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Primary amoebic meningoencephalitis (PAM) is a rare but fatal disease caused by Naegleria fowleri, a single-cell, free-living ameba. N. fowleri amebae usually live in natural waters, but occasionally can be [...]

Abstract Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) have the potential application in evaluating pathological structural change of the optic nerve. We aimed to evaluate the value of the OCT and OCTA parameters of the optic disk and macular in differentiating early chronic primary angle-closure glaucoma (CPACG) and early pituitary adenoma (PA) in case of mild visual field defects (the mean defect (MD) > 6 dB). The results showed that regarding OCTA parameters, CPACG patients had lower retinal blood flow density of most layers of the optic disk and macular than PA patients. Regarding OCT parameters, CPACG patients had thinner circumpapillary retinal nerve fiber layer (CP-RNFL) in all quadrants and average CP-RNFL, ganglion cell layer (GCL) and macular ganglion cell complex (GCC) in each quadrant of macular inner and outer rings, and inner plexus layer (IPL) of macular inner ring, superior-outer ring and temporal-outer ring than PA patients. The Z test indicated that OCTA parameters and OCT parameters had similar value in the diagnosis of disease. In conclusion, in the case of similar visual field damage, early CPACG patients have smaller blood flow density and thinner optic disk and macular than early PA. OCTA has similar performance to OCT in diagnosing CPACG and PA.

We investigated a fatal case of primary amoebic meningoencephalitis from an indoor surfing center in Taiwan. The case was detected through encephalitis syndromic surveillance. Of 56 environmental specimens, 1 was positive for Naegleria fowleri ameba. This report emphasizes the risk for N. fowleri infection from inadequately disinfected recreational waters, even indoors.

Background : AMP-activated protein kinase (AMPK) is a key enzyme for cellular energy homeostasis and improves metabolic disorders. Brown and beige adipose tissues exert thermogenesis capacities to dissipate energy in the form of heat. Here, we investigated the beneficial effects of the antioxidant alpha-lipoic acid (ALA) in menopausal obesity and the underlying mechanisms. Methods : Female Wistar rats (8 weeks old) were subjected to bilateral ovariectomy (Ovx) and divided into four groups: Sham (n=8), Ovx (n=11), Ovx+ALA2 (n=10), and Ovx+ALA3 (n=6) (ALA 200 and 300 mg/kg/day, respectively; gavage) for 8 weeks. 3T3-L1 cells were used for in vitro study. Results : Rats receiving ALA2 and ALA3 treatment showed significantly lower levels of body weight and white adipose tissue (WAT) mass than those of the Ovx group. ALA improved plasma lipid profiles including triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Hematoxylin & eosin staining of inguinal WAT showed that ALA treatment reduced Ovx-induced adipocyte size and enhanced uncoupling protein 1 (UCP1) expression. Moreover, plasma levels of irisin were markedly increased in ALA-treated Ovx rats. Protein expression of brown fat-specific markers including UCP1, PRDM16, and CIDEA was downregulated by Ovx but markedly increased by ALA. Phosphorylation of AMPK, its downstream acetyl-CoA carboxylase, and its upstream LKB1 were all significantly increased by ALA treatment. In 3T3-L1 cells, administration of ALA (100 and 250 μM) reduced lipid accumulation and enhanced oxygen consumption and UCP1 protein expression, while inhibition of AMPK by dorsomorphin (5 μM) significantly reversed these effects. Conclusion : ALA improves estrogen deficiency-induced obesity via browning of WAT through AMPK signaling.

BackgroundMost of patients with prostate cancer (PCa) are elderly and have a long course of disease. Preoperative assessment of the patient's clinical nutritional status facilitates early intervention and improves patient prognosis.MethodsWe assessed the nutritional status of PCa patients utilizing the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) scoring systems. Survival comparisons between groups were conducted using Kaplan-Meier curve analysis and log-rank tests, while Cox proportional hazards regression analysis was employed to identify independent prognostic factors. Furthermore, we implemented bootstrap-based optimism correction methods to validate the scoring systems and applied decision curve analysis to evaluate the non-inferiority of these three clinical nutrition scoring systems relative to the conventional American Joint Committee on Cancer (AJCC) staging.ResultsIn this study, malnutrition was diagnosed in 31.51% of the patients using the NRI, 13.02% using the PNI, and 88.28% using the CONUT score. After adjusting for confounders, normal nutritional status as defined by NRI and PNI emerged as an independent prognostic factor for prostate-specific antigen progression-free survival (PSA-PFS). However, nutritional status assessed by CONUT inaccurately predicted PSA-PFS. Normal nutritional status, as determined by all three scoring systems, was found to be an independent prognostic factor for progression-free survival (PFS). Following adjustments for optimistic estimates, the C-index for NRI in predicting both PSA-PFS and PFS remained the highest among the three scoring systems. The results of the DCA indicated that the C-index of all three scoring systems was higher than that of AJCC stage.ConclusionsNRI, PNI, and CONUT are convenient and clinically applicable scoring systems. A clinical malnutrition intervention may improve the prognosis of prostate cancer patients.

Objective: To evaluate the efficacy of CO2 fractional laser and microneedling pretreatment combined with ALA-PDT for moderate-to-severe acne, aiming to optimize clinical treatment. Methods: Patients were randomly divided into three groups: Group A (CO2 fractional laser + ALA-PDT), Group B (microneedling + ALA-PDT), and Group C (ALA-PDT). Each group underwent photodynamic therapy once a week for 3 weeks. Efficacy was assessed at the end of the 4th week, and recurrence was assessed at the end of the 12th week. Results: A total of 150 patients with moderate to severe acne were included in this study, with 50 patients in each group. Four weeks after the end of treatment, the effective rates were 88 % for Group A, 62 % for Group B, and 36 % for Group C. Statistically significant differences were found between the groups (P < 0.05), with Group A showing superior efficacy compared to Group B (P < 0.05). No serious systemic or local adverse reactions were observed in any group. No recurrence was seen in any group 12 weeks after the end of treatment, and some patients continued to show improvement in skin lesions over time. Conclusion: Both the CO2 fractional laser group and the microneedling group improved the efficacy of photodynamic therapy for moderate to severe acne compared to the control group, with the CO2 fractional laser group demonstrating better efficacy and fewer adverse effects.

BackgroundPrescription medication labels (PMLs) predominantly dispensed in English, are an important adjunct to medication counselling. PMLs are routinely used by pharmacy staff to counsel older adults about their medications. This study sought to identify challenges that pharmacy staff observe older adults face in using their PMLs, and to identify and quantify solutions employed by pharmacy staff during medication counselling to address such challenges.MethodsTen in-depth interviews were done with primary care pharmacy staff to gather the range of challenges and solutions. Subsequently, a quantitative survey, informed by the qualitative findings, was administered to 121 pharmacy staff to assess if the reported solutions were commonly used.ResultsThe two main challenges were incongruity between PML language (English) and older adults' language proficiency, and poor PML legibility. The solutions, classified under three themes, were simplifying medication information on PMLs, supplementing PMLs with additional medication information and mitigating poor readability.ConclusionsPharmacy staff observed challenges faced by older adults in using PMLs during medication counselling. Ad-hoc improvisations by pharmacy staff to PMLs were pervasive. System-level PML improvements, such as provision of legible bilingual medication instructions, pharmaceutical pictograms and additional medication information, through patient information leaflets or using quick response (QR) codes on PMLs, should be considered. This will facilitate patient-provider communication, especially in settings with language dissonance between PMLs and patients.

The ginsenoside isomers were analyzed and distinguished by using inlet ionization-high resolution mass spectrometry technology under positive and negative ion modes with optimum inlet temperatures. The results showed that under the full scanning mode of positive and negative ion modes with the optimum experimental temperature, different types of ions were formed according to the characteristics of different numbers of polymers formed by isomeric monomers of ginsenoside, and the identification of ginsenoside isomers was realized. For the identification of ginsenoside CK and Rh2, there was no obvious difference in their MS spectra under positive ion mode. However, under negative ion mode with the inlet temperature of 200 ℃, ginsenoside CK tended to form polymers of [M+Cl]－, Rh2 tended to form polymers of [M+COOH]－, and the number of polymers of CK was significantly higher than that of Rh2. For the identification of ginsenoside Rb2 and Rc, under positive ion mode with the inlet temperature of 200 ℃, ginsenoside Rb2 and Rc could produce polymers of [M+Na]+, but the polymers peak intensity of Rb2 was significantly higher than that of Rc. Under negative ion mode with the inlet temperature of 200 ℃, Rb2 tended to form polymers of [M+Cl]－, and Rc tended to form polymers of [M+COOH]－. For the identification of ginsenoside Rg1 and Rf, there was no obvious difference in their MS spectra under the positive ion mode. Under negative ion mode with the inlet temperature of 200 ℃, Rg1 and Rf tended to form polymers of [M+Cl]－ and [M−H]−, respectively. In this study, the three pairs of isomers in ginsenosides were basically identified by using the full MS scanning method and the control of the mass spectrometry inlet temperature. The experimental method is simple, fast, and has the characteristics of low consumption. This study confirms that the entrance ionization mass spectrometry technique can provide a theoretical reference for the rapid discrimination and identification of ginsenoside isomers.

The waste from nuclear power plants worldwide has to be isolated from humans and his environment for about 100 000 years to equal the levels of natural uranium. If, however, the long-lived actinides could be separated from the spent fuel and transmuted, then the isolation time could be shortened to about 1 000 years. It is known that one class of N-containing soft ligands has excellent extraction ability and selectivity for minor actinides (MA), the separation of MA/lanthanides(Ln) from high level waste has been expected. One of the limiting points to ensure a safe and stable long-term operation is the resistance against radiation of all chemicals involved in the systems due to the highly radioactive field and high nitric acid concentration. Derivatives of 2,6-bis(1,2,4-triazine-3-yl)pyridine(BTP), 6,6'-bis(1,2,4-triazin-3-yl)-2,2'-bipyridine(R-BTBP) and 2,9-bis(1,2,4-triazin-3-yl)-1,10-phenanthroline(R-BTPhen) were widely employed for trivalent minor actinoid and lanthanoid separation in the promising innovative Selective Actinide Extraction(i-SANEX) and Grouped Actinide Extraction(EURO-GANEX) processes. However, researches towards radiolytic stability of these N-donor ligands presented controversial results. Herein, researches on stability against γ-radiation or α-radiation of R-BTP, R-BTBP, R-BTPhen and 2,6-bis[1H-1,2,3-triazol-4-yl]-pyridine(PyTri) at different experimental conditions and solvent formulations are reviewed. In most cases, γ irradiations were performed using 60Co sources and α irradiation were performed using 241Am or 244Cm solution. The effects of molecular structure, dose and dose rate, contact between phases, oxygen content, different phase composition, acidity, diluent and phase modifier on the γ-radiation stability of these ligands are introduced. The performance and changes in the composition have been analyzed during the irradiation experiment by different techniques, such as Raman spectroscopy, HPLC-MS and ICP-MS, to determine the degradation of the organic or aqueous solvents. These data were used to provide critical insight into the fundamental radiolysis mechanisms responsible for the radiolytic stability of ligands. In general, degradation was slower in the presence of both organic and aqueous phases during irradiation for both the hydrophobic and hydrophilic ligands. However, different experimental conditions and solvent formulations may lead to different degradation paths and degradation rates, and these experimental results are not comparable. Moreover, it is generally accepted that simulate radiation conditions, usually 60Co, may exaggerate or underestimate the influence of radiation effects. The controversial results obtained demonstrate the importance of developing realistic irradiation experiments where different factors affecting the performance can be easily studied and isolated. The existing problems in the study of radiolytic stability are summarized, and the key research directions in this field are prospected.

Anticancer chemotherapy with cyclophosphamide (CTX) is accompanied by toxic side effects such as bone marrow suppression and intestinal mucosal injury, which seriously affects the treatment tolerance and prognosis of patients. In recent years, polysaccharides have been used as detoxifying and synergistic adjuncts for antitumor drugs due to their anticancer, anti-inflammatory, and immunoregulatory activities. This paper systematically summarizes polysaccharide purification technologies, elaborates on the detoxification mechanism of polysaccharides on CTX from multiple perspectives such as immunomodulation, antioxidation, intestinal protection, liver and kidney protection, and reproductive system protection, and discusses the synergistic effect of polysaccharides with CTX by directly or indirectly killing tumors. Furthermore, the regulatory pathways of polysaccharides in cancer chemotherapy are summarized from two aspects: toxicity reduction and efficacy enhancement. We hope that this review could provide a reference for research on the mechanism of action of polysaccharides in reducing the toxicity and enhancing the efficacy of CTX, and provide new directions for reducing the toxic side effects of CTX.

BackgroundVasculogenic Mimicry (VM) can reduce the efficacy of anti-angiogenesis and promote distant metastasis in hepatocellular carcinoma (HCC). Our previous studies have found that Celastrus orbiculatus extract (COE) can inhibit the VM formation in HCC by reducing EphA2 expression. However the underlying mechanism related to EphA2 in VM formation is unclear.PurposeThis study aimed to confirm that EphA2 is one of the potential targets of COE, and to explore the effect of EphA2 in VM formation in hypoxia context in HCC.MethodsTCM Systems Pharmacology database and proteomics analysis were used to explore the key targets of COE in HCC treatment. CD31-PAS double staining and VE-CAD staining were used to indicate vasculogenic mimicry. The localization of EphA2 and VE-CAD was examined through fluorescent microscopy. CCK8 assay, cell invasion assay, and tube formation assay were used to indicate the formation of VM under hypoxic conditions. The regulatory relationship of EphA2 upstream and downstream molecules were evaluated through COIP and Western Blot. The nude mouse xenograft tumor models were used to observe the VM formation after knocking down or overexpressing EphA2.ResultsEphA2 is identified to the target of COE, and the driving gene of HCC. In HCC surgical specimens, EphA2 expression is closely associated with the VM formation of HCC. COE-regulated EphA2 is involved in hypoxia-induced VM formation in HCC cells in vitro. EphA2 is regulated by HIF directly or indirectly by C-MYC. Overexpression of EphA2 can promote the VM formation of HCC in nude mice, while knocking down EphA2 can inhibit the VM formation.ConclusionEphA2, as a target of COE, plays a crucial regulatory role in the formation of vasculogenic mimicry in HCC, involving upstream HIF/MYC transcriptional promotion and downstream PI3K/FAK/VE-CAD expression regulation.

BackgroundResearch on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era.MethodsThis cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI.ResultsIn total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5–17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6–12.8%). GAD4 (“Trouble relaxing”) had the highest EI in the whole network model, followed by ISI5 (“Interference with daytime functioning”) and GAD6 (“Irritability”). In contrast, PHQ4 (“Fatigue”) had the highest bridge EI values in the network, followed by GAD4 (“Trouble relaxing”) and ISI5 (“Interference with daytime functioning”). Additionally, ISI4 “Sleep dissatisfaction” (average edge weight = −1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL.ConclusionDepression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.

The beneficial effect of social interaction in mitigating the incidence of post-stroke depression (PSD) and ameliorating depressive symptoms has been consistently demonstrated through preclinical and clinical studies. However, the underlying relationship with oxytocin requires further investigation. In light of this, the present study aimed to explore the protective effect of pair housing on the development of PSD and the potential relationship with oxytocin receptors. The PSD model was induced by middle cerebral artery occlusion (MCAO) for 50 min, followed by 4-week isolated housing and restrained stress. Subsequently, each mouse in the pair-housing group (PH) was pair-housed with an isosexual healthy partner. Another group was continuously administrated fluoxetine (10 mg/Kg, i.p, once a day) for 3 weeks. To elucidate the potential role of oxytocin, we subjected pair-housed PSD mice to treatment with an oxytocin receptor (OXTR) antagonist (L368,889) (5 mg/Kg, i.p, once a day) for 3 weeks. At 31 to 32 days after MCAO, anxiety- and depressive-like behaviors were assessed using sucrose consumption, forced swim test, and tail-suspension test. The results showed that pair housing significantly improved post-stroke depression to an extent comparable to that of fluoxetine treatment. Furthermore, pair housing significantly decreased corticosterone in serum, increasing OXT mRNA expression in the hypothalamus. Treatment with L368,889 essentially reversed the effect of pair housing, with no discernible sex differences apart from changes in body weight. Pair housing increased hippocampal serotonin (5-HT), but treatment with L368,889 had no significant impact. Additionally, pair housing effectively reduced the number of reactive astrocytes and increased Nissl's body in the cortex and hippocampal CA3 regions. Correspondingly, treatment with L368,889 significantly reversed the changes in the Nissl's body and reactive astrocytes. Moreover, pair housing downregulated mRNA levels of TNF-α, IL-1β, and IL-6 in the cortex caused by PSD, which was also reversed by treatment with L368,889. In conclusion, pair housing protects against the development of PSD depending on OXT and OXTR in the brain, with no significant divergence based on sex. These findings provide valuable insights into the potential of social interaction and oxytocin as therapeutic targets for PSD. Further research into the underlying mechanisms of these effects may contribute to the development of novel treatments for PSD.