Iron (Fe), manganese (Mn), copper (Cu) and zinc (Zn) are essential micronutrients that are necessary for plant growth and development, but can be toxic at supra-optimal levels. Plants have evolved a complex homeostasis network that includes uptake, transport, and storage of these metals. Previously, we reported that the OsbHLH156-OsIRO2 transcription factor (TF) complex is activated under Fe deficient condition and acts as a central regulator on Strategy II Fe acquisition. In this study, the role of the TF complex on Mn, Cu and Zn uptake was evaluated. Fe deficiency caused significant increased Mn, Cu and Zn concentrations in shoot. The increase of these divalent metal concentrations was significantly suppressed in osbhlh156 and osiro2 mutants, suggesting that the TF complex plays roles on Mn, Cu and Zn uptake and transport. RNA-sequencing assay showed that the genes associated with Mn, Cu, and Zn uptake and transport were significantly suppressed in the osbhlh156 and osiro2 mutants. Transcriptional activation assays demonstrated that the TF complex could directly bind to the promoters of OsIRT1 , OsYSL15 , OsNRAMP6 , OsHMA2 , OsCOPT1/7 and OsZIP5/9/10 and activate their expression. In addition, the TF complex is required to activate the expression of NA and 2’deoxymugineic acid (DMA) synthesis genes, which in turn facilitate the uptake and transport of Mn, Cu and Zn. Furthermore, OsbHLH156 and OsIRO2 promote Cu accumulation to partially restore the Fe-deficiency symptom. Taken together, the OsbHLH156-OsIRO2 TF complex functions as a core regulator not only in Fe homeostasis, but also in Mn, Cu and Zn accumulation.

ObjectivesWe aim to investigate the functional profiles of perilesional gray matter (GM) in epileptic patients with focal cortical dysplasia (FCD) and to correlate these profiles with FCD II subtypes, surgical outcomes, and different antiseizure medications (ASMs) treatment response patterns.MethodsNine patients with drug-responsive epilepsy and 30 patients with drug-resistant epilepsy (11 were histologically confirmed FCD type IIa, 19 were FCD type IIb) were included. Individual-specific perilesional GM and contralateral homotopic GM layer masks were generated. These masks underwent a two-voxel (2 mm) dilation from the FCD lesion and contralateral homotopic region, resulting in 10 GM layers (20 mm). Layer 1, the innermost, progressed to Layer 10, the outermost. Amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) analyses were conducted to assess the functional characteristics of ipsilateral perilesional GM and contralateral homotopic GM.ResultsCompared to the contralateral homotopic GM, a significant reduction of ALFF was detected at ipsilateral perilesional GM layer 1 to 6 in FCD type IIa (after Bonferroni correction p < 0.005, paired t-test), whereas a significant decrease was observed at ipsilateral perilesional GM layer 1 to 2 in FCD type IIb (after Bonferroni correction p < 0.005, paired t-test). Additionally, a significant decrease of the ReHo was detected at ipsilateral perilesional GM layer 1 compared to the CHRs in FCD type IIb. Notably, complete resection of functional perilesional GM alterations did not correlate with surgical outcomes. Compared to the contralateral homotopic GM, a decreased ALFF in the ipsilateral perilesional GM layer was detected in drug-responsive patients, whereas decreased ALFF in the ipsilateral perilesional GM layer 1–6 and decreased ReHo at ipsilateral perilesional GM layer 1 were observed in drug-resistant patients (after Bonferroni correction p < 0.005, paired t-test).ConclusionOur findings indicate distinct functional profiles of perilesional GM based on FCD histological subtypes and ASMs’ response patterns. Importantly, our study illustrates that the identified functional alterations in perilesional GM may not provide sufficient evidence to determine the epileptogenic boundary required for surgical resection.

Abstract Objective The Bern score is based on brain magnetic resonance imaging (MRI) to predict the probability of cerebrospinal fluid (CSF) leak in spontaneous intracranial hypotension (SIH). The aim of this study is to investigate the association between lumbar puncture opening pressure (OP) and the Bern score. Methods We retrospectively reviewed OP measurement records and neuroimaging of patients with SIH in our center. The Bern score and its components were measured based on contrast‐enhanced brain MRI. The associations between OP and the Bern score, as well as its components, were analyzed. Patients were divided as low‐pressure (LP) group (OP < 60 mmH2O) and not‐low‐pressure (NLP) group (OP ≥ 60 mmH2O). Differences in terms of the Bern score and its components were compared between the two groups. Results Seventy‐one (mean age 40.4 ± 10.6 years) patients with myelography confirmed CSF leak were included in this study. The mean disease duration when performed brain MRI was 32 ± 29 days, with a mean Bern score of 5.1 ± 2.7 and a mean OP of 68.6 ± 60.3 mmH2O. There are statistically negative correlations between OP and the Bern score (p < .001), as well as suprasellar cistern (p < .01) and prepontine cistern (p < .01). The presence of venous engorgement (p < .01) and pachymeningeal enhancement (p < .001) were significantly associated with OP. The LP groups have higher Bern scores than the NLP group (5.9 ± 2.5 vs. 4.2 ± 2.6, p = .004). Conclusions A higher Bern score is indicative of not only an increased likelihood of a CSF leak but also a greater probability of low OP in patients with SIH. For patients with a Bern score ≥5 and positive heavily T2‐weighted MR myelography findings, epidural blood patch is reasonable before invasive myelography.

Objective: This study explored the role of obstructive sleep apnea (OSA) in post stroke anxiety (PSA) in noncardiogenic ischemic stroke patients.Methods: 180 patients with noncardiogenic ischemic stroke were consecutively enrolled from January 2019 to December 2019. All patients underwent polysomnography (PSG) to assess for OSA. OSA severity was identified based on the apnea hypopnea index (AHI), i.e., no OSA (AHI <5), mild OSA (5 = AHI <15), and moderate to severe OSA (AHI >= 15). Neuropsychological assessments were performed at acute phase and 6 months later to evaluate anxiety (Chinese version of the Zung self-rating anxiety scale [SAS], and Beck Anxiety Inventory [BAI]), depression (Patient Health Questionnaire-9, [PHQ-9]), and cognition (Mini-mental state examination, [MMSE], and Montreal Cognitive Assessment, [MOCA]). Clinical di-agnoses of PSA were made based on interviews and the anxiety scales. The correlations between PSA and OSA were investigated in Logistic regression analysis.Results: The prevalence of acute-phase and 6-month PSA were 27 (15%) and 52 (28.9%) respectively. Moderate to severe OSA and post-stroke depression (PSD) were the influencing factors of acute-phase PSA. 6-Month PSA was not associated with OSA but was associated with acute-phase anxiety, educa-tion status and MOCA. Logistic regression analysis including respiratory and sleeping parameters showed that AHI and micro-arousal index contributed to acute-phase PSA.Conclusions: Acute-phase PSA was associated with OSA severity, potentially through OSA-caused sleep discontinuity. While 6-month PSA was associated with acute-phase anxiety, highlighting the need for integration of screening for and management of OSA and PSA at acute phase.(c) 2023 Elsevier B.V. All rights reserved.

Background: To evaluate the clinical effect and application of evidence-based nursing combined with PDCA cycle management in reducing postoperative brain edema and depression in patients with brain tumors. Methods: A total of 110 patients with brain tumors were selected as the research objects and randomly divided into the research group and control group, with 55 patients in each group respectively. The patients in the control group were given routine nursing, while those in the research group were given evidence-based nursing combined with PDCA cycle management nursing intervention. The cerebral edema and other adverse reactions, depression, satisfaction degree of nursing intervention, and daily life ability after 6 months were observed and compared between the two groups. Results: With the implementation of evidence-based nursing combined with PDCA cycle management nursing intervention, the incidence of cerebral edema in the research group was 12.73%. The satisfaction degree of nursing intervention in the research was group 94.55%, which was significantly better than the control group 70.91% (P < 0.05); Comparing the daily life ability after 6 months, the ADL score of the research group was significantly better than that of the control group (P < 0.05). Conclusion: Evidence-based nursing combined with PDCA cycle management nursing intervention for patients with brain tumors after surgery will reduce the incidence of postoperative cerebral edema, relieve patients' emotions, reduce the degree of pain, and improve patients' satisfaction degree with medical staff.

Purpose This study investigated the associations of peripheral iron status with different manifestations of restless legs syndrome (RLS), including leg movements (LMs) on polysomnography (PSG), disease severity, and impact on patients. Patients and Methods In this cross-sectional study, 108 patients with RLS were enrolled at Sir Run Run Shaw Hospital’s Center for Sleep Medicine. Demographic information, disease characteristics, RLS severity, and impact on patients were assessed through a semi-structured questionnaire. Peripheral iron indicators [serum ferritin, iron, and transferrin concentrations; unsaturated iron-binding capacity (UIBC) and total iron-binding capacity (TIBC); transferrin saturation (TSAT)] were measured following PSG to assess sleep stages, respiratory events, microarousals and LM parameters. Data from patients with and without ferritin concentration < 50 µg/L were compared in crude analyses, and Spearman correlations of other iron indicators with RLS data were examined. An ordinal logistic regression model was used to adjust for age, sex, body mass index, years of education, age at the time of RLS onset, prior treatment (yes/no), C-reactive protein (CRP)/hemoglobin level, total sleep time and apnea-hypopnea index. Results Multivariate analysis showed that periodic LMs during sleep (PLMS) and other LM parameters were significantly associated with a ferritin concentration < 50 µg/L, UIBC, TIBC, and serum transferrin concentration, but not serum iron or TSAT. By contrast, the severity and impact of RLS were not associated with a ferritin concentration < 50 µg/L or other peripheral iron indicators in the multivariate model. Conclusion In this study, peripheral iron status was associated mainly with motor components (LMs on PSG) rather than sensory components (severity and impact of RLS) after adequately controlling for potential confounders, such as CRP and hemoglobin levels. Commonly used peripheral iron metabolism indicators may therefore not be ideal biomarkers of RLS severity or impact on patients.

Background Levodopa is regarded as a standard medication in Parkinson disease (PD) treatment. However, long-term administration of levodopa leads to levodopa-induced dyskinesia (LID), which can markedly affect patient quality of life. Previous studies have shown that neuroinflammation in the brain plays a role in LID and increases potential neuroinflammatory mediators associated with the side effects of levodopa. Objective The treatment effect of C16 (a peptide that competitively binds integrin αvβ3 and inhibits inflammatory cell infiltration) and angiopoietin-1 (Ang-1; a vascular endothelial growth factor vital for blood vessel protection), along with levodopa, was evaluated in a rodent model of PD. Methods We administered a combination of C16 and Ang-1 in a rodent model of PD induced by MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine). Seventy-five mice were randomly divided into five treatment groups: control, vehicle, levodopa, C16+Ang-1, and levodopa+C16+Ang-1. Behavioral, histological, and electrophysiological experiments were used to determine neuron function and recovery. Results The results showed that C16+Ang-1 treatment alleviated neuroinflammation in the CNS and promoted the recovery effects of levodopa on neural function. Conclusion Our study suggests that C16+Ang-1 can compensate for the shortcomings of levodopa, improve the CNS microenvironment, and ameliorate the effects of levodopa. This treatment strategy could be developed as a combinatorial therapeutic in the future.