Asymmetric Outcomes of Type 1 Retinopathy of Prematurity after Bilateral Intravitreal Ranibizumab Treatment

Purpose. To present cases with retinopathy of prematurity (ROP), who were treated with intravitreal injection of ranibizumab (IVR) and had unpredictable asymmetric outcomes. Methods. A retrospective review was performed in infants with type 1 ROP and had bilateral IVR (0.25 mg/0.025 mL) as initial treatment. Patients were classified into the asymmetric outcome group and the symmetric outcome group. Results. Eighty-four patients (168 eyes) were included. There were 18 eyes of 9 patients (10.7%) in the asymmetric outcome group and 150 eyes of 75 patients (89.3%) in the symmetric outcome group. In the symmetric outcome group, 86 eyes (57.3%) had ROP regression, 60 eyes (40%) had reactivation requiring laser treatment, and 4 eyes (2.7%) progressed to retinal detachment requiring vitrectomy. In the asymmetric outcome group, one of the eyes of the 9 patients had ROP regression with/without reactivation after IVR, while the contralateral eyes had negative response, including remarkable posterior fibrosis, partial or total retinal detachment, and vitreous hemorrhage. There was statistically significant difference between the birth weight of the two groups. Conclusion. Contralateral eyes with ROP can take a different clinical course after ranibizumab treatment. High rate of reactivation after IVR is another concern that ophthalmologists should pay attention to

Emerging trends and focus of research on the relationship between traumatic brain injury and gut microbiota: a visualized study

BackgroundTraumatic brain injury (TBI) is one of the most serious types of trauma and imposes a heavy social and economic burden on healthcare systems worldwide. The development of emerging biotechnologies is uncovering the relationship between TBI and gut flora, and gut flora as a potential intervention target is of increasing interest to researchers. Nevertheless, there is a paucity of research employing bibliometric methodologies to scrutinize the interrelation between these two. Therefore, this study visualized the relationship between TBI and gut flora based on bibliometric methods to reveal research trends and hotspots in the field. The ultimate objective is to catalyze progress in the preclinical and clinical evolution of strategies for treating and managing TBI.MethodsTerms related to TBI and gut microbiota were combined to search the Scopus database for relevant documents from inception to February 2023. Visual analysis was performed using CiteSpace and VOSviewer.ResultsFrom September 1972 to February 2023, 2,957 documents published from 98 countries or regions were analyzed. The number of published studies on the relationship between TBI and gut flora has risen exponentially, with the United States, China, and the United Kingdom being representative of countries publishing in related fields. Research has formed strong collaborations around highly productive authors, but there is a relative lack of international cooperation. Research in this area is mainly published in high-impact journals in the field of neurology. The “intestinal microbiota and its metabolites,” “interventions,” “mechanism of action” and “other diseases associated with traumatic brain injury” are the most promising and valuable research sites. Targeting the gut flora to elucidate the mechanisms for the development of the course of TBI and to develop precisely targeted interventions and clinical management of TBI comorbidities are of great significant research direction and of interest to researchers.ConclusionThe findings suggest that close attention should be paid to the relationship between gut microbiota and TBI, especially the interaction, potential mechanisms, development of emerging interventions, and treatment of TBI comorbidities. Further investigation is needed to understand the causal relationship between gut flora and TBI and its specific mechanisms, especially the “brain-gut microbial axis.

Effects of a Wildfire on Selected Physical, Chemical and Biochemical Soil Properties in a Pinus massoniana Forest in South China

Pinus massoniana forests bordering South China are often affected by wildfires. Fires cause major changes in soil properties in many forest types but little is known about the effects of fire on soil properties in these P. massoniana forests. Such knowledge is important for providing a comprehensive understanding of wildfire effects on soil patterns and for planning appropriate long-term forest management in these forests. Changes in soil physical properties, carbon, nutrients, and enzymes were investigated in a P. massoniana forest along a wildfire-induced time span consisting of an unburned soil, and soils 0, one, four, and seven years post-fire. Soil (0–10 cm) was collected from burned and unburned sites immediately and one, four, and seven years after a wildfire. The wildfire effects on soil physical and chemical properties and enzyme activities were significantly different among treatment variation, time variation, and treatment-by-time interaction. Significant short-term effects on soil physical, chemical, and biological properties were found, which resulted in a deterioration of soil physical properties by increasing soil bulk density and decreasing macropores and capillary moisture. Soil pH increased significantly in the soil one-year post-fire. Carbon, total nitrogen (N) and phosphorus (P), and available N and P increased significantly immediately and one year after the wildfire and decreased progressively to concentrations lower than in the unburned soil. Total potassium (K) and exchangeable K increased immediately after the wildfire and then continuously decreased along the burned time-span. Urease, acid phosphatase, and catalase activities significantly decreased compared to those in the unburned soil. In fire-prone P. massoniana forests, wildfires may significantly influence soil physical properties, carbon, nutrients, and enzyme activity

Erector spinae muscle-based nomogram for predicting in-hospital mortality among older patients with severe community-acquired pneumonia

Abstract Background No multivariable model incorporating erector spinae muscle (ESM) has been developed to predict clinical outcomes in older patients with severe community-acquired pneumonia (SCAP). This study aimed to construct a nomogram based on ESM to predict in-hospital mortality in patients with SCAP. Methods Patients aged ≥ 65 years with SCAP were enrolled in this prospective observational study. Least absolute selection and shrinkage operator and multivariable logistic regression analyses were used to identify risk factors for in-hospital mortality. A nomogram prediction model was constructed. The predictive performance was evaluated using the concordance index (C-index), calibration curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis. Results A total of 490 patients were included, and the in-hospital mortality rate was 36.1%. The nomogram included the following independent risk factors: mean arterial pressure, peripheral capillary oxygen saturation, Glasgow Coma Scale score (GCS), lactate, lactate dehydrogenase, blood urea nitrogen levels, and ESM cross-sectional area. Incorporating ESM into the base model with other risk factors significantly improved the C-index from 0.803 (95% confidence interval [CI], 0.761–0.845) to 0.836 (95% CI, 0.798–0.873), and these improvements were confirmed by category-free NRI and IDI. The ESM-based nomogram demonstrated a high level of discrimination, good calibration, and overall net benefits for predicting in-hospital mortality compared with the combination of confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65), Pneumonia Severity Index (PSI), Acute Physiology and Chronic Health Evaluation II (APACHEII), and Sequential Organ Failure Assessment (SOFA). Conclusions The proposed ESM-based nomogram for predicting in-hospital mortality among older patients with SCAP may help physicians to promptly identify patients prone to adverse outcomes. Trial registration This study was registered at www.chictr.org.cn (registration number Chi CTR-2300070377)

Effect of Hypothermia Therapy on Children with Traumatic Brain Injury: A Meta-Analysis of Randomized Controlled Trials

Hypothermia therapy is a promising therapeutic strategy for traumatic brain injury (TBI); however, some trials have shown that hypothermia therapy has a negative effect on patients with TBI. The treatment of hypothermia in children with TBI remains controversial. We conducted a search of six online databases to validate the literature on comparing hypothermia with normal therapy for children with TBI. Eight randomized controlled trials (514 patients) were included. The meta-analysis indicated that hypothermia therapy may increase the Glasgow Outcome Scale (GOS) scores. However, in terms of improving the rate of complications, intracranial pressure (ICP), mortality, cerebral perfusion pressure (CPP), and length of stay both in hospital as well as pediatric ICU, the difference was not statistically significant. Hypothermia therapy may have clinical advantages in improving the GOS scores in children with TBI compared with normothermic therapy, but hypothermia therapy may have no benefit in improving the incidence of complications, ICP, mortality, CPP, and length of stay both in pediatric ICU as well as hospital. The decision to implement hypothermia therapy for children with TBI depends on the advantages and disadvantages from many aspects and these must be considered comprehensively

Temperature and Recognition Dual Responsive Poly(N-Isopropylacrylamide) and Poly(N,N-Dimethylacrylamide) with Adamantyl Side Group

A series of copolymers with an adamantyl side group (poly(NIPAM-co-AdMA) and poly(DMAM-co-AdMA)) were prepared by radical copolymerization of N-isopropylacrylamide (NIPAM) and N,N-dimethylacrylamide (DMAM) with a 2-methyl-2-adamantylmethacrylate (AdMA) monomer. The structure and composition of the as-synthesized copolymers were characterized by Fourier transform infrared (FT-IR) spectroscopy, proton nuclear magnetic resonance (1H NMR) spectroscopy, gel permeation chromatography (GPC), thermogravimetric analysis (TGA), and elemental analysis. Temperature and recognition dual responsivity of the copolymers was investigated by cloud point (Tcp) and dynamic light scattering (DLS), respectively. The results show that the as-synthesized copolymers are a kind of temperature-responsive polymer with a lower critical solution temperature (LCST). Tcp was approximately consistent with the critical temperature of intermolecular copolymer association (Tass) from DLS. For these copolymers, Tcp decreases with increasing content of AdMA unit in the copolymers. After the addition of β-cyclodextrins (β-CD), Tcp increases, and the increment of Tcp values gradually became large with increasing content of AdMA in the copolymers. It is host-guest molecular recognition of β-CD and adamantyl groups that endows the as-synthesized copolymers with recognition-tunable thermosensitivity

Early onset coats’ disease initially treated as unilateral ROP at 39 weeks postmenstrual age: a case report

Abstract Background This is the youngest case of Coats’ disease, in terms of postmenstrual age (PMA), to be reported in the literature. This case highlights the remarkable variations in the clinical manifestations and the very early onset of Coats’ disease. This case is unusual in both the age of onset and atypical clinical features, which resemble retinopathy of prematurity (ROP). Case presentation We report a case of a preterm boy born at 31 5/7 weeks gestational age who presented with atypical Coats’ disease and was initially diagnosed as having ROP of only one eye at 39 weeks PMA. After initial laser treatment, severe exudative retinal detachment (ERD) occurred after initial laser treatment for ROP. Fundus fluorescein angiography (FFA) showed telangiectasia and anastomosis of peripheral retinal vessels and nonperfusion areas, and the diagnosis of Coats’ disease was thus established. A series of intravitreal injections of ranibizumab (IVR) and laser ablations were performed to resolve the exudation and to ablate the abnormal vessels. At the last visit, the retinopathy was under control, and useful vision was preserved. Conclusions Coats’ disease resembling stage 3 ROP can be detected before the expected date of childbirth. Therefore, asymmetric ROP should be differentiated from Coats’ disease