Abnormal Rate Research Articles

Identified Candidate Genes of Semen Trait in Three Pig Breeds Through Weighted GWAS and Multi-Tissue Transcriptome Analysis

High-quality semen is an essential factor for the success of artificial insemination, and revealing the genetic structure of pig semen traits helps improve semen quality. This study aimed to identify candidate genes associated with semen traits in three pig breeds (Duroc, Landrace, and Yorkshire) through weighted GWAS and multi-tissue transcriptome analysis. In this study, to identify candidate genes associated with semen traits in Duroc, Landrace, and Yorkshire, we performed weighted GWAS in four traits (sperm motility, sperm progressive motility, sperm abnormality rate, and total sperm count) using 936 pigs and multi-tissue transcriptome analysis using 34 tissues RNA-seq data of 5457 pigs from FarmGTEx. It was found that 16, 9, and 12 significant SNPs associated with semen traits were identified in Duroc, Landrace, and Yorkshire, with corresponding 7, 5, and 7 candidate genes in these three breeds, respectively, which may be involved in mammal spermatogenesis, testicular function, and male fertility. Moreover, we not only found the same candidate gene DNAI2 as in previous studies but also found two new candidate genes PNLDC1 and RSPH3, which were identified simultaneously in both Landrace and Yorkshire. By integrating the GWAS and multi-tissue transcriptome analysis results, we found that candidate genes associated with semen traits of three pig breeds were highly expressed in the testis tissue. The three genotypes of rs320928244 had significant effects on the expression of the DYNLT1 gene in the testis tissue of Landrace. These results together showed that these candidate genes were mainly related to sperm motility defects. This study helps deepen the understanding of the genetic basis of semen traits and provides a theoretical foundation for improving the semen quality of Duroc, Landrace, and Yorkshire breeds.

The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome.

Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary Tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS. A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters. A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively. DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.

Indications of a benthic foraminifer Cribrononion gnythosuturatum to salinities revealed by eDNA metabarcoding and morphological methods.

Cribrononion gnythosuturatum is a widely distributed benthic foraminifer. However, its adaptability to salinity changes is still poorly understood. To investigate the response of C. gnythosuturatum to salinity changes, sediment samples were collected from an intertidal zone of the Yellow Sea and cultured at 13 salinity gradients from 0 to 60psu for 10weeks. The results of the culture experiments were analyzed using morphological and eDNA methods. The results showed that extremely high tests broken rate at low salinities (<15psu). Under high salinities (>50psu), the stained protoplasm was concentrated in the center of the chambers. Meanwhile, both morphological and eDNA metabarcoding results showed that under abnormal salinity conditions (15-25psu or 40-50psu), the abundance, relative abundance and growth rate of C. gnythosuturatum reached the maximum value, while the tests were well preserved. This study reveals the mechanism by which C. gnythosuturatum is used as a salinity indicator for paleoenvironments.

Aneuploidy rates and clinical pregnancy outcomes after preimplantation genetic testing for aneuploidy using the progestin-primed ovarian stimulation protocol or the gonadotropin-releasing hormone antagonist protocol.

To investigate the chromosome abnormality rates and clinical pregnancy outcomes after preimplantation genetic testing for aneuploidy (PGT-A) using either the progestin-primed ovarian stimulation (PPOS) protocol or the gonadotropin-releasing hormone (GnRH) antagonist protocol. The study included 431 PGT-A cycles in which controlled ovarian stimulation was performed using the PPOS protocol (n = 320 cycles) or GnRH antagonist protocol (n = 111 cycles) between January 2018 and December 2021. Frozen embryo transplantation was subsequently performed in 309 cycles with transplantable blastocysts. The number of retrieved oocytes, embryo development, next-generation sequencing results, and clinical pregnancy outcomes were compared between the two protocols. The primary outcome measure was the aneuploidy rate. Secondary outcome measures were clinical pregnancy per first frozen-thawed embryo transfer cycle and cumulative live birth rates per PGT-A cycle. There were no statistically significant between-group differences in the number of retrieved oocytes, available blastocysts, and high-quality blastocyst rate. The aneuploidy rates were similar between the two groups. There was no significant difference in clinical pregnancy outcomes, including the clinical pregnancy, implantation, miscarriage, live birth, or cumulative live birth rates, after frozen-thawed embryo transfer cycles (P>0.05). The study found no significant difference in the aneuploidy rate, clinical pregnancy rate and cumulative live birth rate after PGT-A cycles between those using the PPOS protocol and those using the GnRH antagonist protocol.

Quantifying the Relationship Between Clinician-Administered Measures of Vestibulo-Ocular Reflex and Oculomotor Function and Patient-Reported Outcome After Pediatric Mild Traumatic Brain Injury.

In pediatric mild traumatic brain injury (mTBI), high rates of abnormalities are observed in vestibulo-ocular reflex (VOR) and oculomotor (OM) function, but there is a lack of understanding of how these impairments may affect daily functioning. To determine the extent to which clinician-administered measures of VOR and OM function are associated with patient-reported levels of activity limitations and participation restriction in children and adolescents within 31days post-mTBI. Cross-sectional design. Tertiary care pediatric hospital. Participants with mTBI aged 7 to 17.99years. Participants were assessed on a battery of VOR and OM tests within 31days of injury. The Dizziness Handicap Inventory (DHI) and Cardiff Visual Ability Questionnaire (CVAQ) measured patient-reported dizziness and visual disability. The vestibular/ocular motor screening tool (VOMS), Head Thrust Test, computerized Dynamic Visual Acuity (DVA) Test, and video Head Impulse Test were administered to assess VOR and OM function. Linear regression examined the associations between clinician-administered measures of VOR and OM function and patient-reported functional outcomes. The sample consisted of 100 youth (54.4% female; mean age 13.92 [2.63]; mean time since injury: 18.26 [6.16] days). Associations were found between (1) DHI score and age (1.773 [0.473-3.073], P =.01), VOR symptom provocation (18.499 [11.312-25.686], P ≤.001), and DVA (-29.433 [-59.206 to -2.60], P =.03); and (2) CVAQ score and version symptom provocation (0.796 [0.185-1.406], P =.01). High abnormal proportions (up to 56.7%) were found in VOMS performance. The symptom provocation induced by VOR and OM tasks was associated with patient-reported dizziness and visual disability outcomes, highlighting the detrimental impact of symptoms on daily functioning. The findings of this study will assist clinicians when interpreting patient-reported measures of activity limitation and participation restriction.

Prenatal diagnosis and clinical pregnancy outcome of fetuses with conotruncal defects in a Chinese cohort.

This study aimed to explore genetic etiologies of conotruncal defects (CTDs) in fetuses by analyzing the results of different genetic tests and to assess pregnancy outcomes of fetuses with CTD in a Chinese prenatal cohort. A total of 146 fetuses that underwent invasive prenatal genetic testing for CTD at the prenatal diagnosis center of the International Peace Maternity and Child Health Hospital between January 2018 and December 2022 were retrospectively analyzed. All of them underwent chromosomal microarray analysis (CMA) and karyotype analysis, but only 27 underwent whole-exome sequencing (WES). The results of these different genetic testing methods were collected and compared. Data on pregnancy outcomes and neonate prognosis were obtained from the electronic medical records and postpartum telephone follow-up. Among the 146 fetuses with CTD, the chromosome abnormality rate was 22.6% (33/146), and the detection rate of abnormal chromosomes in CMA and karyotype was 15.8% (23/146). Among the 27 pregnant women who accepted WES, five had pathogenic variants. The detection rate of abnormal chromosomes by CMA was higher in infants with an interrupted aortic arch (IAA) than in the other infant groups (60.0%, χ2 = 11.661, P = 0.045, c2-test or Fisher's exact test). Congenital heart disease is a complex congenital heart disease with an etiology closely related to genetic abnormalities. Therefore, invasive genetic testing and CMA are recommended as first-line tests for all fetuses with CTD detected by prenatal ultrasound, especially IAA. WES should be recommended when necessary.

Impact of preprocedural LA strain on outcome in severe MS

Abstract Background In patients with mitral stenosis (MS), left atrial (LA) remodeling is crucial for predicting outcomes in severe cases. In this study, we aimed to investigate whether LA longitudinal strain, a parameter of LA remodeling, is associated with adverse outcomes following mitral valve (MV) intervention in patients with severe MS. Methods We included patients with severe MS who underwent percutaneous mitral valvuloplasty (PMV) or MV replacement (MVR) from the long-term registry of Multicenter mitrAl STEnosis with Rheumatic etiology (MASTER) except for previous valvular surgery / intervention or coronary artery bypass surgery, at least moderate other valvular dysfunction, abnormal heart rate (&amp;lt;50 or &amp;gt;100 beats per minute). LA longitudinal strain for each patient was measured on pre-interventional echocardiography, and decreased LA strain was defined as the lower cut-off value on receriver operating characteristics analysis. The primary outcome was defined as all-cause mortality. Results Among 505 patients over a mean follow-up of 6.8 ± 4.9 years after MV intervention, 27 (5.3%) patients had experienced primary outcomes. Patients with decreased LA strain were older (61.1 ± 11.6 vs. 58.2 ±12.1 years, p=0.007), had more atrial fibrillation (97.6 vs. 79.5%, p&amp;lt;0.001), underwent more MVR (89.4 vs. 82.8%, p=0.038), had higher mean diastolic pressure gradient (MDPG) and right ventricular systolic pressure, had lower left ventricular ejection fraction, and larger LA. Patients with decreased LA strain (&amp;lt; 12.2%) revealed a poorer outcome than those with preserved LA strain (log-rank p&amp;lt;0.001) (Figure 1). Conclusions Decreased LA strain on pre-interventional echocardiography was associated with an increased risk of all-cause death after MV intervention. Further prospective studies would be warranted to establish the risk stratification of MV intervention in patients with severe MS. Figure 1. Kaplan-Meier analysis for primary outcomes according to the cut-off value of LA longitudinal strain in patients with severe MS.

Impact of Smoking on Cervical Histopathological Changes in High-Risk HPV-Positive Women: A Matched Case–Control Study

Background and Objectives: The aims of this study were to assess the impact of smoking on cervical histopathology in women with high-risk HPV types 16 and 18 (the most common types) utilizing comprehensive clinical data and to conduct a risk analysis based on smoking pack-years. Materials and Methods: Between 2022 and 2024, 1048 high-risk HPV-positive women aged 25 to 65 years were categorized into two groups: smokers and non-smokers. Data acquired from a histopathological examination of samples collected during a colposcopic evaluation of these women were compared individually regarding clinical and demographic factors, specifically age, gravida, parity, and alcohol consumption. Subsequently, the impact of prolonged and excessive smoking on histopathological cellular changes was assessed in women with the same characteristics. A case–control study was performed on 312 smokers and 312 non-smokers following mutual matching. Results: The women were matched one-to-one regarding gravida, parity, and alcohol consumption. Subsequently, they were paired within a ±2-year age range. The mean age of the smoker group was 47.1 ± 8.8, while that of the non-smoker group was 47.2 ± 8.5 (p: 0.904). In all cases of high-risk HPV positivity, the rate of normal cervical cytological results was 14% in women who smoked and 29% in women who did not smoke. The LGSIL, HGSIL, ASC-H, and AGC-NOS rates were elevated in the smoker group, and a statistically significant difference was observed between the two groups in terms of abnormal cervical cytological results (p &lt; 0.001). After a colposcopic biopsy, the smoker group exhibited higher rates of HGSILs, LGSILs, AGC-NOS, and CIS pathological lesions (28% vs. 23%), whereas the non-smoker group exhibited higher rates of chronic cervicitis (23% vs. 16%). However, no statistically significant difference was found between the two groups (p: 0.092). In a comparison of endocervical curettage (ECC) samples, it was observed that the HGSIL, CIS, and AGC-FN rates in the smoker group were almost the same as those in the non-smoker group. However, the LGSIL histopathology results (32% vs. 18%) were higher, and the rate of negativity with no pathology was higher in the non-smoker group (72% vs. 59%). A statistically significant difference in ECC histopathology was noted between the two groups (p &lt; 0.001). An ROC analysis conducted between smoking pack-years and the colposcopic and endocervical curettage biopsy results revealed that the cutoff value for the colposcopic abnormal histopathological results increased, with 40% sensitivity and 76% specificity above 20 pack-years (AUC: 0.592 and p: 0.025). Additionally, the abnormal histopathology rates for endocervical curettage exhibited 81% sensitivity and 32% specificity above 13 pack-years (AUC: 0.586 and p: 0.008). The rate of abnormalities in the colposcopic biopsy results was 2.19 times higher for individuals with over 20 pack-years, and the rate of abnormalities in the ECC results was 2.08 times higher for those with over 13 pack-years; additionally, statistically significant results were obtained (p-values of 0.027 and 0.008, respectively). Conclusions: The most important cause of neoplastic changes in the cervix uteri is high-risk HPV infection, with evidence indicating that prolonged excessive smoking significantly exacerbates the persistence and progression of HPV infection, thereby influencing neoplastic changes in the cervix uteri. It is crucial for women to cease smoking in order to eradicate HPV infection from the body.

Efficacy and safety of various drug combinations in treating plaque Psoriasis: A meta-analysis

Background Psoriasis, a chronic inflammatory disease affecting the skin, joints, and nails (2-3% worldwide), significantly affects quality of life. Genetic and environmental factors also play key roles. Topical corticosteroids, calcineurin inhibitors, and oral corticosteroids help to manage plaque psoriasis symptoms, but combination therapies might offer greater effectiveness and improved safety profiles. These combinations could potentially reduce medication dosages and side effects in patients. Objective To assess the efficacy and safety of various drug combinations over conventional monotherapies in the treatment of moderate to severe plaque psoriasis, which incorporates palmoplantar psoriasis and psoriasis vulgaris, by discovering and utilizing research articles comprising the same or similar variables as PASI 75 and evaluating the information using RevMan v5.4.1. Method We reviewed the efficacy and safety of combination therapy vs. monotherapy/placebo for moderate-to-severe plaque psoriasis (palmoplantar and vulgaris) using PASI 75 via RevMan v5.4.1. Risk of bias assessment and funnel plots were employed to assess the heterogeneity of each paper. Inclusion criteria – Publications &lt; 20yrs, RCTs, plaque/palmoplantar/psoriasis vulgaris; exclusion criteria – Guttate/arthritic psoriasis, pediatric and pregnant individuals, publications &gt; 20 yrs. Results Seventeen studies were analyzed, comprising a total of 2291 patients (n=1147 with combination regimens and n=1144 with control regimen in the analysis). A significant PASI 75- response was observed in the pioglitazone combination subgroup as compared to placebo (OR=4.92,95% CI 2.19-11.05, P = 0.0001); methotrexate combination subgroup as compared to placebo (OR=2.56, 95% CI 1.67-3.94, P&lt; 0.0001) test of subgroup differences showed P= 0.14, I2= 34%. Incidence rate of abnormality in levels of liver enzymes (OR=1.89,9.5% CI 6.69-5.22, P=0.22), nausea (OR=1.28,95% CI 0.77-2.14, P=0.34), headache (OR=1.28,95% CI 0.77-2.14, P=0.58), fatigue (OR=0.89, 95% CI 0.41-1.90, P=0.45).] Conclusion This study showed that combination therapy is very effective for plaque psoriasis, with promising combinations of pioglitazone. While safety seems similar between the groups, larger studies are needed to determine the long-term effects. These findings suggest that personalized treatment plans could improve outcomes; however, confirmation through larger trials is crucial before wider use. This opens doors to research on optimal combinations for individual patients.

Incidence of ophthalmic manifestations in congenital cytomegalovirus (CMV)

BackgroundCongenital cytomegalovirus (CMV) infections are associated with eye manifestations, especially in patients with systemic disease. However, there are no ophthalmic screening guidelines for infants with congenital CMV.MethodsRetrospective review of pediatric patients (< 18 years old, 2010–2023) with a diagnosis of congenital CMV and at least 1 eye examination. Gestational age at birth, systemic findings, and ophthalmic findings at initial and final eye examinations were collected.ResultsSeventy-two patients (47% male) with congenital CMV underwent initial eye examination at 2.1 ± 2.9 years of age (median 0.3 years). Thirty-one patients (43%) only had one eye examination while 41 patients had follow-up (1 month-19 years). Fifty-two patients (72%) had systemic findings, most commonly hearing loss (50%), neurologic abnormalities (39%), and developmental delay (38%). Patients born < 36 weeks gestation (n = 15) had a higher rate of systemic findings, neurologic abnormalities, developmental delay, and intrauterine growth restriction compared to full-term patients. Twenty-four (33%) patients had ocular findings and all also had systemic manifestations. Strabismus (26%) and optic nerve abnormalities (17%) were most common. Only 2 patients (3%) were diagnosed with retinitis, which was detected at initial examination.ConclusionsOne-third of patients with congenital CMV had ocular findings in conjunction with systemic manifestations. Retinitis was rare and detected on initial eye examination. While initial screening for retinitis is important, patients with systemic sequelae of congenital CMV are at risk for other eye manifestations and require continued follow-up.

Rewarding twenty-year experience with initial and repeat EKG and echocardiographic screening for prevention of sudden death in detecting abnormal findings.

To further analyze the impacts, findings, and modalities of multiple cardiac screenings to answer the question - are multiple screens necessary and useful in youth? Over 20 years, the Anthony Bates Foundation (ABF) has offered free and low-cost cardiac screenings to youth and their families nationwide. The volunteer force has provided blood pressure, and ultrasound tests to participants throughout the 20 years. After year 7, electrocardiograms were added to the screening. Over the 20 years, ABF abnormal findings held steady between 10 - 13%, with Potential Life-Threatening (PLT) findings at 2.5%. The participants that have experienced multiple screening tests on average would repeat within 2.5 years, have abnormal findings at 31.84%, PLT at 11.43%, and total echocardiography-related abnormal findings at 16.82%. The variance between male and female attendance by age is also noted during the review of ABF repeat screened data. Male attendance was at 59.65% and female 40.35%. The abnormality rate of males for the first visit was 10.9% followed by the second visit of 18.80%. The abnormality rate of females for the first visit was 12.22% followed by the second visit of 17.09%. A detailed analysis of abnormal findings is presented in this manuscript. Cardiac screening involving multiple repeated screenings appears to be effective in detecting increasing numbers of abnormal findings that can be lifesaving.

Clinical Analysis of Congenital Duodenal Obstruction and the Role of Annular Pancreas

Background and Objectives: Congenital duodenal obstruction (CDO) is a very rare anomaly with an incidence of 1 in 5000–10,000 live births. Annular pancreas is one of the reasons for CDO and is defined as the pancreatic tissue encircling the duodenum. The exact cause of annular pancreas remains unclear. Materials and Methods: A retrospective study was conducted on all prenatally diagnosed cases of CDO, with the diagnoses and ethiology confirmed by surgery after birth from 1 January 2018 to 1 January 2024. The cases suspected of having CDO in their fetuses underwent ultrasound evaluations on a weekly or biweekly basis. The cohort was divided into two groups, “CDO with annular pancreas” and “CDO without annular pancreas”, in order to compare the clinical characteristics and outcomes. Results: A total of 34 cases of CDO were detected prenatally, with 30 of these cases being confirmed through postnatal surgical interventions. The underlying ethiology was duodenal atresia in 15 cases (50%), duodenal web in 2 cases (6.6%) and annular pancreas in 13 cases (43.3%). All cases had a dilated stomach and double bubble sign. Polyhydramnios was identified in all cases except for one. Three cases were terminated and intrauterine demise was observed in one case. Nine of the cases (33%) died in the postnatal period. In 19 cases (55.9%), CDO was associated with chromosomal abnormalities. Chromosomal abnormalities were significantly more common in the cases of CDO with annular pancreas (p = 0.033). Conclusions: The prenatal diagnosis of CDO is mostly based on findings of double bubble and polyhydramnios. An annular pancreas, although rare, is an important cause of neonatal duodenal obstruction. An accurate diagnosis is usually performed during a laparotomy. Given the higher rates of chromosomal abnormalities in cases of annular pancreas, it is clear that more reliable markers or imaging techniques are needed to detect the ethiology of CDO in the prenatal period.

Nicotinamide riboside supplementation ameliorates ovarian dysfunction in a PCOS mouse model

Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility among women of reproductive age, yet the range of effective treatment options remains limited. Our previous study revealed that reduced levels of nicotinamide adenine dinucleotide (NAD+) in ovarian granulosa cells (GCs) of women with PCOS resulted in the accumulation of reactive oxygen species (ROS) and mitochondrial dysfunction. However, it is still uncertain whether increasing NAD+ levels in the ovaries could improve ovarian function in PCOS. In this study, we demonstrated that supplementation with the NAD+ precursor nicotinamide riboside (NR) prevented the decrease in ovarian NAD+ levels, normalized estrous cycle irregularities, and enhanced ovulation potential in dehydroepiandrosterone (DHEA)-induced PCOS mice. Moreover, NR supplementation alleviated ovarian fibrosis and enhanced mitochondrial function in ovarian stromal cells of PCOS mice. Furthermore, NR supplementation improved oocyte quality in PCOS mice, as evidenced by reduced abnormal mitochondrial clustering, enhanced mitochondrial membrane potential, decreased ROS levels, reduced spindle abnormality rates, and increased early embryonic development potential in fertilized oocytes. These findings suggest that supplementing with NAD+ precursors could be a promising therapeutic strategy for addressing ovarian infertility associated with PCOS.Graphical Ovarian NAD+ levels decreased in DHEA-induced PCOS mice, accompanied by mitochondrial dysfunction in oocytes and ovarian stromal cells, resulting in reduced oocyte quantity and quality, decreased early embryonic development potential, and increased ovarian fibrosis. After increasing ovarian NAD+ levels by NR supplementation to restore PCOS-related impairment of mitochondria function, ovarian dysfunction in PCOS was attenuated as characterized by improved oocyte quantity and quality, enhanced early embryonic development potential, and decreased ovarian fibrosis.

An Assessment of Intermittent and Continuous Enteral Feeding in Critically Ill Children.

The inability to ensure adequate nutrition for patients, and failure to provide adequate calorie and protein intake, result in malnutrition, leading to increased morbidity and mortality. The present study assesses the two approaches to enteral nutrition-intermittent and continuous enteral feeding-in critically ill pediatric patients in Türkiye to determine the superiority of one method over the other. Included in this multicenter prospective study were patients receiving enteral nutrition via a tube who were followed up over a 3-month period. Anthropometric data, calorie and protein intake, and signs of feeding intolerance were evaluated in a comparison of the different feeding methods. A total of 510 patients were examined. In the continuous enteral feeding (CEF) group, 20.2% of patients developed metabolic abnormalities, and 49.5% experienced enteral nutrition intolerance, both of which were higher than in the intermittent enteral feeding (IEF) group, and the differences were statistically significant. No significant differences were observed between the two feeding methods in terms of reaching the target calorie intake on days 2 and 7 (p > 0.05). On day 7, there were significant differences between the two feeding methods in terms of calorie and protein intake (p = 0.023 and 0.014, respectively). In the present study, assessing the IEF and CEF approaches to enteral nutrition, critically ill pediatric patients receiving intermittent feeding exhibited lower rates of enteral nutrition intolerance and metabolic abnormalities. Furthermore, the calorie and protein intake on day 7 were noted to be higher in the IEF group than in the CEF group. Further randomized controlled trials are needed to confirm the findings of the present study.

Director Departure and Noncompliance With Securities Laws

ABSTRACTResearch Question/IssueThis study investigates director departures surrounding the actual commencement of noncompliance events when public perception of the wrongdoing is less likely to exist.Research Findings/InsightsUsing a manually constructed nonaccounting noncompliance dataset of the Securities and Exchange Commission’s enforcement actions and hand‐collected information on directors’ status and characteristics, this study finds that firms not complying with securities laws experienced significantly higher unexpected director departures than control firms during the period in which the noncompliance began. Outside directors, in particular, tend to leave in the pre‐noncompliance period but not in the post‐noncompliance phase. The findings are robust across propensity score–matched tests, conditional logistic regression, and when controlling for CEO turnover. Further exploration of the characteristics of departing directors provides insights into the dynamics of the internal governance mechanism. It shows that directors with a background in an area of specialized expertise tend to leave noncompliant firms. The evidence also suggests that power struggles between departing directors and managers in noncompliant firms might contribute to director departure.Theoretical/Academic ImplicationsThis study extends the literature aimed at unraveling internal governance mechanisms around firms’ negative events. Since there are several important points along the timeline of a negative event, providing evidence on director behavior around these points can offer deeper insights into internal governance mechanisms.Practitioner/Policy ImplicationsThis study provides unique evidence that there is an abnormal departure rate of directors before the commencement of firms’ wrongdoings. This departure is consistent with explanations that directors with an information advantage from a special background are likely to foresee that problems or power struggles between directors and managers are likely to induce the departure of a director who is in a relatively weak position. The findings offer insights for policy makers, suggesting that regulators may need to reflect upon the shortcomings of the current governance system and how to hold management accountable, rather than putting heavy emphasis on developing doctrines for directors’ duties.

The role of audiological features and horizontal semicircular canal function at various frequencies in vestibular migraine and Menière’s disease

Background Vestibular migraine (VM) and Menière’s disease (MD) have numerous overlapping symptoms. Distinguishing the two common recurrent vestibulopathies was challenging. Objectives To assess the characteristics of hearing loss and the horizontal semicircular canal function in VM and MD. Materials and methods Various frequency horizontal semicircular canal function tests, including caloric test, video head impulse test (vHIT), and rotatory chair test, as well as multifrequency audiological test with pure-tone average (PTA), were carried out. Results The hearing threshold of all frequencies in VM is lower than that of MD (p < .05). The phase shift at 0.01 Hz, 0.02 Hz, 0.04 Hz, 0.08 Hz and 0.64 Hz was significantly different in VM and MD patients. The gain at 0.01 Hz differed between VM and MD (p < .05); the time constant (RTc) in VM patients was longer than that of MD patients (p < .05). The incidence of caloric test abnormality was 40% in VM patients and 68.3% in MD patients. The abnormal rate of horizontal semicircular canal vHIT was 3.2% in VM and 5.8% in the MD, and the rates of overt/cover saccades were 9.7% and 17.6%, respectively. Conclusions The degree and type of hearing loss were conducive to distinguishing between VM and MD, and the rotatory chair test was a necessary supplement.

Prevalence of dyslipidemia and influencing factors in HIV-infected people before starting antiretroviral therapy in China, 2018-2023

Objective: To investigate the prevalence of baseline dyslipidemia in HIV-infected people before starting antiviral therapy (ART) in China. Methods: The data were collected from HIV/AIDS ART database of Chinese Disease Prevention and Control Information System. A national sample of HIV- infected people who initiated ART from 2018 to 2023 was used to collect baseline information, including sociodemographic characteristics and laboratory test results. According to the Chinese Lipid Management Guidelines (2023) and the National Cholesterol Education Program Adult Treatment Panel Ⅲ guidelines, triglyceride (TG) ≥1.7 mmol/L or total cholesterol (TC) ≥5.2 mmol/L were identified as dyslipidemia. Statistical analysis was performed with software SAS 9.4. An unconditional logistic regression model was used to analyze the factors influencing TG and TC abnormalities in HIV-infected patients before ART. Results: A total of 359 952 adults infected with HIV were included in this study, the prevalence rate of dyslipidemia was 38.41% (138 263/359 952). The abnormal rates of TG and TC were 31.40% (113 041/359 952) and 13.75% (49 494/359 952), respectively. In all age groups except for the 25-44 age groups, the abnormal rates of TG and TC were higher in HIV-infected women than in HIV-infected men. In HIV-infected patients, women, those aged 45-64 years, those lived in northeast region, those had heterosexual transmission, and those with BMI ≥28.0 kg/m2, CD4+T lymphocytes counts ≥500 cells/µl had higher rates of baseline dyslipidemia (all P<0.05). Conclusions: The abnormal rate of TG in HIV-infected people before ART was higher in China from 2018 to 2023, especially in HIV-infected women, and the abnormal rate of TG and TC increased with age. Attention should be paid to the clinical diagnosis and ART selection in the treatment of HIV infection.

Application of 3D-Flair MRI and vestibular function assessment in profound sudden sensorineural hearing loss patients

Objective: To analyse the 3D-Flair MRI manifestations of the inner ear, vestibular function status, and their correlation with hearing treatment outcomes in patients with severe sudden sensorineural hearing loss (SSNHL), and to explore potential prognostic indicators for sudden deafness. Methods: The clinical data of adult patients with unilateral profound sudden sensorineural hearing loss were retrospectively analyzed in Otorhinolaryngology Department of Shandong Provincial ENT Hospital from March 2018 to August 2020. Patients were categorized based on the results of their inner ear 3D-Flair MRI into two groups: the normal MRI group and the abnormal MRI group. The abnormal group was further divided into three subgroups: those with non-absorbed high signal in the inner ear, those with absorbed high signal, and those with destruction of the blood-labyrinth barrier. SPSS 26.0 statistical software was applied to analyze the differences in hearing efficacy, caloric tests, vestibular evoked myogenic potentials (VEMP), video head impulse tests (vHIT), and the incidence of dizziness/vertigo among various patient groups. Results: A total of 191 patients with complete data were collected (97 males and 94 females, aged from 13 to 69 years old). There were 50 cases in the normal inner ear 3D-Flair MRI group. A total of 141 cases were found in the group with abnormal 3D-Flair MRI, including 50 cases of high signal unabsorbed, 71 cases of absorption high signal and 20 cases of blood labyrinth barrier destruction. There were no significant differences in age, sex, lateral ratio of hearing loss and course of disease among four groups (all P>0.05).The significant efficiencies of hearing recovery, in the group with normal 3D-FLAIR MRI were better than those in the abnormal group (P<0.05) after treatment. Among the four groups, there were significant differences in the apparent efficiency and total effective rate between the normal group and the inner ear high signal absorption group (χ²=4.007, P=0.045; χ²=6.925, P=0.009). The abnormal rates of bithermal caloric test, vHIT results and dizziness/vertigo symptoms in the abnormal group were higher than those in the normal group (P<0.05). There were significant differences in oVEMP abnormality rate, vHIT abnormality rate and incidence of dizziness/vertigo among the three groups with 3D-FLAIR MRI abnormality (P<0.05). There were significant differences in caloric test, oVEMP, vHIT abnormality rate and incidence of dizziness/vertigo among the four groups (P<0.05). The positive rates of caloric test, cVEMP test and vHIT test in patients with dizziness/vertigo were higher than those in patients without dizziness/vertigo (P<0.05). The abnormal rates of posterior semicircular canal and horizontal semicircular canal in patients with dizziness/vertigo were significantly increased (P<0.05) than patients without dizziness/vertigo. The recovery rate, effective rate and total effective rate of patients without dizziness/vertigo were significantly better than those with dizziness/vertigo (P<0.05). Conclusions: The 3D-Flair MRI of the inner ear and vestibular function tests have reference value for the prognosis assessment of patients with severe sudden sensorineural hearing loss. Abnormal 3D-FLAIR MRI of the inner ear, especially absorption high signal, is associated with high incidence of vestibular dysfunction and dizziness/vertigo, with poor prognosis. Patients with severe sudden sensorineural hearing loss who have symptoms of dizziness/vertigo are more likely to exhibit abnormal results in vestibular function tests, with a higher susceptibility to involvement of the posterior and horizontal semicircular canals.

The clinical significance of mirror patterns of cerebrospinal fluid oligoclonal immunoglobulin G bands (IgG-OCBs) in peripheral neuropathy disorders.

CSF (cerebrospinal fluid) oligoclonal immunoglobulin G bands (IgG-OCBs) analysis plays a crucial role in diagnosis of various neurological disorders. However, the clinical significance of mirror pattern bands remains unclear, and their precise application is not well understood. We retrospectively reviewed a total of 7597 IgG-OCB records detected using isoelectric focusing from May 2020 and August 2023 at Huashan Hospital. Among these, 121 mirror pattern bands (62 type IV and 59 type V) were identified in patients with neurological disorders. Basic clinical data, including discharge diagnosis, gender, and age, were collected. Additionally, CSF and serum immunological parameters, as well as monoclonal protein (M protein) detection, were reviewed. Although mirror pattern bands are rarely observed in neurological diseases, approximately half of these patterns were found in patients with peripheral neuropathy (PN). In the type IV group, 40.74 % of cases were associated with immune-mediated PN, while type V pattern was predominantly observed in cancer-related/lymphoproliferative PN, comprising 63.33 % of the cases. Patients with cancer-related or lymphoproliferative PN showed significantly higher IgG-CSF concentrations (p = 0.017) and 24-h intrathecal IgG synthesis rate (p = 0.022), indicating a stronger humoral immune response. Additionally, both patients with immune-mediated PN and cancer-related/lymphoproliferative PN exhibited abnormal intrathecal synthesis rate and moderate to severe blood-brain barrier impairment. Furthermore, the type V group also exhibited a high prevalence of M protein positivity. The differential immunological responses and distinct patterns of OCBs observed in our study underscore the critical role of OCB analysis in the diagnostic workup of PN.

Effects of cochlear implantation on vestibular function in patients with large vestibular aqueduct syndrome

Objective:This study aimed to compare the effects of cochlear implantation（CI） on vestibular function in patients with large vestibular aqueduct syndrome（LVAS） and in patients with extremely severe deafness with normal inner ear structure. Methods:A total of 28 LVAS patients and 28 patients with normal inner ear structure who suffered from extremely severe deafness were selected. The parameters of caloric tests, bone conduction evoked cervical vestibular-evoked myogenic potentials（cVEMP）, bone conduction evoked ocular vestibular-evoked myogenic potentials（oVEMP） and video head impulse tests（v-HIT） were compared between the two groups before and after CI. The data were analyzed using SPSS 26.0 software. Results:There was no significant difference in the results of the preoperative caloric test, v-HIT, and oVEMP（P1, N1） between the LVAS group and the control group（P>0.05）. Compared to the control group, the LVAS group exhibited a shorter cVEMP P1[（13.41±0.71）ms vs （16.28±0.89）ms, P<0.000 1], shorter N1[（19.83±0.54）ms vs （28.18±1.56）ms, P<0.000 1], higher amplitude[（123.60±83.80）μV vs （73.92±79.85）μV, P=0.049 4] and higher oVEMP amplitude[（16.60±13.87）μV vs （9.96±10.47）μV, P=0.028 5] before CI. The abnormal rate of caloric test increased in both groups after CI（25.00% vs 57.14%, P=0.028 8, 32.14% vs 82.14%, P=0.000 3, respectively）. There was no significant difference in the v-HIT parameters in both groups before and after the operation. As for the LVAS group, there was no statistically significant difference in cVEMP and oVEMP induction rates before and after operation. In the control group, there was a decrease in cVEMP induction rate（96.42% vs 64.28%, P=0.005 2） and oVEMP induction rate（96.42% vs 57.14%, P=0.000 9） after CI. LVAS group showed a shorter cVEMP P1[（13.41±0.71）ms vs （10.30±0.60）ms, P<0.000 1]; shorter cVEMP N1[（19.86±0.53）ms vs （18.97±1.33）ms, P=0.004 7]; decreased amplitude[（124.50±84.86）μV vs （64.35±61.57）μV, P=0.001 0] and shorter oVEMP amplitude[（15.92±13.03）μV vs （9.16±9.20）μV, P=0.009 9] after CI. The oVEMP N1 in the control group was longer than that before operation[（11.73 ± 0.91）ms vs （13.35 ± 2.60）ms, P=0.019 6], whereas there was no significant difference in other VEMP parameters after CI. Conclusion:Before CI, there was no significant difference in the results of the caloric test and v-HIT between the LVAS group and the control group, but the LVAS group exhibited increased sensitivity to acoustic stimulation-induced myogenic potentials. After CI, the function of the semicircular canal was impaired in both groups in the low-frequency area, and remained largely unaffected in the high-frequency area. Additionally, the function of the otolith in the LVAS group was less affected than that in the control group after CI, which may be related to the fact that the enlarged vestibular aqueduct of the LVAS patients acted as the third window of the inner ear.