Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

OBJECTIVES

Prediction of embolic events (EEs) in infective endocarditis (IE) could inform clinical decisions, such as surgical timing. We conducted a systematic review to more precisely define associations between risk factors and EEs.

METHODS

We searched two bibliographic databases (1994-2018) for observational studies that reported EEs in IE patients and considered clinical, microbiological or echocardiographic risk factors. Studies that did not use Duke criteria or only investigated a subset of IE patients were excluded. Study quality was assessed using the Newcastle-Ottawa scale. A pooled risk ratio (RR) for each risk factor was estimated using random-effects models; statistical heterogeneity was estimated using I².

RESULTS

Of 3862 unique citations, 47 cohort studies (11 215 IE cases) were included; 54 risk factors were analysed in at least two studies, with nine studies reporting other individual factors. Most studies were of high methodological quality. Major predictors of EEs were intravenous drug use (RR 1.69, 95% CI 1.32-2.17; I² = 46%), Staphylococcus aureus infection (RR 1.64, 95% CI 1.45-1.86, I² = 32%), mitral valve vegetation (RR 1.24, 95% CI 1.11-1.37, I² = 30%), and vegetation size >10 mm (RR 1.87, 95% CI 1.57-2.21, I² = 48%). EE risk was also higher with human immunodeficiency virus, chronic liver disease, elevated C-reactive protein, Staphylococcus spp. infection, vegetation presence, and multiple, mobile or prosthetic mechanical valve vegetation, and lower with Streptococcus spp. infection. Most findings were unchanged in sensitivity analyses that removed studies with pulmonary EEs from the outcome.

CONCLUSIONS

Given the serious consequences of embolism, surgical evaluation may be considered in patients with these risk factors.

Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study

BACKGROUND

Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention.

METHOD

A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis.

RESULTS

Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course.

CONCLUSIONS

A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Identification and interaction analysis of key genes and microRNAs in atopic dermatitis by bioinformatics analysis

BACKGROUND

Atopic dermatitis (AD) is a skin disease that carries a major health burden, but the exact mechanism of the disease is not yet known.

AIM

To identify the key genes and micro (mi)RNAs in AD, and to explore their potential molecular mechanisms.

METHODS

From the Gene Expression Omnibus (GEO) database, we downloaded microarray data for GSE32924 (mRNA profile) and GSE31408 (miRNA profile), which were analysed using GEO2R. Functional and pathway enrichment analyses were performed using the DAVID database, and the protein-protein interaction network was constructed with Cytoscape software. In addition, targets of differentially expressed miRNAs (DEMs) were predicted by the online resource miRDB.

RESULTS

In total, 328 differentially expressed genes (DEGs) were identified, including 121 upregulated and 207 downregulated genes. Gene Ontology analyses showed that upregulated genes were significantly enriched in immune responses, while downregulated genes were mainly involved in epidermis development. In addition, we identified three DEMs, all of which were downregulated. Hsa-let-7a-5p may target CCR7, and hsa-miR-26a-5p probably targets HAS3.

CONCLUSIONS

We identified lists of DEGs and DEMs in AD. Bioinformatics and interaction analysis may provide new clues for further studies of AD.

Remotely Assessing Fraction of Photosynthetically Active Radiation (FPAR) for Wheat Canopies Based on Hyperspectral Vegetation Indexes

Fraction of photosynthetically active radiation (FPAR), as an important index for evaluating yields and biomass production, is key to providing the guidance for crop management. However, the shortage of good hyperspectral data can frequently result in the hindrance of accurate and reliable FPAR assessment, especially for wheat. In the present research, aiming at developing a strategy for accurate FPAR assessment, the relationships between wheat canopy FPAR and vegetation indexes derived from concurrent ground-measured hyperspectral data were explored. FPAR revealed the most strongly correlation with normalized difference index (NDI), and scaled difference index (N^*). Both NDI and N^* revealed the increase as the increase of FPAR; however, NDI value presented the stagnation as FPAR value beyond 0.70. On the other hand, N^* showed a decreasing tendency when FPAR value was higher than 0.70. This special relationship between FPAR and vegetation index could be employed to establish a piecewise FPAR assessment model with NDI as a regression variable during FPAR value lower than 0.70, or N^* as the regression variable during FPAR value higher than 0.70. The model revealed higher assessment accuracy up to 16% when compared with FPAR assessment models based on a single vegetation index. In summary, it is feasible to apply NDI and N^* for accomplishing wheat canopy FPAR assessment, and establish an FPAR assessment model to overcome the limitations from vegetation index saturation under the condition with high FPAR value.

Analysis of Different Hyperspectral Variables for Diagnosing Leaf Nitrogen Accumulation in Wheat

Hyperspectral remote sensing is a rapid non-destructive method for diagnosing nitrogen status in wheat crops. In this study, a quantitative correlation was associated with following parameters: leaf nitrogen accumulation (LNA), raw hyperspectral reflectance, first-order differential hyperspectra, and hyperspectral characteristics of wheat. In this study, integrated linear regression of LNA was obtained with raw hyperspectral reflectance (measurement wavelength = 790.4 nm). Furthermore, an exponential regression of LNA was obtained with first-order differential hyperspectra (measurement wavelength = 831.7 nm). Coefficients (R²) were 0.813 and 0.847; root mean squared errors (RMSE) were 2.02 g·m^-2 and 1.72 g·m^-2; and relative errors (RE) were 25.97% and 20.85%, respectively. Both the techniques were considered as optimal in the diagnoses of wheat LNA. Nevertheless, the better one was the new normalized variable (SD_r - SD_b)/(SD_r + SD_b), which was based on vegetation indices of R² = 0.935, RMSE = 0.98, and RE = 11.25%. In addition, (SD_r - SD_b)/(SD_r + SD_b) was reliable in the application of a different cultivar or even wheat grown elsewhere. This indicated a superior fit and better performance for (SD_r - SD_b)/(SD_r + SD_b). For diagnosing LNA in wheat, the newly normalized variable (SD_r - SD_b)/(SD_r + SD_b) was more effective than the previously reported data of raw hyperspectral reflectance, first-order differential hyperspectra, and red-edge parameters.

Binder-free Sn–Si heterostructure films for high capacity Li-ion batteries

This study fabricated and demonstrated a functional, stable electrode structure for a high capacity Li-ion battery (LIB) anode. Effective performance is assessed in terms of reversible lithiation for a significant number of charge–discharge cycles to 80% of initial capacity. The materials selected for this study are silicon and tin and are co-deposited using an advanced manufacturing technique (plasma-enhanced chemical vapour deposition), shown to be a scalable process that can facilitate film growth on 3D substrates. Uniform and hybrid crystalline–amorphous Si nanowire (SiNW) growth is achieved via a vapour–liquid–solid mechanism using a Sn metal catalyst. SiNWs of less than 300 nm diameter are known to be less susceptible to fracture and when grown this way have direct electrical conductivity to the current collector, with sufficient room for expansion. Electrochemical characterisation shows stable cycling at capacities of 1400 mA h g⁻¹ (>4 × the capacity limit of graphite). This hybrid system demonstrates promising electrochemical performance, can be grown at large scale and has also been successfully grown on flexible carbon paper current collectors. These findings will have impact on the development of flexible batteries and wearable energy storage.

This study fabricated and demonstrated a functional, stable electrode structure for a high capacity Li-ion battery (LIB) anode.

Hemispheric asymmetry of the frontolimbic cortex in young adults with borderline personality disorder

OBJECTIVE

Although the frontolimbic cortex has been implicated in borderline personality disorder (BPD), information about possible asymmetries in this region in patients with BPD is limited. This study aimed to examine whether frontolimbic cortex asymmetries differ between patients with BPD and healthy individuals.

METHODS

The brains of 30 young adult patients with BPD and 32 healthy control subjects were scanned with magnetic resonance imaging (MRI). The participants completed self-report scales assessing impulsivity, affect intensity and other psychological variables. Gray matter volume, surface area, and cortical thickness in regions of interest (ROIs), namely anterior insula (AI) and anterior cingulate cortex (ACC) were determined and the data were probed for hemisphere-group interactions.

RESULTS

Relative to controls, patients with BPD had reduced cortical thickness in left ACC and less surface area and gray matter volume in left AI. Significant group-hemisphere interactions were observed for gray matter volume and surface area of AI and for cortical thickness of ACC. Post hoc analysis showed that the BPD patients had greater frontolimbic cortex asymmetry than healthy controls; furthermore, greater asymmetry of AI&ACC correlated with a higher score in attention subscale of Barratt Impulsiveness Scale.

CONCLUSION

Patients with BPD have greater frontolimbic asymmetry than healthy individuals.

Extracellular matrix protein 1 promotes cell metastasis and glucose metabolism by inducing integrin β4/FAK/SOX2/HIF-1α signaling pathway in gastric cancer

Extracellular matrix protein 1 (ECM1) is related to strong invasiveness and poor prognosis in major malignancies, but the underlying mechanism remains unknown. Here we aimed to elucidate the function of ECM1 on cell metastasis and glucose metabolism in gastric cancer (GC). The level of ECM1 in sera and tissues of patient with GC were positively correlated with tumor invasion and recurrence. Genetic manipulation of ECM1 expression affected cell metastasis and glucose metabolism in GC cell lines. Enhanced ECM1 expression facilitated gene expression levels associated with epithelial-mesenchymal transition (EMT) and glucose metabolism. Interestingly, our results indicated that ECM1 directly interacted with integrin β4 (ITGB4) and activated ITGB4/focal adhesion kinase (FAK)/glycogen synthase kinase 3β signaling pathway, which further induced the expression of transcription factor SOX2. Aberrant expression of SOX2 altered gene expression of EMT factors and glucose metabolism enzymes. Furthermore, SOX2 enhanced hypoxia-inducible factor α (HIF-1α) promoter activity to regulate glucose metabolism. The micro-positron emission tomography/computed tomography imaging of xenograft model showed that ECM1 substantially increased ¹⁸F-fluorodeoxyglucose uptake in xenograft tumors. Using in vivo mouse tail vein injection experiments, ECM1 was also found to increase in lung surface metastasis. These findings provide evidence that ECM1 regulates GC cell metastasis and glucose metabolism by inducing ITGB4/FAK/SOX2/HIF-1α signal pathway and have important implications for the development of therapeutic target to prevent tumor metastasis and recurrence.

Astaxanthin increases radiosensitivity in esophageal squamous cell carcinoma through inducing apoptosis and G2/M arrest

Nowadays esophageal squamous cell carcinoma (ESCC) is primarily treated by a comprehensive approach combining surgical resection and neoadjuvant chemo- or radiotherapy. However, ESCC is resistant to radiation therapy, resulting in its invasion, infiltration, and metastasis. It usually has rapidly progressed and has a poor outcome clinically. The purpose of this study is to determine the potential radiosensitizing effect of astaxanthin (ATX) and explore the underlying mechanisms in ESCC cells in vitro. ESCC cell lines were exposure to irradiation, in the presence or absence of ATX treatment. Cell viability and radiosensitization were tested by CCK8 assay and clonogenic survival assay, respectively. Cell apoptosis and the changes of cell cycle distribution were observed by flow cytometry. The protein expression of Bcl2, Bax, CyclinB1, and Cdc2 was examined by western blot analysis. It was shown that ATX improved radiosensitivity of ESCC cells and induced apoptosis and G2/M arrest via inhibiting Bcl2, CyclinB1, Cdc2, and promoting Bax expression. In conclusion, ATX might function as a promising radiosensitizer in ESCC cells by leading to apoptosis and G2/M arrest.