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ObjectivesTo conduct an updated systematic review and meta-analysis of association between sleep and all-cause cognitive disorders.MethodsPubMed and EMBASE were searched from inception to 18 February 2019. Cohort studies exploring longitudinal associations of sleep with cognitive decline or dementia were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment. The robust error meta-regression model was used to conduct the dose–response meta-analysis for sleep duration.Results11 155 reports were searched and 51 eligible cohorts with 15 sleep problems were included for our meta-analyses. Ten types of sleep conditions or parameters, including six (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) with moderate-to-high levels of evidence, were linked to higher risk of all-cause cognitive disorders. Furthermore, a U-shaped relationship was revealed for the associations with sleep duration.ConclusionsSleep management might serve as a promising target for dementia prevention.

ObjectiveInflammation plays a crucial role in the pathogenesis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Our study aimed to analyse previous inconsistent results of inflammatory markers in AD and MCI quantitatively.MethodsStudies reporting concentrations of peripheral or cerebrospinal fluid (CSF) markers were included, and eligible data on AD, MCI and control were extracted. Pooled Hedges’s g was adopted to illustrate comparisons, and various confounding factors were used to explore sources of heterogeneity.ResultsA total of 170 studies were included in the meta-analysis and systematic review, which demonstrated increased peripheral levels of high-sensitivity C reactive protein (Hedges’s g 0.281, p<0.05), interleukin-6 (IL-6) (0.429, p<0.005), soluble tumour necrosis factor receptor 1 (sTNFR1) (0.763, p<0.05), soluble tumour necrosis factor receptor 2 (sTNFR2) (0.354, p<0.005), alpha1-antichymotrypsin (α1-ACT) (1.217, p<0.005), IL-1β (0.615, p<0.05) and soluble CD40 ligand (0.868, p<0.005), and CSF levels of IL-10 (0.434, p<0.05), monocyte chemoattractant protein-1 (MCP-1) (0.798, p<0.005), transforming growth factor-beta 1 (1.009, p<0.05), soluble triggering receptor expressed on myeloid cells2 (sTREM2) (0.587, p<0.001), YKL-40 (0.849, p<0.001), α1-ACT (0.638, p<0.001), nerve growth factor (5.475, p<0.005) and visinin-like protein-1 (VILIP-1) (0.677, p<0.005), in AD compared with the control. Higher levels of sTNFR2 (0.265, p<0.05), IL-6 (0.129, p<0.05) and MCP-1 (0.779, p<0.05) and lower levels of IL-8 (−1.293, p<0.05) in the periphery, as well as elevated concentrations of YKL-40 (0.373, p<0.05), VILIP-1 (0.534, p<0.005) and sTREM2 (0.695, p<0.05) in CSF, were shown in MCI compared with the control. Additionally, increased peripheral sTNFR1 (0.582, p<0.05) and sTNFR2 (0.254, p<0.05) levels were observed in AD compared with MCI.ConclusionSignificantly altered levels of inflammatory markers were verified in comparison between AD, MCI and control, supporting the notion that AD and MCI are accompanied by inflammatory responses in both the periphery and CSF.

Background The objective of this study was to evaluate the association between red cell distribution width/platelet ratio (RPR) and 30-day and 1-year mortality in acute ischemic stroke (AIS). Methods Data for the retrospective cohort study were collected from the Medical Information Mart for Intensive Care (MIMIC) III database. RPR was divided into two groups: RPR ≤ 0.11 and RPR > 0.11. The study outcomes were 30-day mortality and 1-year mortality from AIS. Cox proportional hazard models were utilized to assess the association between RPR and mortality. Subgroup analyses were applied based on age, tissue-type plasminogen activator (IV-tPA), endovascular treatment, and myocardial infarction. Results A total of 1,358 patients were included in the study. Short- and long-term mortality occurred in 375 (27.61%) and 560 (41.24%) AIS patients, respectively. A high RPR was significantly associated with increased 30-day [hazard ratio (HR): 1.45, 95% confidence interval (CI): 1.10 to 1.92, P  = 0.009] and 1-year mortality (HR: 1.54, 95%CI: 1.23 to 1.93, P  < 0.001) in AIS patients. Meanwhile, RPR was found to be significantly related to 30-day mortality in AIS patients aged < 65 years (HR: 2.19, 95% CI: 1.17 to 4.10, P = 0.014), without IV-tPA use (HR: 1.42, 95% CI: 1.05 to 1.90, P  = 0.021), without using endovascular treatment (HR: 1.45, 95% CI: 1.08 to 1.94, P  = 0.012), and without myocardial infarction (HR: 1.54, 95% CI: 1.13 to 2.10, P  = 0.006). Additionally, RPR was associated with 1-year mortality in AIS patients aged < 65 years (HR: 2.54, 95% CI: 1.56 to 4.14, P  < 0.001), aged ≥ 65 years (HR: 1.38, 95% CI: 1.06 to 1.19, P  = 0.015), with (HR: 1.46, 95% CI: 1.15 to 1.85, P  = 0.002) and without using IV-tPA (HR: 2.30, 95% CI: 1.03 to 5.11, P  = 0.041), without using endovascular treatment (HR: 1.56, 95% CI: 1.23 to 1.96, P  < 0.001), and without myocardial infarction (HR: 1.68, 95% CI: 1.31 to 2.15, P  < 0.001). Conclusion Elevated RPR is associated with a high risk of short-term and long-term mortality in AIS.

BackgroundInformation from well-established dementia risk models can guide targeted intervention to prevent dementia, in addition to the main purpose of quantifying the probability of developing dementia in the future.MethodsWe conducted a systematic review of published studies on existing dementia risk models. The models were assessed by sensitivity, specificity and area under the curve (AUC) from receiver operating characteristic analysis.ResultsOf 8462 studies reviewed, 61 articles describing dementia risk models were identified, with the majority of the articles modelling late life risk (n=39), followed by those modelling prediction of mild cognitive impairment to Alzheimer’s disease (n=15), mid-life risk (n=4) and patients with diabetes (n=3). Age, sex, education, Mini Mental State Examination, the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological assessment battery, Alzheimer’s Disease Assessment Scale-cognitive subscale, body mass index, alcohol intake and genetic variables are the most common predictors included in the models. Most risk models had moderate-to-high predictive ability (AUC>0.70). The highest AUC value (0.932) was produced from a risk model developed for patients with mild cognitive impairment.ConclusionThe predictive ability of existing dementia risk models is acceptable. Population-specific dementia risk models are necessary for populations and subpopulations with different characteristics.

BackgroundBullous pemphigoid (BP) is the most common autoimmune subepidermal bullous disease of the skin. First-line treatment of systemic corticosteroids may cause serious adverse events. Rituximab, omalizumab, and dupilumab should be explored as alternative treatment options to improve outcomes.ObjectiveTo systematically review the rituximab, omalizumab, and dupilumab treatment outcomes in bullous pemphigoid.MethodsA PubMed, Embase, Web of Science, and Cochrane library search were conducted on March 10, 2022. A total of 75 studies were included using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.ResultsUse of rituximab (n=122), omalizumab (n=53) and dupilumab (n=36) were reported in 211 patients with BP. Rituximab led to complete remission in 70.5% (n=86/122) and partial remission in 23.8% (n=29/122) of patients within 5.7 months, with a recurrence rate of 20.5% (n=25/122). 9.0% (n=11/122) of patients died and infection (6.6%, n=8/122) was the most common adverse event. Omalizumab led to complete remission in 67.9% (n=36/53) and partial remission in 20.8% (n=11/53) of patients within 6.6 months, with a recurrence rate of 5.7% (n=3/53). 1.9% (n=1/53) of patients died and thrombocytopenia (1.9%, n=1/53) was observed as the most common adverse event. Dupilumab led to complete remission in 66.7% (n=24/36) and partial remission in 19.4% (n=7/36) of patients within 4.5 months of treatment without any reported adverse events, with a recurrence rate of 5.6% (n=2/36).ConclusionsRituximab, omalizumab, and dupilumab have similar clinical benefits for BP patients. However, rituximab resulted in higher recurrence rates, adverse events, and mortality rates.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022316454.

High dimensional biomedical data contain tens of thousands of features, accurate and effective identification of the core features in these data can be used to assist diagnose related diseases. However, there are often a large number of irrelevant or redundant features in biomedical data, which seriously affect subsequent classification accuracy and machine learning efficiency. To solve this problem, a novel filter feature selection algorithm based on redundant removal (FSBRR) is proposed to classify high dimensional biomedical data in this paper. First of all, two redundant criteria are determined by vertical relevance (the relationship between feature and class attribute) and horizontal relevance (the relationship between feature and feature). Secondly, to quantify redundant criteria, an approximate redundancy feature framework based on mutual information (MI) is defined to remove redundant and irrelevant features. To evaluate the effectiveness of our proposed algorithm, controlled trials based on typical feature selection algorithm are conducted using three different classifiers, and the experimental results indicate that the FSBRR algorithm can effectively reduce the feature dimension and improve the classification accuracy. In addition, an experiment of small sample dataset is designed and conducted in the section of discussion and analysis to clarify the specific implementation process of FSBRR algorithm more clearly.

The wind environment quality at the height of pedestrians can significantly affect the thermal comfort and physical and mental health of pedestrians, promote the diffusion of air pollutants and inhibit the formation of urban heat island effect, and has been paid more and more attention in the field of urban and rural planning. This paper takes Jianlan Road commercial pedestrian Street as an example to maximize the thermal comfort of pedestrians. Based on CFD numerical simulation technology and space syntax theory, the pedestrian wind environment of the accessible space of the block is selected for quantitative research. Through numerical simulation, the influence of block spatial form on the wind environment at pedestrian height under the initial condition of uniform air flow is analyzed, and some suggestions are put forward for the optimization of block spatial form. Finally, the block optimization scheme is verified and simulated. The visualization results show that the wind environment quality of the optimized high-accessibility space is significantly improved, the proportion of comfort zone is increased from 58.2% to 86%, and the static wind rate is reduced from 41.8% to 14%. The wind environment optimization effect is obvious.

We define the anisotropic Rabi model as the generalization of the spin-boson Rabi model: The Hamiltonian system breaks the parity symmetry; the rotating and counterrotating interactions are governed by two different coupling constants; a further parameter introduces a phase factor in the counterrotating terms. The exact energy spectrum and eigenstates of the generalized model are worked out. The solution is obtained as an elaboration of a recently proposed method for the isotropic limit of the model. In this way, we provide a long-sought solution of a cascade of models with immediate relevance in different physical fields, including (i) quantum optics, a two-level atom in single-mode cross-electric and magnetic fields; (ii) solid-state physics, electrons in semiconductors with Rashba and Dresselhaus spin-orbit coupling; and (iii) mesoscopic physics, Josephson-junction flux-qubit quantum circuits.

In plants, the photosynthetic machinery photosystem II (PSII) consists of a core complex associated with variable numbers of light-harvesting complexes II (LHCIIs). The supercomplex, comprising a dimeric core and two strongly bound and two moderately bound LHCIIs (C₂S₂M₂), is the dominant form in plants acclimated to limited light. Here we report cryo–electron microscopy structures of two forms of C₂S₂M₂ (termed stacked and unstacked) from Pisum sativum at 2.7- and 3.2-angstrom resolution, respectively. In each C₂S₂M₂, the moderately bound LHCII assembles specifically with a peripheral antenna complex CP24-CP29 heterodimer and the strongly bound LHCII, to establish a pigment network that facilitates light harvesting at the periphery and energy transfer into the core. The high mobility of peripheral antennae, including the moderately bound LHCII and CP24, provides insights into functional regulation of plant PSII.

IntroductionCognitive impairment is a debilitating manifestation in Parkinson’s disease (PD). We sought to investigate predictors of PD-CI (PD with cognitive impairment).MethodsWe systematically searched PubMed and Cochrane Library for prospective cohort studies and pooled estimates via random-effects models. Primary analyses for all types of cognitive impairments and subgroup analyses by separate outcomes were conducted.ResultsA total of 28,009 studies were identified, of which 57 studies with 31 factors were included in the meta-analysis. In the primary analysis, 13 factors were associated with PD-CI, comprising advanced age [relative risk (RR) = 1.07, 95% confidence interval (CI) = 1.03–1.12], age at onset (RR = 4.43, 95% CI = 1.87–10.54), postural-instability-gait disorder (RR = 3.76, 95% CI = 1.36–10.40), higher Hoehn and Yahr stage (RR = 1.83, 95% CI = 1.35–2.47), higher UPDRS III score (RR = 1.04, 95% CI = 1.01–1.08), rapid eye movement sleep behavior disorder (RR = 3.72, 95% CI = 1.20–11.54), hallucinations (RR = 3.09, 95% CI = 1.61–5.93), orthostatic hypotension (RR = 2.98, 95% CI = 1.41–6.28), anxiety (RR = 2.59, 95% CI = 1.18–5.68), APOE ε2 (RR = 6.47, 95% CI = 1.29–32.53), APOE ε4 (RR = 3.04, 95% CI = 1.88–4.91), electroencephalogram theta power > median (RR = 2.93, 95% CI = 1.61–5.33), and alpha power < median (RR = 1.77, 95% CI = 1.07–2.92). In the subgroup analysis, MAPT H1/H1 genotype increased the risk of dementia in PD. Sixty-four studies were included in the systematic review, of which 12 factors were additionally correlated with PD-CI using single studies.ConclusionsAdvanced age, genetic variation in APOE and MAPT, gait disturbance, motor assessments, non-motor symptoms, and electroencephalogram may be promising predictors for PD-CI.