 diabetes mellitus (T2DM). MethodsFifty patients with T2DM underwent cardiovascular autonomic function testing and the SUDOSCAN test and completed the COMPASS 31 questionnaire. We developed a SUDOSCAN-based sudomotor subscore as a substitute for the original sudomotor subscore (based on the quantitative sudomotor axon reflex test [QSART]). The modified CASS score (SUDOSCAN-based sudomotor subscore combined with the adrenergic and cardiovagal subscores) and the original CASS score without suomotor assessment (sum of the adrenergic and cardiovagal subscores) were obtained according to the results of the cardiovascular autonomic function and SUDOSCAN tests. ResultsThe total COMPASS 31 score was significantly correlated with the modified CASS score (p = 0.019 and 0.037 for the raw and weighted scores, respectively) but not with the CASS score without sudomotor assessment. After adding the SUDOSCAN-based sudomotor subscore, the number of patients identified as having diabetic autonomic neuropathy (DAN) increased from 24 (48 %, based on the CASS score without sudomotor assessment) to 35 (70 %, based on the modified CASS score). The modified CASS score enhances the accuracy of assessing autonomic function and improves the diagnosis of diabetic autonomic neuropathy (DAN) among patients with T2DM. In medical settings where QSART is not accessible, SUDOSCAN testing offers a practical and efficient alternative.

Vestibular function after simultaneous bilateral cochlear implantation in adults.

Binaural hearing enhances speech intelligibility, source localization, and speech comprehension in noisy environments. Although bilateral cochlear implantation (CI) offers several benefits, concerns arise regarding the risk of bilateral postoperative vestibular dysfunction with simultaneous CI. This study aimed to longitudinally evaluate changes in vestibular function in adult patients who underwent simultaneous bilateral CI using minimally invasive electrodes and surgical techniques. A retrospective review was conducted on 10 patients who underwent simultaneous bilateral CI at our hospital. Vertigo symptoms and vestibular function test results were examined preoperatively, 1-6 months postoperatively, and 1 year postoperatively. Nystagmus tests, caloric reflex tests, vestibular evoked myogenic potentials (VEMP) measurements, and static stabilometry were performed as vestibular function tests. Although an initial transient decline in vestibular function was observed, no significant long-term decline was observed in the caloric reflex test, ocular VEMP (oVEMP), or cervical VEMP (cVEMP). Moreover, regardless of the presence or absence of abnormalities in caloric reflex, oVEMP, or cVEMP, no significant deterioration was detected in the static stabilometer test. While two patients reported preoperative dizziness, all patients were symptom-free 1 year postoperatively. The findings suggest that using current minimally invasive electrodes and surgical techniques in simultaneous bilateral CI leads to temporary vestibular function decline postoperatively. However, most patients experience a recovery in function over time, highlighting the potential safety and efficacy of the procedure. Simultaneous bilateral CI surgery is viable, depending on the patient's auditory needs and burden.

Design of Automatic Insect Trap Hypothenemus hampei Ferr. based on Solar Cells as a Source of Stinging Energy

One of the plant-disturbing organisms that always harms coffee plants is the insect Hypothenemus hampei Ferr. which causes fruit borer attacks. This study aims to design a solar panel-based H. hampei trapper. This tool is designed to work automatically according to the settings on the solar charge controller; it can catch H. hampei effectively; this tool has a low current (DC) that is safe for farmers; this tool can be used in plantation areas far from PLN because the source of electrical energy comes from solar cells; maintenance costs are relatively cheap, but the tool is designed to operate in the long term. The H. hampei trap uses solar panels as an energy source and is equipped with a stinger that works automatically by utilizing the solar charge controller feature. The functional test results show that the tool that has been designed can work well according to the plan made. The average consumption of stingers is 23.70 Wh. The average panel energy yield is 26.85 Wh. The panels’ energy output has exceeded the amount of energy the stingers need. The tool is designed to trap H. hampei well.

Association between PNPLA3 and TM6SF2 gene polymorphisms and non-alcoholic fatty liver disease patients in Kazakhstan

&lt;b&gt;Background:&lt;/b&gt; Non-alcoholic fatty liver disease (NAFLD) is a growing burden on a global scale and considered as the most common liver disease of the 21&lt;sup&gt;st&lt;/sup&gt; century, affecting both adults and children. Genome-wide association studies (GWAS) in the field of liver diseases have made a significant contribution to the understanding of genetic background for NAFLD development. Targeted genes like PNPLA3 and TM6SF2 showed some relationship with the steatosis and hepatocellular carcinoma within NAFLD patients. In this study, we tried to analyze the frequency of PNPLA3 and TM6SF2 gene polymorphisms and their relationship to changes in instrumental and laboratory markers, the composition of the gut microbiome, the development and progression of NAFLD stage in Kazakhstan.&lt;br /&gt; &lt;b&gt;Materials and methods:&lt;/b&gt; 39 individuals were involved in this study, including 18 men and 21 women: patients with a history of heavy alcohol consumption (&amp;gt;20 g/day) and other specific diseases such as hepatitis B and C virus infection, etc. were excluded. The diagnosis was established based on the results of clinical assessment and laboratory-instrumental results. The microbiome composition of the large intestine was studied by semiconductor sequencing of the bacterial genome using biochips. The degree of steatosis and liver fibrosis were evaluated by fibroscanning on fibroscan touch 502. Genotyping of PNPLA3 and TM6SF2 were carried out by PCR.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; According to PNPLA3 genotyping: 21 patients (53.85%) were C/G, 7 (17.95%) were C/C and 11 (28.20%) were G/G. Within analyzed variables, GGT showed statistically significant difference among nucleotide variability with p-value of 0.012. Other parameters within metabolic panel also showed statistically significant difference between groups, namely, total cholesterol (p=0.036) and LDL (p=0.006). Genotyping of TM6SF2 includes 24 patients (61.54%) with C/C, 15 (38.46%) with C/T and 0 with T/T. The relationship between TM6SF2 liver function test results showed no statistically significant differences between groups. All other parameters including gut microbiome analysis are not statistically significant.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; In this study, C/G genotype possesses the highest risk and GGT along with LDL were the statistically significant parameter between them in PNPLA3 gene. TM6SF2 and gut microbiome analysis did not reveal any statistically significant differences. Additional studies with larger sample size are recommended to obtain for more detailed and sensitive results.

Screening and combination selection of multifunctional actinomycetes for aerobic composting.

To screen the most effective combination of multipurpose actinomycete strains for aerobic composting, lignocellulose-degrading strains were obtained through enrichment culture, separation and purification, and multiselection culture. The isolated strains were identified on the basis of morphology and 16S rRNA gene sequencing and comparison. The obtained actinomycetes were screened for the lignocellulose degradation rate, ammonia and hydrogen sulfide removal rate, and cellulase activity. Subsequently, a combination of strains with ecological coordination and complementary functions was determined through antagonistic tests. The combined strains were subjected to a straw fermentation test to evaluate their degradation effect. As a result, 20 strains of actinomycetes were isolated and identified from more than 56 samples from different sources, including 18 strains of Streptomyces sp. and 2 strains of Nocardiopsis sp. After a number of screenings, eight strains of actinomycetes with strong function were obtained. From the results of function and antagonistic tests, strains A3, A7, A8, A11, and A16 were selected to form consortia. The straw fermentation test showed that the lignocellulose degradation rate of the strain combination was as high as 39.8%, which was significantly higher than that of eachevery single strain (P < 0.05). The screened multifunctional actinomycete strains and their combination enriched the actinomycete germplasm resources used for microbial enhanced aerobic composting.IMPORTANCEWith the development of animal husbandry in China, the production of a large amount of livestock and poultry manure has become one of the main agricultural pollution sources. High-temperature aerobic composting stands out as one of the most crucial methods for the safe and resourceful utilization of livestock and poultry manure, serving as an essential link between crop cultivation, animal breeding, and sustainable agricultural development. Numerous studies have demonstrated that the addition of exogenous multifunctional bacterial agents to compost reduces not only harmful emissions but also sequesters or increases essential nutrients. However, these efficacies depend on the specific functions of the bacteriophage itself, the harmonization and complementarity within the colony, and its ability to adapt to the environment. In recent years, relatively few studies have been conducted on actinomycetes. This experiment provides excellent actinomycete resources for the production of high-efficiency and high-quality compost compound microbial agents of manure and straw.