Search

Abstract Aims Sarcopenia has been found to be frequently associated with co‐morbidity among patients with heart failure (HF). However, there remain insufficient data to accurately estimate the global prevalence of sarcopenia in HF. Therefore, the purpose of this research was to conduct a systematic review and meta‐analysis to estimate the current overall prevalence of sarcopenia in patients with HF. Methods and results We searched relevant databases for studies published up to 13 July 2020, assessing sarcopenia in vpatients with HF. After careful screening, data of included articles were extracted with a predesigned Excel form. Then the pooled prevalence of sarcopenia in patients with HF was calculated using the random‐effects model. The Q test was used to assess the heterogeneity, and I2 statistic was calculated to quantify and evaluate the heterogeneity. Subgroup analyses were conducted to determine potential sources of heterogeneity. A total of 2852 articles were initially identified, and after removing duplicate publications and applying the selection criteria, we reviewed 79 full‐text articles. Finally, 11 articles (n = 1742 patients with HF) were included in this systematic review and meta‐analysis. The pooled prevalence of sarcopenia in patients with HF was 34% [95% confidence interval (CI): 22–47%, I2 = 96.59%] and ranged from 10% to 69%. However, substantial heterogeneity between studies (I2 = 96.59%, P

Abstract Background Serum lactate has long been used to evaluate hypoxia and predict prognosis in critically ill patients, however, discrepancy in lactate measurements between different sites have not been recognized as a useful tool for monitoring hypoxia and evaluating outcome. Methods Data were obtained from the clinical information system of the intensive care unit (ICU) in a tertiary academic hospital for 1582 ICU patients with vasoactive drug requirement and valid paired blood gas. The mortality rates were compared between patients with sustained negative venous to arterial lactate gradient (VALac) and the others using the Cox proportional hazard model. Predictive factors associated with negative VALac were searched. Results A sustained negative VALac was significantly associated with higher 30 day ICU mortality [Adjusted hazard ratio (HR) = 2.31, 95% confidence interval (CI), 1.07–4.99; p = 0.032. Propensity score- weighted HR: 2.57; 95% CI, 1.17–5.64; p = 0.010]. Arterial lactate in the first blood gas pair, 24-h arterial lactate clearance, use of epinephrine, mean positive end-expiratory pressure level, and extracorporeal membrane oxygenation initiation showed statistically significant association with sustained negative VALac during the first 24 h. Conclusion The sustained negative VALac in the early stage of treatment may suggest additional information about tissue hypoxia than arterial lactate alone. Critical care physicians should pay more attention to the lactate discrepancy between different sites in their clinical practice.

Multimodal remote sensing image matching is a challenging task because of the existence of significant radiometric differences. To address the problem, we develop a novel multimodal remote sensing image matching method based on self-similarity features. The offset mean filtering method is proposed first to calculate the self-similarity features fast based on the symmetry of the self-similarity. The self-similarity features are presented through a multichannel self-similarity map (SSM) and a corresponding multichannel symmetric SSM. On this basis, we develop the image matching method, including a feature detector named improved maximal self-dissimilarities (IMSD) and a feature descriptor named oriented self-similarity (OSS). The IMSD detector is designed by introducing the two multichannel SSMs into the maximal self-dissimilarities (MSD) detector for feature point detection. The OSS descriptor is proposed based on the orientations of the self-similarities extracted from the multichannel SSMs. We conduct experiments with a variety of optical, synthetic aperture radar, and light detection, and ranging data. Our results demonstrate the advantages of our proposed IMSD detector and OSS descriptor in comparison with state-of-the-art detectors and descriptors, respectively. The image registration results further confirm the effectiveness of the proposed method.

Serum human hedgehog-interacting protein (HHIP) concentration is associated with diabetes. However, the relationship between HHIP and polycystic ovary syndrome (PCOS) or abnormal sex hormones remains unknown. This study was an observational cross-sectional study, with additional short-term intervention studies and follow-up studies. Bioinformatics analysis was performed to explore the association of PCOS with metabolic-related genes and signaling pathways. OGTT and EHC were performed on all participants. Lipid infusion, cold exposure, and 45-min treadmill test were performed on all healthy women. A total of 137 women with PCOS were treated with metformin, GLP-1RA, or TZDs for 24 weeks. Serum HHIP levels were higher in insulin resistance (IR) and PCOS women. Circulating HHIP levels were significantly correlated with adiponectin (Adipoq) levels, obesity, IR, and metabolic indicators. A correlation presented between HHIP and DHEA-S, FAI, SHBG, and FSH. Serum HHIP levels were significantly elevated by oral glucose challenge in healthy women, but not affected by EHC. Lipid infusion decreased serum HHIP levels, while cold exposure increased HHIP levels in healthy women. GLP-1RA and TZD treatment reduced serum HHIP levels in PCOS women, while metformin treatment did not affect HHIP levels. HHIP may be a useful biomarker and novel drug target for PCOS and IR individuals.

To study the geological environmental records of alpine-karst-type tufa deposits in the eastern margin of the Tibetan Plateau, the calcareous tufa profile exposed by the “8.8” Jiuzhaigou earthquake was taken as the research object and combined with a field geological investigation. Further, the petrography, sedimentology, chronology, and elemental geochemistry of the calcareous tufa were studied and analyzed. The results show the following. (1) The Sparkling Lake calcareous tufa profile was deposited under the background of a warm and humid climate during the Holocene. The growth pattern follows a bottom-to-top deposition. (2) At 750 ± 30–300 ± 30 aB.P., the calcareous tufa layers were gray-black as a whole, and the changes in mineral composition and elemental geochemistry indicate a fluctuating upward trend for temperature and precipitation during this period. (3) The formation of two sets of black peat layers in the upper part of the tufa calcareous profile is due to the synergistic action of multiple factors caused by strong tectonic activity. In conclusion, the deposition mechanism of the calcareous tufa in Jiuzhaigou was controlled by paleoclimate hydrology and glaciation for a long time, while strong tectonic activity over a short period of time considerably changed the color, structure, element content, and mineral composition of the calcareous tufa.

Molecular imprinting (MI) technology has been used in electrochemical analysis technology because of its unique selectivity and specificity. In this work, an electrochemical sensor based on in-situ inorganic MI-Au-MoO3/graphene for bisphenol A (BPA) analysis is designed, where MI-MoO3 is hybridized with graphene nanosheets and Au nanoparticles, and BPA is acted as the temple molecular. Differential pulse voltammetry (DPV) was used to evaluate the sensing performance of the MI-Au-MoO3/rGO sensor toward BPA determination and it is about 2.0 times that of NI-Au-MoO3/rGO. The as-constructed sensor presents a wide linear range from 0.01 to 106.04 μM and a low limit of detection of 0.003 μM. It also displays outstanding stability and repeatability up to 20 days, and can be used to analyze the content of BPA in dust leachate and plastic bottle. This sensor offers a promising strategy for environment pollution and food analysis via MI technology.

Abstract Background To explore the association between the ratio of tricuspid annular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP), and long- and short-term outcomes in mechanically ventilated septic shock patients. Methods Septic shock patients admitted to the intensive care unit (ICU) were screened for enrollment. Echocardiographic parameters including TAPSE and tricuspid regurgitation velocity, haemodynamic and respiratory parameters, and prognostic data were obtained. Results One hundred eighteen subjects were enrolled in this study, among whom 75 survived and 43 died at the one-year follow-up. ROC curve analysis revealed that the TAPSE/PASP ratio was able to assess one-year all-cause mortality with an area under the curve of 0.817 (95% CI: 0.739–0.896, p 0.5 mm/mmHg (log-rank 32.934, p

Abstract Background This study aimed to determine whether a focused 2-day cardiac ultrasound training course could enable physicians to obtain and interpret focused cardiac ultrasound (FCU) images from critically ill patients. Methods We retrospectively reviewed the FCU images submitted by the physicians who attended a 2-day FCU training courses. Three experienced trainers reviewed the images separately. They determined whether the images were assessable and scored the images on an 8-point scale. They also decided whether the physicians provided correct responses for visual estimations of the left ventricular ejection fraction (LVEF) and right ventricle (RV) dilatation and septal motion. Results Among the 327 physicians, 291 obtained images that were considered assessable (89%). The scores for parasternal short-axis view were lower than those obtained for other transthoracic echocardiographic views, p

Background: Browning of white adipose tissues (WAT) is recognized as a novel way to combat obesity and its related comorbidities. Thus, a lot of dietary agents contributing to browning of WAT have been identified. Objective: In this study, we try to explore the mechanism of the browning of WAT induced by resveratrol (Res) in 3T3-L1 adipocytes. Methods: The levels of cell viability and lipid accumulation were evaluated under different concentrations of Res. Cell signaling pathway analysis was performed to investigate the possible mechanisms of the WAT browning effect of Res in 3T3-L1 cells. Results: We found that Res induced the brown fat-like phenotype by activating protein expressions of brown adipocyte-specific markers, such as peroxisome proliferator-activated receptor gamma (PPAR-γ), peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), and uncoupling protein 1 (UCP1). Besides, Res reduced lipid accumulation, as shown by Oil Red O staining. The increased small lipid droplets implied that Res-treated 3T3-L1 adipocytes had some features of brown adipocytes. The brown fat-like phenotype in 3T3-L1 adipocytes induced by Res was possibly mediated by activation of mammalian target of rapamycin (mTOR), as brown adipocyte-specific markers were decreased by rapamycin, an inhibitor of mTOR and the MHY1485 treatment, an activator of mTOR, showed the similar effect of Res on browning markers. Conclusions: Res induced brown-like adipocyte phenotype in 3T3-L1 adipocytes partly via mTOR pathway, which provided new insights into the utilization of Res to prevent obesity and related comorbidities.

Abstract Background Respiratory variation of inferior vena cava is problematic in predicting fluid responsiveness in patients with right ventricular dysfunction. However, its effectiveness in patients with isolated left ventricular systolic dysfunction (ILVD) has not been reported. We aimed to explore whether inferior vena cava diameter distensibility index (dIVC) can predict fluid responsiveness in mechanically ventilated ILVD patients. Methods Patients admitted to the intensive care unit who were on controlled mechanical ventilation and in need of a fluid responsiveness assessment were screened for enrolment. Several echocardiographic parameters, including dIVC, tricuspid annular plane systolic excursion (TAPSE), left ventricular ejection fraction (LVEF), and LV outflow tract velocity–time integral (VTI) before and after passive leg raising (PLR) were collected. Patients with LV systolic dysfunction only (TAPSE ≥ 16 mm, LVEF

Actin filaments (F-actin) have been implicated in various steps of endosomal trafficking, and the length of F-actin is controlled by actin capping proteins, such as CapZ, which is a stable heterodimeric protein complex consisting of α and β subunits. However, the role of these capping proteins in endosomal trafficking remains elusive. Here, we found that CapZ docks to endocytic vesicles via its C-terminal actin-binding motif. CapZ knockout significantly increases the F-actin density around immature early endosomes, and this impedes fusion between these vesicles, manifested by the accumulation of small endocytic vesicles in CapZ-knockout cells. CapZ also recruits several RAB5 effectors, such as Rabaptin-5 and Rabex-5, to RAB5-positive early endosomes via its N-terminal domain, and this further activates RAB5. Collectively, our results indicate that CapZ regulates endosomal trafficking by controlling actin density around early endosomes and recruiting RAB5 effectors.

We present a novel echo-based synthetic aperture radar (SAR) image simulation method that comprehensively utilizes both SAR effective view and ray tracing algorithms. To improve the fidelity of simulated SAR images, we first design an SAR effective view algorithm to process the selected facet target model, with the purpose of discretizing the facets in the SAR effective view into lattice targets and ensuring that the interval of lattice targets is set strictly following the Nyquist sampling law. Then, we combine the ray tracing algorithm and SAR echo time-domain simulation and perform SAR echo time-domain simulation of lattice targets based on ray tracing. Various kinds of backscatter coefficient for each point target can be recorded, corresponding to the number of transmitted pulses within the synthetic aperture time. The echo matrixes of lattice targets are superimposed to generate the raw echo signal. Finally, the raw echo signal is processed by using the range-Doppler (RD) imaging algorithm to obtain the simulated SAR image. We conducted SAR image simulation tests on several facet target models, including car body, assault boat, and airplane, with different material properties. The simulated SAR images obtained by the proposed method were qualitatively and quantitatively evaluated. The experimental results verify the effectiveness of the proposed method.

Purpose: This study aimed to describe the clinical and laboratory characteristics and the parameters of the respiratory mechanics of mechanically ventilated patients with confirmed COVID-19 pneumonia and to clarify the risk or protective factors for weaning failure.Methods: Patients diagnosed with COVID-19 pneumonia were selected from the special intensive care unit (ICU) of the Sino-French New City Branch of Tong Ji Hospital, Wuhan, and treated by the National Medical Team Work. They were divided into successful weaning (SW) group (N = 15) and unsuccessful weaning (USW) group (N = 18) according to the prognosis. Information of these patients was analyzed.Results: There were 33 patients included in this study. Patients in the USW group were associated with a poor outcome; the 28-day mortality rate was higher than in the SW group (86.7 vs. 16.7% p < 0.001). By comparison, we found that the initial plateau pressure (Pplat) and driving pressure (DP) of the USW group were higher and that compliance was lower than that of the SW group, but there was no difference between positive end-expiratory pressure (PEEP), partial pressure of carbon dioxide (PCO2), and the ratio of partial pressure arterial oxygen and fraction of inspired oxygen (P/F ratio). Comparing the worst respiratory mechanics parameters of the two groups, the results of the Pplat, DP, compliance, and PEEP were the same as the initial data. The PCO2 of the USW group was higher, while the P/F ratio was lower. A logistic regression analysis suggested that higher Pplat might be an independent risk factor and that higher compliance and lower DP might be protective factors for weaning failure of invasive mechanically ventilated patients with COVID-19 pneumonia.Conclusions: Patients with USW were associated with a poor outcome, higher Pplat might be a risk factor, and a higher compliance and a lower DP might be protective factors for the weaning failure of ventilated COVID-19 patients. Mechanical ventilation settings will affect the patient's prognosis.

Purpose: A phenotype of COVID-19 ARDS patients with extremely low compliance and refractory hypercapnia was found in our ICU. In the context of limited number of ECMO machines, feasibility of a low-flow extracorporeal carbon dioxide removal (ECCO2R) based on the renal replacement therapy (RRT) platform in these patients was assessed.Methods: Single-center, prospective study. Refractory hypercapnia patients with COVID-19-associated ARDS were included and divided into the adjusted group and unadjusted group according to the level of PaCO2 after the application of the ECCO2R system. Ventilation parameters [tidal volume (VT), respiratory rate, and PEEP], platform pressure (Pplat) and driving pressure (DP), respiratory system compliance, arterial blood gases, and ECCO2R system characteristics were collected.Results: Twelve patients with refractory hypercapnia were enrolled, and the PaCO2 was 64.5 [56-88.75] mmHg. In the adjusted group, VT was significantly reduced from 5.90 ± 0.16 to 5.08 ± 0.43 ml/kg PBW; DP and Pplat were also significantly reduced from 23.5 ± 2.72 mmHg and 29.88 ± 3.04 mmHg to 18.5 ± 2.62 mmHg and 24.75 ± 3.41 mmHg, respectively. In the unadjusted group, PaCO2 decreased from 94 [86.25, 100.3] mmHg to 80 [67.50, 85.25] mmHg but with no significant difference, and the DP and Pplat were not decreased after weighing the pros and cons.Conclusions: A low-flow ECCO2R system based on the RRT platform enabled CO2 removal and could also decrease the DP and Pplat significantly, which provided a new way to treat these COVID-19 ARDS patients with refractory hypercapnia and extremely low compliance.Clinical Trial Registration:https://www.clinicaltrials.gov/, identifier NCT04340414.

Although winter wheat has been mapped by remote sensing in several studies, such mapping efforts did not sufficiently utilize contextual information to reduce the noise and still depended heavily on optical imagery and exhausting classification approaches. Furthermore, the influence of similarity measures on winter wheat identification remains unclear. To overcome these limitations, this study developed an object-based automatic approach to map winter wheat using multitemporal Sentinel-1 (S1) and Sentinel-2 (S2) imagery. First, after S1 and S2 images were preprocessed, the Simple Non-Iterative Clustering (SNIC) algorithm was used to conduct image segmentation to obtain homogeneous spatial objects with a fusion of S1 and S2 bands. Second, the temporal phenology patterns (TPP) of winter wheat and other typical land covers were derived from object-level S1 and S2 imagery based on the collected ground truth samples, and two improved distance measures (i.e., a composite of Euclidean distance and Spectral Angle Distance, (ESD) and the difference–similarity factor distance (DSF)) were built to evaluate the similarity between two TPPs. Third, winter wheat objects were automatically identified from the segmented spatial objects by the maximum between-class variance method (OTSU) with distance measures based on the unique TPP of winter wheat. According to ground truth data, the DSF measure was superior to other distance measures in winter wheat mapping, since it achieved the best overall accuracy (OA), best kappa coefficient (Kappa) and more spatial details for each feasible band (i.e., NDVI, VV, and VH/VV), or it obtained results comparable to those for the best one (e.g., NDVI + VV). The resultant winter wheat maps derived from the NDVI band with the DSF measure achieved the best accuracy and more details, and had an average OA and Kappa of 92% and 84%, respectively. The VV polarization with the DSF measure produced the second best winter wheat maps with an average OA and Kappa of 91% and 80%, respectively. The results indicate the great potential of the proposed object-based approach for automatic winter wheat mapping for both optical and Synthetic Aperture Radar (SAR) imagery.

Introduction: Fission1 (Fis1) and parkin are key proteins related to mitochondrial fission and mitophagy, respectively. This study aimed to assess the prognostic value of the Fis1/parkin ratio as a biomarker in patients with sepsis.Methods: Consecutive patients with sepsis (n = 133) or simple infection (n = 24) were enrolled within 24 h of arrival at the intensive care unit (ICU). Serum levels of Fis1, parkin, mitofusin2 (Mfn2), and peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) were measured by enzyme-linked immunosorbent assay (ELISA) upon ICU admission. Clinical parameters and standard laboratory test data were also collected. All patients received follow-up for at least 28 days.Results: Patients with sepsis presented with significantly decreased serum levels of parkin, Mfn2, and PGC-1α, but an increased serum Fis1 level and Fis1/parkin, Fis1/Mfn2, and Fis1/PGC-1α ratios at ICU admission. Relative to patients with simple infections, the ratios were remarkably elevated in septic patients—particularly septic shock patients. The area under the receiver operating characteristic (ROC) curve of the Fis1/parkin ratio was greater than that of Fis1, parkin, Mfn2, and PGC-1α levels as well as that of the Fis1/Mfn2 and Fis1/PGC-1α ratios for prediction of 28-day mortality due to sepsis. All of the ratios were significantly higher in non-survivors than survivors at the 28-day follow-up examination. Fis1/parkin ratio was found to be an independent predictor of 28-day mortality in patients with sepsis.Conclusions: The Fis1/parkin ratio is valuable for risk stratification in patients with sepsis and is associated with poor clinical outcomes for sepsis in the ICU.

Objective To investigate the effect of focused ultrasonography on clinical outcomes of septic shock. Methods Patients with septic shock were randomized into an integrated cardiopulmonary ultrasonography (ICUS) group and conventional (CON) group. Within 1 hour of admission, the ICUS group underwent ICUS examination for hemodynamic decision-making, while the CON group received standard treatment. The primary endpoint was 28-day mortality after admission. The secondary endpoints were cumulative fluid administration in the first 6, 24, and 72 hours; use of vasoactive drugs; lactate clearance; duration of ventilation; and ICU stay. Results Ninety-four qualified patients were enrolled (ICUS group, 49; CON group, 45). ICUS showed no significant effect on 28-day mortality. Within the initial 6 hours, the ICUS group tended to have a higher fluid balance and fluid intake than the CON group. The duration of vasopressor support was shorter in the ICUS group. There were no differences in the cumulative fluid infusion within 24 or 72 hours, lactate clearance, ICU stay, or duration of ventilation. Conclusions The initially focused ICUS did not affect the clinical outcomes of septic shock, but it tended to be associated with a higher fluid balance within the initial 6 hours and shorter duration of vasopressor support.

SARM1 regulates axonal degeneration through its NAD-metabolizing activity and is a drug target for neurodegenerative disorders. We designed and synthesized fluorescent conjugates of styryl derivative with pyridine to serve as substrates of SARM1, which exhibited large red shifts after conversion. With the conjugates, SARM1 activation was visualized in live cells following elevation of endogenous NMN or treatment with a cell-permeant NMN-analog. In neurons, imaging documented mouse SARM1 activation preceded vincristine-induced axonal degeneration by hours. Library screening identified a derivative of nisoldipine (NSDP) as a covalent inhibitor of SARM1 that reacted with the cysteines, especially Cys311 in its ARM domain and blocked its NMN-activation, protecting axons from degeneration. The Cryo-EM structure showed that SARM1 was locked into an inactive conformation by the inhibitor, uncovering a potential neuroprotective mechanism of dihydropyridines.

Using traditional neural network algorithms to adapt to high-resolution range profile (HRRP) target recognition is a complex problem in the current radar target recognition field. Under the premise of in-depth analysis of the long short-term memory (LSTM) network structure and algorithm, this study uses an attention model to extract data from the sequence. We build a dual parallel sequence network model for rapid classification and recognition and to effectively improve the initial LSTM network structure while reducing network layers. Through demonstration by designing control experiments, the target recognition performance of HRRP is demonstrated. The experimental results show that the bidirectional long short-term memory (BiLSTM) algorithm has obvious advantages over the template matching method and initial LSTM networks. The improved BiLSTM algorithm proposed in this study has significantly improved the radar HRRP target recognition accuracy, which enhanced the effectiveness of the improved algorithm.

The interconnected hydropneumatic suspension (ICHPS) has not only the nonlinear stiffness and damping of the independent hydropneumatic suspension (IDHPS) but also antiroll and antipitch functions. The existing analysis of hydropneumatic suspension damping mainly focuses on the orifice and check valve in the suspension cylinder. In this study, the calculation formula of the damping force of ICHPS is established, and the numerical simulation results show that the damping characteristics of the hydraulic hose cannot be ignored. The influence of check valve and hose on the damping characteristics is analyzed. Through the equivalent energy method, the equivalent compression damping ratio and the equivalent recovery damping ratio of the ICHPS are established. It is pointed out that when designing the damping characteristics of the ICHPS, it is necessary to select the orifices, check valves, and hose damping reasonably to make the damping characteristics get the best match.

Objective The perfusion index (PI) is usually used to assess peripheral perfusion, which can be influenced by the cardiac index (CI). CI monitoring is often needed during the treatment of patients with shock. We investigated the relationship between changes in the PI (ΔPI) and changes in the CI (ΔCI) in patients with septic shock. Methods This retrospective study included patients with septic shock who underwent pulse-induced continuous cardiac output monitoring. We measured the CI and PI before and after fluid loading during the first 6 hours of intensive care unit admission. Fluid responsiveness was defined as a ≥10% ΔCI after fluid loading. Other hemodynamic and oxygen-derived parameters were also collected at the exact time of each CI measurement. Results Fifty-five patients were included in the study (29 fluid responders, 26 fluid non-responders). In the univariate analysis, ΔPI was positively correlated with ΔCI. In the multivariable analysis, ΔPI was independently associated with ΔCI. The receiver operating characteristic curve showed that ΔPI was an appropriate marker with which to discriminate a CI increase with an area under the curve of 0.776. Conclusion This study showed a positive correlation between ΔPI and ΔCI during the early treatment phase of septic shock.

Objective To investigate the association of body mass index (BMI) with multivessel coronary artery disease in patients with myocardial infarction. Methods This study was performed in 1566 patients with myocardial infarction in the Department of Cardiology, Affiliated Hospital of Jining Medical University, China. Independent and dependent variables were BMI measured at baseline and multivessel coronary artery disease, respectively. The covariates examined in this study were age, systolic blood pressure, diastolic blood pressure, heart rate, creatinine, uric acid, bilirubin, cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, left ventricular ejection fraction, sex, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, stroke, hypertension, diabetes mellitus, and smoking. Results A nonlinear relationship was detected between BMI and multivessel coronary artery disease, and this was an inverted U-shaped curve and the cutoff point was 26.3 kg/m 2 . The effect sizes and confidence intervals on the left and right sides of the inflection point were 1.10 (1.01–1.20) and 0.85 (0.74–0.97), respectively. Conclusions There is an obesity paradox for BMI > 26.3 kg/m 2 . Future studies should examine the relationship between BMI and prognosis in patients with myocardial infarction, which may be important for improving the prognosis through control of BMI.

Background: The complications of coronavirus disease 2019 (COVID-19) involved multiple organs or systems, especially in critically ill patients. We aim to investigate the neurological complications in critically ill patients with COVID-19.Methods: This retrospective single-center case series analyzed critically ill patients with COVID-19 at the intensive care unit of Tongji Hospital, Wuhan, China from February 5 to April 2, 2020. Demographic data, clinical and laboratory findings, comorbidities and treatments were collected and analyzed.Results: Among 86 patients with confirmed COVID-19, 54 patients (62.8%) were male, and the mean (SD) age was 66.6 (11.1) years. Overall, 65% patients presented with at least one neurological symptom. Twenty patients (23.3%) had symptoms involving the central nervous system, including delirium, cerebrovascular diseases and hypoxic-ischemic brain injury, while 6 patients (7%) had neuromuscular involvement. Seven of 86 patients exhibited new stroke and 6 (7%) cases were ischemic. A significantly higher prevalence of antiphospholipid antibodies was observed in patients with ischemic stroke than in those without stroke (83.3 vs. 26.9%, p < 0.05). Patients with ischemic stroke were more likely to have a higher myoglobulin level, and a lower hemoglobin level.Conclusions: The clinical spectrum of neurological complications in critically ill patients with COVID-19 was broad. Stroke, delirium and neuromuscular diseases are common neurological complications of COVID-19. Physicians should pay close attention to neurological complications in critically ill patients with COVID-19.

Objective We explore how public satisfaction with the healthcare system in China varies with social and economic factors, especially regional variations and changes during 2013–2015.Design Population-based, cross-sectional survey performed between July 2013 and July 2015.Setting General population of China during 2013–2015.Participants A total of 15 969 participants (women=49.4%, sample-weighted average age=51.9).Primary outcome measure Public satisfaction with the healthcare system, defined as ‘being satisfied’ if a respondent’s satisfaction score is ≥70 points.Results The 2-year mean of the satisfaction score of the sample is 68.5 out of 100 points and the score in 2015 is higher than 2013 by 3.5 points. Senior respondents (OR=1.19, p

To investigate whether resveratrol could ameliorate the hepatic steatosis in high-fat diet (HFD) fed mice by modulating gut microbiota composition, fecal microbiota transplantation (FMT) was utilized in this study. Our results showed that resveratrol significantly ameliorated hepatic steatosis in HFD mice, increased the gene expression of fasting-induced adipose factor, and decreased the expression of lipogenesis-related genes and proteins (SREBP-1, FAS and ACC). In addition, resveratrol reversed HFD-induced gut microbiota dysbiosis, with an increase in the relative abundance of Bacteroidetes and a decrease in that of Firmicutes and Proteobacteria. Subsequent results showed the gut microbiota compositions of FMT recipient groups were similar to those of corresponding donor groups. And the changes of state of hepatic steatosis and expression of SREBP-1, ACC and FAS were coordinated with the results of gut microbiota. In conclusion, these results provided evidence to support the resveratrol could ameliorate the hepatic steatosis by modulating the gut microbiota.

Mycoplasma hyopneumoniae (M. hyopneumoniae) is the causative agent of pandemic pneumonia among pigs, namely, swine enzootic pneumonia. Although M. hyopneumoniae was first identified in 1965, little is known regarding its metabolic pathways, which might play a pivotal role during disease pathogenesis. Lipoate is an essential cofactor for enzymes important for central metabolism. However, the lipoate metabolism pathway in M. hyopneumoniae is definitely unclear. Here, we identified a novel gene, lpl, encoding a lipoate protein ligase in the genome of M. hyopneumoniae (Mhp-Lpl). This gene contains 1,032 base pairs and encodes a protein of 343 amino acids, which is between 7.5 and 36.09% identical to lipoate protein ligases (Lpls) of other species. Similar to its homologs in other species, Mhp-Lpl catalyzes the ATP-dependent activation of lipoate to lipoyl-AMP and the transfer of the activated lipoyl onto the lipoyl domains of M. hyopneumoniae GcvH (Mhp H) in vitro. Enzymatic and mutagenesis analysis indicate that residue K56 within the SKT sequence of Mhp H protein is the lipoyl moiety acceptor site. The three-dimensional structure showed typical lipoate protein ligase folding, with a large N-terminal domain and a small C-terminal domain. The large N-terminal domain is responsible for the full enzymatic activity of Mhp-Lpl. The identification and characterization of Mhp-Lpl will be beneficial to our understanding of M. hyopneumoniae metabolism.SummaryLipoic acid is an essential cofactor for the activation of some enzyme complexes involved in key metabolic processes. Lipoate protein ligases (Lpls) are responsible for the metabolism of lipoic acid. To date, little is known regarding the Lpls in M. hyopneumoniae. In this study, we identified a lipoate protein ligase of M. hyopneumoniae. We further analyzed the function, overall structure and ligand-binding site of this protein. The lipoate acceptor site on M. hyopneumoniae GcvH was also identified. Together, these findings reveal that Lpl exists in M. hyopneumoniae and will provide a basis for further exploration of the pathway of lipoic acid metabolism in M. hyopneumoniae.

Abstract Background The tricuspid annular plane systolic excursion (TAPSE) is commonly recommended for estimating the right ventricular systolic function. The central venous pressure (CVP), which is determined by venous return and right heart function, was found to be associated with right ventricular outflow fractional shortening. This study thus aimed to investigate the relationship between the TAPSE and CVP in mechanically ventilated critically ill patients. Methods This is a prospective observational study. From October 1 to December 31, 2017, patients admitted to the intensive care unit with CVP monitoring and controlled mechanical ventilation were screened for enrolment. Echocardiographic parameters, including the TAPSE, mitral annular plane systolic excursion (MAPSE), left ventricular ejection fraction (LVEF), and internal diameter of inferior vena cava (dIVC), and haemodynamic parameters, including the CVP, were collected. Results Seventy-four patients were included. Thirty-one were included in the low LVEF (

Abstract Background Fungal keratitis is one of the major causes of visual impairment worldwide. However, the effectiveness of corneal collagen cross-linking (CXL) for fungal keratitis remains controversial. In this study, we developed an in vitro and an in vivo models to assess the efficacy of CXL for Fusarium keratitis. Methods The effect of in vitro CXL fungicidal was evaluated on the cultures of Fusarium solani which were exposed to irradiation for different durations. Viability of fungal was appraised under four conditions: no treatment (control); CXL: UVA (365 nm)/riboflavin; riboflavin and UVA (365 nm). Each batch of sterile plate culture was irradiated for different CXL durations. The in vivo Therapeutic effect was studied on a mouse keratitis model. The animals were divided randomly into three groups: group A with no treatment (control); Group B with CXL treatment for two minutes and group C with CXL treatment for three minutes. The CXL procedure was performed 24 h post inoculation in each group. All mice with corneal involvement were scored daily for 7 days and 10 days after infection. Corneals were extracted at various time points for quantitative fungal recovery. Histological evaluations were conducted to calculate the number of polymorphonuclear cells. Results Viability of fungal decreased significantly in CXL group with 30-min irradiation compared with that in control, riboflavin and UVA groups (P

Metallo-β-lactamases (MBL) are zinc containing enzymes that cause resistance to β-lactam antibiotics. Here the authors show that the anti-Helicobacter pylori drug colloidal bismuth subcitrate inhibits MBLs by displacing the zinc ions with Bi(III), which is of great interest for the development of antibiotics.

Earth rotation parameters (ERP) are one of the key parameters in realization of the International Terrestrial Reference Frames (ITRF). At present, the International Laser Ranging Service (ILRS) generates the satellite laser ranging (SLR)-based ERP products only using SLR observations to Laser Geodynamics Satellite (LAGEOS) and Etalon satellites. Apart from these geodetic satellites, many low Earth orbit (LEO) satellites of Earth observation missions are also equipped with laser retroreflector arrays, and produce a large number of SLR observations, which are only used for orbit validation. In this study, we focus on the contribution of multiple LEO satellites to ERP estimation. The SLR and Global Positioning System (GPS) observations of the current seven LEO satellites (Swarm-A/B/C, Gravity Recovery and Climate Experiment (GRACE)-C/D, and Sentinel-3A/B) are used. Several schemes are designed to investigate the impact of LEO orbit improvement, the ERP quality of the single-LEO solutions, and the contribution of multiple LEO combinations. We find that ERP estimation using an ambiguity-fixed orbit can attain a better result than that using ambiguity-float orbit. The introduction of an ambiguity-fixed orbit contributes to an accuracy improvement of 0.5%, 1.1% and 15% for X pole, Y pole and station coordinates, respectively. In the multiple LEO satellite solutions, the quality of ERP and station coordinates can be improved gradually with the increase in the involved LEO satellites. The accuracy of X pole, Y pole and length-of-day (LOD) is improved by 57.5%, 57.6% and 43.8%, respectively, when the LEO number increases from three to seven. Moreover, the combination of multiple LEO satellites is able to weaken the orbit-related signal existing in the single-LEO solution. We also investigate the combination of LEO satellites and LAGEOS satellites in the ERP estimation. Compared to the LAGEOS solution, the combination leads to an accuracy improvement of 0.6445 ms, 0.6288 ms and 0.0276 ms for X pole, Y pole and LOD, respectively. In addition, we explore the feasibility of a one-step method, in which ERP and the orbit parameters are jointly determined, based on SLR and GPS observations, and present a detailed comparison between the one-step solution and two-step solution.

Abstract Background Although the role of serum procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of sepsis and septic shock is well studied, it has not been investigated among oldest old patients. The aim of our study is to determine the role of PCT and hs-CRP in the assessment of sepsis and septic shock in this specific group of patients in the ICU. Methods This is a prospective observational study. Patients >85 years of age admitted to the ICU from May 1st, 2016 to February 1st, 2017 were evaluated. Patients were divided into a sepsis and septic shock group(sepsis/SS) and a non-sepsis group. Serum levels of PCT, hs-CRP and the WBC were measured within 12 h of admission. Results A total of 70 patients aged 85 years and older were enrolled in this study. Fifty patients were labelled as sepsis/SS and the other 20 were labelled non-sepsis. A ROC analysis showed that the area under the curves (AUC) of hs-CRP and PCT for the discrimination of sepsis/SS patients were 0.825 (95% confidence interval[CI]: 0.73-0.92; P < 0.001) and 0.819 (95%CI:0.72-0.92; p < 0.001), respectively. In a subgroup analysis of the sepsis/SS group, 27 patients had sepsis, while the other 23 patients had septic shock. The ROC analysis showed that the AUCs of hs-CRP and PCT for the discrimination of septic shock patients from sepsis patients were 0.751 (95% CI: 0.62-0.88; P = 0.002) and 0.719 (95% CI:0.57-0.86; p = 0.007), respectively. Conclusion For the oldest old patients, hs-CRP is not inferior to PCT in the diagnosis of sepsis and septic shock.

The association between religion and health is well debated and receives continuous attention in research. Selection bias is often a major concern among the observatory data routinely used worldwide to examine this topic. Adopting the propensity score matching (PSM) method, the present study tries to assess the treatment effects of religion on self-reported health status. The final sample from the 2007 Spiritual Life Study of Chinese Residents (SLSC) contains 6194 valid responses. The average treatment effects (ATEs) estimated by the PSM method show that respondents with religious affiliations are on average significantly more likely to report being very healthy by 5.2 percentage points (by 3.6 and 9.6 percentage points among Buddhists and Protestants), especially, by 16.2 percentage points among those regarding religion as being very important in their lives. Meanwhile, ATEs of religion on reporting being very happy is 17.0 among Protestants and 13.4 among those regarding religion with high importance and 11.3 among those with “regular religious attendance”.

Global navigation satellite system (GNSS) orbits are traditionally determined by observation data of ground stations, which usually need even global distribution to ensure adequate observation geometry strength. However, good tracking geometry cannot be achieved for all GNSS satellites due to many factors, such as limited ground stations and special stationary characteristics for the geostationary Earth orbit (GEO) satellites in the BeiDou constellation. Fortunately, the onboard observations from low earth orbiters (LEO) can be an important supplement to overcome the weakness in tracking geometry. In this contribution, we perform large LEO constellation-augmented multi-GNSS precise orbit determination (POD) based on simulated GNSS observations. Six LEO constellations with different satellites numbers, orbit types, and altitudes, as well as global and regional ground networks, are designed to assess the influence of different tracking configurations on the integrated POD. Then, onboard and ground-based GNSS observations are simulated, without regard to the observations between LEO satellites and ground stations. The results show that compared with ground-based POD, a remarkable accuracy improvement of over 70% can be observed for all GNSS satellites when the entire LEO constellation is introduced. Particularly, BDS GEO satellites can obtain centimeter-level orbits, with the largest accuracy improvement being 98%. Compared with the 60-LEO and 66-LEO schemes, the 96-LEO scheme yields an improvement in orbit accuracy of about 1 cm for GEO satellites and 1 mm for other satellites because of the increase of LEO satellites, but leading to a steep rise in the computational time. In terms of the orbital types, the sun-synchronous-orbiting constellation can yield a better tracking geometry for GNSS satellites and a stronger augmentation than the polar-orbiting constellation. As for the LEO altitude, there are almost no large-orbit accuracy differences among the 600, 1000, and 1400 km schemes except for BDS GEO satellites. Furthermore, the GNSS orbit is found to have less dependence on ground stations when incorporating a large number of LEO. The orbit accuracy of the integrated POD with 8 global stations is almost comparable to the result of integrated POD with a denser global network of 65 stations. In addition, we also present an analysis concerning the integrated POD with a partial LEO constellation. The result demonstrates that introducing part of a LEO constellation can be an effective way to balance the conflict between the orbit accuracy and computational efficiency.

Objective To perform early assessment of sepsis-induced myocardial dysfunction (SIMD) using strain/stress echocardiography. Methods A canine model of SIMD was established using intravenous injection of lipopolysaccharide (LPS, 2 mg/kg). Thirteen dogs were included, comprising an LPS-treated SIMD group ( n = 7) and saline control group ( n = 6). SIMD was assessed at various time-points using cardiac measurements including haemodynamics and echocardiography. Results Systolic and radial ventricular wall stress and circular ventricular wall stress (WSsc) were significantly lower in the sepsis group versus the control group at all time-points. Logistic regression analysis revealed an inverse correlation between stress rate of the front-posterior and bottom wall and left ventricle systolic wall strength. In contrast, a positive correlation was found between the mean velocity of circumferential fibre shortening (mVCF) or heart rate-adjusted mVCF (RVCF) and WSsc. Using regression equations, predicted values for mVCF and RVCF in animals with sepsis were significantly higher than measured values at 4- 5- and 6-h time-points. Conclusions These findings will further the understanding of pathophysiological alterations in SIMD at the early stage of sepsis, and suggest that strain rate may reflect the nature of myocardial contractility.

MIMO antenna polynomial weighted average design method of downward-looking array SAR was proposed from the angle of surveying and mapping in this paper, in order to solve the ill-posed problem that an equivalent virtual array can be implemented by a variety of physical transmitter-receiver arrays for bistatic MIMO linear array. For wave band, resolution, elevation precision, and working height concerned by the applications of surveying and mapping, the length of equivalent virtual array and actual physical array meeting the needs of large scale topographical mapping was solved. Then array numbers and position vectors of MIMO downward-looking array SAR of real aerial mapping platform were optimized. According to this design, some simulation experiments and comparisons were processed. The results proved the rationality and effectiveness of this array configuration by comparing the differences of 3D imaging results and the original simulation scene, counting mean and standard deviation of elevation reconstruction error eliminating the influence of shadow areas, and counting the probability of elevation reconstruction error within half a resolution of the whole scene and individual building area.

Promoting the browning of white fat may be a potential means of combating obesity. Therefore, in this study, we investigated the effect of resveratrol (RES) on the body weight and browning of white fat in high-fat diet (HFD)-induced obese mice and the potential associated mechanism in vivo. Eight-week-old male mice were randomized to receive different treatments: (1), chow without any additional treatment (chow); (2), chow plus 0.4% resveratrol (chow-RES); (3), HFD without any additional treatment (HFD); and (4), HFD plus 0.4% resveratrol (HFD-RES). After 4 weeks of feeding, additional 8-week-old male recipient mice were randomly allocated to the following 4 treatments: (5), HFD and received feces from chow-fed mice; (6), HFD and received feces from chow-RES-fed mice; (7), HFD and received feces from HFD-fed mice; and (8), HFD and received feces from HFD-RES-fed mice. RES treatment significantly inhibited increases in fat accumulation, promoted the browning of white adipose tissue (WAT) and alleviated gut microbiota dysbiosis in HFD-fed mice. Subsequent analyses showed that the gut microbiota remodeling induced by resveratrol had a positive role in WAT browning, and sirtuin-1 (Sirt1) signaling appears to be a key component of this process. Overall, the results show that RES may serve as a potential intervention to reduce obesity by alleviating dysbiosis of the gut microbiota.

The urban green cover in high-spatial resolution (HR) remote sensing images have obvious multiscale characteristics, it is thus not possible to properly segment all features using a single segmentation scale because over-segmentation or under-segmentation often occurs. In this study, an unsupervised cross-scale optimization method specifically for urban green cover segmentation is proposed. A global optimal segmentation is first selected from multiscale segmentation results by using an optimization indicator. The regions in the global optimal segmentation are then isolated into under- and fine-segmentation parts. The under-segmentation regions are further locally refined by using the same indicator as that in global optimization. Finally, the fine-segmentation part and the refined under-segmentation part are combined to obtain the final cross-scale optimized result. The green cover objects can be segmented at their specific optimal segmentation scales in the optimized segmentation result to reduce both under- and over-segmentation errors. Experimental results on two test HR datasets verify the effectiveness of the proposed method.

Talaromyces marneffei is an opportunistic dimorphic fungus prevalent in Southeast Asia. We previously demonstrated that Mp1p is an immunogenic surface and secretory mannoprotein of T. marneffei. Since Mp1p is a surface protein that can generate protective immunity, we hypothesized that Mp1p and/or its homologs are virulence factors.We examined the pathogenic roles of Mp1p and its homologs in a mouse model. All mice died 21 and 30 days after challenge with wild-type T. marneffei PM1 and MP1 complemented mutant respectively. None of the mice died 60 days after challenge with MP1 knockout mutant (P

To explore the mechanism of mitochondrial uncoupling protein 2 (UCP2) mediating the protective of melatonin when septic cardiomyopathy. UCP2 knocked out mice and cardiomyocytes were used to study the effect of melatonin in response to LPS. Indicators of myocardial and mitochondria injury including mitochondrial membrane potential, mitochondrial permeability transition pore, calcium loading, ROS, and ATP detection were assessed. In addition cell viability and apoptosis as well as autophagy-associated proteins were evaluated. Melatonin was able to protect heart function from LPS, which weakened in the UCP2-knockout mice. Consistently, genipin, a pharmacologic inhibitor of UCP2, augmented LPS-induced damage of AC16 cells. In contrast, melatonin upregulated UCP2 expression and protected the cells from the changes in morphology, mitochondrial membrane potential loss, mitochondrial Ca2+ overload, the opening of mitochondrial permeability transition pore, and subsequent increased ROS generation as well as ATP reduction. Mitophagy proteins (Beclin-1 and LC-3β) were increased while apoptosis-associated proteins (cytochrome C and caspase-3) were decreased when UCP2 was up-regulated. In conclusion, UCP2 may play a protecting role against LPS by regulating the balance between autophagy and apoptosis of cardiomyocytes, and by which mechanisms, it may contribute to homeostasis of cardiac function and cardiomyocytes activity. Melatonin may protect cardiomyocytes through modulating UCP2.

Background. Graft reinfection with hepatitis C (HCV) after liver transplantation is a significant problem in transplant hepatology. This meta-analysis was performed to compare the effectiveness and risk of adverse events of interferon-based therapy with no treatment after liver transplantation. Methods. We searched electronic databases up to July 31, 2013, to obtain relevant research reports that satisfied the inclusion criteria. Meta-analyses were done on randomized controlled trials (RCTs) and nonrandomized trials. Results. A meta-analysis was performed on 2 RCTs and 2 cohort studies comprising a total of 326 patients (171 of whom accepted interferon-based antiviral therapy). The treatment group was found to have higher virological response (VR) rates than controls at 12, 24, 48, and 72 weeks. Patients in the antiviral group had higher sustained virological response (SVR) rates and lower mean alanine aminotransferase levels relative to controls at 48 weeks, but more total serious adverse events (AEs) than controls. Conclusions. Interferon-based treatment has some efficacy in the treatment of HCV graft reinfection following liver transplantation.