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Weipin Niu,1,2,* Yinuo Zhang,3,* Hongyun Liu,4 Na Liang,5 Li Xu,6 Yalin Li,7 Wei Yao,8 Wei Shi,8 Zhiyong Liu1 1Central Laboratory, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 2Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 3College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 4Department of Gynecology, Linyi Central Hospital, Linyi, People’s Republic of China; 5Department of Traditional Chinese Medicine, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, People’s Republic of China; 6Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 7First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 8Department of Gynecology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhiyong Liu, Central Laboratory, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250014, People’s Republic of China, Email zhiyonglq@163.com Wei Shi, Department of Gynecology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Jingshi Road, Jinan, Shandong, 250014, People’s Republic of China, Email 71000131@sdutcm.edu.cnPurpose: Adenomyosis (AM) is a common benign uterine disorder that has deleterious effects on women’s health. However, the pathogenesis of AM is not clearly understood. We aimed to investigate the pathophysiological changes and molecular mechanism in AM.Met

ObjectiveHypertensive response to exercise (HRE) is observed in patients with hypertrophic cardiomyopathy (HCM) with normal resting blood pressure (BP). However, the prevalence or prognostic implications of HRE in HCM remain unclear.MethodsIn this study, normotensive HCM subjects were enrolled. HRE was defined as systolic BP > 210 mmHg in men or >190 mmHg in women, or diastolic BP > 90 mmHg, or an increase in diastolic BP > 10 mmHg during treadmill exercise. All participants were followed for subsequent development of hypertension, atrial fibrillation (AF), heart failure (HF), sustained ventricular tachycardia/fibrillation (VT/VF), and all-cause death. Six hundred and eighty HCM patients were screened.Results347 patients had baseline hypertension, and 333 patients were baseline normotensive. 132 (40%) of the 333 patients had HRE. HRE was associated with female sex, lower body mass index and milder left ventricular outflow tract obstruction. Exercise duration and metabolic equivalents were similar between patients with or without HRE, but the HRE group had higher peak heart rate (HR), better chronotropic response and more rapid HR recovery. Conversely, non-HRE patients were more likely to exhibit chronotropic incompetence and hypotensive response to exercise. After a mean follow-up of 3.4 years, patients with and without HRE had similar risks of progression to hypertension, AF, HF, sustained VT/VF or death.ConclusionHRE is common in normotensive HCM patients during exercise. HRE did not carry higher risks of future hypertension or cardiovascular adverse outcomes. Conversely, the absence of HRE was associated with chronotropic incompetence and hypotensive response to exercise.

To run a cloud application with the required service quality, operators have to continuously monitor the cloud application's run-time status, detect potential performance anomalies, and diagnose the root causes of anomalies. However, existing models of performance anomaly detection often suffer from low re-usability and robustness due to the diversity of system-level metrics being monitored and the lack of high-quality labeled monitoring data for anomalies. Moreover, the current coarse-grained analysis models make it difficult to locate system-level root causes of the application performance anomalies for effective adaptation decisions. We provide a FIne-grained Robust pErformance Diagnosis (FIRED) framework to tackle those challenges. The framework offers an ensemble of several well-selected base models for anomaly detection using a deep neural network, which adopts weakly-supervised learning considering fewer labels exist in reality. The framework also employs a real-time fine-grained analysis model to locate dependent system metrics of the anomaly. Our experiments show that the framework can achieve the best detection accuracy and algorithm robustness, and it can predict anomalies in four minutes with F1 score higher than 0.8. In addition, the framework can accurately localize the first root causes, and with an average accuracy higher than 0.7 of locating first four root causes.

BACKGROUND:Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disease characterized by varying degrees of left ventricular outflow tract obstruction. In a large cohort, we compare the outcomes among 3 different hemodynamic groups. METHODS AND RESULTS:We prospectively enrolled patients fulfilling standard diagnostic criteria for HCM from January 2005 to June 2015. Detailed phenotypic characterization, including peak left ventricular outflow tract pressure gradients at rest and after provocation, was measured by echocardiography. The primary outcome was a composite cardiovascular end point, which included new-onset atrial fibrillation, new sustained ventricular tachycardia/ventricular fibrillation, new or worsening heart failure, and death. The mean follow-up was 3.4±2.8 years. Among the 705 patients with HCM (mean age, 52±15 years; 62% men), 230 with obstructive HCM were older and had a higher body mass index and New York Heart Association class. The 214 patients with nonobstructive HCM were more likely to have a history of sustained ventricular tachycardia/ventricular fibrillation and implantable cardioverter defibrillator implantation. During follow-up, 121 patients experienced a composite cardiovascular end point. Atrial fibrillation occurred most frequently in the obstructive group. Patients with nonobstructive HCM had more frequent sustained ventricular tachycardia/ventricular fibrillation events. In multivariate analysis, obstructive (hazard ratio, 2.80; 95% confidence interval, 1.64-4.80) and nonobstructive (hazard ratio, 1.94; 95% confidence interval, 1.09-3.45) HCM were associated with more adverse events compared with labile HCM. CONCLUSIONS:Nonobstructive HCM carries notable morbidity, including a higher arrhythmic risk than the other HCM groups. Patients with labile HCM have a relatively benign clinical course. Our data suggest detailed sudden cardiac death risk stratification in nonobstructive HCM and monitoring with less aggressiv

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disease characterized by varying degrees of left ventricular outflow tract obstruction. In a large cohort, we compare the outcomes among 3 different hemodynamic groups. We prospectively enrolled patients fulfilling standard diagnostic criteria for HCM from January 2005 to June 2015. Detailed phenotypic characterization, including peak left ventricular outflow tract pressure gradients at rest and after provocation, was measured by echocardiography. The primary outcome was a composite cardiovascular end point, which included new-onset atrial fibrillation, new sustained ventricular tachycardia/ventricular fibrillation, new or worsening heart failure, and death. The mean follow-up was 3.4±2.8 years. Among the 705 patients with HCM (mean age, 52±15 years; 62% men), 230 with obstructive HCM were older and had a higher body mass index and New York Heart Association class. The 214 patients with nonobstructive HCM were more likely to have a history of sustained ventricular tachycardia/ventricular fibrillation and implantable cardioverter defibrillator implantation. During follow-up, 121 patients experienced a composite cardiovascular end point. Atrial fibrillation occurred most frequently in the obstructive group. Patients with nonobstructive HCM had more frequent sustained ventricular tachycardia/ventricular fibrillation events. In multivariate analysis, obstructive (hazard ratio, 2.80; 95% confidence interval, 1.64-4.80) and nonobstructive (hazard ratio, 1.94; 95% confidence interval, 1.09-3.45) HCM were associated with more adverse events compared with labile HCM. Nonobstructive HCM carries notable morbidity, including a higher arrhythmic risk than the other HCM groups. Patients with labile HCM have a relatively benign clinical course. Our data suggest detailed sudden cardiac death risk stratification in nonobstructive HCM and monitoring with less aggressive management in labile HCM.

Forage plays a critical role in the milk production of dairy cows; however, the mechanisms regulating bovine milk synthesis in dairy cows fed high forage rations with different basal forage types are not well-understood. In the study, rice straw (RS, low-quality) and alfalfa hay (AH, high-quality) diets were fed to lactating cows to explore how forage quality affected the molecular mechanisms regulating milk production using RNA-seq transcriptomic method with iTRAQ proteomic technique. A total of 554 transcripts (423 increased and 131 decreased) and 517 proteins (231 up-regulated and 286 down-regulated) were differentially expressed in the mammary glands of the two groups. The correlation analysis demonstrated seven proteins (six up-regulated and one down-regulated) had consistent mRNA expression. Functional analysis of the differentially expressed transcripts/proteins suggested that enhanced capacity for energy and fatty acid metabolism, increased protein degradation, reduced protein synthesis, decreased amino acid metabolism and depressed cell growth were related to RS consumption. The results indicated cows consuming RS diets may have had depressed milk protein synthesis because these animals had decreased capacity for protein synthesis, enhanced proteolysis, inefficient energy generation and reduced cell growth. Additional work evaluating RS- and AH-based rations may help better isolate molecular adaptations to low nutrient availability during lactation.

Forage plays a critical role in the milk production of dairy cows; however, the mechanisms regulating bovine milk synthesis in dairy cows fed high forage rations with different basal forage types are not well-understood. In the study, rice straw (RS, low-quality) and alfalfa hay (AH, high-quality) diets were fed to lactating cows to explore how forage quality affected the molecular mechanisms regulating milk production using RNA-seq transcriptomic method with iTRAQ proteomic technique. A total of 554 transcripts (423 increased and 131 decreased) and 517 proteins (231 up-regulated and 286 down-regulated) were differentially expressed in the mammary glands of the two groups. The correlation analysis demonstrated seven proteins (six up-regulated and one down-regulated) had consistent mRNA expression. Functional analysis of the differentially expressed transcripts/proteins suggested that enhanced capacity for energy and fatty acid metabolism, increased protein degradation, reduced protein synthesis, decreased amino acid metabolism and depressed cell growth were related to RS consumption. The results indicated cows consuming RS diets may have had depressed milk protein synthesis because these animals had decreased capacity for protein synthesis, enhanced proteolysis, inefficient energy generation and reduced cell growth. Additional work evaluating RS- and AH-based rations may help better isolate molecular adaptations to low nutrient availability during lactation.

Stimulating caregiving practices facilitate early child development and learning. This study examined child-, family-, and country-level predictors of maternal and paternal cognitive and socio-emotional caregiving in 28 low- and middle-income countries, using data from the UNICEF 2005 Multiple Indicator Cluster Survey 3. The sample included 134,290 children, aged 0-4 years, from 100,270 families. Results indicated that maternal education and the country Human Development Index (HDI), an index reflecting the social and economic development of countries, were significant predictors of parents' caregiving practices and had large effect sizes. Maternal education further moderated the association between the HDI and parents' caregiving practices. The findings have important implications for supporting quality parenting and for promoting the well-being of young children in low- and middle-income countries. © 2015 Elsevier Inc.

Stimulating caregiving practices facilitate early child development and learning. This study examined child-, family-, and country-level predictors of maternal and paternal cognitive and socio-emotional caregiving in 28 low- and middle-income countries, using data from the UNICEF 2005 Multiple Indicator Cluster Survey 3. The sample included 134,290 children, aged 0-4 years, from 100,270 families. Results indicated that maternal education and the country Human Development Index (HDI), an index reflecting the social and economic development of countries, were significant predictors of parents' caregiving practices and had large effect sizes. Maternal education further moderated the association between the HDI and parents' caregiving practices. The findings have important implications for supporting quality parenting and for promoting the well-being of young children in low- and middle-income countries. © 2015 Elsevier Inc.

Stimulating caregiving practices facilitate early child development and learning. This study examined child-, family-, and country-level predictors of maternal and paternal cognitive and socio-emotional caregiving in 28 low- and middle-income countries, using data from the UNICEF 2005 Multiple Indicator Cluster Survey 3. The sample included 134,290 children, aged 0-4 years, from 100,270 families. Results indicated that maternal education and the country Human Development Index (HDI), an index reflecting the social and economic development of countries, were significant predictors of parents' caregiving practices and had large effect sizes. Maternal education further moderated the association between the HDI and parents' caregiving practices. The findings have important implications for supporting quality parenting and for promoting the well-being of young children in low- and middle-income countries.