Body mass index and the risk of all-cause mortality among patients with nonvalvular atrial fibrillation: a multicenter prospective observational study in China

BACKGROUND/OBJECTIVES

High body mass index (BMI) is associated with increased incident atrial fibrillation (AF) and mortality rate. In patients presenting with nonvalvular AF (NVAF), the prognostic relevance of BMI remains unclear.

SUBJECTS/METHODS

In this prospective observational study, a total of 1759 patients with NVAF (69.9±12.9 years old, 47.9% male) were divided into three clinical settings according to estimated stroke risks (CHADS₂ score ⩽1 (low), =2 (moderate) and ⩾3 (high)). The primary outcome was all-cause mortality, and the secondary outcomes included thromboembolism and major bleeding. Cox-proportional hazard models were used to estimate the association between BMI levels and clinical outcomes.

RESULTS

During a mean follow-up of 1 year representing 1974 patient-years at risk, 256 patients died, 142 suffered from thromboembolism and 17 developed major bleeding. Multivariate adjusted Cox analysis indicated that a BMI of 24.0-27.9 kg/m² was independently associated with improved survival among all patients (hazard ratio (HR) 0.689, 95% confidence interval (CI) 0.512-0.928; P=0.018) and patients at high stroke risk (HR 0.622, 95% CI 0.410-0.943; P=0.024), but not among those at low or moderate stroke risks. No associations were observed between BMI levels and the incidence of thromboembolic events in various clinical settings.

CONCLUSIONS

A paradoxical BMI-all-cause mortality risk association was observed in Chinese patients with NVAF, and this association was pronounced among patients at high stroke risk rather than in those at low stroke risk.

Secretome of Human Fetal Mesenchymal Stem Cell Ameliorates Replicative Senescen

Autologous mesenchymal stem cells (MSC) are widely used cell source for cell-based tissue repair and regeneration, but replicative senescence and the associated loss of cellular activity during in vitro expansion limit their therapeutic potential. How to preserve or even enhance the proliferation and differentiation ability of MSC from aged donors without genetic modification remains a challenge to meet clinical need. MSC isolated from human fetal tissues (hFMSC) exhibit higher proliferation and differentiation activities even in prolonged in vitro culture, which might be modulated by autocrine/paracrine action. In the present study, we hypothesized that the bioactive factors secreted by hFMSC, collectively named as hFMSC secretome (HFS), could possess beneficial effect on human adult MSC (hAMSC) undergoing replicative senescence, thus promoting their capability of proliferation and differentiation. HFS was prepared by centrifugation of hFMSC conditioned medium, followed by column-based concentration, and the total protein content of the HFS was quantified to standardize treatment concentration. When compared with hAMSC secretome (HAS), HFS treatment significantly reduced senescence associated-β-galactosidase expression and activity (senescence marker) and enhanced cell proliferation and osteogenic differentiation potential of hAMSC in prolonged in vitro culture. Cellular studies revealed concomitant activation of sirt1 and foxo3a in hAMSC after HFS treatment, which was associated with upregulation of p21 and downregulation of bax and p53. The changes of these senescence associated markers suggested that HFS, but not HAS, could ameliorate replicative senescence of hAMSC in vitro. In nude mice, HFS pretreatment restored the osteogenic ability of senescent hAMSC. Tumor xenograft model revealed that HFS did not promote tumor growth. In conclusion, this study suggests that HFS could be an effective and safe method to overcome replicative senescence and facilitate the therapeutic potential of hAMSC.

Sustainability assessment of greenhouse vegetable farming practices from environmental, economic, and socio-institutional perspectives in China

To provide growing population with sufficient food, greenhouse vegetable production has expanded rapidly in recent years in China and sustainability of its farming practices is a major concern. Therefore, this study assessed the sustainability of greenhouse vegetable farming practices from environmental, economic, and socio-institutional perspectives in China based on selected indicators. The empirical data were collected through a survey of 91 farm households from six typical greenhouse vegetable production bases and analysis of environmental material samples. The results showed that heavy fertilization in greenhouse vegetable bases of China resulted in an accumulation of N, P, Cd, Cu, Pb, and Zn in soil, nutrient eutrophication in irrigation water, and high Cd in some leaf vegetables cultivated in acidic soil. Economic factors including decreased crop yield in conventional farming bases, limited and site-dependent farmers' income, and lack of complete implementation of subsidy policies contributed a lot to adoption of heavy fertilization by farmers. Also, socio-institutional factors such as lack of unified management of agricultural supplies in the bases operated in cooperative and small family business models and low agricultural extension service efficiency intensified the unreasonable fertilization. The selection of cultivated vegetables was mainly based on farmers' own experience rather than site-dependent soil conditions. Thus, for sustainable development of greenhouse vegetable production systems in China, there are two key aspects. First, it is imperative to reduce environmental pollution and subsequent health risks through integrated nutrient management and the planting strategy of selected low metal accumulation vegetable species especially in acidic soil. Second, a conversion of cooperative and small family business models of greenhouse vegetable bases to enterprises should be extensively advocated in future for the unified agricultural supplies management and improved agricultural extension service efficiency, which in turn can stabilize vegetable yields and increase farmers' benefits.

The modulatory effect of semantic familiarity on the audiovisual integration of face-name pairs

To recognize individuals, the brain often integrates audiovisual information from familiar or unfamiliar faces, voices, and auditory names. To date, the effects of the semantic familiarity of stimuli on audiovisual integration remain unknown. In this functional magnetic resonance imaging (fMRI) study, we used familiar/unfamiliar facial images, auditory names, and audiovisual face-name pairs as stimuli to determine the influence of semantic familiarity on audiovisual integration. First, we performed a general linear model analysis using fMRI data and found that audiovisual integration occurred for familiar congruent and unfamiliar face-name pairs but not for familiar incongruent pairs. Second, we decoded the familiarity categories of the stimuli (familiar vs. unfamiliar) from the fMRI data and calculated the reproducibility indices of the brain patterns that corresponded to familiar and unfamiliar stimuli. The decoding accuracy rate was significantly higher for familiar congruent versus unfamiliar face-name pairs (83.2%) than for familiar versus unfamiliar faces (63.9%) and for familiar versus unfamiliar names (60.4%). This increase in decoding accuracy was not observed for familiar incongruent versus unfamiliar pairs. Furthermore, compared with the brain patterns associated with facial images or auditory names, the reproducibility index was significantly improved for the brain patterns of familiar congruent face-name pairs but not those of familiar incongruent or unfamiliar pairs. Our results indicate the modulatory effect that semantic familiarity has on audiovisual integration. Specifically, neural representations were enhanced for familiar congruent face-name pairs compared with visual-only faces and auditory-only names, whereas this enhancement effect was not observed for familiar incongruent or unfamiliar pairs. Hum Brain Mapp 37:4333-4348, 2016. © 2016 Wiley Periodicals, Inc.

[Analysis of clinical characteristics and risk of stroke and death within 1 year of patients with nonvalvular atrial fibrillation combined with diabetes mellitus]

OBJECTIVE

To explore the clinical characteristics and impact of diabetes mellitus (DM) on prognosis in patients with nonvalvular atrial fibrillation (AF).

METHODS

Data of nonvalvular AF patients in the Chinese Emergency Atrial Fibrillation Registry Study were retrospectively analyzed. The eligible patients were divided into the DM group and the non-DM group. Uni- and multi-variate Cox regression analysis were used to explore risk factors of 1-year outcomes.

RESULTS

A total of 1 644 patients were enrolled in the study with 227 patients combined with DM (16.8%). Compared with non-DM group, patients with DM were older and had higher body weight, had higher prevalence of myocardial infarction, coronary heart disease, hypertension and stroke, and were at higher risk of thromboembolism. The proportion of anticoagulant treatment was low in both groups (10.1% vs 7.4%, P=0.141). Compared with patients without DM, patients with DM had higher all-cause mortality (19.5% vs 12.7%, P=0.004), cardiovascular death (10.8% vs 7.02%, P=0.047) and combined end events (CEE, 26.4% vs 2.4%, P=0.023), while with comparable incidence of stroke (10.1% vs 7.4%, P=0.141). Multi-variate Cox regression analysis showed that DM was an independent risk factor for 1-year all-cause mortality (HR=1.558, 95% CI 1.126-2.156), cardiovascular death (HR=1.615, 95% CI 1.052-2.479) and CEE (HR=1.523, 95% CI 1.098-2.112), while not for stroke (HR=1.523, 95% CI 1.098-2.112).

CONCLUSION

DM is the independent risk factor for all-cause mortality, cardiovascular death and combined end events in patients with nonvalvular AF, while not a predictor for the occurrence of stroke.

Structure of A-C Type Intervariant Interface in Nonmodulated Martensite in a Ni-Mn-Ga Alloy

The structure of A-C type intervariant interface in nonmodulated martensite in the Ni54Mn25Ga21 alloy was studied using high resolution transmission electron microscopy. The A-C interface is between the martensitic variants A and C, each of which has a nanoscale substructure of twin-related lamellae. According to their different thicknesses, the nanoscale lamellae in each variant can be classified into major and minor lamellae. It is the boundaries between these lamellae in different variants that constitute the A-C interface, which is thus composed of major-major, minor-minor, and major-minor lamellar boundaries. The volume fraction of the minor lamellae, λ, plays an important role in the structure of A-C interfaces. For major-major and minor-minor lamellar boundaries, they are symmetrical or asymmetrical tilt boundaries; for major-minor boundary, as λ increases, it changes from a symmetrical tilt boundary to two asymmetrical microfacets. Moreover, both lattice and misfit dislocations were observed in the A-C interfaces. On the basis of experimental observations and dislocation theory, we explain how different morphologies of the A-C interface are formed and describe the formation process of the A-C interfaces from λ ≈ 0 to λ ≈ 0.5 in terms of dislocation-boundary interaction, and we infer that low density of interfacial dislocations would lead to high mobility of the A-C interface.

Metal-Templated Design: Enantioselective Hydrogen-Bond-Driven Catalysis Requiring Only Parts-per-Million Catalyst Loading

Based on a metal-templated approach using a rigid and globular structural scaffold in the form of a bis-cyclometalated octahedral iridium complex, an exceptionally active hydrogen-bond-mediated asymmetric catalyst was developed and its mode of action investigated by crystallography, NMR, computation, kinetic experiments, comparison with a rhodium congener, and reactions in the presence of competing H-bond donors and acceptors. Relying exclusively on weak forces, the enantioselective conjugate reduction of nitroalkenes can be executed at catalyst loadings as low as 0.004 mol% (40 ppm), representing turnover numbers of up to 20 250. A rate acceleration by the catalyst of 2.5 × 10(5) was determined. The origin of the catalysis is traced to an effective stabilization of developing charges in the transition state by carefully orchestrated hydrogen-bonding and van der Waals interactions between catalyst and substrates. This study demonstrates that the proficiency of asymmetric catalysis merely driven by hydrogen-bonding and van der Waals interactions can rival traditional activation through direct transition metal coordination of the substrate.

Serum uric acid level and left ventricular hypertrophy in elderly male patients with nonvalvular atrial fibrillation

BACKGROUND AND AIMS

Recent studies have suggested that serum uric acid (SUA) induces oxidative stress and inflammation, which are involved in the mechanism of cardiac hypertrophy. In patients with atrial fibrillation (AF), comorbidity of left ventricular hypertrophy (LVH) exacerbates cardiac function. In this study, we investigated the association between SUA and cardiac hypertrophy in AF patients.

METHODS AND RESULTS

Initially, 1296 consecutive elderly patients (age >60) with nonvalvular AF were retrospectively selected from the inpatient clinic between January 2012 and April 2015. Demographic, clinical, and echocardiographic characteristics were carefully recorded. The final study population was 577 patients. The mean SUA level was significantly higher in patients with LVH than those without LVH. Compared with the non-LVH group, the LVH group was older, had a higher percentage of female patients, and had lower hemoglobin levels and estimated glomerular filtration rates. Patients in the LVH group also had a higher rate of coronary heart disease and fewer had history of radiofrequency ablation compared with the non-LVH group. In the hyperuricemia group, B-type natriuretic peptide levels, left atrial diameter, left ventricular mass index, and percentage of NYHA (New York Heart Association) class III/IV were significantly higher than the SUA normal group. Multivariate logistic regression analysis indicated the independent risk factors for LVH in elderly AF patients included SUA, age, male sex, the presence of coronary heart disease, and diuretic therapy. Subgroup analysis identified SUA as a significant risk factor associated with LVH in men.

CONCLUSIONS

SUA was independently associated with LVH in elderly male patients with nonvalvular AF.

Discriminative analysis of schizophrenia using support vector machine and recursive feature elimination on structural MRI images

Structural abnormalities in schizophrenia (SZ) patients have been well documented with structural magnetic resonance imaging (MRI) data using voxel-based morphometry (VBM) and region of interest (ROI) analyses. However, these analyses can only detect group-wise differences and thus, have a poor predictive value for individuals. In the present study, we applied a machine learning method that combined support vector machine (SVM) with recursive feature elimination (RFE) to discriminate SZ patients from normal controls (NCs) using their structural MRI data. We first employed both VBM and ROI analyses to compare gray matter volume (GMV) and white matter volume (WMV) between 41 SZ patients and 42 age- and sex-matched NCs. The method of SVM combined with RFE was used to discriminate SZ patients from NCs using significant between-group differences in both GMV and WMV as input features. We found that SZ patients showed GM and WM abnormalities in several brain structures primarily involved in the emotion, memory, and visual systems. An SVM with a RFE classifier using the significant structural abnormalities identified by the VBM analysis as input features achieved the best performance (an accuracy of 88.4%, a sensitivity of 91.9%, and a specificity of 84.4%) in the discriminative analyses of SZ patients. These results suggested that distinct neuroanatomical profiles associated with SZ patients might provide a potential biomarker for disease diagnosis, and machine-learning methods can reveal neurobiological mechanisms in psychiatric diseases.

Measurement of the Transverse Single-Spin Asymmetry in p^{↑}+p→W^{±}/Z^{0} at RHIC

We present the measurement of the transverse single-spin asymmetry of weak boson production in transversely polarized proton-proton collisions at sqrt[s]=500  GeV by the STAR experiment at RHIC. The measured observable is sensitive to the Sivers function, one of the transverse-momentum-dependent parton distribution functions, which is predicted to have the opposite sign in proton-proton collisions from that observed in deep inelastic lepton-proton scattering. These data provide the first experimental investigation of the nonuniversality of the Sivers function, fundamental to our understanding of QCD.

[Clinical characteristics and outcomes of patients with acute aortic dissection: impact of hypertension]

OBJECTIVE

To observe the clinical characteristics and outcomes of patients with acute aortic dissection (AAD) and explore the impact of hypertension.

METHODS

The present study enrolled 1 087 consecutive patients with AAD who were confirmed by computed tomographic scanning in Fuwai Hospital from January 2008 to December 2010. The major endpoints were in-hospital death and long-term mortality during follow up.

RESULTS

A total of 595 (54.7%) patients were Stanford type A and 492 (45.3%) patients were Stanford type B. The median length of follow-up was 24.2 months (interquartile range 10.9, 40.8 months). The prevalence of hypertension was 67.4%(733 cases), and was significantly higher in type B patients than in type A patients (71.3%(351/492) vs. 64.2%(382/595), P=0.01). Regardless of Stanford classification, patients complicating with hypertension were older, had higher comorbidities (coronary heart diseases or diabetes), and less likely to receive surgical treatment compared with those without hypertension (all P<0.05). In Stanford type A AAD group, patients with hypertension had higher levels of admission blood pressure, serum creatinine and inflammatory markers (including WBC count, D-dimer and CRP) than those without hypertension (all P<0.05). In-hospital death (9.9% (38/382)vs. 5.6%(12/213), P=0.07) and long-term mortality (9.0% (31/344) vs. 8.9% (18/201), P=0.98) were similar in hypertensive and normotensive AAD type A patients. In type B AAD group, the in-hospital death rate was significantly higher in patients with hypertension than those without hypertension (5.4%(19/351) vs. 0.7%(1/141), P=0.02), while the long-term mortality was similar (6.9%(23/332) vs. 7.9%(11/140), P=0.71) between patients with and without hypertension. Multiple logistic regression analysis showed that hypertension did not predict the increased risk of in-hospital death of type A or type B AAD patients. The main protective factor of in-hospital mortality was operation in patients with type A AAD. The independent predictors of in-hospital death were age and surgical treatment in patients with type B AAD.

CONCLUSIONS

Hypertension is a common co-morbidity in patients with AAD. AAD patients with hypertension are usually elder, have higher comorbidities of cardiovascular diseases, and less likely to receive surgical treatment compared with those without hypertension, but hypertension is not associated with increased risk of in-hospital and long-term mortality in both AAD type A and type B patients.

Beam Energy Dependence of the Third Harmonic of Azimuthal Correlations in Au+Au Collisions at RHIC

We present results from a harmonic decomposition of two-particle azimuthal correlations measured with the STAR detector in Au+Au collisions for energies ranging from sqrt[s_{NN}]=7.7 to 200 GeV. The third harmonic v_{3}^{2}{2}=⟨cos3(ϕ_{1}-ϕ_{2})⟩, where ϕ_{1}-ϕ_{2} is the angular difference in azimuth, is studied as a function of the pseudorapidity difference between particle pairs Δη=η_{1}-η_{2}. Nonzero v_{3}^{2}{2} is directly related to the previously observed large-Δη narrow-Δϕ ridge correlations and has been shown in models to be sensitive to the existence of a low viscosity quark gluon plasma phase. For sufficiently central collisions, v_{3}^{2}{2} persist down to an energy of 7.7 GeV, suggesting that quark gluon plasma may be created even in these low energy collisions. In peripheral collisions at these low energies, however, v_{3}^{2}{2} is consistent with zero. When scaled by the pseudorapidity density of charged-particle multiplicity per participating nucleon pair, v_{3}^{2}{2} for central collisions shows a minimum near sqrt[s_{NN}]=20  GeV.

Intrinsic Two-Dimensional Organic Topological Insulators in Metal-Dicyanoanthracene Lattices

We predict theoretical existence of intrinsic two-dimensional organic topological insulator (OTI) states in Cu-dicyanoanthracene (DCA) lattice, a system that has also been grown experimentally on Cu substrate, based on first-principle density functional theory calculations. The pz-orbital Kagome bands having a Dirac point lying exactly at the Fermi level are found in the freestanding Cu-DCA lattice. The tight-binding model analysis, the calculated Chern numbers, and the semi-infinite Dirac edge states within the spin-orbit coupling gaps all confirm its intrinsic topological properties. The intrinsic TI states are found to originate from a proper number of electrons filling of the hybridized bands from Cu atomic and DCA molecular orbitals based on which similar lattices containing noble metal atoms (Au and Cu) and those molecules with two CN groups (DCA and cyanogens) are all predicted to be intrinsic OTIs.

New results on the robust stability of PID controllers with gain and phase margins for UFOPTD processes

This paper considers the problem of determining all the robust PID (proportional-integral-derivative) controllers in terms of the gain and phase margins (GPM) for open-loop unstable first order plus time delay (UFOPTD) processes. It is the first time that the feasible ranges of the GPM specifications provided by a PID controller are given for UFOPTD processes. A gain and phase margin tester is used to modify the original model, and the ranges of the margin specifications are derived such that the modified model can be stabilized by a stabilizing PID controller based on Hermite-Biehlers Theorem. Furthermore, we obtain all the controllers satisfying a given margin specification. Simulation studies show how to use the results to design a robust PID controller.

Long non-coding antisense RNA KRT7-AS is activated in gastric cancers and supports cancer cell progression by increasing KRT7 expression

Alterations in long non-coding RNAs (lncRNAs) are associated with human carcinogenesis. One group of lncRNAs, which are antisense in orientation to coding mRNAs (ASs), have been recently described in cancers but are poorly understood. We sought to identify ASs involved in human gastric cancer (GC) and to elucidate their mechanisms of action in carcinogenesis. We performed massively parallel RNA sequencing in GCs and matched normal tissues, as well as in GC-derived and normal gastric epithelial cell lines. One AS, designated Homo sapiens keratin 7 (KRT7-AS), was selected due to its marked upregulation and concordant expression with its cognate sense counterpart, KRT7, in GC tissues and cell lines. KRT7-AS formed an RNA-RNA hybrid with KRT7 and controlled KRT7 expression at both the mRNA and the post-transcriptional levels. Moreover, forced overexpression of the KRT7-overlapping region (OL) of KRT7-AS (but not its non-KRT7-OL portions) increased keratin 7 protein levels in cells. Finally, forced overexpression of full-length KRT7-AS or OL KRT7-AS (but not its non-KRT7-OL regions) promoted GC cell proliferation and migration. We conclude that lncRNA KRT7-AS promotes GC, at least in part, by increasing KRT7 expression.

Centrality and Transverse Momentum Dependence of Elliptic Flow of Multistrange Hadrons and ϕ Meson in Au+Au Collisions at √[sNN]=200 GeV

We present high precision measurements of elliptic flow near midrapidity (|y|<1.0) for multistrange hadrons and ϕ meson as a function of centrality and transverse momentum in Au+Au collisions at center of mass energy √[sNN]=200  GeV. We observe that the transverse momentum dependence of ϕ and Ω v2 is similar to that of π and p, respectively, which may indicate that the heavier strange quark flows as strongly as the lighter up and down quarks. This observation constitutes a clear piece of evidence for the development of partonic collectivity in heavy-ion collisions at the top RHIC energy. Number of constituent quark scaling is found to hold within statistical uncertainty for both 0%-30% and 30%-80% collision centrality. There is an indication of the breakdown of previously observed mass ordering between ϕ and proton v2 at low transverse momentum in the 0%-30% centrality range, possibly indicating late hadronic interactions affecting the proton v2.