Normal Population Research Articles

Risk of infections in multiple myeloma. A population-based study on 8672 multiple myeloma patients diagnosed 2008-2021 from the Swedish Myeloma Registry.

In multiple myeloma (MM), advancements in treatments and toxicity management have enhanced survival rates. This, coupled with shifting age demographics in MM, necessitates an updated understanding of infection risks in MM patients compared to the general population. Using Swedish population-based registries, we investigated the incidence of infections in 8,672 Swedish symptomatic MM patients diagnosed 2008-2021 and 34,561 matched controls. Overall, MM patients had a 5-fold risk (hazard ratio (HR) = 5.30; 95%, Confidence Interval = CI 5.14-5.47) of developing any clinically significant infection compared to matched controls. Bacterial infections represented a 5-fold (HR 4.88; CI 4.70-5.07) increased risk, viral and fungal infections 7-fold compared to controls. The 1st year after MM diagnosis the risk of infections compared to controls was 7 -fold (HR 6.95; CI 6.61-7.30) and remained elevated up to 5 years after the myeloma diagnosis. The risk of infection compared to controls remained 5-fold in MM patients with follow-up till 2022. Preceding MM diagnosis, the risk compared to matched controls was significantly increased up to four years before MM diagnosis (HR1.16; CI 1.05-1.28). Among MM patients, 8% had died within 2 months of diagnosis and infection contributed to 32% of all deaths. After 1 year, 20% MM patients had died, and infection-related mortality was 27%. Our data constitute the largest population-based study to date on the risk of infections compared to the normal population in the era of modern MM therapies and confirms that infections still represent a major threat to patients and underscores importance of preventive strategies.

Structural equation model analysis of the effect of visceral fat on osteoporosis

BackgroundOsteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region.MethodsWe recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis.ResultsAmong the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m2) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise.ConclusionObesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.

Association between dietary inflammatory index and fecal incontinence in American adults: a cross-sectional study from NHANES 2005–2010

ObjectiveRecent studies have demonstrated that the Dietary Inflammatory Index (DII) is relevant to abnormal gut health. However, there is a lack of studies that have explicitly explored the link between fecal incontinence (FI) and DII. The current study aims to explore the relationship between DII and FI.MethodsThe cross-sectional study enrolled a total of 11,747 participants aged 20–85 from NHANES 2005–2010. Weighted logistic regression was conducted to evaluate the relationship between DII and FI, and restricted cubic spline (RCS) was employed to assess the dose-response relationship between DII and FI. Subgroup analyses were performed according to age, gender, race, and BMI.ResultDII levels were found to be significantly higher in patients with FI than in the normal population (p = 0.016). After adjusting for all covariates, DII was found to be significantly correlated with FI (model 2: Q4 vs. Q1, OR = 1.49, 95% CI: 1.04–2.14, p = 0.032, p for trend = 0.039). The dose-response curve revealed that there was no non-linear correlation between DII and FI (p-non-linear = 0.234). Subsequent subgroup analyses uncovered that DII was notably associated with FI in the old (Q4 vs. Q1, OR = 1.84, 95% CI: 1.07–3.18, p = 0.030), female (Q4 vs. Q1: OR = 2.02, 95% CI: 1.23–3.33, p = 0.008), non-Hispanic white (Q4 vs. Q1: OR = 1.70, 95% CI: 1.12–2.59, p = 0.015) populations.ConclusionDII was positively associated with FI, particularly among old, female and non-Hispanic white individuals. Decreasing daily dietary inflammatory levels may be an effective tactic to prevent FI, but the precise mechanisms need to be further investigated.

Distinct CO2-run-out regime from steric effect of electric double layer in electrochemical CO2 reduction

The field of electrochemical CO2 reduction reaction (eCO2RR) is pursuing high operating current densities, eventually controlled by CO2 transport. Here, we develop a new multiscale modeling approach that is able to more generally describe the effects of the electric double layer (EDL) on CO2 transport over a wide potential window extending to utmost potentials. By leveraging it, we identify a distinct CO2-run-out regime where the supply of CO2 runs out due to the EDL steric effect from a dense layer of solvated cations with the maximum layer thickness equal to the solvated cation size. Consequently, CO2RR current density drops at a relatively negative transition potential generating a bell-shaped polarization curve, which is in contrast to the CO2-transport-limited regime where the current density reaches a plateau. Furthermore, we develop a graphical method, verified by experimental data, to generally predict the transition to the CO2-run-out regime. This work sheds new light on the EDL effects for catalyst design and electrolyzer engineering.

Chip-scale integrated holographic devices based on top-emitting vertical cavity surface emitting lasers.

Holography technology is considered the ultimate three-dimensional (3D) visualization technology in the future. However, conventional methods for achieving holography generally utilize discrete optical components and off-chip laser sources, resulting in a large size and high complexity, which are undesirable for practical applications. In this Letter, chip-scale integrated holographic devices are realized by integrating top-emitting vertical cavity surface emitting lasers (VCSELs) with micro holograms printed by 3D femtosecond laser nanoprinting technology. The VCSELs are designed to operate in a single fundamental mode with a Gaussian emission profile. Then the Gaussian beams are phase-modulated by the integrated micro holograms designed by the Gerchberg-Saxton (GS) algorithm and the target holographic images can be displayed behind the holograms. Such integrated holographic devices are of micron size and can be easily scaled into arrays with arbitrary channels on-demand, which are important for achieving miniaturized and portable holographic imaging systems.

Pituitary neuroadenoma as an ‘Incidentaloma’ in a case of road traffic accident

: Pituitary adenomas are the most common tumors found in the Sella region. Functional pituitary adenomas exhibit a wide range of endocrine manifestations due to either hypo- or hyperfunction of the pituitary gland, as well as mass effect. They can have a slow but severe impact on vision due to compression of the optic nerves, optic chiasm and cavernous sinus.: A 42-year-old male, a security guard at a local dabha, was struck by a van while crossing the road. He sustained a head injury and unfortunately passed away during treatment at our tertiary case institute. At autopsy, upon examination of the skull, a mass measuring 5x5x3cm was discovered in the suprasellar area of base of skull. This mass was sent for histopathological examination, which confirmed it to be a "Pituitary neuroendocrine tumor possibly gonadotropic in nature." However, the cause of death in this case was opined as ‘Head injury’.: Forensic pathologists rarely encounter intracranial neoplasms that present as sudden and unexpected deaths. The incidence of undiagnosed fatal brain tumors detected at autopsy has been reported to range between 0.02% and 0.4%. Several studies have investigated the relationship between hormonally active pituitary adenomas and both mental health disorders and quality of life. One study by Johnson et al. found that patients with nonfunctional adenomas reported impairments in physical and emotional well-being compared to the normal population. Headache and visual symptoms are most commonly associated with pituitary adenomas.In the present case, although it was an incidental finding and not contributing to the cause of death, we cannot underestimate the effect of the tumor on the visual acuity of the decedent. Nonetheless, visual impairment due to the tumor could also have partially led to the road traffic accident.

RBC histogram: Useful diagnostic tool in evaluating anaemia

: Anaemia is a widespread public health problem, more common in developing countries. Red blood cell histogram is a vital part for evaluation and diagnosis of anaemia. Histogram can be a useful modality for arriving at the probable diagnosis of anaemia reporting in short span of time.: To observe various RBC Histogram on haematology Analyser in anaemia and analyse the usefulness of RBC Histogram to correlate with peripheral smear.: A prospective study was done in Department of Pathology of Secondary Care hospital from January 2024 to March 2024 on 300 anaemia patients. RBC Histogram were observed, analysed and correlated with peripheral smear. Out of total 300 patients, Most common anaemia is Microcytic Hypochromic (60%), Normocytic normochromic (21.33%), Dimorphic anaemia (12.33%) and macrocytic anaemia (6%). 95.5% microcytic hypochromic anaemia showed left shifted curve, 84.3% Normocytic normochromic anaemia showed normal curve, 88% macrocytic anaemia showed right shift curve. Considering the speed, reliability and less inter observer variation of the modern haematological analysers RBC histogram are important diagnostic tool for various types of anaemia and provide accurate morphological typing of anaemia in most cases hence presumptive report can be released based on RBC histogram.

RBC histogram: Useful diagnostic tool in evaluating anaemia

: Anaemia is a widespread public health problem, more common in developing countries. Red blood cell histogram is a vital part for evaluation and diagnosis of anaemia. Histogram can be a useful modality for arriving at the probable diagnosis of anaemia reporting in short span of time.: To observe various RBC Histogram on haematology Analyser in anaemia and analyse the usefulness of RBC Histogram to correlate with peripheral smear.: A prospective study was done in Department of Pathology of Secondary Care hospital from January 2024 to March 2024 on 300 anaemia patients. RBC Histogram were observed, analysed and correlated with peripheral smear. Out of total 300 patients, Most common anaemia is Microcytic Hypochromic (60%), Normocytic normochromic (21.33%), Dimorphic anaemia (12.33%) and macrocytic anaemia (6%). 95.5% microcytic hypochromic anaemia showed left shifted curve, 84.3% Normocytic normochromic anaemia showed normal curve, 88% macrocytic anaemia showed right shift curve. Considering the speed, reliability and less inter observer variation of the modern haematological analysers RBC histogram are important diagnostic tool for various types of anaemia and provide accurate morphological typing of anaemia in most cases hence presumptive report can be released based on RBC histogram.

Correction: The area under normal ROC curves

Correction: The area under normal ROC curves

Correlative single-molecule and structured illumination microscopy of fast dynamics at the plasma membrane

Total internal reflection fluorescence (TIRF) microscopy offers powerful means to uncover the functional organization of proteins in the plasma membrane with very high spatial and temporal resolution. Traditional TIRF illumination, however, shows a Gaussian intensity profile, which is typically deteriorated by overlaying interference fringes hampering precise quantification of intensities—an important requisite for quantitative analyses in single-molecule localization microscopy (SMLM). Here, we combine flat-field illumination by using a standard πShaper with multi-angular TIR illumination by incorporating a spatial light modulator compatible with fast super-resolution structured illumination microscopy (SIM). This distinct combination enables quantitative multi-color SMLM with a highly homogenous illumination. By using a dual camera setup with optimized image splitting optics, we achieve a versatile combination of SMLM and SIM with up to three channels. We deploy this setup for establishing robust detection of receptor stoichiometries based on single-molecule intensity analysis and single-molecule Förster resonance energy transfer (smFRET). Homogeneous illumination furthermore enables long-term tracking and localization microscopy (TALM) of cell surface receptors identifying spatial heterogeneity of mobility and accessibility in the plasma membrane. By combination of TALM and SIM, spatially and molecularly heterogenous diffusion properties can be correlated with nanoscale cytoskeletal organization and dynamics.

Extensions of curves with high degree with respect to the genus

We classify linearly normal surfaces $S \subset \mathbf{P}^{r+1}$ of degree $d$ such that $4g-4 \leq d \leq 4g+4$, where $g>1$ is the sectional genus (it is a classical result that for larger $d$ there are only cones). We apply this to the study of the extension theory of pluricanonical curves and genus $3$ curves, whenever they verify Property $N_2$, using and slightly expanding the theory of integration of ribbons of the authors and E.~Sernesi. We compute the corank of the relevant Gaussian maps, and we show that all ribbons over such curves are integrable, and thus there exists a universal extension. We carry out a similar program for linearly normal hyperelliptic curves of degree $d\geq 2g+3$. We classify surfaces having such a curve $C$ as a hyperplane section, compute the corank of the relevant Gaussian maps, and prove that all ribbons over $C$ are integrable if and only if $d=2g+3$. In the latter case we obtain the existence of a universal extension.

Extensions of curves with high degree with respect to the genus

We classify linearly normal surfaces $S \subset \mathbf{P}^{r+1}$ of degree $d$ such that $4g-4 \leq d \leq 4g+4$, where $g>1$ is the sectional genus (it is a classical result that for larger $d$ there are only cones). We apply this to the study of the extension theory of pluricanonical curves and genus $3$ curves, whenever they verify Property $N_2$, using and slightly expanding the theory of integration of ribbons of the authors and E.~Sernesi. We compute the corank of the relevant Gaussian maps, and we show that all ribbons over such curves are integrable, and thus there exists a universal extension. We carry out a similar program for linearly normal hyperelliptic curves of degree $d\geq 2g+3$. We classify surfaces having such a curve $C$ as a hyperplane section, compute the corank of the relevant Gaussian maps, and prove that all ribbons over $C$ are integrable if and only if $d=2g+3$. In the latter case we obtain the existence of a universal extension.

Large sampling intervals for learning and predicting chaotic systems with reservoir computing

Reservoir computing (RC) is an efficient artificial neural network for model-free prediction and analysis of dynamical systems time series. As a data-based method, the capacity of RC is strongly affected by the time sampling interval of training data. In this paper, taking Lorenz system as an example, we explore the influence of this sampling interval on the performance of RC in predicting chaotic sequences. When the sampling interval increases, the prediction capacity of RC is first enhanced then weakened, presenting a bell-shaped curve. By slightly revising the calculation method of the output matrix, the prediction performance of RC with small sampling interval can be improved. Furthermore, RC can learn and reproduce the state of chaotic system with a large time interval, which is almost five times larger than that of the classic fourth-order Runge–Kutta method. Our results show the capacity of RC in the applications where the time sampling intervals are constrained and laid the foundation for building a fast algorithm with larger time iteration steps.

Comparison of 2 Serum Free Light Chain Assays with Creatinine Normal and Abnormal Populations Demonstrates the Need for Standardization.

The objective of this study was to compare The Binding Site's Freelite on Optilite and Diazyme's Kappa/Lambda free light chains (K/L FLC) on Abbott Architect c8000 with healthy and renal insufficient populations and to evaluate their respective reference intervals for serum free light chains (sFLCs). Two hundred sixty serum samples were measured for creatinine and sFLCs by both assays and a subset by immunofixation electrophoresis. Verification of manufacturer-defined reference intervals was assessed. Kappa free light chains (KFLC) showed excellent correlation of 0.998 R2 with a slope of 0.73. For Lambda free light chains (LFLC), an acceptable correlation of 0.953 R2 was found with a slope of 1.50 as well as a skewness-based difference with a -12.70 intercept. Healthy estimated glomerular filtration rate (eGFR) ≥60 reference interval verification of central 95% could not be confirmed for either Freelite or Diazyme although LFLC was much closer than KFLC for both assays with Freelite KFLC recovering only 37% of values within reference interval claims. The K/L FLC ratio did not meet 100% claim for both Freelite (91%) and Diazyme (95%) among those with eGFR ≥60. Samples with eGFR ≤59 had increasingly higher levels of KFLC and LFLC for both assays. When comparing worsening eGFR status, Freelite recovered increasingly higher ratios while Diazyme recovered increasingly lower ratios. Healthy reference intervals could not be verified for either Freelite or Diazyme. Renal reference intervals for Freelite are currently warranted while they are not recommended for Diazyme. The differences between these 2 assays can be minimized by standardization efforts such as recalibration.

Clinical Validation of the Somatic FANCD2 Mutation (c.2022-5C>T) as a Novel Molecular Biomarker for Early Disease Progression in Chronic Myeloid Leukemia: A Case–Control Study

Background: Chronic myeloid leukemia (CML) results from chromosomal translocation t(9;22) leading to the formation of the BCR-ABL fusion oncogene. CML has three stages: the chronic phase (CP), the accelerated phase (AP), and the blast crisis (BC). Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML. TKIs work well in CP-CML, and these patients have a survival rate similar to the normal population, but TKIs are less effective in advanced-phase CML. Even with current advances in treatment, BC-CML patients have an average overall survival of less than a year. Early recognition of CML patients at risk of disease progression can help in timely interventions with appropriate TKIs or other therapeutic modalities. Although some markers of disease progression like BCR-ABL kinase domain, ASXL1, and GATA2 mutations are available, no universal and exclusively specific molecular biomarkers exist to early diagnose CML patients at risk of CML progression for timely therapeutic interventions to delay or minimize blast crisis transformation in CML. A recent study found that all BC-CML patients harbored the FANCD2 (c.2022-5C>T) mutation. Therefore, the current study was designed to detect this FANCD2 mutant in AP-CML (early progression phase) and to clinically validate its potential as a novel molecular biomarker of early CML progression from CP to AP. Methods: Our study comprised 123 CP-CML (control group) and 60 AP-CML patients (experimental group) from 2 oncology centers, from January 2020 to July 2023. Mean hemoglobin level, WBC count, platelet count, treatment type, hepatomegaly, splenomegaly, and survival status of AP-CML patients were significantly different from those of CP-CML patients. However, as these clinical parameters cannot help in the early detection of patients at risk of CML progression, there was a need for a clinically validated biomarker of AP-CML. DNA was extracted from the patients’ blood samples, and the FANCD2 gene was sequenced using an Illumina NextSeq500 next-generation sequencer (NGS). Results: The NGS analysis revealed a unique splice-site mutation in the FANCD2 gene (c.2022-5C>T). This mutation was detected in the majority (98.3%) of AP-CML patients but in none of the CP-CML patients or healthy control sequences from genomic databases. The mutation was confirmed by Sanger sequencing. FANCD2 is a member of the Fanconi anemia pathway genes involved in DNA repair and genomic stability, and aberrations of this gene are associated with many cancers. Conclusions: In conclusion, our study shows that the somatic FANCD2 (c.2022-5C>T) mutation is a new molecular biomarker for early CML progression. We recommend further clinical validation of this biomarker in prospective clinical trials.

Clinical Validation of the Somatic FANCD2 Mutation (c.2022-5C>T) as a Novel Molecular Biomarker for Early Disease Progression in Chronic Myeloid Leukemia: A Case–Control Study

Background: Chronic myeloid leukemia (CML) results from chromosomal translocation t(9;22) leading to the formation of the BCR-ABL fusion oncogene. CML has three stages: the chronic phase (CP), the accelerated phase (AP), and the blast crisis (BC). Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML. TKIs work well in CP-CML, and these patients have a survival rate similar to the normal population, but TKIs are less effective in advanced-phase CML. Even with current advances in treatment, BC-CML patients have an average overall survival of less than a year. Early recognition of CML patients at risk of disease progression can help in timely interventions with appropriate TKIs or other therapeutic modalities. Although some markers of disease progression like BCR-ABL kinase domain, ASXL1, and GATA2 mutations are available, no universal and exclusively specific molecular biomarkers exist to early diagnose CML patients at risk of CML progression for timely therapeutic interventions to delay or minimize blast crisis transformation in CML. A recent study found that all BC-CML patients harbored the FANCD2 (c.2022-5C>T) mutation. Therefore, the current study was designed to detect this FANCD2 mutant in AP-CML (early progression phase) and to clinically validate its potential as a novel molecular biomarker of early CML progression from CP to AP. Methods: Our study comprised 123 CP-CML (control group) and 60 AP-CML patients (experimental group) from 2 oncology centers, from January 2020 to July 2023. Mean hemoglobin level, WBC count, platelet count, treatment type, hepatomegaly, splenomegaly, and survival status of AP-CML patients were significantly different from those of CP-CML patients. However, as these clinical parameters cannot help in the early detection of patients at risk of CML progression, there was a need for a clinically validated biomarker of AP-CML. DNA was extracted from the patients’ blood samples, and the FANCD2 gene was sequenced using an Illumina NextSeq500 next-generation sequencer (NGS). Results: The NGS analysis revealed a unique splice-site mutation in the FANCD2 gene (c.2022-5C>T). This mutation was detected in the majority (98.3%) of AP-CML patients but in none of the CP-CML patients or healthy control sequences from genomic databases. The mutation was confirmed by Sanger sequencing. FANCD2 is a member of the Fanconi anemia pathway genes involved in DNA repair and genomic stability, and aberrations of this gene are associated with many cancers. Conclusions: In conclusion, our study shows that the somatic FANCD2 (c.2022-5C>T) mutation is a new molecular biomarker for early CML progression. We recommend further clinical validation of this biomarker in prospective clinical trials.

Computer-aided drug design supporting sunscreen research: a showcase study using previously synthesized hybrid UV filter-antioxidant compounds.

Although quantum mechanical calculations have proven effective in accurately predicting UV absorption and assessing the antioxidant potential of compounds, the utilization of computer-aided drug design (CADD) to support sustainable synthesis research of new sunscreen active ingredients remains an area with limited exploration. Furthermore, there are ongoing concerns about the safety and effectiveness of existing sunscreens. Therefore, it remains crucial to investigate photoprotection mechanisms and develop enhanced strategies for mitigating the harmful effects of UVR exposure, improving both the safety and efficacy of sunscreen products. A previous study conducted synthesis research on eight novel hybrid compounds (I-VIII) for use in sunscreen products by molecular hybridization of trans-resveratrol (RESV), avobenzone (AVO), and octinoxate (OMC). Herein, time-dependent density functional theory (TD-DFT) calculations performed in the gas phase on the isolated hybrid compounds (I-VIII) proved to reproduce the experimental UV absorption. Resveratrol-avobenzone structure-based hybrids (I-IV) present absorption maxima in the UVB range with slight differences between them, while resveratrol-OMC structure-based hybrids (V-VIII) showed main absorption in the UVA range. Among RESV-OMC hybrids, compounds V and VI exhibited higher UV absorption intensity, and compound VIII stood out for its broad-spectrum coverage in our simulations. Furthermore, both in silico and in vitro analyses revealed that compounds VII and VIII exhibited the highest antioxidant activity, with compound I emerging as the most reactive antioxidant within RESV-AVO hybrids. The study suggests a preference for the hydrogen atom transfer (HAT) mechanism over single-electron transfer followed by proton transfer (SET-PT) in the gas phase. With a strong focus on sustainability, this approach reduces costs and minimizes effluent production in synthesis research, promoting the eco-friendly development of new sunscreen active ingredients. The SPARTAN'20 program was utilized for the geometry optimization and energy calculations of all compounds. Conformer distribution analysis was performed using the Merck molecular force field 94 (MMFF94), and geometry optimization was carried out using the parametric method 6 (PM6) followed by density functional theory (DFT/B3LYP/6-31G(d)). The antioxidant behavior of the hybrid compounds (I-VIII) was determined using the highest occupied molecular orbital (εHOMO) and the lowest unoccupied molecular orbital (εLUMO) energies, as well as the bond dissociation enthalpy (BDE), ionization potential (IP), and proton dissociation enthalpy (PDE) values, all calculated at the same level of structural optimization. TD-DFT study is carried out to calculate the excitation energy using the B3LYP functional with the 6-31G(d) basis set. The calculated transitions were convoluted with a Gaussian profile using the Gabedit program.

Copeptin's role in traumatic brain injury: The promising quest for a new biomarker

ObjectiveTraumatic brain injury (TBI) necessitates reliable biomarkers to improve patient care. This study explored copeptin as a potential biomarker in TBI and its relation to vasopressin (ADH) in such patients. MethodsA cross-sectional study was conducted on 50 TBI patients. Exclusion criteria included specific medical conditions and recent traumatic events. Copeptin and ADH testing were performed within 30 days post-trauma. Patient data, Glasgow Coma Scale (GCS) scores, imaging results, and the need for surgical intervention were obtained from medical charts. ResultsCopeptin levels negatively correlated with GCS scores (ρ = − 0.313, p = 0.027), indicating a potential association with trauma severity. Copeptin levels (mean: 3.22 pmol/L, median 2.027 pmol/L, SD = 3.15) tended to be lower than those found in the normal population, suggesting possible neuroendocrine dysfunction post-TBI. ADH levels (mean: 67.93 pmol/L, median 56.474 pmol/L SD = 47.67) were higher than the normal range and associated with the need for surgery (p = 0.048). Surprisingly, copeptin and ADH levels negatively correlated (r = − 0.491; p < 0.001), potentially due to differences in degradation processes and physiological variations in TBI patients. ConclusionCopeptin shows potential as a predictive biomarker for assessing TBI severity and predicting patient outcome. However, its complex relationship with ADH in TBI requires further investigation. Careful interpretation is needed due to potential variations in excretion dynamics and metabolism. Larger studies on TBI patient cohorts are essential to validate copeptin as a reliable biomarker and improve patient care in TBI.

Blake's pouch cyst-like imaging abnormalities in idiopathic normal pressure hydrocephalus

ObjectiveBlake's pouch cyst is a cause of congenital non-communicating hydrocephalus. Recent study revealed that adult onset communicating normal pressure hydrocephalus sometimes accompanied by Blake's pouch cyst-like imaging abnormalities. However, relationships between two disease entities remains uncovered. The aim of this study was to investigate the prevalence of Blake's pouch cyst-like imaging abnormalities in idiopathic normal pressure hydrocephalus and their impact on the clinical features. MethodsFirst, we investigated the existence of Blake's pouch cyst-like imaging abnormalities in 46 idiopathic normal pressure hydrocephalus patients (mean age 76.8 ± 5.2 years old; 28 women) and 247 normal controls (mean age 65.2 ± 4.0 years old; 120 women). Second, the demographic, clinical and imaging characteristics were compared between idiopathic normal pressure hydrocephalus with and without Blake's pouch cyst-like imaging abnormalities. ResultsBlake's pouch cyst-like imaging abnormalities were more prevalent in idiopathic normal pressure hydrocephalus patients (17.4 %) than in the normal population (2.4 %). Idiopathic normal pressure hydrocephalus with Blake's pouch cyst-like imaging abnormalities showed a trend toward a younger onset than those without Blake's pouch cyst-like imaging abnormalities, while clinical features, including the response to cerebrospinal fluid tap test and shunt treatment, did not differ between two groups. ConclusionsIncomplete cerebrospinal fluid obstruction associated with Blake's pouch cyst-like imaging abnormalities may be a cause of idiopathic normal pressure hydrocephalus.

Optimized dispersion Higuchi fractal dimension and its refined composite multi-scale version for signal analysis

Higuchi fractal dimension (HFD), as a classic nonlinear dynamic metric, which is commonly used to detect signal dynamic changes. However, it is difficult for HFD to process signal outliers. To address this issue, dispersion HFD (DHFD) is proposed, which improves the signal complexity representation ability of HFD by introducing the normal cumulative distribution function and round function in dispersion entropy. Nevertheless, the parameter selection of DHFD can affect the complexity value. Therefore, an optimized dispersion HFD (ODHFD) is proposed, which solves the threshold selection problem of DHFD and can more effectively reflect the complexity of the signal. In addition, an optimized refined composite DHFD (ORCMDHFD) has been proposed, which can more comprehensively reflect the complexity information for the signal at multiple scales. The simulation experiment results show that DHFD has a smaller standard deviation than HFD when calculating white noise signal complexity, and DHFD have the least dependence on signal length compared to other metrics, as well as RCMDHFD has the best separability for simulated noise signals. Actual experiments have shown that ODHFD and ORCMDHFD is superior to other entropy and fractal dimension metrics in distinguishing ship radiated noise and mechanical fault signals, and has broad application prospects in the field of signal analysis.