Search

AIMS Culprit-plaque morphology [plaque rupture (PR) and plaque erosion (PE)] and high-risk plaques (HRP) identified by optical coherence tomography (OCT) and residual SYNTAX score (rSS) have been reported to influence clinical outcomes. Thus, in this study, we aimed to investigate the prognostic implication of culprit-plaque morphology and rSS for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS Based on plaque morphology and rSS, 274 STEMI patients were divided into 4 groups: PE/low-rSS (n=61), PE/high-rSS (n=58), PR/low-rSS (n=55), and PR/high-rSS (n=100). According to HRP and rSS, patients were stratified to non-HRP/low-rSS (n=97), non-HRP/high-rSS (n=109), HRP/low-rSS (n=19), and HRP/high-rSS (n=49). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke, and unplanned revascularization of any coronary artery. RESULTS During the follow-up of 2.2 years, 47 (17.2%) MACE were observed. Patients with PR/high-rSS and HRP/high-rSS presented lower survival probability on revascularization and MACE. In fully adjusted analyses, PR/high-rSS group presented higher MACE risk than PE/low-rSS (HR: 4.80, 95% CI: 1.43-16.11, P=0.025). Patients with non-HRP/high-rSS (HR: 2.90, 95% CI: 1.01-8.38, P=0.049) and HRP/high-rSS (HR: 8.67, 95% CI: 2.67-28.21, P＜0.001) presented higher risk of cardiac events than non-HRP/low-rSS. Adding rSS and HRP to the risk prediction model increased the C-statistic to 0.797 (95% CI: 0.737-0.857), with ΔC-statistic of 0.066 (P=0.002) and the NRI (46.0%, 95% CI: 20.5-56.8%, P＜0.001) and IDI (8.7%, 95% CI: 3.6-18.2%, P＜0.001). CONCLUSION High-risk plaques in combination with rSS enhanced the predictive ability for MACE, indicating culprit-plaque features and residual atherosclerosis burden should be taken into account in risk stratification of STEMI patients.

The accuracy of traffic noise prediction models (TNMs) is impaired by affecting factors and system errors. In addition, the traditional traffic noise source cannot be tested as the sound source is generated in the centreline of the road. To address these limitations, a TNM based on the equivalent sound source at the road shoulder was developed. First, the equivalent traffic flow based on the acoustic-equivalent conversion coefficient was calculated and the traffic noise source intensity model was deduced. The shoulder's sound pressure level (SPL) data were then used to formulate a single-vehicle equivalent SPL model and correct the traffic noise source intensity model. The propagation model was fitted according to the attenuation law that traffic noise strength attenuates gradually from the shoulder to the road outside and fluctuates periodically. The results of a case study showed that the absolute percentage error of the proposed model's prediction was 2·3% compared with the measured value, which was better than the performance of the current model suggested in the Chinese specification. The proposed prediction model provides a friendly and less time-consuming approach for city planners and traffic engineers to conduct freeway traffic noise prediction and assessment.

Background and Purpose: Paravertebral arteriovenous shunts (PVAVSs) are rare. Whether the intradural venous system is involved in drainage may lead to differences in clinical characteristics through specific pathophysiological mechanisms. This study aims to comprehensively evaluate the natural history and clinical outcomes of PVAVSs with or without intradural drainage. Methods: Sixty-four consecutive patients with PVAVSs from 2 institutes were retrospectively reviewed. Lesions were classified as type A (n=28) if the intradural veins were involved in drainage; otherwise, they were classified as type B (n=36). The clinical course from initial presentation to the last follow-up was analyzed. Results: The patients with type A shunts were older at presentation (52.5 versus 35.5 years, P P =0.00006). After presentation, the deterioration rates related to gait and sphincter dysfunction were significantly higher in patients with type A than type B shunts (gait dysfunction: 71.8%/y versus 17.0%/y, P =0.0006; sphincter dysfunction: 63.7%/y versus 11.3%/y, P =0.0002). According to the angiogram at the end of the latest treatment, 79% of type A and 75% of type B PVAVSs were completely obliterated. If the lesions were partially obliterated, a significantly higher clinical deterioration rate was observed in patients with type A shunts than those with type B shunts (69.9%/y versus 3.2%/y, P =0.0253). Conclusions: Type A PVAVSs feature rapid progressive neurological deficits; therefore, early clinical intervention is necessary. For complex lesions that cannot be completely obliterated, surgical disconnection of all refluxed radicular veins is suggested.

It is a very well-known fact, that the high complexity of the High Efficiency Video Coding standard (HEVC) is the main hurdle for its wide deployment and use. To tackle this problem, a number of recent research outcomes exploit heuristic algorithms and machine learning, including deep learning, to reduce the coding complexity. However, in most cases, each encoder module, i.e., encoding process, is first accelerated individually, and then different acceleration algorithms are manually combined. Without a holistic strategy, the acceleration potential of multi-module combination is not exploited and the Rate-Distortion (RD) loss is generally not well controlled. To tackle these shortcomings, this paper exploits the acceleration properties of different modules, i.e., the numerical representation of potential time saving and possible RD loss, from which a heuristic model is explored. Then a Heuristic Model Oriented Framework (HMOF) is proposed which adapts the properties of modules to underlying acceleration algorithms. In the framework, two advanced acceleration algorithms, including Border Considered CNN (BC-CNN)-based Coding Unit (CU) partition and Naive Bayes-based Prediction Unit (PU) partition, are proposed for the CU and PU modules, respectively. Further, by leveraging the heuristic model as the guidance to combine the proposed acceleration algorithms, HMOF is globally optimized, where different time saving budgets are wisely allocated to different modules and a theoretically minimal RD loss is achieved. According to the experimental results, through fusing a suitable deep learning technique and a Bayes-Based prediction, the proposed acceleration framework HMOF enable multiple acceleration choices. Here the proposed joint optimization strategy help to make a choice leading to the best cost-performance. Furthermore, within the proposed framework, intra coding time can be precisely controlled with negligible Bjontegaard delta bit-rate (BDBR) loss. In this context, as a complexity control method, HMOF outperforms the state-of-the-art complexity reduction algorithms under a similar complexity reduction ratio. These results partially demonstrate the superiority of the proposed technique.

Background and Aim The aim of prospective study was to determine the prognostic value of combined measures of plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) and pentraxin 3 (PTX3) according to the culprit-plaque morphology (plaque rupture versus plaque erosion) in relation to the in patients with acute ST-elevated myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention. Methods A total of 434 patients with STEMI aged ≥18 years who underwent pre-intervention OCT imaging of culprit lesions between March 2017 and March 2019 were enrolled. Finally, 235 patients who meet the inclusion criteria were enrolled and the cohort was divided into 3 groups according to PCSK9 and PTX3 levels: group A: PCSK9 < median and Pentraxin 3 (N = 72/30.6%); group B: PCSK9 ≥ median or Pentraxin 3≥ median (N = 91/38.7%); group C: PCSK9 ≥ median and Pentraxin 3≥ median (N = 72/30.6%). MACEs were defined as a composite of all-cause death, myocardial infarction (MI) recurrence, and ischemic stroke, revascularization and heart failure. Outcomes During a median follow-up of 2.01 years, 50 patients has occurred MACE. Two-year MACE was higher in group C (23/31.9%) than in group B (16/17.6%) and group A (11/15.3%) (p = 0.028). There was a correlation between PCSK9 and PTX3 (r = 0.302, p < 0.003). In multivariable analysis adjusted for age, gender, risk factors, and serum indexes, being in group C remained independently associated with an increased risk of MACE (hazard ratio [HR]: 2.90; p = 0.010), and group B tended to have higher MACE (HR: 1.76; p = 0.172) compared with group A. Among patients with plaque erosion by OCT, group C was independently associated with an increased risk of MACE (HR: 9.04; p = 0.048) after fully adjustment. However, the significant association was absence among patients with plaque rupture. Conclusion and Relevance This study demonstrated the usefulness of combined measures of PCSK9 and PTX3 to enhance risk stratification in patients with STEMI especially among patients with plaque erosion. Patients with elevation of both PCSK9 and PTX3 had a markedly increased risk of MACE.

BACKGROUND Enteric anastomotic (EA) bleeding is a potentially life-threatening surgical complication associated with enteric anastomosis during simultaneous pancreas and kidney transplantation (SPKT). AIM To investigate whether suture ligation (SL) for submucosal hemostasis during hand-sewn enteric anastomosis could decrease the morbidity of early EA bleeding in SPKT. METHODS We compared the outcomes of 134 patients classified into SL (n = 44) and no SL (NSL) groups (n = 90). This study adheres to the declarations of Istanbul and Helsinki and all donors were neither paid nor coerced. RESULTS During the first postoperative week, the EA bleeding rate in the SL group was lower than that in the NSL group (2.27% vs 15.56%; P = 0.021); no relationship was found between EA bleeding and donor age, mean pancreatic cold ischemia time, platelet count, prothrombin time international normalized rate, activated partial thromboplastin time, and thrombin time. Anastomotic leakage was observed in one case in the SL group at postoperative day (POD) 14 and in one case at POD 16 in the NSL group (P = 0.754). No significant difference was found between the two groups in the patient survival, pancreas graft survival, or kidney graft survival. CONCLUSION SL for submucosal hemostasis during hand-sewn enteric anastomosis in SPKT can decrease the morbidity of early EA bleeding without increasing the anastomotic leakage rate.

BACKGROUND Chronic active Epstein-Barr virus infection (EBV) is a systemic EBV-positive lymphoproliferative disease, which may lead to fatal illness. There is currently no standard treatment regimen for chronic active EBV (CAEBV), and hematopoietic stem cell transplantation is the only effective treatment. We here report a CAEBV patient treated with PEG-aspargase, who achieved negative EBV-DNA. CASE SUMMARY A 33-year-old female Chinese patient who had fever for approximately 3 mo was admitted to our hospital in December 2017. EBV-DNA was positive with a high copy number. She was diagnosed with chronic active EB virus infection. PEG-aspargase was administered at a dose of 1500 U/m2 at a 14-d interval, resulting in eradication of EBV for more than 6 mo. The effect of PEG-aspargase in this patient was excellent. CONCLUSION A chemotherapy regimen containing PEG-aspargase for CAEBV may be further considered.

Ying Wang,1 Xiaoxiao Zhao,1 Peng Zhou,1 Chen Liu,1 Zhaoxue Sheng,1,2 Jiannan Li,1 Jinying Zhou,1 Runzhen Chen,1 Yi Chen,1 Li Song,1 Hanjun Zhao1 &ast;, Hongbing Yan3 &#x002A1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Cardiology, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 3Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People’s Republic of China&ast; These authors contributed equally to this workCorrespondence: Hongbing YanDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, No. 12, Langshan Road, Xili Street, Nanshan District, Shenzhen, 518000, People’s Republic of ChinaTel +86-10-88322285Email hbyanfuwai2018@163.comHanjun ZhaoDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, People’s Republic of ChinaTel +86-15210020808Email 15210020808@163.comBackground: Culprit‑plaque morphology [plaque rupture (PR) and plaque erosion (PE) identified by optical coherence tomography (OCT)] and biomarker of vascular inflammation, pentraxin-3 (PTX3), have been reported to influence clinical outcomes in coronary diseases. We aimed to investigate the prognostic implication of culprit-plaque morphology and plasma PTX3 for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).Methods: A total of 236 patients were enrolled and divided into four groups: PE/low-PTX3 (n = 57), PE/high-PTX3 (n = 47), PR/low-PTX3 (n = 78) and PR/high-PTX3 (n = 54). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke and unplanned revascularization of any coronary artery.Results: During the follow-up of 1.9 years, a total of 40 (16.9%) MACE were observed: 5.3% (3 patients) among patients with PE/low-PTX3, 21.3% (10 patients) among patients with PE/high-PTX3, 17.9% (14 patients) among patients with PR/low-PTX3 and 24.1% (13 patients) among patients with PR/high-PTX3 (Log rank P = 0.013). In fully adjusted analyses, patients with high-PTX3 were associated with higher MACE risk (HR: 2.40, 95% CI: 1.26– 4.57, P = 0.008). Patients with PR/high-PTX3 (HR: 5.63, 95% CI: 1.57– 20.16, P = 0.008) and PE/high-PTX3 (HR: 5.44, 95% CI: 1.46– 20.29, P = 0.012) presented higher MACE risk than those with PE/low-PTX3. Adding plasma PTX3 levels and PR to the risk prediction model increased the area under curves to 76.1% (95% CI: 67.6– 84.5%) and the NRI (28.1%, 95% CI: 0.3– 48.3%, P=0.040) and IDI (2.4%, 95% CI: 0.1– 12.9%, P = 0.040).Conclusion: Patients with PR/high-PTX3 and PE/high-PTX3 presented a poorer prognosis than those with PE/low-PTX3. Combining the culprit-plaque morphology with PTX3 enhanced the predictive ability for MACE and contributed to better identification of high-risk patients.Trial Registration Number: This study is registered at clinical trials.gov as NCT03593928.Keywords: pentraxin-3, plaque rupture, optical coherence tomography, cardiovascular risk, ST-segment elevation myocardial infarction

Objective The clinical significance of the YY1 gene mutation and expression in pancreatic neuroendocrine tumors (PNETs) remains unknown. Therefore, this study aimed to comprehensively analyze the somatic mutation of YY1 in the different subtypes of PNETs. Methods A total of 143 PNETs were assessed by Sanger sequencing to identify the somatic mutation of YY1 gene in various subtypes of PNETs. YY1 protein expression was examined in 103 PNETs by immunohistochemical staining and western blot. Gene mutation and its protein expression were correlated with clinicopathologic features. Results A recurrent mutation (chr14:100743807C>G) in the YY1 gene was identified in 15 of 83 insulinomas (18%) and in only 1 of 60 noninsulinoma PNETs (1.7%) (P = .0045). The YY1 mutation was not found in MEN1-associated insulinomas. The YY1 mutation in insulinomas was correlated with older age and lower serum glucose levels (age, 57 vs 42.5 years, P = .006; blood glucose, 25.2 vs 33.6 mg/dL, P = .008). YY1 protein expression was found in 100 of 103 PNETs, although expression was weaker in metastases than in localized tumors (P = .036). The stronger expression of YY1 protein was associated with favorable disease-free survival of patients with PNETs (log-rank, P = .011; n = 70). Multivariable statistical analysis showed that YY1 protein expression could be an independent predictor of prognosis. Conclusion The hotspot YY1 mutation mostly occurred in insulinomas and rarely in noninsulinoma PNETs. The stronger YY1 protein expression was correlated with the better prognosis of PNETs patients.

Background: Reverse nearest neighbors query is an important means to solve many practical applications based on the concept of Influence Sets. It is widely used in various fields such as data mining, decision support, resources allocation, knowledge discovery, data flow, bioinformatics and so on. Objective: This work aims to improve time efficiency of Reverse Nearest Neighbors query of moving objects with large data scale. Methods: A new spatio - temporal index HRNN-tree is developed.Then an algorithm for reverse nearest neighbors query based on HRNN-tree is developed. Results: Our algorithm is superior to the existing method in execution time. The performance of our algorithm is excellent especially for the queries with large data scale and small values of k. Conclusion: This study devises a new spatio - temporal index HRNN-tree. Then an algorithm for reverse nearest neighbor search of moving objects is developed based on this index. This algorithm avoids that the query performance deteriorates rapidly as the data space grows and has a better performance fort the large data space. This work will be helpful to enrich and improve the abilities of intelligent analysis, mobile computing and quantitative query based on distance for spatio - temporal database.

Background and aims Metabolic syndrome (MetS) is associated with increased incidence of diabetes and cardiovascular diseases in patients initially free from these diseases. However, its prognostic value in patients with established coronary artery diseases remains controversial. Therefore, we aimed to illustrate the prevalence and investigate the impact of MetS in patients with multivessel coronary artery disease (MVD) and acute coronary syndrome (ACS). Methods and results This was a large registry of consecutive patients with ACS referred to primary percutaneous coronary intervention (PCI) and those with MVD were eligible for this analysis. MetS was defined based on modified Adult Treatment Panel III definition. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction and stroke. A total of 2532 patients were included in the current analysis and 993 (39.2%) of them had MetS. The prevalence of MetS increased from 2010 to 2016 (p for trend = 0.005). In patients over 60 years old, the prevalence of MetS decreased with aging (p for trend = 0.002). Female subjects had a higher prevalence than their male counterparts (61.5% verse 32.9% and p Conclusion MetS was frequently observed in patients with MVD and ACS. Patients with MetS were more likely to be young and female. However, it was not an independent predictor for MACE after primary PCI in those patients.

A surface plasmon resonance sensor based on double-sided polished microstructured optical fiber with hollow core is put forward for refractive index sensing. Two gold films parallel to each other attached to the polished surface act as microfluidic sensing channels for the analyte. The artificially introduced air hole can facilitate the phase matching between the core mode and the plasmon mode. The sensitivities of the proposed sensor are investigated by the wavelength, amplitude and phase interrogation methods when the analyte refractive index increases from 1.33 to 1.34. In contrast to the D-shaped design, the double-sided polished structure demonstrates narrower resonance spectral width and greater phase sensitivity. Moreover, the numerical results indicate that the proposed sensor shows a good stability in the fabrication tolerances of ±5% of the thickness of gold film and the depth of polishing, respectively.

BACKGROUND: The key to smooth running of medical insurance lies in whether the medical insurance fund can meet the needs of people’s medical and health services while achieving a balance between income and expenditure. However, the current impacts of various factors make the risk of medical insurance fund more and more prominent. OBJECTIVE: This investigation is to explore the impacts of basic medical insurance fund on the health of urban residents. METHODS: The corresponding risk evaluation index system is obtained from the structure, operation process, and operation results of the medical insurance fund. The health risks of local residents are evaluated based on the Delphi method. RESULTS: The analysis of the influencing factors reveals that the risk of medical insurance fund is significantly correlated with the medical health of urban residents. From 2016 to 2019, the overall risk assessment for health insurance funds of the whole city is around 82 score. CONCLUSION: The risk assessment system proposed can effectively assess the risks of the medical insurance fund for urban residents. This work provides an important reference for risk prevention and control of medical insurance fund management departments.

The objective of this research is to identify and compare contributing factors to pedestrian injury severities in pedestrian-vehicle crashes considering both time-of-day and day-of-week. The pedestrian-vehicle crash data are collected from 2007 to 2018 in North Carolina with categorical factors of pedestrian, driver, vehicle type, crash group, geography, environment, and traffic control characteristics. The final dataset includes 17,904 observations with 69 categorized variables. Four mixed logit models are developed to analyze the crash dataset with segmentations of weekday daytime, weekday nighttime, weekend daytime, and weekend nighttime. A total number of 31 fixed significant factors and 6 random parameter factors to the pedestrian injury severity are detected in four mixed logit models. According to marginal effects, large vehicle involved, pedestrians with age over 65, hit and run, drunk pedestrian, down/dusk light, dark without roadside light, and industrial land use are identified as the contributing factors that result in more than a 0.08 increase in the probability of fatal injury. Compared to the daytime, most factors are found to have more impact on severe injuries in the nighttime. Also, most factors are found to result in more severe injuries on weekends than on weekdays. This study identifies and compares the factors to pedestrian injury severity in pedestrian-vehicle crashes considering the temporal variance in time-of-day (i.e., daytime vs. nighttime) and day-of-week (i.e., weekdays vs. weekends). Random effects are explored in mixed logit models. Differences and possible reasons for the significant factors’ impact within and across time-of-day and day-of-week are also investigated. Corresponding countermeasures and suggestions to mitigate the impacts of major factors are also discussed, which give practical guidance to planners and engineers, and provide a solid reference to further explore the temporal variance of the crash data.

This study aimed to investigate the association of high-risk culprit plaque features by optical coherence tomography (OCT) with residual SYNTAX score (rSS) and the predictive value of rSS for major adverse cardiac events (MACE) in patients with ST segment elevation myocardial infarction (STEMI). We included 274 patients and divided them into 3 groups - rSS=0 (n=72), 0rSS≤8 (n=134), and rSS8 (n=68). There were significant differences in plaque characteristics among three groups (plaque rupture: 44.4% versus 59.0% versus 64.7%, lowest to highest rSS, p=0.040; OCT-defined high-risk plaques: 16.7% versus 23.9% versus 35.3%, lowest to highest rSS, p=0.036; calcification: 38.9% versus 52.5% versus 61.8%, lowest to highest rSS, p=0.024). During a mean follow-up of 2.2 years, MACE occurred in 47 (17.2%) patients; rSS8 group had higher MACE risk compared to rSS=0 (HR: 2.68, 95%CI: 1.11-6.5, P=0.029). In conclusion, culprit plaque morphology was significantly correlated with rSS, and elevated rSS was associated with higher cardiovascular risk in STEMI patients. ClinicalTrials.gov : NCT03593928.

Acute pancreatitis refers to pancreatic enzyme activation caused by a variety of aetiologies, and mainly characterized by local inflammation of the pancreas, with or without diseases of other organ function changes. The main clinical features are abdominal pain and elevated trypsin levels in the blood. Common causes of acute pancreatitis include cholelithiasis, alcohol consumption and hyperlipidaemia, among which drugs are considered to be one of the rare causes of pancreatitis. The patient in this case was a 16-year-old adolescent female who developed acute severe pancreatitis during the treatment of cryptococcal meningitis with voriconazole for 35 days. Following diagnosis that pancreatitis was induced by voriconazole, the drug was immediately stopped and the patient was discharged after symptomatic treatment. The phenomenon of voriconazole-induced pancreatitis is extremely rare, but we hope that this report can arouse greater attention and vigilance of the majority of medical personnel to improve the safety of patients' medication, especially for children or minors.

Background: Pulmonary hypertension (PH) is common in patients with end-stage renal disease (ESRD). Arteriovenous fistulas (AVF) creation may involve in the pathogenesis of PH. The aim of this study was to explore the impact of PH after AVF creation on the AVF failure rate in maintenance hemodialysis (MHD) patients. Methods: From January 1, 2009, to January 1, 2019, we retrospectively collected data of 578 MHD patients in Guangdong Provincial People’s Hospital Blood Purification Center, China. Patients were followed-up until AVF failure or death or May 25, 2020. According to the systolic pulmonary artery pressure (SPAP) within 1 year after the establishment of AVF, the MHD patients were divided into three groups: SPAP ⩽ 35 mmHg, 35 Results: A total of 578 patients were analyzed. The average age was 60.66 ± 15.34 years (58.1% men). Of these, 26.1% of patients were reported PH. The SPAP exhibited a left-skewed nonparametric distribution and the overall SPAP after the creation of AVF was 39.00 (29.00–52.00) mmHg. The median follow-up was 5.8 (5.5–6.3) years. Overall, 12.8% (74/578) patients were reported AVF failure events. There was no significant difference in AVF failure rate among three groups ( p = 0.070). A total of 111 (19.2%) died during the follow-up period. Compared with the SPAP ⩽35 mmHg group, only the all-cause death rate significantly increased in MHD patients with PH ( p Conclusions: The secondary pulmonary hypertension after AVF creation did not increase the risk of AVF failure in MHD patients, but significantly increased the risk of mortality for this portion of the patients. Future larger sample sizes, multi-center, and prospective trials are needed to make sure which type of access will benefit on their survival for MHD patients with SPAP ⩾35 mmHg.

Background Early diagnosis of adolescent psychiatric disorder is crucial for early intervention. However, there is extensive comorbidity between affective and psychotic disorders, which increases the difficulty of precise diagnoses among adolescents. Methods We obtained structural magnetic resonance imaging scans from 150 adolescents, including 67 and 47 patients with major depressive disorder (MDD) and schizophrenia (SCZ), as well as 34 healthy controls (HC) to explore whether psychiatric disorders could be identified using a machine learning technique. Specifically, we used the support vector machine and the leave-one-out cross-validation method to distinguish among adolescents with MDD and SCZ and healthy controls. Results We found that cortical thickness was a classification feature of a) MDD and HC with 79.21% accuracy where the temporal pole had the highest weight; b) SCZ and HC with 69.88% accuracy where the left superior temporal sulcus had the highest weight. Notably, adolescents with MDD and SCZ could be classified with 62.93% accuracy where the right pars triangularis had the highest weight. Conclusions Our findings suggest that cortical thickness may be a critical biological feature in the diagnosis of adolescent psychiatric disorders. These findings might be helpful to establish an early prediction model for adolescents to better diagnose psychiatric disorders.

Assessing the environmental impact of industrial policy is of great importance to China's industrial green transformation and high-quality development, while this topic receives little attention in the literature. Based on the panel data of 29 manufacturing industrial sectors in China's 30 provinces from 2006 to 2015, using a model that includes the year, province, and industry fixed-effect, this paper fills the gap by exploring whether and how industrial policy affects carbon emission in Chinese manufacturing. The result shows that industrial policy significantly increases carbon emission in supported industries by 10.3%, which is achieved by increasing industrial energy consumption, relaxing government environmental regulation, and encouraging enterprises to invest more in fixed assets. Further, the effects of industrial policy on carbon emission are heterogeneous in many aspects. In the central and western regions, technology-intensive industries, industries with stronger government intervention, industries with higher exports, industries supported by both central and local governments, and during the 12th Five-Year Plan, the industrial policy will increase carbon emissions more. Our findings for the first time indicate the negative impact of industrial policies on carbon emission reduction in the Chinese manufacturing industry, which implies that traditional selective industrial policies in developing countries like China need a paradigm shift to achieve green development.

Contemporary treatments for spinal cord arteriovenous shunts are only based on clinicians’ treatment experiences and expertise due to its rarity. We reviewed the clinical course of the largest multicentred cohort to evaluate the efficacy and deficiency of contemporary interventional treatments for spinal cord arteriovenous shunts. The clinical features, treatment results and clinical outcomes of 463 patients with spinal cord arteriovenous shunts were retrospectively assessed. The main outcome was the neurological deterioration that was evaluated based on the modified Aminoff and Logue scale. According to post-treatment digital subtraction angiography, complete obliteration was defined as disappearance of the intradural lesion, whereas partial obliteration was defined as any residual intradural lesion remaining visible and was further categorized as shunt-reduction obliteration (the nidus or shunt points were reduced) or palliative obliteration (only obliterated aneurysms or feeders). Cure rate was 40.6% for the whole cohort, 58.5% after microsurgery, and 26.4% after embolization. The curative resection was associated with non-metameric lesions, lesions with a maximum diameter Although clinical risks of spinal cord arteriovenous shunts were reduced following clinical interventions, contemporary treatments for spinal cord arteriovenous shunt remains associated with considerable risks and incomplete efficacy. Individualized treatment plans should be adopted according to the angio-architectural features and major clinical risks of specific lesions. There is a higher opportunity for complete obliteration for lesions with simple angio-architecture. However, for most of spinal cord arteriovenous shunts with complex vascular anatomy, partial treatment is the only choice. For these patients, palliative obliteration targeting the aneurysms is recommended for reducing haemorrhagic risk, whereas shunt-reduction obliteration is necessary for non-haemorrhagic myelopathy. Contemporary treatment is ineffective in reducing haemorrhagic risk of incurable metameric spinal cord arteriovenous shunts.

Heavy ion therapy is currently recognized as the most advanced cancer radiotherapy approach in the world. This article introduces a high-precision and non-contact measurement method based on close-...

BACKGROUND There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later. In this paper, we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma (ChRCC) involving the allograft kidney. CASE SUMMARY A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil (MMF), and prednisone. Six years post-transplantation, at another hospital, ultrasonography revealed a small mass involving the upper pole of the graft. The patient declined further examination and treatment at this point. Seven years and three months post-transplantation, the patient experienced decreasing appetite, weight loss, gross hematuria, fatigue, and oliguria. Laboratory tests showed anemia (hemoglobin level was 53 g/L). Contrast-enhanced computed tomography revealed a large heterogeneous cystic-solid mass involving the upper pole of the renal allograft. Graft nephrectomy was performed and immunosuppressants were withdrawn. Histological and immunohistochemical features of the tumor were consistent with ChRCC. One year after allograft nephrectomy, low doses of tacrolimus and MMF were administered for preventing allosensitization. Two years after allograft nephrectomy, the patient underwent kidney re-transplantation. Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up. CONCLUSION De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression. Kidney re-transplantation could be a viable treatment. A 2-year malignancy-free period may be sufficient time before re-transplantation.

The safety of lithium-ion batteries is an essential concern where instant and accurate temperature sensing is critical. It is generally desired to put sensors inside batteries for instant sensing. However, the transmission of internal measurement outside batteries without interfering their normal state is a non-trivial task due to the harsh electrochemical environment, the particular packaging structures and the intrinsic electromagnetic shielding problems of batteries. In this work, a novel in-situ temperature sensing framework is proposed by incorporating temperature sensors with a novel signal transmission solution. The signal transmission solution uses a self-designed integrated-circuit which modulates the internal measurements outside battery via its positive pole without package breaking. Extensive experimental results validate the noninterference properties of the proposed framework. Our proposed in-situ temperature measurement by the self-designed signal modulation solution has a promising potential for in-situ battery health monitoring and thus promoting the development of smart batteries. Graphic abstract

To develop a radiomics signature based on multisequence magnetic resonance imaging (MRI) to preoperatively predict peritoneal metastasis (PM) in ovarian cancer (OC). Eighty-nine patients with OC were divided into a training cohort including patients (n = 54) with a single lesion and a validation cohort including patients (n = 35) with bilateral lesions. Radiomics features were extracted from the T2-weighted images (T2WIs), fat-suppressed T2WIs, multi-b-value diffusion-weighted images (DWIs), and corresponding parametric maps. A radiomics signature and nomogram incorporating the radiomics signature and clinical predictors were developed and validated on the training and validation cohorts, respectively. The radiomics signature generated by 6 selected features showed a favorable discriminatory ability to predict PM in OC with an area under the curve (AUC) of 0.963 in the training cohort and an AUC of 0.928 in the validation cohort. The nomogram, comprising the radiomics signature, pelvic fluid, and CA-125 level, showed more favorable discrimination with an AUC of 0.969 in the training cohort and 0.944 in the validation cohort. Net reclassification index with values of 0.548 in the training cohort and 0.500 in the validation cohort. Radiomics signature based on multisequence MRI serves as an effective quantitative approach to predict PM in OC patients. A nomogram of radiomics signature and clinical predictors could further improve the prediction ability of PM in patients with OC. • Multisequence MRI-based radiomics showed a favorable discriminatory ability to predict PM in OC. • The nomogram incorporating the radiomics signature and clinical predictors was clinically useful to preoperatively predict PM in patients with OC.

Patients with homozygous familial hypercholesterolemia (HoFH) have a high risk for premature death. Supravalvular aortic stenosis (SVAS) is a common and the feature lesion of the aortic root in HoFH. The relation between SVAS and the risk of premature death in patients with HoFH has not been fully investigated. The present study analysis included 97 HoFH patients with mean age of 14.7 (years) from the Genetic and Imaging of Familial Hypercholesterolemia in Han Nationality Study. During the median (±SD) follow-up 4.0 (±4.0) years, 40 (41.2%) participants had SVAS and 17 (17.5%) participants experienced death. The proportion of premature death in the non-SVAS and SVAS group was 7.0% and 32.5%, respectively. Compared with the non-SVAS group, SVAS group cumulative survival was lower in the HoFH (log-rank test, p

Previous studies have shown that alterations in autophagy-related proteins exist extensively after traumatic brain injury (TBI). However, whether autophagy is enhanced or suppressed by TBI remains controversial. In our study, a controlled cortical impact was used to establish a model of moderate TBI in rats. We found that a significant increase in protein levels of LC3-II and SQSTM1 in the injured cortex group. However, there were no significant differences in protein levels of VPS34, Beclin-1, and phosphor-ULK1, which are the promoters of autophagy. Lysosome dysfunction after TBI might lead to autophagosome accumulation. In addition, the highly specific autophagy inhibitor SAR405 administration reduced TBI-induced apoptosis-related protein cleaved caspase-3 and cleaved caspase-9 levels in the ipsilateral cortex, as well as brain edema and neurological defects accessed by mNSS. Furthermore, chloroquine treatment reversed the beneficial effects of SAR405 by increasing the accumulation of autophagosomes. Finally, our data showed that autophagy inhibition by VPS34 gene knockout method attenuated cell death after TBI. Our findings indicate that impaired autophagosome degradation is involved in the pathological reaction after TBI, and the inhibition of autophagy contributes to attenuate neuronal cell death and functional defects.

Recently, recommender systems play a pivotal role in alleviating the problem of information overload. Latent factor models have been widely used for recommendation. Most existing latent factor models mainly utilize the interaction information between users and items, although some recently extended models utilize some auxiliary information to learn a unified latent factor for users and items. The unified latent factor only represents the characteristics of users and the properties of items from the aspect of purchase history. However, the characteristics of users and the properties of items may stem from different aspects, e.g., the brand-aspect and category-aspect of items. Moreover, the latent factor models usually use the shallow projection, which cannot capture the characteristics of users and items well. Deep neural network has shown tremendous potential to model the non-linearity relationship between users and items. It can be used to replace shallow projection to model the complex correlation between users and items. In this paper, we propose a Neural network based Aspect-level Collaborative Filtering model (NeuACF) to exploit different aspect latent factors. Through modelling the rich object properties and relations in recommender system as a heterogeneous information network, NeuACF first extracts different aspect-level similarity matrices of users and items, respectively, through different meta-paths, and then feeds an elaborately designed deep neural network with these matrices to learn aspect-level latent factors. Finally, the aspect-level latent factors are fused for the top-N recommendation. Moreover, to fuse information from different aspects more effectively, we further propose NeuACF++ to fuse aspect-level latent factors with self-attention mechanism. Extensive experiments on three real world datasets show that NeuACF and NeuACF++ significantly outperform both existing latent factor models and recent neural network models.

Aim To develop a model for predicting renal recovery in cardiac surgery patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT). Methods Data from a prospective randomized controlled trial, conducted in a tertiary hospital to compare the survival effect of two dosages of hemofiltration for continuous RRT in cardiac surgery patients between March 20, 2012 and August 9, 2015, were used to develop the model. The outcome was renal recovery defined as alive and dialysis-free 90 days after RRT initiation. Multivariate logistic regression with a stepwise backward selection of variables based on Akaike Information Criterion was applied to develop the model, which was internally validated using bootstrapping. Model discrimination, calibration, and clinical value were assessed using the concordance index (C-Index), calibration plots, and decision curve analysis, respectively. Results Totally, 211 patients with AKI requiring RRT (66.8% male) with median age of 57 years were included. The incidence of renal recovery was 33.2% (n = 70). The model included six variables: body mass index stratification, baseline estimated glomerular filtration rate, hypertension, sepsis, mean arterial pressure, and mechanical ventilation. The C-Index for this model was 0.807 (95%CI, 0.744-0.870). After correction by the bootstrap, the C-Index was 0.780 (95%CI, 0.720-0.845). The calibration plots indicated good consistency between actual observations and model prediction of renal recovery. Decision curve analysis demonstrated the model was clinical usefulness. Conclusion We developed and validated a model to predict the chance of renal recovery in cardiac surgery patients with AKI requiring RRT. This article is protected by copyright. All rights reserved.

The current collector fracture failure of lithium-ion batteries (LIBs) occurs during its winding production process frequently, and the consequent damages are usually large, but little research has been conducted on this phenomenon. This work stems from the difficulty and obstacles in the winding process of actual production of LIBs. The fracture failure of the current collectors is easily caused by the evolution and mutation of the mechanical behavior during the winding process, resulting in safety hazards and poor efficiency. The purpose of this work is to reveal the evolution and distribution mechanism of circumferential strain of the current collectors on the fracture failure under the constraint of winding process. Experimental tests, finite element calculations and theoretical model are used to study the evolution and distribution of circumferential strain. The dynamic evolution process of circumferential strain is tested accurately, and the mechanism of fracture failure of current collectors is revealed. The criterion for current collector strength is proposed based on the results of strain analysis and SEM observation.

The present study investigated the various failure modes of strengthened steel columns by mortar-filled fiber-reinforced polymer (FRP) tubes to analytically formulate the ultimate capacities of these steel columns. A simple and effective method, wherein a mortar-filled FRP tube was sleeved outside the steel member, was also formulated to enhance the buckling resistance capacity of compressed steel members. In addition, to facilitate the connection of the column to other structural members, the length of the sleeved mortar-filled FRP tubes is less than that of the original steel columns. Theoretical analyses were also performed on the critical sections of such composite columns at their ultimate states to identify their potential failure modes, such as FRP-tube splitting at the ends or on the insides of wrapped areas, local buckling at the steel ends of transition zones, and global buckling of the composite columns. The corresponding ultimate capacity of each failure mode was then analytically formulated to characterize the critical failure mode and ultimate load capacity of the columns. The current theoretical results were compared with those from literature to validate the applicability of the developed ultimate limit design approaches for FRP-mortar-steel composite columns.

BACKGROUND Acquired pure red cell aplasia (aPRCA) related to human parvovirus B19 (HPV B19) is rarely reported in simultaneous pancreas-kidney transplantation (SPKT) recipients; there has yet to be a case report of early postoperative infection. In this current study, we report the case of a Chinese patient who experienced the disease in the early postoperative period. CASE SUMMARY A 63-year-old man, with type 2 diabetes and end-stage renal disease, received a brain dead donor-derived SPKT. Immunosuppression treatment consisted of tacrolimus, prednisone, enteric-coated mycophenolate sodium (EC-MPS), and thymoglobulin combined with methylprednisolone as induction. The hemoglobin (Hb) level declined due to melena at postoperative day (POD) 3, erythropoietin-resistant anemia persisted, and reticulocytopenia was diagnosed at POD 20. The bone marrow aspirate showed decreased erythropoiesis and the presence of giant pronormoblasts at POD 43. Metagenomic next-generation sequencing (mNGS) of a blood sample identified HPV B19 infection at POD 66. EC-MPS was withdrawn; three cycles of intravenous immunoglobulin (IVIG) infusion therapy were administered; and tacrolimus was switched to cyclosporine. The HPV B19-associated aPRCA resolved completely and did not relapse within the 1-year follow-up period. The diminution in mNGS reads was correlated with Hb and reticulocyte count improvements. CONCLUSION HPV B19-associated aPRCA can occur at an early period after SPKT. An effective therapy regimen includes IVIG infusion and adjustment of the immuno-suppressive regimen. Moreover, mNGS can be used for the diagnosis and to reflect disease progression.

This study aimed to investigate the predictive value of mean platelet volume/platelet count ratio (MPR) for coronary plaque features in patients with ST segment elevation myocardial infarction (STEMI). A total of 275 STEMI patients undergoing preintervention optical coherence tomography examination were included, with 142 categorized as plaque rupture (PR) and 133 as plaque erosion (PE). Multivariable logistic regression showed higher MPR was an independent predictor of PR (tertile 3 vs tertile 1, odds ratio: 6.257, 95% confidence interval: 1.586-24.686, P = 0.009). MPR showed better diagnostic performance than other platelet indices. The optimal MPR threshold for diagnosing PR was 0.0473 (sensitivity: 0.721, specificity: 0.647). When added to models of established risk factors, MPR significantly improved the predictive accuracy of PR (area under the curve: 0.767 vs 0.722, P difference = 0.004). In conclusion, for STEMI patients, MPR was an independent predictor of PR and improved diagnostic performance for PR.

We propose and verify the sliding failure mode in the passive zone of a foundation pit with skirt reinforcement using numerical experiments. Calculation of the passive earth pressure is based on the equilibrium condition of limited earth pressure. The advantage of this approach is that the stability of the support structure can be calculated using the shear strength parameters of undisturbed soil without these parameters for the soilcement. We discuss the passive earth pressure of foundation pits with reinforcement mass of finite width, in addition to different arrangements of the same volume and different shape. For specific projects, factors such as deformation control and project cost should also be taken into account when deciding the type of reinforcement mass form that should be used, in addition to meeting the stability requirements.

Surface plasmon coupled emission (SPCE) is a new analytical technique that provides increased and directional radiation based on the near-field interaction between fluorophores and surface plasmons but suffers from the limitation of insufficient sensitivity. The assembly of hollow-porous plasmonic nanoparticles could be the qualified candidate. After the introduction of gold nanocages (AuNCs), fluorescence signal enhancement was realized by factors over 150 and 600 compared with the normal SPCE and free space emission, respectively, with a fluorophore layer thickness of approximately 10 nm; hence, the unique enhancement of SPCE by the AuNCs effectively overcomes the signal quenching induced by resonance energy transfer (in normal SPCE). This enhancement was proven to be triggered by the superior wavelength match, the enhanced electromagnetic field, and new radiation channel and process induced by the AuNC assembly, which provides an opportunity to increase the detection sensitivity and establish an optimal plasmonic enhancement system. The amplified SPCE system was employed for multiwavelength simultaneous enhancement detection through the assembly of mixed hollow nanoparticles (AuNCs and gold nanoshells), which could broaden the application of SPCE in simultaneous sensing and imaging for multianalytes.

Microglia are the resident immune cells in the central nervous system and play an essential role in brain homeostasis and neuroprotection in brain diseases. Exosomes are crucial in intercellular communication by transporting bioactive miRNAs. Thus, this study aimed to investigate the function of microglial exosome in the presence of ischemic injury and related mechanism. Oxygen-glucose deprivation (OGD)-treated neurons and transient middle cerebral artery occlusion (TMCAO)-treated mice were applied in this study. Western blotting, RT-PCR, RNA-seq, luciferase reporter assay, transmission electron microscope, nanoparticle tracking analysis, immunohistochemistry, TUNEL and LDH assays, and behavioral assay were applied in mechanistic and functional studies. The results demonstrated that exosomes derived from microglia in M2 phenotype (BV2-Exo) were internalized by neurons and attenuated neuronal apoptosis in response to ischemic injury in vitro and in vivo. BV2-Exo also decreased infarct volume and behavioral deficits in ischemic mice. Exosomal miRNA-137 was upregulated in BV2-Exo and participated in the partial neuroprotective effect of BV2-Exo. Furthermore, Notch1 was a directly targeting gene of exosomal miRNA-137. In conclusion, these results suggest that BV2-Exo alleviates ischemia-reperfusion brain injury through transporting exosomal miRNA-137. This study provides novel insight into microglial exosomes-based therapies for the treatment of ischemic brain injury.

Rationale: Thoracic aortic aneurysm (TAA) leads to substantial mortality worldwide. Familial and syndromic TAAs are highly correlated with genetics. However, the incidence of sporadic isolated TAA (iTAA) is much higher, and the genetic contribution is not yet clear. Objective: Here, we examined the genetic characteristics of sporadic iTAA. Methods and Results: We performed a genetic screen of 551 sporadic iTAA cases and 1071 controls via whole-exome sequencing. The prevalence of pathogenic mutations in known causal genes was 5.08% in the iTAA cohort. We selected 100 novel candidate genes using a strict strategy, and the suspected functional variants of these genes were significantly enriched in cases compared with controls and carried by 60.43% of patients. We found more severe phenotypes and a lower proportion of hypertension in cases with pathogenic mutations or suspected functional variants. Among the candidate genes, Testin ( TES ), which encodes a focal adhesion scaffold protein, was identified as a potential TAA causal gene, accounting for 4 patients with 2 missense variants in the LIM1 domain (c.751T>C encoding p.Y251H; c.838T>C encoding p.Y280H) and highly expressed in the aorta. The 2 variants led to a decrease in TES expression. The thoracic aorta was spontaneously dilated in the Tes Y249H knock-in and Tes −/− mice. Mechanistically, the p.Y249H variant or knockdown of TES led to the repression of vascular smooth muscle cell contraction genes and disturbed the vascular smooth muscle cell contractile phenotype. Interestingly, suspected functional variants of other focal adhesion scaffold genes, including TLN1 (Talin-1) and ZYX (zyxin), were also significantly enriched in patients with iTAA; moreover, their knockdown resulted in decreased contractility of vascular smooth muscle cells. Conclusions: For the first time, this study revealed the genetic landscape across iTAA and showed that the focal adhesion scaffold genes are critical in the pathogenesis of iTAA.

Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the machine (|Pa/Qb|) can reflect the dysfunction of VA. This study was conducted to explore the impact of arteriovenous fistula (AVF) dysfunction and to explore the clinical reference value of |Pa/Qb|. Methods: We retrospectively identified adults who underwent hemodialysis at 3 hospitals. Data were acquired from electronic health records. We evaluated the pattern of the association between |Pa/Qb| and AVF dysfunction during 1 year using a Cox proportional hazards regression model with restricted cubic splines. Then, the patients were grouped based on the results, and hazard ratios were compared for different intervals of |Pa/Qb|. Results: A total of 490 patients were analyzed, with an average age of 55 (44, 66) years. There were a total of 85 cases of AVF dysfunction, of which 50 cases were stenosis and 35 cases were thrombosis. There was a U-shaped association between |Pa/Qb| and the risk of AVF dysfunction (p for nonlinearity 0.52 increased the risk of AVF dysfunction. Compared with the group with a |Pa/Qb| value between 0.30 and 0.52, the groups with |Pa/Qb| 0.52 had a 4.04-fold (p = 0.002) and 3.41-fold (p < 0.001) greater risk of AVF dysfunction, respectively. Conclusions: The appropriate range of |Pa/Qb| is between 0.30 and 0.52. When |Pa/Qb| is 0.52, the patient’s AVF function or Qb setting should be reevaluated to prevent subsequent failure.

Intra prediction is the key technology to reduce spatial redundancy in the modern video coding standard. Recently, deep learning based methods that directly generate the intra prediction by neural network achieve superior performance than traditional directional based intra prediction. However, these methods lack the ability to handle complex blocks which contain mixed directional textures or recurrent patterns since they only use the neighboring reference samples of the current one. The other intermediate information denoted as reference priors in this paper generated during the coding process is not exploited. In this paper, a Current Frame Priors assisted Neural Network (CFPNN) is presented to improve the intra prediction efficiency. Specifically, we utilize the local contextual information provided by the neighboring multiple references as the primary inference source. In addition to the neighboring references, we additionally use the other two reference priors within the current frame – the predictor searched by intra block copy (IntraBC) and the corresponding residual component. The IntraBC predictor provides useful nonlocal information to help generate more accurate prediction for complex blocks together with neighboring local information. While the residual component contains unique information that reflects the characteristics of the block to some extent is utilized to reduce the noise contained in the reconstructed reference samples. Moreover, we investigate the best way to integrate the proposed method into the codec. Experimental results demonstrate that compared to HEVC, our proposed CFPNN achieves an average of 4.1% BD-rate reduction for the luma component under the All Intra configuration.

Rationale: The progressive disruption of extracellular matrix (ECM) proteins, particularly early elastin fragmentation followed by abnormalities in collagen fibril organization, are key pathological processes that contribute to dissecting abdominal aortic aneurysm (AAA) pathogenesis. Lysyl hydroxylase 1 (LH1) is essential for type I/III collagen intermolecular crosslinking and stabilization. However, its function in dissecting AAA has not been explored. Here, we investigated whether LH1 is significantly implicated in dissecting AAA progression and therapeutic intervention. Methods and Results: Sixteen-week-old male LH1-deficient and wild-type (WT) mice on the C57Bl/6NCrl background were infused with angiotensin II (Ang II, 1000 ng/kg per minute) via subcutaneously implanted osmotic pumps for 4 weeks. Ang II increased LH1 levels in the abdominal aortas of WT mice, whereas mice lacking LH1 developed dissecting AAA. To evaluate the related mechanism, we performed whole-transcriptomic analysis, which demonstrated that LH1 deficiency aggravated gene transcription alterations; in particular, the expression of thrombospondin-1 was markedly upregulated in the aortas of LH1-deficient mice. Furthermore, targeting thrombospondin-1 with TAX2 strongly inhibited the proinflammatory process, matrix metalloproteinase (MMP) activity and vascular smooth muscle cells (VSMCs) apoptosis, ultimately decreasing the incidence of dissecting AAA. Restoration of LH1 protein expression in LH1-deficient mice by intraperitoneal injection of an adeno-associated virus normalized thrombospondin-1 levels, subsequently alleviating dissecting AAA formation and preserving aortic structure and function. Consistently, in human AAA specimens, decreased LH1 expression was associated with increased thrombospondin-1 levels. Conclusions: LH1 deficiency contributes to dissecting AAA pathogenesis, at least in part, by upregulating thrombospondin-1 expression, which subsequently enables proinflammatory processes, MMP activation and VSMCs apoptosis. Our study provides evidence that LH1 is a potential critical therapeutic target for AAA.

Healed plaque is a hallmark of previous regional plaque rupture or erosion. We hypothesized that the plasma level of trimethylamine N-oxide (TMAO) is related to healed culprit plaque in ST-segment elevation myocardial infarction (STEMI) patients.A prospective cohort of 206 patients with STEMI, who were examined by optical coherence tomography (OCT) was enrolled in our study. After exclusion, 156 patients were categorized into healed plaque (n = 54) and nonhealed plaque (n = 102) groups. Plasma TMAO levels were detected by stable isotope dilution liquid chromatography tandem mass spectrometry in these two groups. Increased age and low BMI were more common in patients with healed plaques than in those without healed plaques. Through OCT observation, plaque rupture (81.5% vs. 45.1%, p 0.001), thin cap fibroatheroma (TCFA) and macrophages (42.6% vs. 20.6%, p = 0.004, 70.4% vs. 26.5%, p 0.001, respectively) were more frequently seen in patients with healed plaques than in those without healed plaques. The TMAO level in patients with healed plaques was significantly higher than that in patients with nonhealed plaques (3.9 μM [2.6-5.1] vs. 1.8 μM [1.0-2.7], p 0.001). Furthermore, the receiver operating characteristic curve showed that TMAO can be used as a potential biomarker to predict healed plaque presence with a cutoff value of 2.9 μM (AUC = 0.810, sensitivity: 72.2%, specificity: 81.4%).Healed plaque in STEMI patients is associated with a high level of plaque vulnerability and inflammation. A high level of plasma TMAO can be a useful biomarker to differentiate STEMI patients with healed culprit plaques.

Highly conductive, conformable and gel-free electrodes are desirable in human electrophysiology. Besides, intimately coupling with human skin, wearable strain sensors can detect numerous physiological signals, such as wrist pulse and breath. In this study, a multilayer graphene nanosheet film (MGNF) with high conductivity was prepared by the Marangoni self-assembly for using in tattoo dry electrodes (TDEs) and in a graphene tattoo strain sensor (GTSS). Compared to commercial Ag/AgCl gel electrodes, TDEs have lower skin-electrode contact impedance and could detect human electrocardiogram for 24-hour wearing more accurately as well as electromyogram. Through designing a slim serpentine ribbon structure, a resistance-type GTSS, without deterioration even after 2000 cycles, is well demonstrated for human wrist pulse and breath sensing. With the advantages of high conductivity and conformability, MGNF provides support to fabricate low-cost, customizable, and high-performance electronic tattoos for human electrophysiology and strain sensing.

Background The study aimed to construct a clinical model based on preoperative data for predicting acute kidney injury (AKI) following cardiac surgery in patients with normal renal function. Methods A total of 22,348 consecutive patients with normal renal function undergoing cardiac surgery were enrolled. Among them, 15,701 were randomly selected for the training group and the remaining for the validation group. To develop a model visualized as a nomogram for predicting AKI, logistic regression was performed with variables selected using least absolute shrinkage and selection operator regression. The discrimination, calibration, and clinical value of the model were evaluated. Results The incidence of AKI was 25.2% in the training group. The new model consisted of nine preoperative variables, including age, male gender, left ventricular ejection fraction, hypertension, hemoglobin, uric acid, hypomagnesemia, and oral renin-angiotensin system inhibitor and non-steroidal anti-inflammatory drug within 1 week before surgery. The model had a good performance in the validation group. The discrimination was good with an area under the receiver operating characteristic curve of 0.740 (95% confidence interval, 0.726–0.753). The calibration plot indicated excellent agreement between the model prediction and actual observations. Decision curve analysis also showed that the model was clinically useful. Conclusions The new model was constructed based on nine easily available preoperative clinical data characteristics for predicting AKI following cardiac surgery in patients with normal kidney function, which may help treatment decision-making, and rational utilization of medical resources.

Recycling is a major approach in developing sustainable polymers to cope with environmental pollution and resource waste, but it still remains a challenge to design high-performance closed-loop rec...

Background: Massive monoclonal or oligoclonal expansion of CD8+ T cells is a notable feature of primary infections of the Epstein–Barr virus (EBV). However, the clinical significance of this expansion is not clear. Results: An increase in the CD8dimCD3+ lymphocyte subset in patients with active EBV infection was due to caspase-8-dependent apoptosis was found using flow cytometry in this study. The number of these cells was associated with the illness severity. Pan-T-cell antigen and receptor analyses were also compared in patients with active EBV infections and T-cell large granular lymphocytic leukemia to provide additional diagnostic information. Conclusion: The increase in CD8dimCD3+ cells could be a biomarker of active EBV infection and an exclusion indicator of T-cell large granular lymphocytic leukemia with flow cytometric analysis.

Infrared lead chalcogenide quantum dots (QDs) suffer fast degradation due to the easy oxidation of surface chalcogen atoms. Here, we report a trioctylphosphine-mediated surface passivation method to improve the air stability of PbS QDs. Surface mechanism study reveals an in situ surface reaction, which leads to site-selective passivation of surface S atoms with lead mono-carboxylate. The surface capping motif sufficiently protects PbS QDs from oxygen and improves their stability as well as quantum efficiency regardless of the QD size and original ligands on surface cations. The modified PbS QDs display no obvious fluorescence quenching and surface oxidization after 30 days of air exposure. The robust surface capping also provides high compatibility of PbS QDs with polymers for optoelectronic device fabrication. The near-infrared LEDs based on the modified PbS QDs display a slight degradation of only 1.47% from the maximum intensity after continuous operation in air for 250 hours (lifetime > 10,000 h) at 0.5 W/cm2 power density, indicating the surface passivation route is promising strategy for promoting practical optoelectronic application of PbS QDs.

AIMS Voriconazole is a broad-spectrum antifungal agent for the treatment of invasive fungal infections. There is limited information about the pharmacokinetics and appropriate dosage of voriconazole in patients with liver dysfunction. This study aimed to explore the relationship between voriconazole trough concentration (Ctrough ) and toxicity, identify the factors significantly associated with voriconazole pharmacokinetic parameters and propose an optimised voriconazole dosing regimen for patients with liver dysfunction. METHODS The study prospectively enrolled 51 patients with 272 voriconazole concentrations. Receiver operating characteristic curves were used to explore the relationship between voriconazole Ctrough and toxicity. The pharmacokinetic data was analysed with nonlinear mixed-effects method. Dosing simulations stratified by total bilirubin (TBIL, TBIL-1: TBIL < 51 μmol/L; TBIL-2: 51 μmol/L ≤ TBIL < 171 μmol/L; TBIL-3: TBIL ≥ 171 μmol/L) were performed. RESULTS Receiver operating characteristic curve analysis revealed that voriconazole Ctrough of ≤ 5.1 mg/L were associated with significantly lower the incidence of adverse events. A 1-compartment pharmacokinetic model with first-order absorption and elimination was used to describe the data. Population pharmacokinetic parameters of clearance, volume of distribution and oral bioavailability were 0.88 L/h, 148.8 L and 88.4%, respectively. Voriconazole clearance was significantly associated with TBIL and platelet count. The volume of distribution increased with body weight. Patients with TBIL-1 could be treated with a loading dose of 400 mg every 12 hours (q12h) for first day, followed by a maintenance dose of 100 mg q12h administered orally or intravenously. TBIL-2 and TBIL-3 patients could be treated with a loading dose of 200 mg q12h and maintenance doses of 50 mg q12h or 100 mg once daily and 50 mg once daily orally or intravenously, respectively. CONCLUSIONS Lower doses and longer dosing intervals should be considered for patients with liver dysfunction. TBIL-based dosing regimens provide a practical strategy for achieving voriconazole therapeutic range and therefore maximizing treatment outcomes.

Background Neonatal hyperbilirubinemia (NNH) is a common disease in newborns. This research study aimed to assess the associations between uridine diphospho-glucuronate-glucuronosyltransferase 1A1 (UGT1A1, c.-3279 T > G) polymorphisms and NNH risk. Methods We searched PubMed, the Cochrane Library, and the Embase electronic databases. All published eligible studies before July 1, 2019, were searched for this meta-analysis. Results We identified 7 independent studies including 1560 cases. The data showed that in the general population, compared with the GT + GG vs TT and GG vs TT, c.-3279 T > G (rs4124874) was significantly related to a higher NNH risk (GG vs TT: OR = 1.865, 95% CI: 1.031–3.373, P = 0.039; GT + GG vs TT: OR = 1.331, 95% CI: 1.055–1.679, P = 0.016). Although not statistically significant, the data showed that c.3279 T > G had a tendency to be associated with NNH under the allele model and GG vs GT + TT in the overall population (G vs T: OR = 1.288, 95% CI: 0.982–1.689, P = 0.067; GG vs TT + GT: OR = 1.583, 95% CI: 0.947–2.647, P = 0.080). Conclusion The UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism increased susceptibility to NNH, especially for the comparison of GT + GG vs TT and GG vs TT. In the future, we can use homozygous state of the UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism for the diagnosis and screening of molecular biomarkers in NNH patients.

The Shone’s complex, defined as a constellation of parachute mitral valve (PMV), supravalvular ring of the left atrium, subaortic stenosis, and aorta coarctation, is a rare entity, which more commonly occurs in its incomplete form. We report the case of a 28-year-old female patient who presented for chest congestion and palpitation with history of congenital mitral valve malformation. Echocardiography revealed the coexistence of PMV, aortic coarctation with bicuspid aortic valve (BAV), and ventricular septum defect (VSD). The patient then received surgical intervention. The diagnosis of Shone’s complex with BAV and VSD made by echocardiography were confirmed later at surgery.