Clinical management and nursing care for patients with tracheostomy following traumatic brain injury

Tracheostomy is a routine surgical procedure in patients with severe traumatic brain injury, which requires mechanical ventilation to maintain gas exchange and avoid hypoxemia. Inadequate tracheostomy timing, nursing care, and decannulation would lead to a series of complications, such as aggravated pneumonia and prolonged intubation. The effects of early tracheostomy versus late tracheostomy have been explored. And early tracheostomy is more likely associated with shorter hospital stays and fewer complications. But the relevant reports are controversial. A safe and fast tracheostomy decannulation would facilitate the recovery. However, there was a broad variability in the indications and timing of tracheostomy and decannulation. High-quality evidence is subsequently lacking. We conducted this review to address gaps in knowledge regarding the management strategy and nursing protocol in patients with tracheostomy and decannulation following traumatic brain injury. A multidisciplinary tracheostomy team containing nursing care was also discussed to provide the best service to these patients

Artificially sweetened beverage consumption and all-cause and cause-specific mortality:an updated systematic review and dose-response meta-analysis of prospective cohort studies

Background: Artificially sweetened beverages (ASB) are consumed globally, but their impact on overall health remains uncertain. We summarized published associations between ASB intake with all-cause and cause-specific mortality. Methods: We searched Medline, Embase, Web of Science, and Cochrane CENTRAL databases until August 2023. Random effect meta-analysis was conducted to calculate pooled risk ratios (RRs) and 95% confidence intervals (95%CIs) for highest versus lowest categories of ASB consumption in relation to all-cause and cause-specific mortality. Linear and non-linear dose-response analyses were also performed. Results:Our systematic review and meta-analysis included 11 prospective cohort studies. During a median/mean follow-up period of 7.0 to 28.9 years, 235,609 deaths occurred among 2,196,503 participants. Intake of ASB was associated with higher risk of all-cause and CVD mortality with pooled RRs (95%CIs) of highest vs. lowest intake categories of 1.13 (1.06, 1.21) (I2 = 66.3%) for all-cause mortality and 1.26 (1.10, 1.44) (I2 = 52.0%) for CVD mortality. Dose-response analysis revealed a non-linear association of ASB with all-cause mortality (pnon−linearity = 0.01), but a linear positive association with CVD mortality (pnon−linearity = 0.54). No significant association was observed for ASB intake and cancer mortality. Moreover, a secondary meta-analysis demonstrated that replacing 1 serving/day of sugary sweetened beverages (SSB) with ASB was associated with 4–6% lower risk of all-cause and CVD mortality. Per NutriGrade, the evidence quality for associations between ASB intake with all-cause and CVD mortality was moderate. Conclusions: Higher intake of ASB was associated with higher risk of all-cause and CVD mortality, albeit a lower risk than for SSB. Systematic review registration: PROSPERO registration no. CRD42022365701.</p

Different wildfire types promoted two-step terrestrial plant community change across the Triassic-Jurassic transition

Frequent wildfires associated with emplacement of the Central Atlantic Magmatic Province (CAMP) are thought to have been important drivers of two significant changes in terrestrial plant communities and diversity during the Triassic-Jurassic Mass Extinction (TJME, ca. 201.51 Ma). ​However, it remains to be investigated whether these two changes are potentially related to different wildfire types. To better understand this relationship, we used a new method to reanalyze fossil pollen and spores across the Triassic-Jurassic transition in the Jiyuan Basin from the North China Plate. Results show that two peaks in wildfire frequency experienced different types of wildfires, with each linked to significant changes in plant communities and diversity losses. In the first wildfire peak, canopy fires dominated and are accompanied by significant losses of canopy forming plants, while in the second wildfire peak, ground cover fires dominated accompanied by significant losses of ground cover plants. ​Changes in atmospheric humidity conditions were an important control on the two different wildfire peaks. Relatively humid climatic conditions corresponded to the prevalence of canopy fires and hindered the spread and development of ground cover fires in wet surface conditions. Conversely, relatively arid climatic conditions corresponded with the prevalence of ground cover fires in dry surface environments. Our results provide a potential relationship between terrestrial plant communities and wildfire types, which is important to further understanding of terrestrial environmental and floral changes driven by Large Igneous Provinces

Scopararanes C–G: New Oxygenated Pimarane Diterpenes from the Marine Sediment-Derived Fungus Eutypella scoparia FS26

Five new oxygenated pimarane diterpenes, named scopararanes C–G (1–5) were isolated from the culture of a marine sediment-derived fungus Eutypella scoparia FS26 obtained from the South China Sea. The structures of these compounds were established on the basis of extensive spectroscopic analysis. The absolute configurations of compounds 1–5, were determined by CD spectroscopic analysis and comparison with literature data. All isolated compounds (1–5) were evaluated for their cytotoxic activities against MCF-7, NCI-H460, and SF-268 tumor cell lines by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) method

Different wildfire types promoted two-step terrestrial plant community change across the Triassic-Jurassic transition

Frequent wildfires associated with emplacement of the Central Atlantic Magmatic Province (CAMP) are thought to have been important drivers of two significant changes in terrestrial plant communities and diversity during the Triassic-Jurassic Mass Extinction (TJME, ca. 201.51 Ma). ​However, it remains to be investigated whether these two changes are potentially related to different wildfire types. To better understand this relationship, we used a new method to reanalyze fossil pollen and spores across the Triassic-Jurassic transition in the Jiyuan Basin from the North China Plate. Results show that two peaks in wildfire frequency experienced different types of wildfires, with each linked to significant changes in plant communities and diversity losses. In the first wildfire peak, canopy fires dominated and are accompanied by significant losses of canopy forming plants, while in the second wildfire peak, ground cover fires dominated accompanied by significant losses of ground cover plants. ​Changes in atmospheric humidity conditions were an important control on the two different wildfire peaks. Relatively humid climatic conditions corresponded to the prevalence of canopy fires and hindered the spread and development of ground cover fires in wet surface conditions. Conversely, relatively arid climatic conditions corresponded with the prevalence of ground cover fires in dry surface environments. Our results provide a potential relationship between terrestrial plant communities and wildfire types, which is important to further understanding of terrestrial environmental and floral changes driven by Large Igneous Provinces

Pseudonocardians A–C, New Diazaanthraquinone Derivatives from a Deap-Sea Actinomycete Pseudonocardia sp. SCSIO 01299

Pseudonocardians A–C (2–4), three new diazaanthraquinone derivatives, along with a previously synthesized compound deoxynyboquinone (1), were produced by the strain SCSIO 01299, a marine actinomycete member of the genus Pseudonocardia, isolated from deep-sea sediment of the South China Sea. The structures of compounds 1–4 were determined by mass spectrometry and NMR experiments (1H, 13C, HSQC, and HMBC). The structure of compound 1, which was obtained for the first time from a natural source, was confirmed by X-ray analysis. Compounds 1–3 exhibited potent cytotoxic activities against three tumor cell lines of SF-268, MCF-7 and NCI-H460 with IC50 values between 0.01 and 0.21 μm, and also showed antibacterial activities on Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212 and Bacillus thuringensis SCSIO BT01, with MIC values of 1–4 μg mL−1

Three Pairs of New Spirocyclic Alkaloid Enantiomers From the Marine-Derived Fungus Eurotium sp. SCSIO F452

Three pairs of new spirocyclic alkaloid enantiomers eurotinoids A–C (1–3), as well as a known biogenetically related racemate dihydrocryptoechinulin D (4) were isolated from a marine-derived fungus Eurotium sp. SCSIO F452. Their structures were determined by spectroscopic analyses and electronic circular dichroism (ECD) calculations. Compounds 1 and 2 represent the first two “meta” products from a non-stereoselective [4 + 2] Diels-Alder cycloaddition presumably between an enone group of a diketopiperazine alkaloid and a diene group of a benzaldehyde derivative via a new head-to-tail coupling mode biosynthetically, while 3 and 4 were “ortho” products. Their enantiomers exhibited different antioxidative and cytotoxic activities. The modes of action were investigated by a preliminary molecular docking study

Identification of disulfidptosis related subtypes, characterization of tumor microenvironment infiltration, and development of DRG prognostic prediction model in RCC, in which MSH3 is a key gene during disulfidptosis

Disulfidptosis is a newly discovered mode of cell death induced by disulfide stress. However, the prognostic value of disulfidptosis-related genes (DRGs) in renal cell carcinoma (RCC) remains to be further elucidated. In this study, consistent cluster analysis was used to classify 571 RCC samples into three DRG-related subtypes based on changes in DRGs expression. Through univariate regression analysis and LASSO-Cox regression analysis of differentially expressed genes (DEGs) among three subtypes, we constructed and validated a DRG risk score to predict the prognosis of patients with RCC, while also identifying three gene subtypes. Analysis of DRG risk score, clinical characteristics, tumor microenvironment (TME), somatic cell mutations, and immunotherapy sensitivity revealed significant correlations between them. A series of studies have shown that MSH3 can be a potential biomarker of RCC, and its low expression is associated with poor prognosis in patients with RCC. Last but not least, overexpression of MSH3 promotes cell death in two RCC cell lines under glucose starvation conditions, indicating that MSH3 is a key gene in the process of cell disulfidptosis. In summary, we identify potential mechanism of RCC progression through DRGs -related tumor microenvironment remodeling. In addition, this study has successfully established a new disulfidptosis-related genes prediction model and discovered a key gene MSH3. They may be new prognostic biomarkers for RCC patients, provide new insights for the treatment of RCC patients, and may inspire new methods for the diagnosis and treatment of RCC patients

Health Consequences Among COVID-19 Convalescent Patients 30 Months Post-Infection in China

The health consequences among COVID-19 convalescent patients 30 months post-infection were described and the potential risk factors were determined. In August 2022 we recruited 217 COVID-19 convalescent patients who had been diagnosed with COVID-19 in February 2020. These convalescent patients were residents of multiple districts in Wuhan, China. All convalescent patients completed a detailed questionnaire, laboratory testing, a 6-min walk test, a Borg dyspnea scale assessment, lung function testing, and had a chest CT. The potential risk factors for health consequences among COVID-19 convalescent patients 30 months post-infection were identified using a multivariate logistic regression model. The majority of convalescent patients were in good overall health and returned to work 30 months post-infection; however, 62.2% of the convalescent patients had long COVID symptoms. The most common symptoms were chest pain, fatigue, and dizziness or headaches. The convalescent patients with severe symptoms had a significantly higher proportion of depression disorder ( P = 0.044) and lower health-related quality of life ( P = 0.034) compared to the convalescent patients with mild symptoms. Compared to convalescent patients who were not vaccinated, convalescent patients who received three vaccines had significantly less fatigue, lower anxiety and depression scores, and had a better health-related quality of life (all P < 0.05). Older age was associated with a higher risk of long COVID (OR = 1.52, 95% CI = 1.16–2.02) and chest CT abnormalities (OR = 1.75, 95% CI = 1.33–2.36). Female gender was associated with a higher risk of anxiety (OR = 3.20, 95% CI = 1.24–9.16) and depression disorders (OR = 2.49, 95% CI = 1.11–5.92). Exercise was associated with a lower risk of anxiety (OR = 0.41, 95% CI = 0.18–0.93). Notably, vaccination protected convalescent patients from developing long COVID symptoms (OR = 0.18, 95% CI = 0.06–0.50), anxiety disorders (OR = 0.22, 95% CI = 0.07–0.71), and depression disorders (OR = 0.33, 95% CI = 0.12–0.92). The majority of COVID-19 convalescent patients were in good overall health 30 months post-infection and returned to work. More attention should be paid to convalescent patients who are older, female, physically inactive, and not vaccinated