Anthropogenic activity shapes the assemble and co-occurrence pattern of microbial communities in fishing harbors around the Bohai economic circle

This study aimed to elucidate the effects of coastal environmental stress on the composition of sediment bacterial communities and their cooccurrence patterns in fishing harbors around the Bohai Economic Circle, China. Compared with the natural sea area, fishing harbors contained higher levels of organic pollution (organic pollution index = 0.12 ± 0.026) and considerably reduced bacterial richness and evenness. The distributions of sediment microbial communities clustered along the pollutant concentration gradients across fishing harbors. Betaproteobacteria dominated (76%) organically polluted fishing harbors, which were mostly disturbed by anthropogenic activities. However, the harbors also revealed the absence of numerous pathogenic (Coxiella and Legionella) and photosynthetic (Synechococcus and Leptolyngbya) bacteria. Abundant genera, including Thiobacillus and Arenimonas, exhibited a positive correlation with total phosphorus and a negative correlation with total nitrogen in sediments. Meanwhile, Sulfurovum, Psychrobacter, and Woeseia showed the opposite trend. Pollutant accumulation and anthropogenic activities caused the decrease in the sediment microbial diversity and dispersal ability and promoted convergent evolution. Severely polluted harbors with simplified cooccurrence networks revealed the presence of destabilized microbial communities. In addition, the modularity of bacterial networks decreased with organic pollution. Our results provide important insights into the adjustment mechanism of microbial communities to community organization and functions under environmental pollution stress. Overall, this study enhanced our understanding of how microbial communities in coastal sediments adapted and survived amidst anthropogenic activities like oily effluent discharges from large ships, wash water, domestic sewage, garbage, and fisheries wastes. It also examined their resilience to future contamination.

The Impact of a Humanized Nursing Model on the Nursing Outcomes of Emergency Transfusion Patients

Background

Emergency transfusion is a frequently performed invasive medical procedure. Patients often experience negative emotions and exhibit poor compliance during transfusion. Therefore, it is imperative to proactively implement effective nursing interventions.

Objective

This study aims to investigate the impact of a humanized nursing model on the nursing outcomes of emergency transfusion patients.

Design

This research was conducted as a randomized controlled experiment.

Setting

The study was conducted in the emergency department of Suzhou Hospital of Integrated Chinese and Western Medicine.

Participants

A total of 120 patients who underwent emergency transfusion treatment in our hospital from February 2021 to October 2022 were selected. They were divided into two groups, the control group, and the observation group, using a random number table method, with 60 patients in each group.

Interventions

The control group received standard nursing care, while the observation group received humanized nursing.

Primary Outcome Measures

The primary outcome measures included (1) assessment of psychological states, (2) evaluation of physical and mental comfort, (3) assessment of transfusion compliance, (4) incidence of adverse transfusion events, and (5) assessment of nursing satisfaction.

Results

Prior to nursing interventions, anxiety and depression scores were not significantly different between the two groups (P > .05). After nursing interventions, both groups exhibited a decrease in scores, with the observation group showing a more significant reduction compared to the control group (P < .05). In all aspects of physical and mental comfort, the observation group scored significantly higher than the control group (P < .05). Transfusion compliance and nursing satisfaction were significantly higher in the observation group compared to the control group (P < .01). The incidence of adverse transfusion events in the observation group was significantly lower than in the control group (P < .01).

Conclusions

Humanized nursing significantly improves anxiety and depression in emergency transfusion patients, enhances their physical and mental comfort, and increases transfusion compliance while reducing adverse transfusion events. It leads to high patient satisfaction with nursing services.

Exercise to socialize? Bidirectional relationships between physical activity and loneliness in middle-aged and older American adults

Physical inactivity and loneliness are both associated with health risks and can affect each other through various social and behavioral mechanisms. However, current evidence on this relationship is equivocal and mostly based on cross-sectional data. This longitudinal study aimed to determine whether current levels of physical activity (moderate and vigorous intensity) and loneliness are associated with future respective states of themselves and each other. We used data from waves 6-14 (2002-2018) of the Health and Retirement Study (n = 20 134) in a mixed-effects and random-intercept cross-lagged panel model. Analysis showed that current loneliness and physical activity were associated with each future respective state. Additionally, weekly participation in moderate-intensity, but not vigorous-intensity, physical activity was associated with a lower likelihood of becoming lonely in the future (relative risk [RR] = 0.94; 95% CI, 0.90-0.99). However, changes in physical activity were not associated with deviation from a person's typical level of loneliness (for vigorous intensity, mean deviation [MD] = 0.00; 95% CI: -0.04 to 0.03; for moderate-intensity, MD = 0.01; 95% CI: -0.03 to 0.04). Loneliness was not associated with moderate- or vigorous-intensity physical activity in subsequent waves. This suggests that while lower physical activity levels can be associated with future loneliness, changing levels of physical activity has little impact on loneliness at the individual level.

Rydberg atom electric field sensing for metrology, communication and hybrid quantum systems

Rydberg atoms-based electric field sensing has developed rapidly over the past decade. A variety of theoretical proposals and experiment configurations are suggested and realized to improve the measurement metrics, such as intensity sensitivity, bandwidth, phase, and accuracy. The Stark effect and electromagnetically induced transparency (EIT) or electromagnetically induced absorption (EIA) are fundamental physics principles behind the stage. Furthermore, various techniques such as amplitude- or frequency-modulation, optical homodyne read-out, microwave superheterodyne and frequency conversion based on multi-wave mixing in atoms are utilized to push the metrics into higher levels. In this review, different technologies and the corresponding metrics they had achieved were presented, hoping to inspire more possibilities in the improvement of metrics of Rydberg atom-based electric field sensing and broadness of application scenarios.

Ergodicity breaking from Rydberg clusters in a driven-dissipative many-body system

It is challenging to probe ergodicity breaking trends of a quantum many-body system when dissipation inevitably damages quantum coherence originated from coherent coupling and dispersive two-body interactions. Rydberg atoms provide a test bed to detect emergent exotic many-body phases and nonergodic dynamics where the strong Rydberg atom interaction competes with and overtakes dissipative effects even at room temperature. Here, we report experimental evidence of a transition from ergodic toward ergodic breaking dynamics in driven-dissipative Rydberg atomic gases. The broken ergodicity is featured by the long-time phase oscillation, which is attributed to the formation of Rydberg excitation clusters in limit cycle phases. The broken symmetry in the limit cycle is a direct manifestation of many-body collective effects, which is verified experimentally by tuning atomic densities. The reported result reveals that Rydberg many-body systems are a promising candidate to probe ergodicity breaking dynamics, such as limit cycles, and enable the benchmark of nonequilibrium phase transition.

Impact of Enhanced Emergency Nursing Processes on the Rescue Outcomes of Emergency Patients with Chest Pain

Background

Chest pain, a sudden and perilous symptom, is frequently encountered in the emergency department. Prompt and efficient first-aid measures and nursing interventions are crucial for effectively rescuing emergency patients experiencing chest pain.

Objective

This study aims to investigate the impact of an enhanced emergency nursing process on the rescue outcomes of emergency patients with chest pain.

Design

A randomized controlled study was conducted.

Setting

The research was conducted at Suzhou Hospital of Integrated Traditional Chinese and Western Medicine.

Participants

A total of 90 emergency chest pain patients admitted between December 2021 and June 2022 were selected and divided into two groups, with 45 cases in each group.

Interventions

The control group received routine emergency nursing, while the observation group underwent an improved emergency nursing protocol.

Primary Outcome Measures

(1) Treatment initiation time, emergency rescue time, recovery time of vital signs, and hospital stay; (2) curative effect; (3) pain scores; (4) incidence of adverse events; and (5) patient satisfaction.

Results

Compared to the control group, the observation group exhibited shorter treatment initiation time, emergency rescue time, recovery time of vital signs, and hospital stay (P < .05). The effective rate in the observation group was higher (P < .05), and pain scores were lower at 30 min, 60 min, 120 min, and 240 min post-rescue (P < .05). The occurrence of adverse events was reduced in the observation group (P = .005), and patient satisfaction was higher at discharge (P < .05).

Conclusion

The enhanced emergency nursing process effectively reduces the clinical rescue time for emergency patients with chest pain, enhances rescue efficiency, seizes crucial opportunities for saving lives, and improves patient satisfaction. These findings have significant positive implications for clinical applications.

Effect of the molecular weight of DOM on the indirect photodegradation of fluoroquinolone antibiotics

Dissolved organic matter (DOM) is ubiquitous and widespread in natural water and influences the transformation and removal of antibiotics. Nevertheless, the influence of DOM molecular weight (MW) on the indirect photodegradation of antibiotics has rarely been reported. This study attempted to explore the influence of the molecular weight of DOM on the indirect photodegradation of two fluoroquinolone antibiotics (FQs), ofloxacin (OFL) and norfloxacin (NOR), by using UV-vis absorption and fluorescence spectroscopy. The results showed that indirect photodegradation was considered the main photodegradation pathway of FQs in DOM fractions. Triplet-state excited organic matter (3DOM*) and singlet oxygen (1O2) were the main reactive intermediates (RIs) that affected the indirect photodegradation of FQs. The indirect photodegradation rate of FQs was significantly promoted in DOM fractions, especially in the low molecular weight DOM fractions (L-MW DOM, MW < 10 kDa). The results of excitation-emission matrix spectroscopy combined with parallel factor analysis (EEM-PARAFAC) showed that terrestrial humic-like substances had a higher humification degree and fluorophore content in L- MW DOM fractions, which could produce more 3DOM* and 1O2 to promote the indirect photodegradation of FQs. This study provided new insight into the effects of DOM at the molecular weight level on the indirect photodegradation of antibiotics in natural water.

Environmental forcing of phytoplankton carbon-to-diversity ratio and carbon-to-chlorophyll ratio: A case study in Jiaozhou Bay, the Yellow Sea

The relationships between phytoplankton carbon (C) biomass and diversity (i.e., C-to-H' ratio) and chlorophyll a (i.e., C-to-Chl a ratio) are good indicators of marine ecosystem functioning and stability. Here we conducted four cruises spanning 2 years in Jiaozhou Bay to explore the dynamics of C-to-H' and C-to-Chl a ratios. The results showed that the phytoplankton C biomass and diversity were dominated by diatoms, followed by dinoflagellates. The average C-to-H' ratio ranged from 84.10 to 912.17, with high values occurring in the northern region of the bay. In contrast, the average C-to-Chl a ratio ranged between 15.55 and 89.47, and high values primarily appeared in the northern or northeastern part of the bay. In addition, the redundancy analysis showed that temperature and phosphate (DIP) were significantly correlated with both ratios in most cases, indicating that temperature and DIP may be key factors affecting the dynamics of C-to-H' and C-to-Chl a ratios.

Reliability and validity testing of the ASSIST functional performance index

Reliability and validity testing of the ASSIST Functional Performance Index (AFPI) was conducted, focusing on persons with physical disabilities (PwPD). The AFPI was iteratively developed to assess persons' needs for Mainstream Smart Home Technologies (MSHT) as Assistive Technology (AT) and to measure the impact of a service delivery model for MSHT. The AFPI consists of 46 items organized by functional domains. A total of N = 22 PwPD completed the AFPI twice. The median response time between these two time points was four days. Test-retest reliability of overall scores was assessed using the Intraclass Correlation Coefficient model (ICC, 3.1). The weighted kappa coefficient was applied to conduct an item analysis, demonstrating moderate to substantial agreement in all but one of the items. During the second administration, validity was established by correlating the number of hours of assistance and total AFPI scores with the SCI-FI Self-Care and Basic Mobility Short Form Questionnaires. Results indicate that the AFPI demonstrates good to very good validity as an assessment tool and outcome measure in recommending and evaluating the impact of MSHT for PwPD. Future studies, including more participants and persons with cognitive and sensory disabilities, may further establish the clinical utility of the AFPI.

Spatial distribution and potential ecological risk assessment of heavy metals in the sediments of fishing ports along the coasts of the Yellow Sea and Bohai Sea

More than 1,154 fishing ports are widely distributed in China's coastal areas. To date, however, few studies on the pollution and ecological risks of heavy metals in these fishing ports have been reported. In this study, the heavy metals of 148 sediment samples collected from 37 fishing ports along the coasts of the Yellow Sea and Bohai Sea were detected. The results showed that the average contents of Cu, Pb, Zn, and Cd were 53.58 ± 44.53, 27.90 ± 18.10, 143.52 ± 74.72 and 0.28 ± 0.15 mg/kg, respectively. Based on the geoaccumulation index (Igeo) and the potential ecological risk index (RI), we found that fishing ports were the most severely polluted by Cu, but Cd had the highest ecological risk, and most of fishing ports were in moderate potential ecological risk. The positive correlation between heavy metals and total organic carbon indicated that heavy metals in fishing ports were mainly affected by anthropogenic activities.

The characteristics of CDOM structural composition and the effect on indirect photodegradation of sulfamerazine

Sulfamerazine (SM) is a commonly used antibiotic and have been widely used to control various bacterial infectious diseases. The structural composition of colored dissolved organic matter (CDOM) is known to be a major factor that influences the indirect photodegradation of SM, yet the influence mechanism remains unknown. In order to understand this mechanism, CDOM from different sources was fractionated using ultrafiltration and XAD resin, and characterized using UV-vis absorption and fluorescence spectroscopy. The indirect photodegradation of SM in these CDOM fractions was then investigated. Humic acid (JKHA) and Suwannee River natural organic matter (SRNOM) were used in this study. The results showed that CDOM could be divided into four components (three humic-like components and one protein-like component), and terrestrial humic-like components C1 and C2 were found to be the main components that promote SM indirect photodegradation due to their high aromaticity. The indirect photodegradation of SM was much faster in low molecular weight (MW) solutions, whose structures were dominated by greater aromaticity and terrestrial fluorophores in JKHA and higher terrestrial fluorophores in SRNOM. The HIA and HIB fractions of SRNOM contained large aromaticity and high fluorescence intensities of C1 and C2, resulting in a greater indirect photodegradation rate of SM. The HOA and HIB fractions of JKHA had abundant terrestrial humic-like components and contributed more to SM indirect photodegradation.

[Soybean isoflavones alleviate cerebral ischemia/reperfusion injury in rats by inhibiting ferroptosis and inflammatory cascade reaction]

OBJECTIVE

To explore the mechanism that mediates the effect of soybean isoflavones (SI) against cerebral ischemia/reperfusion (I/R) injury in light of the regulation of regional cerebral blood flow (rCBF), ferroptosis, inflammatory response and blood-brain barrier (BBB) permeability.

METHODS

A total of 120 male SD rats were equally randomized into sham-operated group (Sham group), cerebral I/R injury group and SI pretreatment group (SI group). Focal cerebral I/R injury was induced in the latter two groups using a modified monofilament occlusion technique, and the intraoperative changes of real-time cerebral cortex blood flow were monitored using a laser Doppler flowmeter (LDF). The postoperative changes of cerebral pathological morphology and the ultrastructure of the neurons and the BBB were observed with optical and transmission electron microscopy. The neurological deficits of the rats was assessed, and the severities of cerebral infarction, brain edema and BBB disruption were quantified. The contents of Fe²⁺, GSH, MDA and MPO in the ischemic penumbra were determined with spectrophotometric tests. Serum levels of TNF-α and IL-1βwere analyzed using ELISA, and the expressions of GPX4, MMP-9 and occludin around the lesion were detected with Western blotting and immunohistochemistry.

RESULTS

The rCBF was sharply reduced in the rats in I/R group and SI group after successful insertion of the monofilament. Compared with those in Sham group, the rats in I/R group showed significantly increased neurological deficit scores, cerebral infarction volume, brain water content and Evans blue permeability (P < 0.01), decreased Fe²⁺ level, increased MDA level, decreased GSH content and GPX4 expression (P < 0.01), increased MPO content and serum levels of TNF-α and IL-1β (P < 0.01), increased MMP-9 expression and lowered occludin expression (P < 0.01). All these changes were significantly ameliorated in rats pretreated with IS prior to I/R injury (P < 0.05 or 0.01).

CONCLUSION

SI preconditioning reduces cerebral I/R injury in rats possibly by improving rCBF, inhibiting ferroptosis and inflammatory response and protecting the BBB.

The Joint Effect of Body Mass Index and Serum Lipid Levels on Incident Dementia among Community-Dwelling Older Adults

OBJECTIVES

This study aimed to explore the joint effect of body mass index (BMI) and serum lipids levels on incident dementia.

METHODS

We prospectively followed up with 1,627 dementia-free community residents aged ≥60 for 5.7 years on average. At baseline, weight, and height were measured, and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were detected in serum. Demographic characteristics were collected through questionnaires. Dementia was based on consensus diagnosis of neurologists and neuropsychologists using DSM-IV criteria. Additive Cox proportional model was used to assess the exposure-response relationship between BMI and serum lipid levels and dementia risk. Interactions and further classifications of BMI and serum lipid levels were further presented by bivariate surface models and decision-tree models.

RESULTS

The joint effects of TC with BMI, TG with BMI, and LDL-C with BMI on the risk of incident dementia shared a similar pattern, different from their independent exposure-response curves. The joint effect of HDL-C with BMI showed an S-surface but without statistical significance. Participants with TC<5.4 mmol/L and BMI<21 kg/m2 (Hazard Ratio(HR) 1.93, 95% Confidence Interval (CI) 1.05-3.53), TC<5.4 mmol/L and BMI≥21 kg/m2 (HR 1.73, 95% CI 1.09-2.72), and TC≥5.4 mmol/L and BMI<21 kg/m2 (HR 4.02, 95% CI 2.10-7.71) were identified to have the increased risk of incident dementia compared to those with TC≥5.4 mmol/L and BMI≥21 kg/m2. Participants with TG<1.7 mmol/L and BMI<21 kg/m2 had an increased risk of incident dementia compared to those with TG≥1.7 mmol/L and BMI≥21 kg/m2 (HR 1.98, 95%CI 1.17-3.3). Participants with LDL-C≥3.3 mmol/L and BMI<21 kg/m2 were identified to have an increased risk of incident dementia compared to those with LDL-C≥3.3 mmol/L and BMI≥21 kg/m2 (HR 3.33, 95%CI 1.64-6.78).

CONCLUSIONS

Our study showed that low BMI combined with low or high levels of serum lipids may increase the risk of dementia among older adults. This finding suggests the potential impacts of these two metabolic indexes on the risk of dementia.

Ocean acidification and warming significantly affect coastal eutrophication and organic pollution: A case study in the Bohai Sea

Most coastal ecosystems are faced with novel challenges associated with human activities and climate change such as ocean acidification, warming, eutrophication, and organic pollution. However, data on the independent or combined effects of ocean acidification and warming on coastal eutrophication and organic pollution at present are relatively limited. Here, we applied the generalized additive models (GAMs) to explore the dynamics of coastal eutrophication and organic pollution in response to future climate change in the Bohai Sea. The GAMs reflected the fact that acidification alone favors eutrophication and organic pollution, while warming alone inhibits these two variables. Differently, the interactions between acidification and warming in the future may further exacerbate the organic pollution but may mitigate the progress of eutrophication. These different responses of eutrophication and organic pollution to acidification and warming may be attributed to algae growth and microbial respiration, as well as some physical processes such as stratification.

Different responses of phytoplankton and zooplankton communities to current changing coastal environments

Marine plankton are faced with novel challenges associated with environmental changes such as ocean acidification, warming, and eutrophication. However, data on the effects of simultaneous environmental changes on complex natural communities in coastal ecosystems are relatively limited. Here we made a systematic analysis of biological and environmental parameters in the Bohai Sea over the past three years to suggest that plankton communities responded differently to current changing coastal environments, with the increase of phytoplankton and the decrease of zooplankton. These different changes of phyto- and zooplankton potentially resulted from the fact that both the effect of acidification as a result of pH decline and the effect of warming as a consequence of increasing temperature favored phytoplankton over zooplankton at present. Furthermore, water eutrophication and salinity as well as heavy metals Hg, Zn, and As had more or less diverse consequences for the dynamics of phytoplankton and zooplankton. Differently, with ongoing climate change, we also revealed that both phytoplankton and zooplankton would decrease in the future under the influence of interactions between acidification and warming.

Spatiotemporal evolution of nutrients and the influencing factors in Laizhou Bay over the past 40 years

The nutrient status in Laizhou Bay has changed in composition and structure as a result of anthropogenic activities and climate change, which has led to several environmental problems (e.g., eutrophication, organic pollution and red tides). To better understand the spatiotemporal variations in dissolved inorganic nitrogen (DIN), dissolved inorganic phosphorus (DIP), and eutrophication in the Laizhou Bay, we collected historical research data and conducted four cruises in 2021. The highest surface DIN was found to occur in autumn and predominantly concentrated in the southwestern bay. The highest surface DIP content was found in winter and distributed in the northwestern bay. Surface organic pollution showed estuaries as the most polluted areas. In the past 40-60 years, the DIN, DIP, and eutrophication have shown an inverted U-shaped trend, and the bay has changed from N limitation to P limitation. Economic development, phytoplankton absorption, and bottom mineral release are factors influencing the content and distribution of nutrient in the bay.

Ecological risk assessment of heavy metal pollutants and total petroleum hydrocarbons in sediments of the Bohai Sea, China

Heavy metals and organic pollutants like total petroleum hydrocarbons (TPHs) in coastal marine sediments are receiving extensive attention, as they may pose a serious threat to the aquatic environment and ecosystem health. To date, however, data on the long-term variations in the levels of sedimentary heavy metals and TPHs as well as their ecological risks are relatively limited. Here, we conducted 12 cruises spanning 3 years in the Bohai Sea and obtained ~1400 sediment samples to explore the long-term variations of heavy metals (i.e., Hg, As, Cu, Zn, Pb, Cd) and TPHs, and to assess their potential ecological risks. The results suggested that the ranges for the levels of Hg, As, Cu, Zn, Pb, Cd, and TPHs in sediments between 2019 and 2021 were <0.01-0.07, 0.23-10.72, 8.07-20.67, 25.52-46.55, 10.94-28.19, 0.14-0.56, and 9.14-18.41 mg kg^-1, respectively. Based on the single factor evaluation (F_i) for sediment quality, we found that most of the evaluation factors in the study area met the requirements of sediment quality standard (i.e., F_i < 1), except for the factor of metal Cd in some cases. The implication is that the sediment in the Bohai Sea was fairly clean in terms of heavy metals and TPHs. However, the concentration of metal Cd exceeded the sediment quality standard during May 2019 and 2020 (i.e., F_i > 1), indicating that Cd could be identified as a major pollutant in surface sediments. Also, based on the ecological risk assessment (E_i) of heavy metal pollutants, we found that the metal Cd had reached a level with potential ecological risk in some cases (80 ≤ E_i < 160). As such, we further suggested that the Cd contamination might have a potential risk on the Bohai Sea' ecosystem.

Diagnostic performance of on-site computation of quantitative flow ratio by a coronary computed tomography angiography based algorithm: comparison of distal and lesion-specific measurements

Introduction

Guidelines recommend secondary ischemia assessment following a coronary computed tomography angiography (CTA) with suspected obstructive coronary artery disease (CAD). Coronary CTA-derived quantitative flow ratio (CT-QFR) is an on-site technique performed on acquired CTA images that estimates the functional severity of a coronary stenosis. However, CT-QFR measurements are available throughout the coronary vessel with no clear recommendations as to which specific values should be used for identifying obstructive CAD, e.g. most distal or lesion-specific values.

Purpose

First, to investigate the feasibility of CT-QFR and the correlation and agreement with invasive fractional flow reserve (FFR). Secondly, to compare the diagnostic performance of distal versus lesion-specific CT-QFR for identifying obstructive CAD defined by invasive coronary angiography (ICA) with FFR.

Methods

A total of 1732 prospectively included patients with symptoms suggestive of CAD referred for CTA were included. All patients with ≥50% diameter stenosis (DS) on CTA were subsequently referred for ICA with conditional FFR in lesions with 30–89%DS. Obstructive CAD was defined by ICA as FFR ≤0.80 or high-grade stenosis by visual assessment (≥90%DS). A blinded analysis of CT-QFR was performed in patients referred to ICA with measurements at the distal end of a vessel (distal CT-QFR) and 1 cm distal to stenotic lesions on CTA (lesion-specific). CT-QFR ≤0.80 was defined as abnormal. For correlation analyses to invasive FFR, CT-QFR was assessed corresponding to the position of the invasive pressure sensor.

Results

In total, 445/1732 (25%) patients had suspected obstructive CAD at CTA and underwent subsequent ICA. CT-QFR analysis was feasible in 423/445 (95%) patients. CT-QFR correlated (Pearson's rho 0.54, p&lt;0.001) and agreed (mean difference –0.02±0.09) to FFR with CT-QFR overestimating FFR (Fig. 1). Obstructive CAD was identified in 190/423 (44%) patients by ICA. Distal and lesion-specific CT-QFR classified 196 (46%) and 171 (40%) patients as abnormal, respectively. Areas under the receiver-operating characteristic curves for distal versus lesion-specific CT-QFR were similar (0.86 (95% CI: 0.82–0.89) vs. 0.86 (0.82–0.90), p=0.80). Sensitivities for distal and lesion-specific CT-QFR were 78% (95% CI: 71–84) vs. 74% (67–80), p=0.01, respectively, and specificities 79% (95% CI: 74–84) vs. 87% (82–91), p&lt;0.01, respectively. Distal and lesion-specific CT-QFR had similar diagnostic accuracy (79 (95% CI: 75–83), vs. 81 (77–85), p=0.07) (Fig. 2).

Conclusion

In patients with suspected obstructive CAD on CTA, non-invasive estimation of FFR using CT-QFR is feasible with moderate correlation and good agreement with invasive FFR. Overall diagnostic performance of distal and lesion-specific values for discriminating obstructive CAD by invasive FFR are similar. The use of CT-QFR could therefore potentially reduce the need for referral to invasive angiography after CTA.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Aarhus UniversityRegion Mid Jutland

Comparison of second-line on-site computed quantitative flow ratio from coronary computed tomography angiography to PET perfusion imaging for detecting obstructive coronary artery disease

Introduction

In patients with suspected obstructive coronary artery disease (CAD) on coronary computed tomography (CTA), guidelines endorse second-line selective testing for hemodynamic evaluation of suspected CAD. A variety of non-invasive modalities are available, and myocardial perfusion imaging with Rubidium-82 positron emission tomography (PET) is an established method with high diagnostic performance. Recently, an on-site method estimating computed tomography-derived quantitative flow ratio (CT-QFR) showed promising results for discriminating obstructive CAD. However, no study has compared the diagnostic performances of PET and CT-QFR.

Purpose

To assess a possible non-inferiority of CT-QFR compared to PET in patients with suspected obstructive CAD at CTA using invasive coronary angiography (ICA) with fractional flow reserve (FFR) as reference.

Methods

Patients (n=1732, 57% males, age 59±9.5) referred on a clinical indication with symptoms suggestive of obstructive CAD underwent routine CTA. Patients with ≥50% diameter stenosis (DS) on CTA were referred for PET and subsequent ICA with FFR. CT-QFR was analyzed post-hoc blinded to PET and ICA results.

Abnormal CT-QFR was defined as CT-QFR ≤0.80 in any vessel with a diameter ≥1.5mm. An independent core-lab evaluated PET scans as abnormal/normal with optional analyst-dependent application of pre-specified criteria; summed stress score of ≥4 in ≥2 contiguous segments, vessel-specific myocardial blood flow (MBF) &lt;2.00 ml/g/min, global myocardial blood flow reserve ≤1.8, and/or transient ischemic dilatation ratio &gt;1.13. Obstructive CAD was defined as ICA with FFR ≤0.80 or high-grade stenosis (≥90% DS).

Results

In total, 445/1732 patients (25%) had suspected obstructive CAD on CTA of whom 400/445 patients (90%) underwent subsequent PET and ICA. CT-QFR was successfully analysed in 383/400 (96%) patients classifying 174/383 (45%) patients as having disease. In comparison, PET classified 130/383 (34%) patients as having disease. In total, obstructive CAD by ICA with FFR was identified in 162 (42%) patients.

There was no significant difference in area under the receiver-operating characteristic curves for CT-QFR compared to the best performing PET metric (lowest vessel-specific MBF); 0.84 (95% CI 0.80–0.89) vs. 0.81 (0.77–0.85), p=0.19)) (Fig. 1). Overall diagnostic accuracy of CT-QFR versus PET was similar (78% (95% CI 74–82) vs. 77% (72–81), p=0.70. Sensitivities for CT-QFR and PET were 78% (71–84) and 63% (55–70), p&lt;0.01, respectively, and specificities 78% (72–84) and 87% (82–91), p=0.01, respectively (Fig. 2). Three-vessel or left main disease on ICA was correctly identified in 30/31 patients by both CT-QFR and PET.

Conclusion

In patients with suspected obstructive CAD by CTA, second-line CT-QFR was non-inferior to PET for discriminating obstructive CAD by invasive FFR; Although diagnostic accuracy was similar, CT-QFR demonstrated higher sensitivity while PET showed higher specificity

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Aarhus University PhD fellowshipRegion Mid Health Research Foundation

Murray law-based quantitative flow ratio for assessment of left main bifurcation derived from a single fluoroscopic angiographic view as compared to FFRCT

Background

In patients with complex CAD, the presence of left main (LM) disease is an important prognostic factor in assessing the risk balance between PCI and CABG. Functional assessment has become standard of care to evaluate the significance of coronary stenosis and to justify the performance of PCI in the contemporary practice. FFRCT is a well-established method based on 3D reconstruction of coronary artery derived from CCTA. The Murray law-based quantitative flow reserve (μQFR) is a novel computational method of invasive angiography relying on a single angiographic view that takes into account side branches diameters to compute fractal flow division. The aim of the current analysis is to evaluate in patients with complex CAD the feasibility of μQFR in LM bifurcation and its diagnostic concordance with FFRCT. The impact of the optimal viewing angle defined by CCTA on the physiological assessment of the LM bifurcation using a single angiographic view was also evaluated.

Methods

In 299 consecutive patients with 3-vessel disease with or without LM coronary artery disease, up to 3 analyzable fluoroscopic projections per patient were analysed with μQFR retrospectively. FFRCT and μQFR were measured at 3 fiducial landmark points: i) point of LM bifurcation (POB); ii) proximal LAD 10 mm distal to POB; ii) proximal LCX 10 mm distal to POB. CCTA-based “optimal viewing angle” of LM bifurcation are computed by creating a 3-point closed spline involving the LM, LAD, and LCX at 5mm from the POB and subsequently by reconstructing the “en face” fluoroscopic viewing angle of the spline. The en face viewing angle provides an optimal assessment of the bifurcation geometry [1]. In terms of Rx gantry angulation, the closest angiographic projection to the optimal viewing angle derived from CCTA was defined as the “best fluoroscopic projection” for each patient.

Results

In 299 patients, 793 projections were analysed with μQFR and compared to FFRCT. Single view μQFR was analyzable in 100%. Correlation and agreement between μQFR and FFRCT for 793 projections in 299 patients are shown in Figure 1A, 2A. The Spearman's correlation coefficient showed moderate correlations at POB (r=0.481, p&lt;0.001) and LCX (r=0.584, p&lt;0.001), and strong correlation at LAD (r=0.642, p&lt;0.001). Correlation and agreement between μQFR and FFRCT for best projections from each patient are shown in Figure 1B, 2B. Correlations were improved in the best projections with the following Spearman's correlation coefficient: at POB (r=0.522, p&lt;0.001), LCX (r=0.622, p&lt;0.001), and LAD (r=0.695, p&lt;0.001).

Conclusion

Computation of μQFR from a single angiographic view has a high feasibility. Tailored optimal fluoroscopic view is essential for the physiological assessment of the LM bifurcation using a single angiographic view. Evaluation of diagnostic accuracy of μQFR warrants further analysis of the LMCAD after prospective planning of the optimal fluoroscopic view based on the selection of the best CCTA 3D view.

Funding Acknowledgement

Type of funding sources: None.

Umbilical Cord-derived Mesenchymal Stem Cells with Surfactant Protein B Alleviates Inflammatory Response in Acute Respiratory Distress Syndrome by Regulating Macrophage Polarization

Background:

Acute respiratory distress syndrome (ARDS) is a severe disorder that is related to a high mortality. Mesenchymal stem cells (MSCs) have shown strong effects in relieving lung injury.

Aims:

To determine the role of umbilical cord-derived MSCs (UC-MSCs) together with surfactant protein B (SP-B) in ARDS.

Study Design:

Animal experimentation.

Methods:

Immunophenotypic characteristics of UC-MSCs were identified. BALB/c mice were intratracheally administrated with lipopolysaccharide (LPS) and received UC-MSCs or UC-MSCs transfected with SP-B (UC-MSCs-SP-B). Pathological changes and lung injury degrees after transplantation were assessed by histological and biochemical analyses. Inflammatory chemokine and cytokine production in the bronchoalveolar lavage fluid (BALF) was measured using enzyme-linked immunoassay. Flow cytometry was used to examine macrophage phenotypes and differentiation of T-helper 17 (Th17) and T-regulatory (Treg) in the BALF.

Results:

Our results showed that isolated UC-MSCs possessed multilineage differentiation potential. SP-B transfection into UC-MSCs strengthened the effects of UC-MSCs on lung function repair in LPS-induced ARDS. UC-MSCs and UC-MSCs-SP-B attenuated cellular infiltration. Additionally, UC-MSCs and UC-MSCs-SP-B inhibited the inflammatory response by promoting M2-like polarization, as well as reduced Th17 differentiation and promoted Treg differentiation.

Conclusion:

UC-MSCs in combination with SP-B, alleviates inflammatory reaction in ARDS by regulating macrophage polarization.

Genetic variants associated with expression of TCF19 contribute to the risk of head and neck cancer in Chinese population

BACKGROUND

Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common cancers worldwide and includes cancers arising from the oral cavity, pharynx and larynx. Genome-wide association studies have found several genetic variants related to the risk of SCCHN; however, they could only explain a small fraction of the heritability. Thus, more susceptibility loci associated with SCCHN need to be identified.

METHODS

An association study was conducted by genotyping 555 patients with SCCHN and 1367 controls in a Chinese population. Single-variant association analysis was conducted on 63 373 SNPs, and the promising variants were then confirmed by a two-stage validation with 1875 SCCHN cases and 4637 controls. Bioinformatics analysis and functional assays were applied to uncover the potential pathogenic mechanism of the promising variants and genes associated with SCCHN.

RESULTS

We first identified three novel genetic variants significantly associated with the risk of SCCHN (p=7.45×10^-7 for rs2517611 at 6p22.1, p=1.76×10^-9 for rs2524182 at 6p21.33 and p=2.17×10^-10 for rs3131018 at 6p21.33). Further analysis and biochemical assays showed that rs3094187, which was in a region in high linkage disequilibrium with rs3131018, could modify TCF19 expression by regulating the binding affinity of the transcription factor SREBF1 to the promoter of TCF19. In addition, experiments revealed that the inhibition of TCF19 may affect several important pathways involved in tumourigenesis and attenuate the cell proliferation and migration of SCCHN.

CONCLUSION

These findings offer important evidence that functional genetic variants could contribute to development of SCCHN and that TCF19 may function as a putative susceptibility gene for SCCHN.

A two-in-one Janus NIR-II AIEgen with balanced absorption and emission for image-guided precision surgery

Fluorescence imaging in the near-infrared II (NIR-II, 1000-1700 nm) region opens up new avenues for biological systems due to suppressed scattering and low autofluorescence at longer-wavelength photons. Nonetheless, the development of organic NIR-II fluorophores is still limited mainly due to the shortage of efficient molecular design strategy. Herein, we propose an approach of designing Janus NIR-II fluorophores by introducing electronic donors with distinct properties into one molecule. As a proof-of-concept, fluorescent dye 2 TT-m, oC6B with both twisted and planar electronic donors displayed balanced absorption and emission which were absent in its parent compound. The key design strategy for Janus molecule is that it combines the merits of intense absorption from planar architecture and high fluorescence quantum yield from twisted motif. The resulting 2 TT-m, oC6B nanoparticles exhibit a high molar absorptivity of 1.12 ⨯104 M-1 cm-1 at 808 nm and a NIR-II quantum yield of 3.7%, displaying a typical aggregation-induced emission (AIE) attribute. The highly bright and stable 2 TT-m, oC6B nanoparticles assured NIR-II image-guided cancer surgery to resect submillimeter tumor nodules. The present study may inspire further development of molecular design philosophy for highly bright NIR-II fluorophores for biomedical applications.