Brain-wide activation involved in 15 mA transcranial alternating current stimulation in patients with first-episode major depressive disorder

Background Although 15 mA transcranial alternating current stimulation(tACS)has a therapeutic effect on depression,the activations of brain structures in humans accounting for this tACS configuration remain largely unknown.Aims To investigate which intracranial brain structures are engaged in the tACS at 77.5 Hz and 15 mA,delivered via the forehead and the mastoid electrodes in the human brain.Methods Actual human head models were built using the magnetic resonance imagings of eight outpatient volunteers with drug-naïve,first-episode major depressive disorder and then used to perform the electric field distributions with SimNIBS software.Results The electric field distributions of the sagittal,coronal and axial planes showed that the bilateral frontal lobes,bilateral temporal lobes,hippocampus,cingulate,hypothalamus,thalamus,amygdala,cerebellum and brainstem were visibly stimulated by the 15 mA tACS procedure.Conclusions Brain-wide activation,including the cortex,subcortical structures,cerebellum and brainstem,is involved in the 15 mA tACS intervention for first-episode major depressive disorder.Our results indicate that the simultaneous involvement of multiple brain regions is a possible mechanism for its effectiveness in reducing depressive symptoms.

Corrigendum:Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease

https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on pages 1602-1607,Issue 7,Volume 19 of Neural Regeneration Research(Zhao et al.,2024),the first author’s affiliations were incorrectly tagged.

The burden of upper motor neuron involvement is correlated with the bilateral limb involvement interval in patients with amyotrophic lateral sclerosis:a retrospective observational study

Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.

Patients Involved in Funding Research.A Look Back at the Unique Experience of the ECLAIR Working Group of Canceropole CLARA

This article aims to share an innovative experience of organizing and funding research involving those most directly affected:patients.The“ECLAIR”working group of the Canceropole Lyon Auvergne-Rhone-Alpes(CLARA)was created at the end of 2020 with the goal of contributing to the development of a call for projects on the patient experience in oncology,which was launched in January 2021.Initially composed of 8 members,including 7 patients,coordinated by a project manager from CLARA,the ECLAIR working group actively participated in drafting the specifications of the call for projects,developing the eligibility criteria for applications,revising the evaluation and selection criteria for projects,and monitoring the selected projects.This experience was repeated twice.With significant freedom of action,the working group made two decisions that strongly demonstrate the commitment to supporting research partnerships and the active involvement of those affected:firstly,by making partnership a mandatory requirement for the eligibility of applications,and secondly,by conducting the selection of projects themselves,after an independent scientific evaluation phase.Seeking to shed light on the“black box”of partnership,the article also presents the concrete modalities of interaction among the working group members,the adjustments made between different editions of the call for projects,and the relationships maintained with CLARA.

Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy

BACKGROUND The use of neoadjuvant therapy(NAT)in distal cholangiocarcinoma(dCCA)with regional arterial or extensive venous involvement,is not widely accepted and evidence is sparse.AIM To synthesise evidence on NAT for dCCA and present the experience of a highvolume tertiary-centre managing dCCA with arterial involvement.METHODS A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received NAT.All patients from 2017 to 2022 who were referred for NAT for dCCA at our centre were retrospectively collected from a prospectively maintained database.Baseline characteristics,NAT type,progression to surgery and oncological outcomes were collected.RESULTS Twelve studies were included.The definition of“unresectable”locally advanced dCCA was heterogenous.Four studies reported outcomes for 9 patients who received NAT for dCCA with extensive vascular involvement.R0 resection rate ranged between 0 and 100%but without survival benefit in most cases.Remaining studies considered either NAT in resectable dCCA or inclusive with extrahepatic CCA.The presented case series includes 9 patients(median age 67,IQR 56-74 years,male:female 5:4)referred for NAT for borderline resectable or locally advanced disease.Three patients progressed to surgery and 2 were resected.One patient died at 14 months with evidence of recurrence at 6 months and the other died at 51 months following recurrence 6 months postoperatively.CONCLUSION Evidence for benefit of NAT is limited.Consensus on criteria for uniform definition of resectability for dCCA is required.We propose using the established National-Comprehensive-Cancer-Network®criteria for pancreatic ductal adenocarcinoma.

Spousal Involvement in the Workplace of Doctors: What Is Defined as Appropriate or Inappropriate

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.

Determinants of Occipital Involvement in Males and Females with Pattern Hair Loss: A Retrospective Study

Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is often used as a donor site for hair transplantation procedures. However, evidence suggests that the occipital region may also be affected by PHL, although to a lesser extent compared to the frontal and vertex regions. Objective: To assess the levels and determinants of occipital involvement in PHL, focusing on gender and disease severity. Such data would enhance the comprehensive understanding of PHL progression and inform development of improved treatment strategies. Methods: This retrospective study involved 1993 adults (1000 males, 993 females) following for PHL at a specialized hair clinic in Jeddah, Saudi Arabia. Any patient who had hair transplantation in the past and any male who had balding areas (Hamilton-Norwood scales 4 to 7) at the initial consultation was excluded. The primary outcome was occipital involvement, defined as >10% thin hairs in the trichometry assessments of the occipital region. Additional data included patients age, treatment status, disease severity, and other trichometry parameters. Results: The prevalence of occipital involvement was found to be 23.8% overall, significantly more frequent in females (35.6%) than males with early PHL (Hamilton-Norwood scales 2 and 3) (12.1%) (p Conclusion: This study underscored the relevance of gender and disease severity in occipital involvement in PHL. Females had significantly higher rates of occipital involvement, suggesting that gender differences are critical in understanding PHL progression. Future research should aim to validate these findings, with an aim to refine therapeutic and surgical approaches to improve patient outcomes.

Experienced Involvement (ExIn) in Social-Psychiatric Care of Germany-Challenges and Chances

This study explores the integration of Experienced Involvement(ExIn)in social-psychiatric care in Germany,emphasizing both the challenges and opportunities it presents.The European Leonardo da Vinci Project(2005-2007)established a curriculum for ExIn,promoting participatory structures in psychiatric services.While peer support is well-established in other European countries,Germany’s experience is still developing.This research uses a mixed methods design,combining quantitative surveys and qualitative interviews,to investigate the professional experiences of ExIn recovery companions and team colleagues in German clinics and support services.The findings reveal numerous benefits:for social-psychiatric services,ExIn enhances service quality,inclusivity,and accessibility;for team colleagues,it fosters reflexivity,hope,and trust,and improves self-care;for service users,it provides empowerment,easy access to support,trust,and hope,and offers credible role models.Despite these benefits,challenges such as stigmatization,lack of recognition,and financial constraints remain and require to be addressed.The study highlights the need and provides implications for a dedicated and inclusive approach to effectively implementing ExIn,ultimately enriching psychiatric care through experiential knowledge and reducing prejudice within mental health services.

Acute flare of systemic lupus erythematosus with extensive gastrointestinal involvement: A case report and review of literature

BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.

Retraction:Macrophage involvement in the pathological evolution of ulcerative colitis-associated colon cancer and progress of related traditional Chinese medicine drug interventions

Traditional Medicine Research has retracted this article upon the request of the editor-in-chief and academic committee.On June 5,2023,we received a complaint regarding possible picture plagiarism within the article,which promoted the decision to retract this article.Following a comprehensive examination,it was determined that the content depicted in this article's pictures was identical to that found in another published paper.Consequently,the editorial office determined that retracting the article was necessary.

Current guidelines for diagnosis and management of hepatic involvement in hereditary hemorrhagic teleangiectasia

Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in adults.Different vascular shunts(arteriovenous,arterioportal or portovenous)lead to different clinical manifestations.Even though no hepatic-related symptoms are reported in the majority of cases,the severity of liver disease could lead to refractory medical conditions,in some cases requiring liver transplantation.The aim of this manuscript is to provide an updated overview of the current evidence regarding the diagnosis and treatment of HHT liver involvement and liver-related complications.

Variant of Guillain-Barrésyndrome with anti-sulfatide antibody positivity and spinal cord involvement:A case report

BACKGROUND Guillain-Barrésyndrome(GBS)is an acute autoimmune-mediated polyneuropathy.Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patients with GBS.However,spinal cord involvement is relatively rare in these cases.CASE SUMMARY A 68-year-old woman was admitted to the hospital with weakness of the limb for more than 3 d.Additional symptoms included neck pain,progressive numbness in the distal extremities,urinary and fecal retention,and reduced perception of temperature.She was diagnosed with an anti-sulfatide antibody-positive GBS variant and discharged after treatment with methylprednisolone and intravenous human immunoglobulin pulse therapy.Unlike common cases of anti-sulfatide antibody-positive GBS,this patient had atypical clinical symptoms of spinal cord involvement.No similar cases have previously been reported in China.CONCLUSION Although GBS is associated with a poor prognosis,a prompt diagnosis allows early administration of combined intravenous human immunoglobulin and methylprednisolone pulse therapy.

Infrequent organ involvement in immunoglobulin G4-related prostate disease: A case report

BACKGROUND Immunoglobulin G4-related prostate disease(IgG4-RPD)characterized by a high count of IgG4-positive plasma cells has distinctive serological and radiological findings.Here we report a case of a patient who was successfully treated for IgG4-RPD,which manifested as frequent micturition,dysuric,and systemic lymphadenopathy.CASE SUMMARY The patient was a 33-year-old man who was referred to our hospital because of urinary tract symptoms that had persisted for 4 years.A physical examination revealed systemic lymphadenopathy and blood tests showed hyperglobulinemia with an IgG level of 18.90 g/L and an IgG4 level of 18.40 g/L.Computed tomography(CT)revealed bilateral lacrimal gland,right parotid gland and prostatic enlargement.Based on these findings,IgG4-RD was suspected,and further pathological examination and follow-up results showed expected results.Finally,the patient was diagnosed with IgG4-RPD based on clinical symptoms,pathological examination,therapeutic effects,and follow-up results.He received 50 mg oral prednisolone(the dose was gradually reduced and a low dose was used for long-term maintenance)in combination with cyclophosphamide 1.0 g via an intravenous drip for 6 mo.One year after the treatment was initiated,he was free of urinary or other complaints and his serum IgG4 level normalized.CONCLUSION In IgG4-RPD with severe urinary tract symptoms,radiological findings should be carefully examined.IgG4-RPD prognosis is good because the disease responds well to glucocorticoids.Furthermore,it is urgent for clinicians and pathologists to improve their understanding of IgG4-RPD.

Asian variant intravascular large B-cell lymphoma with highly suspected central nervous system involvement:A case report

BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare subtype of extranodal lymphoma.In particular,the Asian variant of IVLBCL is characterized by hemophagocytic lymphohistiocytosis along with bone marrow involvement.However,central nervous system(CNS)involvement is uncommon in this variant compared to the Western variant.Here,we report a case of typical Asian variant IVLBCL with highly suspected CNS involvement and discuss the nature of the disease and its genetic aberration.CASE SUMMARY A 67-year-old female patient complained of gradually worsening cognitive impairment.While hospitalized,she developed a high fever and showed marked bicytopenia.Intracranial imaging revealed a suspected leptomeningeal disease.Although no malignant cells were found in the cerebrospinal fluid(CSF),the protein and lactate dehydrogenase levels in CSF were increased.Bone marrow examination revealed an increased number of hemophagocytic histiocytes,and 18F-fluorodeoxyglucose(FDG)positron emission tomography with computerized tomography scan revealed increased FDG uptake in both adrenal glands,the liver,and the right ethmoid sinus.A tissue biopsy showed atypical large lymphoid cells with prominent nucleoli in the vessels,and the tumor cells were positive for CD20,BCL2,BCL6,and IRF4/MUM1.In addition,targeted sequencing identified MYD88,TET2,and PIM1 mutations.Consequently,we diagnosed the patient with the Asian variant of IVLBCL with highly suspected CNS involvement.CONCLUSION Suspicion of IVLBCL and immediate diagnosis lead to timely treatment.Moreover,careful CNS examination at diagnosis is recommended.

Male Involvement in the Maternal Health Care: Expectations of Pregnant Women in Bolgatanga Municipality in the Upper East Region of Ghana

Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).

Fifth Definition for Strategic HRM:HRM Involvement

This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of SHRM so far.This study presents a new approach for the development of the field.It is HRM involvement.HRM involvement is related to appointment of managers and board of directors.Because board of directors appoints managers in firms,HR must be member of board of directors.Because managers achieve firm performance(market share and profit),and Board of Directors appoints managers.Therefore,HRM manager must be involved with board of directors to affect appointments.This study uses semantic content analysis and systematic review methods as a research methodology.To conclude,organizations may apply strategic HRM through strategic HR Directors at top level,appointment of C-level Executives and HRM involvement.

Disentangling brain PrP^(C)proteoforms and their roles in physiology and disease

The cellular prion protein(PrPC),a cell surface glycoprotein of 209 amino acids,has been considerably studied over the decades mainly due to its critical involvement in transmissible spongiform encephalopathies,or prion diseases.Indeed,it is the misfolding and aggregation of PrPC into pathological assemblies-named PrPSc-that constitute prions,the agents causing these unusual neurodegenerative diseases affecting humans and animals(Prusiner,1982).Furthermore,increasing evidence support its relevance also in other neurodegenerative diseases(NDDs),such as Alzheimer’s and Parkinson’s diseases(Corbett et al.,2020).

Multifunctional glycolipids as multi-targeting therapeutics for neural regeneration

Many patients with neurodegenerative diseases,such as Alzheimer’s(AD)and Parkinson’s(PD)diseases suffer from disease progression without any satisfying clinical intervention,likely due to our lack of knowledge on how normal aging impacts the pathogenic mechanisms of these debilitating diseases.A growing body of literature has emerged in recent years that clearly demonstrates the involvement of glycolipids in the protein-oligomerization of neurodegenerative disorders.We hypothesize that changes in glycolipids composition are a common mechanism underlying the shift from healthy brain aging to the neuropathological processes of neurodegenerative diseases.

An early scoring system to predict mechanical ventilation for botulism: a single-center-based study

BACKGROUND: Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism. The present study aimed to establish a new scoring system to predict mechanical ventilation(MV) for botulism patients.METHODS: A single-center retrospective study was conducted to identify risk factors associated with MV in botulism patients from 2007 to 2022. Univariate analysis and multivariate logistic regression analysis were used to screen out risk factors for constructing a prognostic scoring system. The area under the receiver operating characteristic(ROC) curve was calculated.RESULTS: A total of 153 patients with botulism(66 males and 87 females, with an average age of 43 years) were included. Of these, 49 patients(32.0%) required MV, including 21(13.7%) with invasive ventilation and 28(18.3%) with non-invasive ventilation. Multivariate analysis revealed that botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement were independent risk factors for MV. These risk factors were incorporated into a multivariate logistic regression analysis to establish a prognostic scoring system. Each risk factor was scored by allocating a weight based on its regression coefficient and rounded to whole numbers for practical utilization([botulinum toxin type A: 1], [pneumonia: 2], [incubation period ≤1 day: 2], [hypoxia <90%: 2], [severity of muscle involvement: grade Ⅱ, 3;gradeⅢ, 7;grade IV, 11]). The scoring system achieved an area under the ROC curve of 0.82(95% CI 0.75–0.89, P<0.001). At the optimal threshold of 9, the scoring system achieved a sensitivity of 83.7% and a specificity of 70.2%.CONCLUSION: Our study identified botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement as independent risk factors for MV in botulism patients. A score ≥9 in our scoring system is associated with a higher likelihood of requiring MV in botulism patients. This scoring system needs to be validated externally before it can be applied in clinical settings.

An unusual cause of myocardial infarction in an elderly man

Cardiac involvement in eosinophilic granulomatosis with polyangiitis (EPGA) is increasingly recognized,but it is unusual to be the initial presentation.We report a case of vasculitic myocardial infarction (MI) and cardiogenic shock in an elderly man caused by EPGA.A 73-year-old man presented with acute chest pain radiating to back for two days.He has a history of asthma and allergic rhinitis for more than ten years well controlled by inhaled corticosteroid.The electrocardiogram showed sinus rhythm,right bundle-branch block and anterolateral ST-segment depression.He had elevated troponin T of 548 ng/L (reference:<14 ng/L),creatine kinase of 454 IU/L (reference:39–308 IU/L)。