Randomized trial of transcutaneous auricular vagus nerve stimulation on patients with disorders of consciousness: A study protocol

BackgroundTranscutaneous auricular vagus nerve stimulation (taVNS) has recently been explored for the treatment of Disorders of consciousness (DoC) caused by traumatic brain injury. The evidence of taVNS during the consciousness recovery has been recently reported. However, the mechanism of taVNS in the recovery of consciousness is not clear. This study attempts to investigate the effectiveness of taVNS in DoC by means of Coma Recovery Scale-Revised (CRS-R), Magnetic resonance imaging (MRI), Electrophysiology (EEG), and Single-molecular array (Simoa).Methods/designNighty patients with DoC acquired brain injury are randomized into one of three groups receiving sham taVNS or active taVNS (just left and left or right), respectively. Each of the three groups will experience a 40 days cycle (every 10 days for a small period, baseline 2 weeks, intervention 2 weeks, 40 min per day, 5 days per week, then no intervention for 2 weeks, intervention 2 weeks, 40 min per day, and 5 days per week). Primary outcomes (CRS-R) will be recorded five times during every period. Secondary outcomes will be recorded at the first and at the last period [MRI, EEG, Phosphorylated tau (P-tau), and Neurofilament light chain (NFL)]. We will take notes the adverse events and untoward effects during all cycles.DiscussionTranscutaneous auricular vagus nerve stimulation as a painless, non-invasive, easily applied, and effective therapy was applied for treatment of patients with depression and epilepsy several decades ago. Recent progress showed that taVNS has behavioral effects in the consciousness recovery. However, there is no clinical evidence to support the effects of taVNS on brain activity. Therefore, we will design a randomized controlled trial to evaluate the effectiveness and safety of taVNS therapy for DoC, and explore neural anatomy correlated to taVNS during the consciousness recovery. Finally, this protocol also tests some biomarkers along with the recovery of consciousness.Clinical Trial RegistrationChinese Clinical Trial Registry, ChiCTR2100045161. Registered on 9 April 2021

Exploring Urban Green Space Optimization of the Urban Walking Life Circle in Fuzhou, China

The spatial distribution of urban green spaces (UGS) is closely related to the health of residents and the ecological pattern of cities. Exploring the equity of UGSs plays an important role in urban planning and also provides guidance for urban development. Taking the main urban area of Fuzhou City as an example, this study uses network big data and census data to pinpoint the population demand, evaluates the accessibility and equity of UGS within the basic living circle, neighborhood living circle and daily living circle of residents at the scale of residential and sub-districts. Based on the G2SFCA model, we also quantify the actual effective UGS’s service capacity. Then, using the scale and travel range as the entry point, we further discuss the similarities and differences under different scales and different travel ranges. Finally, optimization strategies are proposed for the construction status. The results show that: (1) The spatial allocation of urban green space resources varies significantly, and there is a serious inequity in the spatial distribution of urban green space under pedestrian conditions; (2) The results of UGS accessibility, equity, and service capacity in Fuzhou at both residential and sub-district scales are consistent; (3) Urban construction should be multi-level overall planning, combined with local economic and social development factors in accordance with local conditions to take measures. The results of the study can provide a scientific reference for the optimization of the spatial distribution of UGS

La(Zn

A new diluted magnetic semiconductor La(Zn1−2xMnxCux)SbO in bulk form has been successfully synthesized. Spins and carriers are introduced by co-doping Mn and Cu into Zn sites of the parent semiconductor LaZnSbO. Doping Mn or Cu alone does not induce magnetic ordering. Only when Mn and Cu are co-doped, can the system undergo a ferromagnetic transition below the Curie temperature $T_C~{\sim}15\ \text{K}$ . The ferromagnetic La(Zn1−2xMnxCux)SbO shares the same two-dimensional crystal structure as that of the 1111-type iron pnictide superconductor $\text{LaFeAsO}_{1-\delta}$ . A relatively large coercive field of ${\sim}7000\ \text{Oe}$ is observed from the iso-thermal magnetization measured at 2 K

Data_Sheet_1_Randomized trial of transcutaneous auricular vagus nerve stimulation on patients with disorders of consciousness: A study protocol.doc

BackgroundTranscutaneous auricular vagus nerve stimulation (taVNS) has recently been explored for the treatment of Disorders of consciousness (DoC) caused by traumatic brain injury. The evidence of taVNS during the consciousness recovery has been recently reported. However, the mechanism of taVNS in the recovery of consciousness is not clear. This study attempts to investigate the effectiveness of taVNS in DoC by means of Coma Recovery Scale-Revised (CRS-R), Magnetic resonance imaging (MRI), Electrophysiology (EEG), and Single-molecular array (Simoa).Methods/designNighty patients with DoC acquired brain injury are randomized into one of three groups receiving sham taVNS or active taVNS (just left and left or right), respectively. Each of the three groups will experience a 40 days cycle (every 10 days for a small period, baseline 2 weeks, intervention 2 weeks, 40 min per day, 5 days per week, then no intervention for 2 weeks, intervention 2 weeks, 40 min per day, and 5 days per week). Primary outcomes (CRS-R) will be recorded five times during every period. Secondary outcomes will be recorded at the first and at the last period [MRI, EEG, Phosphorylated tau (P-tau), and Neurofilament light chain (NFL)]. We will take notes the adverse events and untoward effects during all cycles.DiscussionTranscutaneous auricular vagus nerve stimulation as a painless, non-invasive, easily applied, and effective therapy was applied for treatment of patients with depression and epilepsy several decades ago. Recent progress showed that taVNS has behavioral effects in the consciousness recovery. However, there is no clinical evidence to support the effects of taVNS on brain activity. Therefore, we will design a randomized controlled trial to evaluate the effectiveness and safety of taVNS therapy for DoC, and explore neural anatomy correlated to taVNS during the consciousness recovery. Finally, this protocol also tests some biomarkers along with the recovery of consciousness.Clinical Trial RegistrationChinese Clinical Trial Registry, ChiCTR2100045161. Registered on 9 April 2021.</p

Mutational spectrum and prognostic stratification of intermediate-risk acute myeloid leukemia

The mutational spectrum and prognostic stratification of intermediate-risk acute myeloid leukemia (IR-AML), which accounts for a substantial number of AML, are unclear. In order to explore the prognostic significance of the mutational spectrum in IR-AML, 106 IR-AML patients were collected from The Cancer Genome Atlas database. Sixty-two patients underwent chemotherapy-only, forty-four proceeded to allogeneic hematopoietic stem cell transplantation (allo-HSCT). Fifty-five patients had more than five recurrent genetic mutations. NPM1 had the highest mutation frequency, followed by DNMT3A, FLT3, RUNX1, IDH2, IDH1, and TET2. In all patients, allo-HSCT was an independent favorable factor for EFS and OS (P = 0.036, P = 0.001, respectively); age >= 60 years, FLT3-ITD and mutations in DNMT3A and RUNX1 were independent risk factors for survival (all P <0.05). In the chemotherapy-only group, multivariate analysis showed that age 60 years was an independent risk factor for EFS and OS (P = 0.008, P = 0.017, respectively). In the allo-HSCT group, multivariate analysis indicated that MLL-PTD was an independent risk fact for EFS (P = 0.037), FLT3-ITD and RUNX1 mutations independently contributed to poor OS (P = 0.035, P = 0.014, respectively). In conclusion, older age was an important risk factor for IR-AML patients undergoing chemotherapy-only; FLT3-ITD, MLL-PTD and RUNX1 mutations were significant risk factors for IR-AML patients who received allo-HSCT