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BackgroundPreoperative prediction of lymph node metastases has a major impact on prognosis and recurrence for patients with papillary thyroid carcinoma (PTC). Thyroid ultrasonography is the preferred inspection to guide the appropriate diagnostic procedure.PurposeTo investigate the relationship between PTC and cervical lymph node metastasis (CLNM, including central and lateral LNM) using both conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS).Material and MethodsOur study retrospectively analyzed 379 patients diagnosed with PTC confirmed by surgical pathology at our hospital who underwent US and CEUS examinations from October 2016 to March 2021. Individuals were divided into two groups: the lymph node metastasis group and the nonmetastasis group. The relationship between US and CEUS characteristics of PTC and CLNM was analyzed. Univariate and multivariable logistic regression methods were used to identify the high-risk factors and established a nomogram to predict CLNM in PTC. Furthermore, we explore the frequency of CLNM at each nodal level in PTC patients.ResultsUnivariate analysis indicated that there were significant differences in gender, age, tumor size, microcalcification, contact with the adjacent capsule, multifocality, capsule integrity and enhancement patterns in CEUS between the lymph node metastasis group and the nonmetastasis group (all P50% were independent risk factors for CLNM in PTC, which determined the nomogram. The diagnostic model had an area under the curve (AUC) of 0.756 (95% confidence interval, 0.707-0.805). And calibration plot analysis shown that clinical utility of the nomogram. In 162 PTC patients, the metastatic rates of cervical lymph nodes at levels I-VI were 1.9%, 15.4%, 35.2%, 34.6%, 15.4%, 82.1%, and the difference was statistically significant (P50% are present.

Increasing evidence suggested that the gut microbiome-brain axis plays a critical role in regulating cognitive functions. In this study, we aimed to investigate the dietary treatment effect of Spirulina platensis on learning deficits in high fat diet (HFD) fed mice and clarify the potential mechanisms via investigating the gut microbiome-brain axis. Dietary administration of 1% and 2% Spirulina platensis for 16 weeks significantly improved the spatial learning and memory performance of the HFD-fed mice in both Barnes Maze test and Morris water maze test. The Aβ accumulation, tau-hyperphosphorylation, and neuroinflammation in the hippocampus were significantly inhibited by Spirulina platensis. Spirulina platensis also abrogated HFD induced gut microbial dysbiosis and unbalance of gut microbial metabolites indicating its modulating effect on the gut-brain axis. This study provides further evidence for the application of Spirulina platensis as functional supplement for treatment of Alzheimer’s disease.

Summary: Light sensitivity of the vertebrate retina relies on the integrity of photoreceptors, including rods and cones. Research in patients with Alzheimer's disease (AD) and in AD transgenic mice reports that accumulated amyloid-β (Aβ) plaques in the retina are toxic to retinal neurons. Moreover, Aβ plaques are deposited around the rods and cones, yet photoreceptor anomalies remain unclear in AD. Here, we identify the progressive degeneration of rods and cones characterized by impaired expression of phototransduction proteins, morphological alterations, functional deficits, and even cell loss. Furthermore, we demonstrate that cell senescence and necroptosis were involved in rod degeneration. Importantly, using in vivo scotopic electroretinogram, we detected rod degeneration in early-stage AD transgenic mice before Aβ plaques were observed in the brain. Moreover, we demonstrate that rod degeneration was among the earliest AD retinal manifestations compared with other types of retinal neurons. Overall, our study is the first to identify and detect in vivo, early-onset photoreceptor degeneration in AD.

An asymmetric 1,3‐dipolar cycloaddition of β‐fluoroalkylated α,β‐unsaturated 2‐acyl imidazole with nitrones or N,N'‐cyclic azomethine imines to construct chiral α‐fluoroalkylated γ‐amino alcohols or chiral α‐fluoroalkylated 1,3‐diamino compounds has catalyzed by chiral‐at‐metal rhodium complexes is reported. The corresponding products with three contiguous tertiary stereocenters were obtained in 62%–98% yields with stereoselectivities up to >20:1 dr and 99% ee. Remarkably, as low as 0.06 mol% of chiral‐at‐metal rhodium complex can promote a gram‐scale reaction with nitrones or N,N'‐cyclic azomethine imines. [ABSTRACT FROM AUTHOR]

Although sleep duration and depression were correlated, their temporal sequence and how the sequence influence on future risk of cardiovascular disease (CVD) remained undetermined. This study aimed to explore the temporal relationship between sleep duration and depression, and its association with future CVD risk. We included 10,629 middle-aged and elderly participants with repeated measurements of sleep duration and depressive symptoms (measured by Center for Epidemiological Studies-Depression scale [CES D]) at the first two visits from the China Health and Retirement Longitudinal Study. Cross-lagged analysis and mediation analysis were used to examine the temporal relationship between sleep duration and depression and its impact on future risk of CVD. The adjusted cross-lagged path coefficient from baseline sleep duration to follow-up CES-D (β 1 = −0.191; 95 % confidence interval [CI], −0.239 to −0.142) was significantly greatly than that from baseline CES-D to follow-up sleep duration (β 2 = −0.031; 95 % CI, −0.031 to −0.024) (P difference < 0.0001). Similarly, the path coefficient from baseline sleep duration to annual changes in CES-D was significantly greater than that from baseline CES-D to annual changes in sleep duration (β 1 = −0.093 versus β 2 = −0.015, P difference < 0.0001). The path coefficient from baseline sleep duration to follow-up CES-D in CVD group was significantly greater than that in those without CVD (P difference of β 1 = 0.0378). Furthermore, 27.93 % of the total association of sleep duration with CVD was mediated by depression symptoms. The findings provide evidence that decrease in sleep duration probably precedes the increased in depressive symptoms, and depression partially mediated the pathway from sleep duration to incident CVD. • Decrease in sleep duration preceded the increase in depressive scores. • The relationship was significantly stronger in subjects with CVD. • 27.93 % of the association of sleep duration with CVD was mediated through depression. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the associations of general and central obesity with risk of first cardiometabolic disease (FCMD), cardiometabolic multimorbidity (CMM), and death. Methods: A total of 86,169 participants who were CMD‐free were included from the Kailuan cohort and categorized into four groups by quartiles of BMI, waist to hip ratio (WHR), weight‐adjusted waist index, and waist to height ratio. We defined FCMD as the first onset of diabetes, stroke, or myocardial infarction and CMM as co‐occurrence of at least two CMDs. Multistate models were used to estimate hazard ratios and 95% CI. Results: A total of 18,461 participants developed FCMD, of whom 1476 progressed to CMM, and 10,009 died during follow‐ups. Both general and central adiposity indices increased the risk of transition from baseline to FCMD and from FCMD to CMM. However, compared with the first quartile, the hazard ratio (95% CI) of the fourth quartile of BMI was 0.86 (95% CI: 0.80–0.91) for transition from health to death and 0.66 (95% CI: 0.59–0.74) from FCMD to death, whereas the corresponding estimates of WHR were 1.22 (95% CI: 1.14–1.31) and 1.16 (95% CI: 1.02–1.32), respectively. Conclusions: Central adiposity indices such as WHR were associated with an increased risk of CMD and mortality, showing no evidence for the obesity paradox and thereby supporting a shift of public focus from BMI only to both general obesity and adiposity distribution. [ABSTRACT FROM AUTHOR]

Aims: To investigate the associations of baseline and longitudinal cardiovascular health (CVH) measured by 'Life's Essential 8' (LE8) metrics with the risk of diabetes in Chinese people with normoglycaemia or prediabetes. Materials and Methods: A total 86,149 participants without diabetes were enroled from the Kailuan study and were stratified by baseline glycaemic status (normoglycaemia or prediabetes). Cardiovascular health score ranged from 0 to 100 points was categorised into low (0–49), middle (50–79), and high (80–100) CVH status. Cox regressions were used to assess the associations of baseline and time‐updated CVH status with incident diabetes in the overall cohort and across baseline glycaemic statuses. Results: During a median follow‐up of 12.94 (interquartile rage: 12.48–13.16) years, we identified 13,097 (15.20%) cases of incident diabetes. Baseline and time‐updated high CVH status was associated with a lower risk of diabetes, the corresponding hazard ratio (HR) versus low CVH status was 0.27 (95% confidence interval [CI], 0.23–0.31) and 0.26 (95% CI, 0.23–0.30) in the overall cohort, respectively. Additionally, the effect of high CVH on diabetes was more prominent in participants with normoglycaemia than those with prediabetes (P < 0.0001), with an HR of 0.26 (95% CI, 0.22–0.31) versus 0.50 (95% CI, 0.41–0.62) for baseline CVH, and 0.25 (95% CI, 0.21–0.30) versus 0.39 (95% CI, 0.32–0.48) for time‐updated CVH. Conclusions: Elevated baseline and longitudinal CVH score assessed by LE8 metrics is associated with a lower risk of subsequent diabetes, especially in normoglycaemic adults. [ABSTRACT FROM AUTHOR]

Background: Elevated homocysteine levels are associated with increased blood coagulation and platelet activity and may modulate the response to antiplatelet therapies. We aimed to investigate the effects of homocysteine levels on the efficacy and safety of ticagrelor–acetylsalicylic acid (ASA) versus clopidogrel–ASA among patients with minor stroke or transient ischemic attack who carried CYP2C19 loss-of-function alleles. Methods: We conducted a post hoc analysis of the CHANCE-2 (The Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events–II) trial. Participants were randomly assigned to treatment with ticagrelor–ASA or clopidogrel–ASA. We categorized participants into groups with elevated and non-elevated homocysteine levels, based on the median level. The primary efficacy outcome was recurrent stroke within 90-day follow-up. The primary safety outcome was severe or moderate bleeding within 90 days. Results: A total of 2740 participants were randomly assigned to receive ticagrelor–ASA and 2700 to receive clopidogrel–ASA. Use of ticagrelor–ASA was associated with a reduced risk of recurrent stroke among participants with elevated homocysteine levels (74 [5.3%] v. 119 [8.5%]; hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.45–0.81), but not among those with non-elevated levels (86 [6.4%] v. 87 [6.7%]; HR 0.97, 95% CI 0.71–1.32; p = 0.04 for interaction). When analyzed as a continuous variable, the benefits of ticagrelor–ASA with regard to recurrent stroke increased as homocysteine levels increased (p = 0.04 for interaction). No significant interaction between homocysteine levels and treatment with regard to severe or moderate bleeding was observed (p = 0.7 for interaction). We found a significant interaction between homocysteine levels and therapy with regard to recurrent stroke in females (p = 0.04 for interaction) but not males. Interpretation: In comparison with clopidogrel–ASA, ticagrelor–ASA conferred more benefit to patients with elevated homocysteine levels, particularly to female patients, in this secondary analysis of a randomized controlled trial involving patients with minor ischemic stroke or TIA. Trial registration: ClinicalTrials.gov, no. NCT04078737 [ABSTRACT FROM AUTHOR]

Surgical removal of the thyroid gland (TG) for treating thyroid disorders leaves the patients on lifelong hormone replacement that partially compensates the physiological needs, but regenerating TG is challenging. Here, an approach is reported to regenerate TG within the spleen for fully restoring the thyroid's functions in mice, by transplanting thyroid tissue blocks to the spleen. Within 48 h, the transplanted tissue efficiently revascularizes, forming thyroid follicles similar to the native gland after 4 weeks. Structurally, the ectopically generated thyroid integrates with the surrounding splenic tissue while maintaining its integrity, separate from the lymphatic tissue. Functionally, it fully restores the native functions of the TG in hormone regulation in response to physiological stimuli, outperforming the established method of oral levothyroxine therapy in maintaining systemic homeostasis. The study demonstrates the full restoration of thyroid functions post‐thyroidectomy by intrasplenic TG regeneration, providing fresh insights for designing novel therapies for thyroid‐related disorders. [ABSTRACT FROM AUTHOR]

In the context of wetland restoration, the reconstruction of an ecosystem's structure typically manifests within a relatively short timeframe, while the restoration of its function often necessitates an extended period of time following the implementation of restoration measures. Consequently, it becomes imperative to engage in the comprehensive, long-term dynamic monitoring of restored wetlands to capture timely information regarding the ecological health status of wetland restoration. In this paper, we aimed to precisely assess the ecosystem health of a typical wetland that had been converted from farmland to wetland in Fujin National Wetland Park in 2022. We selected 18 ecological, social, and economic indicators to establish a wetland ecological health evaluation model, and then used the method of an analytic hierarchy process (AHP) to calculate the weights for each indicator and acquire the ecological health index (EHI) score. The results of our study revealed that the ecosystem health index was 3.68, indicating that the FNWP wetland ecosystem was in "good" condition; this result was mainly affected by wetland water quality (0.382). The ecological health assessment of restored wetlands can monitor wetland ecological resources and provide a scientific basis for the management and protection of restored wetlands. [ABSTRACT FROM AUTHOR]