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Objective: To study the effect of acupuncture on clinical symptom score, blood pressure (BP), ABI and baPWV index in patients with mild to moderate essential hypertension. Methods: The single-blind Randomized controlled trial included 90 patients with mild to moderate essential hypertension who were randomly divided into two acupuncture groups and a control group. The control group was treated with Western medicine, while the experimental group was treated with medicine and acupuncture at different acupoints, Acupuncture Group Ⅰ and Acupuncture Group Ⅱ. The treatment lasted for 12 weeks and the indexes were collected before and after treatment. The primary outcome measure was changes in blood pressure. The secondary outcome measures were ABI, baPWV and TCM symptom score. The safety evaluation index was the incidence of adverse events. Results: Acupuncture Group Ⅰ, Acupuncture Group Ⅱ and Control group all had 30 patients finished the study. The results showed that there were significant differences in blood pressure, ABI, baPWV index and TCM symptom score in the group compared with before intervention (P < 0.05). Acupuncture Group Ⅰ is superior to Acupuncture Group Ⅱ in improving systolic blood pressure, baPWV level, TCM symptom score and total effective rate. There are significant differences between the two groups and control group in various indexes, and the above differences are statistically significant (PConclusions: The results show that acupuncture can effectively reduce blood pressure, improve clinical symptoms, and improve the level of arteriosclerosis index with high safety. More effective acupuncture points have been explored.

The yellow nutsedge (Cyperus esculentus L. 1753) is an unconventional oil plant with oil-rich tubers, and a potential alternative for traditional oil crops. Here, we reported the first high-quality and chromosome-level genome assembly of the yellow nutsedge generated by combining PacBio HiFi long reads, Novaseq short reads, and Hi-C data. The final genome size is 225.6 Mb with an N50 of 4.3 Mb. More than 222.9 Mb scaffolds were anchored to 54 pseudochromosomes with a BUSCO score of 96.0%. We identified 76.5 Mb (33.9%) repetitive sequences across the genome. A total of 23,613 protein-coding genes were predicted in this genome, of which 22,847 (96.8%) were functionally annotated. A whole-genome duplication event was found after the divergence of Carex littledalei and Rhynchospora breviuscula, indicating the rich genetic resources of this species for adaptive evolution. Several significantly enriched GO terms were related to invasiveness of the yellow nutsedge, which may explain its plastic adaptability. In addition, several enriched Kyoto Encyclopedia of Genes and Genomes pathways and expanded gene families were closely related with substances in tubers, partially explaining the genomic basis of characteristics of this oil-rich tuber.

BackgroundPatients often experience postoperative nausea and vomiting (PONV) after catheter ablation of atrial fibrillation (AF) because of the use of opioids for anaesthesia and analgesia during the procedure. Some clinical trials have demonstrated that acupuncture-assisted anaesthesia (AAA) reduces opioid consumption and prevents PONV. Although several studies have been conducted on AAA, its safety and efficacy in AF catheter ablation remain unclear due to small sample sizes and a paucity of methodologically rigorous designs. Therefore, this trial was designed to evaluate the safety and efficacy of AAA in reducing PONV and morphine hydrochloride consumption during catheter ablation.MethodsThis single-centre, patient-blinded, randomised, non-penetrating sham-controlled trial will be conducted in China. A total of 100 patients will be randomly assigned to the AAA and conventional anaesthesia (CA) groups in a ratio of 1:1. The patients will receive AAA or CA plus sham acupuncture during catheter ablation and will be followed up for 30 days. The primary outcomes include the total amount of morphine hydrochloride consumed during catheter ablation and PONV within the first 24 hours after the procedure. The secondary outcomes include pain, nausea and vomiting, anxiety, patient’s ability to cope during catheter ablation, AF recurrence and quality of life, as assessed using the numeric rating scale. Adverse events will be recorded and their influence will be analysed at the end of the trial.DiscussionThis study will help in evaluating the safety and efficacy of AAA applied for AF catheter ablation in reducing opioid doses during the procedure and the occurrence of PONV.Ethics and disseminationThe study has been approved by the Medical Ethics Committee of Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine. The results of the study will be published in peer-reviewed journals and presented at conferences if possible.Trial registration numberChiCTR 2100042646; Chinese Clinical Trial Registry.

Background Both bicuspid aortic valve (BAV) and bovine aortic arch (BA) are considered as markers of thoracic aortic disease (TAD). But the association between them is not yet clear. This study aimed to explore the potential association of BAV and BA with TAD. Methods The study involved 449 participants who underwent their first aortic valve replacement in Fuwai Hospital from June 2017 to March 2018. All patients underwent multidetector computed tomography and echocardiography before surgery. The clinical characteristics were recorded to analyze the association between BAV, BA, and TAD. The univariate and multivariate logistic regression analyses were applied to identify the risk factors for TAD. Results BA accounted for 79.8% of the arch variants and was the most common aortic arch branching variant. BAV was present in 52.6% of the patients with BA and 38.1% of the patients with normal arch (NA). Among the 185 patients in the BAV subgroup, 50 had BA and 135 had NA. No significant differences were found in BAV anatomical phenotype, aortopathy phenotype, and valve function between BA and NA. The multivariate analysis showed that the presence of BAV and male sex were the risk predictors of TAD. BA was not a risk factor for TAD in either univariate or multivariate analysis. Conclusions The proportion of BAV in patients with BA was significantly higher than that of NA, but the BAV phenotype and aortopathy were not related to BA. BAV was a risk factor for TAD, whereas BA was not associated with TAD.

This study describes a high-performance single-particle mass spectrometry (HP-SPAMS) design in detail. The comprehensive improvements of the injection system, optical sizing system, mass spectrometry, and data acquisition system have improved particle detection efficiency and chemical analysis. The combination of an aerodynamic particle concentrator (APC) system and a wide range of aerodynamic lenses (ADLs) enables the concentration of particles in the 100–5000 nm range by a factor of 3–5 times. The ion delayed exaction technology of bipolar time-of-flight mass spectrometry improves the mass resolution by 2~3 times, allowing the differentiation of multiple homogeneous masses of different substances. Moreover, the 4-channel data acquisition technology greatly enhances the dynamic range of mass spectrometry. The as-improved HP-SPAMS enhances the overall capability of the instrument in terms of particle detection number and detection efficiency. Moreover, it improves accuracy and sensitivity for component identification of individual particles. The experimental performance of HP-SPAMS shows that the sizing detection efficiency of polystyrene latex microspheres is almost 70 %–100 % in the range of 300–3000 nm. Compared to the previous SPAMS, HP-SPAMS has a larger inlet flow rate, detection efficiency, and higher laser frequency, which makes HP-SPAMS increase the effective number of particles detected in the air by 47.8 times and improve the temporal resolution of detection. For the analysis of individual particles, the HP-SPAMS's improved resolution helps distinguish between most organic fragment ions and metal ions and facilitates the analysis of complex aerosol particles. For the analysis of individual particles, the increased resolution of the HP-SPAMS contributes to the differentiation of most organic fragment ions and metal ions and facilitates the evaluation of complex aerosol particles. In the case of atmospheric lead-containing particles, for example, HP-SPAMS can completely differentiate the isotopes of lead elements and the number of lead-containing particles is 145 times higher than that detected by SPAMS. The outstanding detection efficiency and chemical analysis capability of HP-SPAMS will be of great importance for low concentration aerosol detection and complex aerosol component analysis.

Background Deep learning (DL) has achieved great success in medical imaging and could be utilized for the non-invasive calculation of fractional flow reserve (FFR) from coronary computed tomographic angiography (CCTA) (CT-FFR). Purpose To examine the ability of a DL-based CT-FFR in detecting hemodynamic changes of stenosis. Material and Methods This study included 73 patients (85 vessels) who were suspected of coronary artery disease (CAD) and received CCTA followed by invasive FFR measurements within 90 days. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristics curve (AUC) were compared between CT-FFR and CCTA. Thirty-nine patients who received drug therapy instead of revascularization were followed for up to 31 months. Major adverse cardiac events (MACE), unstable angina, and rehospitalization were evaluated and compared between the study groups. Results At the patient level, CT-FFR achieved 90.4%, 93.6%, 88.1%, 85.3%, and 94.9% in accuracy, sensitivity, specificity, PPV, and NPV, respectively. At the vessel level, CT-FFR achieved 91.8%, 93.9%, 90.4%, 86.1%, and 95.9%, respectively. CT-FFR exceeded CCTA in these measurements at both levels. The vessel-level AUC for CT-FFR also outperformed that for CCTA (0.957 vs. 0.599, P Conclusion CT-FFR is superior to conventional CCTA in differentiating functional myocardial ischemia. In addition, it has the potential to differentiate prognoses of patients with CAD.

There is controversy about whether symptomatic population with coronary artery calcium score (CACS) of zero have coronary artery disease (CAD) and the distribution at different ages. We sought to analyze the prevalence of CAD in symptomatic patients with zero CACS, especially in different age groups. We studied patients suspected of CAD and underwent CACS scan and coronary computed tomography angiography (CTA). We included patients with CACS of zero. Clinical data was collected to achieve information on demographic characteristics and risk factors. The presence of plaque and obstructive CAD were analyzed based on coronary CTA. The association between age and the prevalence of plaque and obstructive CAD was evaluated.Overall 5514 patients (51.1% men; mean age 54.40 years) were analyzed, of whom 4120 (74.72%) with normal coronary artery, 1394 (25.28%) with plaque and 514 (9.32%) with obstructive CAD. The prevalence of plaque and obstructive CAD increased significantly with age (p 70). RRs of prevalence of obstructive CAD also increased with age in the multivariate model (RR = 2.075 for 40–50, RR = 4.102 for > 70). Quite a few CAD could occur in symptomatic patients with CACS of zero, especially in old patients. Coronary CTA was required to exclude CAD in this cohort.

We sought to compare the prevalence and volume of lipid plaque, fibrous plaque, and calcified plaque in patients with smokers versus nonsmokers.We studied consecutive patients suspected of coronary artery disease and who underwent coronary computed tomography angiography. A structured interview and review of existing clinical data was conducted before computed tomography angiography to collect information on demographic characteristics, the presence of cardiovascular risk factors. The volume of lipid, fibrous, and calcified plaque were automatically calculated and marked in different colors according to predefined Hounsfield unit thresholds. The prevalence and volume of plaques were compared between smokers and nonsmokers.Overall 6380 patients (3351 men and 3029 women, mean age 55.35 years) were finally analyzed, of whom 2075 (32.5%) were smokers, and 4305 (67.5%) were never smokers. The prevalence of any plaque in smokers was significantly higher compared to never smokers (47.7% vs. 32.3%, p0.001). Smoking was an independent risk factor of the presence of any plaque after correcting for age, gender, body mass index, hypertension, dyslipidemia, diabetes, and family history in a multivariate model (odds ratio = 1.250 (1.088-1.437), p = 0.002). The volume of lipid plaque, fibrous plaque, calcified plaque, and total plaque in smokers was significantly greater than nonsmokers (p0.001).The prevalence and volume of lipid plaque, fibrous plaque, and calcified plaque were significantly higher in smokers versus never smokers.

Background Coronary computed tomography angiography (CCTA) is a noninvasive, less expensive, low‐radiation alternative to invasive coronary angiography (ICA). ICA is recommended for coronary evaluation before heart valvular surgery, and the supporting evidence for CCTA is insufficient. Our study is a single‐center, prospective cohort study designed to evaluate the feasibility of CCTA instead of ICA in detection of coronary artery disease before surgery. Methods and Results Heart valvular surgery candidates were consecutively enrolled between April 2017 and December 2018. Nine hundred fifty‐eight patients in the CCTA group underwent CCTA primarily, and those with ≥50% coronary stenosis or uncertain diagnosis underwent subsequent ICA. One thousand five hundred twenty‐five patients in the ICA group underwent ICA directly before surgery. Coronary artery bypass grafting decision was made by surgeons according to CCTA or ICA results. Most of the patients (78.8%) in the CCTA group avoided invasive angiography. Thirty‐day mortality (0.7% versus 0.9%, P =0.821), myocardial infarction (6.4% versus 6.9%, P =0.680 ), and low cardiac output syndrome (4.2% versus 2.8%, P =0.085) were similar in the CCTA and ICA groups. Median duration of follow‐up was 19.3 months (interquartile range, 14.2–30.0 months), cumulative rates of mortality (2.6% versus 2.6%, P =0.882) and major adverse cardiac events (9.6% versus 9.0%, P =0.607) showed no difference between the 2 groups. Coronary evaluation expense was lower in the CCTA group ($149.6 versus $636.0, P Conclusions The strategy of using CCTA as a doorkeeper in coronary evaluation before heart valvular surgery showed noninferiority in identification of candidates for coronary artery bypass grafting and postoperative safety.

Xiang Wang,1,2 Xin-Shuang Ren,3 Yun-Qiang An,3 Zhi-Hui Hou,3 Yi-Tong Yu,3 Bin Lu,3,&ast; Fang Wang1,2,&ast; 1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China; 2Graduate School of Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, People’s Republic of China; 3Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fang WangDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel +86 10 85132266Email fw_wangdr@163.comBin LuDepartment of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Bei-Li-Shi Street, Xicheng District, Beijing, 100037, People’s Republic of ChinaTel +86 10 88398700Email binlu_bl09@163.comBackground: A limitation associated with coronary computed tomography angiography (CCTA) is the lack of a normal reference value for aortic root dimensions and the uncertainty of the influence of age and gender on these dimensions. The purpose of the present study was to identify the normal values and variations of aortic root dimensions in healthy individuals and investigate how gender and age affect aortic root size.Methods: A total of 1286 healthy yellow population (52.7 ± 11.0 years, 634 male) who underwent CCTA were retrospectively included in the present study. Male and female patients were divided into seven groups according to age (< 30 years old, 30– 39, 40– 49, 50– 59, 60– 69, 70– 79, ≥ 80 years old). In these age groups, we measured and compared the parameters of the aortic root.Results: After body surface area (BSA) correction, the aortic root parameters of females were found to be greater than those of males in the 40– 49 age group (P< 0.05). There were no significant differences in aortic root parameters between genders in other age groups, except for the diameter of the ascending aorta, which was greater in females (P< 0.05). In males, age was positively correlated with aortic root parameters (P< 0.05), except for the annulus short diameter and LVOT short diameter. In females, age was positively correlated with aortic root parameters (P< 0.05), except for the left coronary ostia height and the LVOT short diameter.Conclusion: Aortic root dimensions are affected by age and gender. After BSA correction, females show larger aortic root dimensions than males, and aortic root diameters increase with age.Keywords: aortic root, BSA, CCTA, age, gender

Objective We performed this meta-analysis to determine which stent among everolimus eluting stents (EES), sirolimus eluting stents (SES) and paclitaxel eluting stents (PES) should be preferred for the treatment of DM patients. Methods A systematic search of publications about randomized controlled trials (RCTs) focused on diabetic patients received EES, SES or PES was conducted. We evaluated the following indicators: target vessel revascularization (TVR), target lesion revascularization (TLR), late luminal loss (LLL), stent thrombosis (ST), myocardial infarction (MI), all-cause mortality and cardiac mortality. Results EES showed obvious advantages over SES for DM patients, as it induced the lowest rate of target vessel revascularization and target lesion revascularization (TLR) (p = 0.04). In addition, EES induced lower in-segment LLL than PSE and SES and lower in-stent LLL than PES in DM patients (all p p = 0.04) and MI rates compared to PES (RR = 0.44, 95% CI: 0.26–0.73, p = 0.0002). Furthermore, EES could reduce the ST rate compared with both SES (RR = 0.53, 95% CI: 0.28–0.98, p = 0.04) and PES (RR = 0.18, 95% CI: 0.07–0.51, p = 0.001). Conclusion Among those three types of stents, EES should be the first recommended stent for DM patients.

Automatic analysis of coronary artery in coronary computed tomography angiography (CCTA) is important for clinicians to diagnose and evaluate coronary artery disease (CAD). Often there are two analysis tasks involved: centerline extraction and lumen segmentation, which are related yet often treated separately in the literature. In this work, we leverage their mutual relationship and propose an automatic approach for joint centerline extraction and lumen segmentation from CCTA using a hybrid of deep learning models. Our approach features the following designs, including: (i) the use of CNNTracker that traces out the centerline from seeds to detected ostia or the end of vessels, which fixes the breakage issue commonly found in previous pixel-based segmentation methods; (ii) a vascular Graph Convolutional Network (GCN) that leverages the geometric shape prior for accurate mesh-based lumen segmentation; (iii) the alternation between CNNTracker and GCN that refines the centerline and reduces the drift in tracking. We experiment the proposed method on CCTA data from 101 patients and achieve state-of-the-art performance in both centerline extraction and lumen segmentation of the right coronary artery (RCA), left anterior descending (LAD), and left circumflex (LCX).

Background Noncalcified plaques (NCPs) and mixed plaques (MPs) are considered as the high-risk coronary plaques. Endothelin-1 (ET-1) is a vasoactive peptide and shows a high expression in vulnerable plaque. The aim of this study is to investigate the relationship between the bigET-1, the precursor of ET-1, and NCPs/MPs in a Chinese population. Methods and results A total of 513 patients with chest pain and suspected coronary artery disease were collected and divided into three groups with no plaques, calcified plaques, or NCPs/MPs according to the characteristics of all the plaques. It demonstrated that NCPs/MPs were associated with elevated bigET-1 (P < 0.001). Moreover, the proportion of NCPs/MPs was significantly increased from 43.3% in bigET-1 tertile 1 to 61.0% in tertile 3 group (P = 0.001). Multiple logistic regression analysis further showed that bigET-1 was an independent predictor for the presence of NCPs/MPs (odds ratio = 1.858; 95% confidence interval: 1.017–3.394; P = 0.044). Conclusion The bigET-1 could be an independent predictor for the presence of NCPs/MPs., Noncalcified plaques (NCPs) and mixed plaques (MPs) are considered as the high risk coronary plaques. Endothelin- 1(ET-1) is a vasoactive peptide and shows a high expression in vulnerable plaque. However, the relationship between circulating ET-1 and NCPs/MPs is still an unanswered question. In the present study, we found that NCPs and MPs were associated with elevated plasma bigET-1, the precursor of ET-1. The patients with NCPs and MPs had significantly elevated bigET-1, compared to those without coronary plaque or those have calcified plaques. Multiple logistic regression analysis further showed that bigET-1 was an independent predictor for the presence of NCPs/MPs. The finding highlights the potential value of this assay in predicting the characteristics of plaques in patients with suspected or known coronary artery disease.

Identifying disease activity in Takayasu arteritis (TAK) is challenging. This study aimed to investigate the value of quantitative characterization with computed tomography angiography in the assessment of disease activity in patients with TAK.We retrospectively analysed the data on 162 aortic CT angiography from 140 TAK patients. Patients were categorized based on disease activity according to the National Institutes of Health criteria into two groups: active disease group (n = 65) and inactive disease group (n = 97).Patients with active TAK had a thicker wall compared with patients with inactive TAK (5.2 ± 2.4 mm vs. 2.5 ± 0.8 mm, p 0.001). The relative post-contrast enhancement ratio of the thickened wall was higher in active TAK than in inactive TAK (1.5 ± 0.3 vs. 1.1 ± 0.2, p 0.001). Given a thickness cutoff of 3.3 mm, sensitivity for active-phase TAK was 83.1%, specificity 89.7%, positive predictive value 84.4%, and negative predictive value 88.8%. With a relative post-contrast enhancement ratio cutoff of 1.2, sensitivity for active-phase TAK was 89.2%, specificity 76.3%, positive predictive value 71.6%, and negative predictive value 91.3%. In receiver-operating characteristic curves comparison, maximal wall thickness and relative post-contrast enhancement ratio were superior to C-reactive protein and erythrocyte sedimentation rate for determining active phase disease (p 0.05).Quantitative characterization with CT angiography was a useful tool to assess disease activity in TAK patients. Maximal wall thickness and relative post-contrast enhancement ratio have a high sensitivity and specificity for detecting TAK activity.

Macrophages exhibit heterogeneity and plasticity and imbalance between pro-inflammatory and anti-inflammatory macrophages plays a critical role in atherosclerosis progression. Telomerase reverse transcriptase (TERT) in macrophages can be activated by nuclear factor-kappa B (NF-κB), but the regulation of telomerase activation on macrophages polarization remains unknown. We previously identified microRNA-216a (miR-216a) to promote inflammation through directly targeting the Smad3/NF-κB pathway. The present study aimed to assess whether miR-216a can regulate telomerase activity and promote macrophages polarization during atherosclerosis progression. The results verified that TERT was highly expressed in macrophages of human carotid atherosclerotic plaques. miR-216a was found to promote telomerase activation in macrophages by 4.5-fold (P = 0.002) through the Smad3/NF-κB pathway. miR-216a also induced macrophages senescence characterized by senescence-associated-β-galactosidase activity and p53 and p16 expression. TERT overexpression promoted the transformation of M2 to M1 while this conversion was suppressed once TERT was inhibited, and the related inflammatory factors and lipid uptake ability of M1 cells were also increased by TERT. In the carotid atherosclerotic plaques from miR-216a-treated apolipoprotein E−/− mice, the numbers of M1 macrophages were increased whereas M2 cells reduced, accompanying with inhibited Smad3 expression and upregulated inflammatory markers and TERT activity. Furthermore, plasma miR-216a level was specifically higher in patients with vulnerable mixed plaques (n = 181) than those with calcified plaques (n = 73) and controls (n = 264). In summary, our findings first revealed a new molecular mechanism of macrophage polarization involving telomerase activation induced by miR-216a through the Smad3/NF-κB signaling, which might serve as a potential therapeutic target for atherosclerosis progression.

Bicuspid aortic valve (BAV) is the most common congenital heart disease. Different distribution of valve dysfunction was found in patients with BAV in different age and sex groups, but related difference was not well established. The aim of our study is to investigate age- and sex-related clinical characteristics differences in patients with BAV.Six hundred twenty patients with BAV who had moderate or severe aortic valve dysfunction were included in the study. Basic clinical data and image data were recorded. Patients were classified into four different age groups: (A: ≤ 50 years old; B: 50-60 years old; C: 60-70 years old; D: > 70 years old). The sex-related clinical difference in different age groups was compared. Association between incidence of aortic valve dysfunction and age was evaluated.Male patients had more frequent aortic regurgitation (AR) in patients younger than 70 years old (A: 52.3% versus 20.0%, P = 0.012; B: 43.2% versus 17.8%, P < 0.001; C: 17.0 versus 2.6%, P = 0.002), whereas female patients were more likely to have aortic stenosis (AS) (A: 75.0% versus 34.1%, P = 0.001; B: 77.8% versus 37.0%, P < 0.001; C: 93.6% versus 69.8%, P < 0.001). Frequency of AR in male patients decreased with age, whereas frequency of AS increased. Trend test showed a significant difference in incidence of aortic valve dysfunction as age increased in male patients (AR, P < 0.001; AS, P < 0.001). No trend was found in female patients.Male patients with BAV present more often with moderate/severe AR at a young age, and the frequency of AR decreases with age. Female patients with BAV had more frequent AS at first presentation regardless of age.

To investigate prognostic significance of follow-up CT findings for initially medically treated type B aortic intramural hematoma (IMH). We performed a retrospective pooled analysis of individual patient data, including baseline and follow-up CT characteristics. All enrolled patients were followed up for adverse aorta-related events, defined as a composite of aortic disease–related death and surgical or endovascular aortic repair. A total of 238 patients (73.9% men) were included, with a mean age of 58.1 ± 9.8 years. During follow-up, 83 patients (34.9%) experienced adverse aorta-related events, most of the events (83.1%) occurred within 1 month after follow-up CT imaging (n = 69). In the Cox regression model for predicting adverse aorta-related events, baseline maximal aortic diameter (MAD) (HR = 1.05, p = 0.008), ulcer-like projection (ULP) (HR = 2.47, p

This study explored the strength limitations of municipal solid waste incineration (MSWI) bottom ash-based geopolymer, which can limit its use in building materials. The calcium content in MSWI bottom ash was increased by the addition of varying amounts of granulated blast furnace slag (GBFS) and calcium-containing chemicals. The results showed that the low calcium content of MSWI bottom ash in geopolymer was the main cause of insufficient polymerisation. Both GBFS and calcium-containing chemicals improved geopolymer microstructure and enhanced the degree of polymerisation, which clearly improved the compressive strength. However, further increases in geopolymer compressive strength were not significant when the GBFS content was greater than 40%, and the compressive strength decreased sharply when hydrated Ca(OH)2 content was greater than 5%.

Deep learning is a growing trend in medical image analysis. There are limited data of deep learning techniques applied in Chest X-rays. This paper proposed a deep learning algorithm for cardiothoracic ratio (CTR) calculation in chest X-rays. A fully convolutional neural network was employed to segment chest X-ray images and calculate CTR. CTR values derived from the deep learning model were compared with the reference standard using Bland-Altman analysis and linear correlation graphs, and intra-class correlation (ICC) analyses. Diagnostic performance of the model for the detection of heart enlargement was assessed and compared with other deep learning methods and radiologists. CTR values derived from the deep learning method showed excellent agreement with the reference standard, with mean difference 0.0004 ± 0.0133, 95% limits of agreement -0.0256 to 0.0264. Correlation coefficient between deep learning and reference standard was 0.965 (P

Background Plasma fibrinogen (FIB) has been demonstrated to be a risk factor for cardiovascular disease. Patients with non-calcified plaque (NCP) or mix plaque (MP) have a higher risk of poor outcomes. However, the association between FIB and the presence of NCP or MP (NCP/MP) remains unclear, and if present, whether sex has any impact on this association remains unknown. The aim of this study was to investigate the role of FIB in predicting the presence of NCP/MP and evaluate whether sex has any impact on this association. Methods A total of 329 subjects were recruited, and the clinical and laboratory data were collected. Plasma FIB was detected by enzyme-linked immunosorbent assay. According to whether they had coronary atherosclerotic plaques and the characteristics of the most stenotic plaque, we divided them into three groups: no plaque (NP), calcified plaque (CP), and NCP/MP. Results Patients with NCP/MP had significantly higher FIB level in females, but not in males. Multiple logistic regression analysis showed that FIB was an independent risk factor for the presence of NCP/MP (odds ratio [OR] = 3.677, 95% CI 1.539–8.785, P = 0.003) in females. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value FIB for predicting the presence of NCP/MP was 3.41 g/L (area under curve [AUC] = 0.73, 95% CI 0.63–0.82, P

Successful fabrication of smart membrane based on cellulose fabric for controllable oil/water separation was reported. Sheet hexagonal ZnO was in situ synthesized on surface of cellulose fibers using NaOH/urea and ZnCl2 aqueous solution which were also exploited to fix ZnO steadily due to their swelling and dissolving effects on cellulose. Reversible wettability transition between superhydrophobicity/superoleophilicity and superhydrophilicity/superoleophobicity underwater was manipulated easily by dipping into a lauric acid ethanol solution and NaOH/ethanol water solution in turn for 2min. In detail, the as-prepared functionalized membranes can separate weight or light oil/water mixtures with separation efficiency higher than 98% of water removing and 96.5% of oil removing and high oil flux of 2900–3200 L h−2 m-2 and water flux of 3100–3400 L h−2 m−2. Simultaneously, the modified fabrics exhibited good stability and excellent recyclability via 20 times cycle operations of wettability transition and separation.

This study investigated the influence of different curing methods on the strength development of municipal solid waste incinerator bottom ash alkali-activated mortars. The results showed that standard room curing is not suitable for alkali-activated materials. The main reason for this is the humidity > 95% in the curing room, which causes wet sample surfaces. This leads to OH− and free alkali leaching, which severely affects strength development. Soaking curing further aggravates this effect. However, seal curing effectively prevents the leaching of OH− and free alkali and thus maintains high alkalinity, which benefits the strength development. Therefore, the method of seal curing is more suitable for alkali-activated materials.

This study investigated the carbonation resistance of municipal solid waste incinerator (MSWI) bottom ash alkali-activated concrete (BA) and Portland cement concrete (CC) through the accelerated carbonation test. The results show that BA has lower resistance against carbonation compared to CC under the conditions of the accelerated carbonation experiment. However, BA displayed a unique anti-diffusion behavior under natural conditions which significantly reinforced its carbonation resistance. The anti-diffusion behavior was closely related to the amount of liquid sodium silicate in the activator. Moreover, the pH value in complete carbonation zone of BA was much higher compared to that of CC. The main reason is that liquid sodium silicate turned into magadiite in BA and then the magadiite turned back to liquid sodium silicate to release a large amount of OH− under low concentrations of CO2. This resulted in a rapid increase in pH value of the pore fluid and generation of the anti-diffusion behavior.

Background/Aim: Epidemiological evidence on the mechanisms for association between long-term exposure to fine particulate matters (PM2.5) and coronary events is limited. We investigated the role of...

Residential green space and neighborhood walkability are important foundations of a healthy and sustainable city. Yet, their associations with atherosclerosis, the disease underlying clinical coronary heart disease (CHD), is unknown, especially in susceptible populations. We aim to explore the associations of exposure to residential green space and neighborhood walkability with coronary atherosclerosis. In this study of 2021 adults with suspected CHD, we evaluated the associations of exposure to green space (using Normalized Difference Vegetation Index [NDVI] and enhanced vegetation index [EVI] surrounding each participant’s home) and neighborhood walkability (using walkability index and number of parks near home) with atherosclerosis (using coronary artery calcium score, CAC) using linear regression model adjusted for individual-level characteristics. Mediation analysis was further applied to explore potential mechanisms through the pathways of physical activity, air pollution, and psychological stress. In the primary model, an interquartile increase in annual mean NDVI and EVI within the 1-km area was associated with −15.8% (95%CI: −28.7%, −0.7%), and −18.6% (95%Cl: −31.3%, −3.6%) lower CAC score, respectively. However, an interquartile increase in the walkability index near home was associated with a 7.4% (95% CI: 0.1%, 15.2%) higher CAC score. The combined exposure to a green space area in a 1-km area and the walkability index were inversely associated with atherosclerosis, albeit with a smaller magnitude than a single-exposure model. The findings from a mediation analysis suggested that increased physical exercise and ameliorated particulate matter < 2.5 μm (PM(2.5)) may partially contribute to the relationship between green space and atherosclerosis, and for walkability index, partially explained by increased PM(2.5) exposure. Our study suggested a beneficial association between green space and atherosclerosis, but an adverse association between neighborhood walkability and atherosclerosis. Therefore, urban development that aims to improve neighborhood walkability should jointly account for enhancing green space properties from a public health perspective.