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BackgroundThe detection of dyskalemias—hypokalemia and hyperkalemia—currently depends on laboratory tests. Since cardiac tissue is very sensitive to dyskalemia, electrocardiography (ECG) may be able to uncover clinically important dyskalemias before laboratory results. ObjectiveOur study aimed to develop a deep-learning model, ECG12Net, to detect dyskalemias based on ECG presentations and to evaluate the logic and performance of this model. MethodsSpanning from May 2011 to December 2016, 66,321 ECG records with corresponding serum potassium (K+) concentrations were obtained from 40,180 patients admitted to the emergency department. ECG12Net is an 82-layer convolutional neural network that estimates serum K+ concentration. Six clinicians—three emergency physicians and three cardiologists—participated in human-machine competition. Sensitivity, specificity, and balance accuracy were used to evaluate the performance of ECG12Net with that of these physicians. ResultsIn a human-machine competition including 300 ECGs of different serum K+ concentrations, the area under the curve for detecting hypokalemia and hyperkalemia with ECG12Net was 0.926 and 0.958, respectively, which was significantly better than that of our best clinicians. Moreover, in detecting hypokalemia and hyperkalemia, the sensitivities were 96.7% and 83.3%, respectively, and the specificities were 93.3% and 97.8%, respectively. In a test set including 13,222 ECGs, ECG12Net had a similar performance in terms of sensitivity for severe hypokalemia (95.6%) and severe hyperkalemia (84.5%), with a mean absolute error of 0.531. The specificities for detecting hypokalemia and hyperkalemia were 81.6% and 96.0%, respectively. ConclusionsA deep-learning model based on a 12-lead ECG may help physicians promptly recognize severe dyskalemias and thereby potentially reduce cardiac events.

Background: Demonstrating a positive impact of educational programs on clinical care outcomes is challenging. We assess students' knowledge, attitudes, and behaviors as short-term outcomes of integrating a structured Traditional Chinese Medicine course within a Western medical school. Methods: A prospective questionnaire survey was conducted among first-year and second-year undergraduate medical students who participated in the "Introduction to Chinese Medicine" course in 2020. The survey assessed their knowledge, attitudes, and behaviors before and after completing the 32-hour course. Results: In total, 89 participants who completed both pre- and post-course questionnaires exhibited significantly higher scores in Chinese medicine knowledge after the course (3.82 ± 0.67 vs. 4.05 ± 0.73, p = 0.002). The majority of medical students displayed positive attitudes towards traditional Chinese medicine (80.9% vs. 83.3%, p = 0.392), particularly regarding the statement, "Traditional Chinese medicine emphasizes holistic considerations and whole person health to a greater extent than Western medicine does" (75.3% vs. 88.8%, p = 0.017). Additionally, most medical students reported proactive behaviors related to integrative care with Chinese medicine, including inquiring about Chinese medicine therapy history (76.4%), the concurrent use of Western and Chinese medications (78.7%) and participating in academic exchanges with Chinese medicine physicians (78.7%) after the course. More medical students expressed an intention to proactively learn more about Chinese medicine after the course (40.4% vs. 51.7%, p = 0.031). Conclusions: The elective "Introduction to Chinese Medicine" course enhanced Taiwanese Western medical students' knowledge of Chinese medicine, fostered positive attitudes towards integrative healthcare involving Chinese medicine, and increased their willingness to learn more about Chinese medicine for future clinical practice. Trial registration: Registration prior to patient enrollment was not applicable because participants were not assigned to treatment groups in this study. [ABSTRACT FROM AUTHOR]

Primary cardiac angiosarcoma is a rare and aggressive malignancy with a poor prognosis. This case report highlights the challenges in diagnosing and managing such tumors, especially when complicated by cardiac tamponade. We present the case of a 52-year-old male with primary cardiac angiosarcoma, initially presenting with cardiac tamponade, which led to the subsequent diagnosis of an aggressive tumor. Prompt recognition and interdisciplinary collaboration facilitated timely intervention, resulting in successful surgical resection and favorable short-term outcomes. However, the overall prognosis remains poor due to the aggressive nature of the disease. This case underscores the importance of early recognition, comprehensive diagnostic evaluation, and aggressive multimodal treatment strategies. [ABSTRACT FROM AUTHOR]

Partial anomalous pulmonary venous connection (PAPVC) is a relatively rare congenital heart anomaly characterized by abnormal drainage of one or more pulmonary veins into a location other than the left atrium. In this case report, we present a 70-year-old male diagnosed with PAPVC with a vertical vein connected between the left upper pulmonary vein and the innominate vein. The transcatheter occlusion of the vertical vein was successfully achieved using a vascular plug. The report underscores transcatheter occlusion as a minimally invasive and effective alternative to surgical correction for PAPVC; it may provide advantages such as a shorter hospital stay, faster recovery time, and reduced complications. [ABSTRACT FROM AUTHOR]

We found that GroEL in Porphyromonas gingivalis accelerated tumor growth and increased mortality in tumor‐bearing mice; GroEL promoted proangiogenic function, which may be the reason for promoting tumor growth. To understand the regulatory mechanisms by which GroEL increases the proangiogenic function of endothelial progenitor cells (EPCs), we explored in this study. In EPCs, MTT assay, wound‐healing assay, and tube formation assay were performed to analyze its activity. Western blot and immunoprecipitation were used to study the protein expression along with next‐generation sequencing for miRNA expression. Finally, a murine tumorigenesis animal model was used to confirm the results of in vitro. The results indicated that thrombomodulin (TM) direct interacts with PI3K/Akt to inhibit the activation of signaling pathways. When the expression of TM is decreased by GroEL stimulation, molecules in the PI3K/Akt signaling axis are released and activated, resulting in increased migration and tube formation of EPCs. In addition, GroEL inhibits TM mRNA expression by activating miR‐1248, miR‐1291, and miR‐5701. Losing the functions of miR‐1248, miR‐1291, and miR‐5701 can effectively alleviate the GroEL‐induced decrease in TM protein levels and inhibit the proangiogenic abilities of EPCs. These results were also confirmed in animal experiments. In conclusion, the intracellular domain of the TM of EPCs plays a negative regulatory role in the proangiogenic capabilities of EPCs, mainly through direct interaction between TM and PI3K/Akt to inhibit the activation of signaling pathways. The effects of GroEL on tumor growth can be reduced by inhibiting the proangiogenic properties of EPCs through the inhibition of the expression of specific miRNAs. [ABSTRACT FROM AUTHOR]

Orthotopic allograft transplantation (OAT) is a significant approach to addressing organ failure. However, persistent immune responses to the allograft affect chronic rejection, which induces OAT vasculopathy (OATV) and organ failure. Porphyromonas gingivalis can infiltrate remote organs via the bloodstream, thereby intensifying the severity of cardiovascular, respiratory, and neurodegenerative diseases and cancer. GroEL, a virulence factor of P. gingivalis promotes pro‐inflammatory cytokine production in host cells, which assumes to play a pivotal role in the pathogenesis of cardiovascular diseases. Although the aggravation of OATV is attributable to numerous factors, the role of GroEL remains ambiguous. Therefore, this study aimed to investigate the impact of GroEL on OATV. Aortic grafts extracted from PVG/Seac rats were transplanted into ACI/NKyo rats and in vitro human endothelial progenitor cell (EPC) and coronary artery endothelial cell (HCAEC) models. The experimental findings revealed that GroEL exacerbates OATV in ACI/NKyo rats by affecting EPC and smooth muscle progenitor cell (SMPC) function and enabling the anomalous accumulation of collagen. In vitro, GroEL spurs endothelial‐mesenchymal transition in EPCs, reduces HCAEC tube formation and barrier function by downregulating junction proteins, accelerates HCAEC aging by lowering mitochondrial membrane potential and respiratory function, and impedes HCAEC migration by modulating cytoskeleton‐associated molecules. This study suggests that P. gingivalis GroEL could potentially augment OATV by impacting vascular progenitor and endothelial cell functions. [ABSTRACT FROM AUTHOR]

Magic is an art form that has been traced back 1000 years ago. Previous studies have been conducted to investigate the positive effects magic could bring on human beings. Herein, we organize studies on the positive effects and the use of magic tricks in aspects of performing, witnessing, discovering the secrets of magic, and finally, in educational settings. We discovered that magic not only benefits well-being with physical and mental improvement but also works well as a therapeutic use for hospitals, pediatric settings, and rehabilitation for patients with functional loss. With research on the human mind developing rapidly, magic could also be a great study tool for exploring human cognition and perception. We conclude that magic has already brought about a great number of promising effects in various settings. Therefore, in this manuscript, we discuss how performing and perceiving magic tricks could bring positive effects on researchers and human beings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the hemorheological and inflammatory changes before and after coronary artery bypass graft (CABG) surgery, as factors such as hypothermia, hemodilution, transfusion, and other variables affect blood viscosity and inflammation during the procedure. Methods: A total of 25 patients who underwent CABG surgery were enrolled in this study. Whole blood was collected just before the CABG (D0), 2 days after surgery (D2), and 5 days after surgery (D5). The plasma viscosity (PV) and whole blood viscosity (WBV) were measured at shear rates ranging from 0.1 to 1000 s−1 using a rheometer, and the mean values were compared. Inflammatory markers were also assessed and analyzed in relation to the hemorheological changes. Results: Compared with the baseline values, the PV significantly increased after 5 days. WBV showed a significant increase on day 2 and after 5 days. The WBV and fibrinogen were significantly correlated on day 2 and day 5 but not before surgery. Inflammatory markers such as CRP, WBC, platelets, and fibrinogen also demonstrated notable changes in relation to the hemorheological alterations. Conclusions: This study highlights the crucial finding that hyperviscosity, characterized by elevated PV and WBV, persists for almost one week after on-pump CABG surgery. Understanding the interplay between inflammation and hemorheological properties during the postoperative period is crucial for optimizing patient care. Future research should focus on exploring the underlying mechanisms and potential therapeutic interventions to mitigate the impact of inflammation on blood viscosity and improve patient outcomes following CABG surgery. [ABSTRACT FROM AUTHOR]

Various pathological alterations, including lipid-deposition-induced comparative cardiac lipotoxicity, contribute to cardiac aging in the failing heart. A decline in endogenous myogenin proteins can lead to the reversal of muscle cell differentiation and the creation of mononucleated muscle cells. Myogenin may be a specific regulator of adaptive responses to avoid pathological hypertrophy in the heart. Hence, it is important to understand the regulation of myogenin expression and functions in response to exposure to varied stresses. In this study, we first examined and verified the cytotoxic effect of palmitic acid on H9c2 cells. The reduction in myogenin mRNA and protein expression by palmitic acid was independent of the effect of glucose. Meanwhile, the induction of cyclooxygenase 2 and activating transcription factor 3 mRNAs and proteins by palmitic acid was dependent on the presence of glucose. In addition, palmitic acid failed to disrupt cell cycle progression when H9c2 cells were treated with no glucose. Next, we examined the functional role of myogenin in palmitic-acid-treated H9c2 cells and found that myogenin may be involved in palmitic-acid-induced mitochondrial and cytosolic ROS generation, cellular senescence, and mitochondrial membrane potential. Finally, the GSE150059 dataset was deposited in the Gene Expression Omnibus website and the dataset was further analyzed via the molecular microscope diagnostic system (MMDx), demonstrating that many heart transplant biopsies currently diagnosed as no rejection have mild molecular-antibody-mediated rejection-related changes. Our data show that the expression levels of myogenin were lower than the average level in the studied population. Combining these results, we uncover part of the functional role of myogenin in lipid- and glucose-induced cardiac cell stresses. This finding provides valuable insight into the differential role of fatty-acid-associated gene expression in cardiovascular tissues. Additionally, the question of whether this gene expression is regulated by myogenin also highlights the usefulness of a platform such as MMDx-Heart and can help elucidate the functional role of myogenin in heart transplantation. [ABSTRACT FROM AUTHOR]