Dual-source signal amplification electrochemiluminescence sensor combined with molecularly imprinted polymers for the imidacloprid detection

A novel lanthanide metal-organic-gel (MOG)-derived material/nitrogen-doped graphdiyne (Tb-Ru-MOG/CeO2/N-GDY) composite with a dual-source signal amplification strategy was prepared and used to construct a molecularly imprinted sensor based on bifunctional monomers for the detection of imidacloprid (IMI) using electrochemiluminescence (ECL). In a green reaction environment, terbium (III) (Tb3+) can undergo multiple coordination reactions with 4'-(4-carboxyphenyl)-2,2':6',2″-terpyridine (Hcptpy) and tris(4,4'-dicarboxylicacid-2,2'-bipyridyl) ruthenium (II) dichloride (Ru(dcbpy)32+), and combine with ceria nanoparticles (CeO2 NPs) to form Tb-Ru-MOG/CeO2. Within the Tb-Ru-MOG/CeO2 framework, energy transfer from the double ligands can sensitize the central Tb3+, triggering a distinct antenna effect and energy-transfer, and its polyporous configuration offered a nanoconfined space for Ce3+/Ce4+ to effectively catalyze coreactant radicals (S2O82-), leading to in-situ endogenous activation ECL reactions. The conductive N-GDY accelerated electron movement and increased the loading on the electrode surface, enhancing the exogenous excitation of the ECL signals. Leveraging the synergistic effect of the bifunctional monomer, the synthesized molecularly imprinted polymers (MIPs) ECL sensor demonstrated a wide detection range from 10 nM to 10,000 nM for IMI, with a limit of detection (LOD) of 1.37 nM, showcasing an innovative concept for the dual-source strategy of signal amplification in integrated ECL composites to analyze food and environmental hazards.

Meta-analysis of the correlation between pulmonary hypertension and echocardiographic parameters in patients with chronic kidney disease

Objective

To investigate the correlation between pulmonary hypertension (PH) and echocardiographic parameters in patients with chronic kidney disease (CKD).

Methods

PubMed, Embase, Web of Science, Cochrane, VIP, CNKI, and Wanfang databases were systematically searched for articles published from inception to 19 May 2023. Study quality was estimated using the Quality Assessment of Case-Control Studies tool. Forest plots were drawn using R language software. The "metacor" function in the "meta" package was utilized for meta-analysis of the r-values and their standard errors. Heterogeneity and sensitivity analyses were carried out, with the main outcomes as r-value, p-value, and I2 value.

Results

Eleven studies were included, with 1,809 CKD patients. The correlations between 12 echocardiographic parameters and PH were analyzed. Except for FS and LVEF which were negatively correlated with CKD-PH, the other 10 parameters were positively correlated with CKD-PH. Among them, LA was highly correlated with CKD-PH (0.70 < r < 0.89); LVDD, RA, RV, LVMI, and LVDS were moderately correlated with CKD-PH (0.40 < r < 0.69); while PA, IVS, LVPW, SV, FS, and LVEF were lowly correlated with CKD-PH (0.20 < r < 0.39). The synthesized estimates were stable against heterogeneity.

Conclusion

CKD-PH patients may have large cardiac chambers, thickened septal tissue on both sides of the chambers, reduced pulmonary artery flow rates, and decreased left ventricular function.

Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo Liver Resection and Autotransplantation

BACKGROUND Hepatic cystic echinococcosis (HCE) is a frequently overlooked parasitic liver disease, for which the commonly recommended treatment is radical resection. However, this approach is often associated with severe comorbidities such as HBV/HCV, cirrhosis, and hepatic carcinoma, among others. CASE REPORT In this report, we present a case successfully managed by ex vivo liver resection and autologous liver transplantation (ELRA). In the described case, ex vivo resection was not feasible due to recurrent lesions and infections invading the portal vein, which resulted in portal vein cavernous transformation. CONCLUSIONS Through this paper, we aim to detail the treatment process, showcasing the feasibility and advantages of ELRA. Additionally, we propose a novel approach for the treatment of this disease, while emphasizing the importance of radical resection surgery to prevent long-term complications.

Safety and clinical efficacy of immune checkpoint inhibitors in advanced gastric cancer in the real world

BACKGROUND

To evaluate the clinical efficacy and safety of immune checkpoint inhibitors in patients with advanced gastric cancer in the real world.

METHODS

The retrospective analysis was conducted on the clinical records of 402 patients with advanced gastric cancer who were admitted to the Nanjing Drum Tower Hospital between December 2017 and April 2022 and who had received immunotherapy. Observation target: drug use, treatment, adverse reaction type and grade, objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), and overall survival (OS).

RESULTS

By retrospectively analyzing the data of patients with advanced gastric cancer treated with ICIs previously admitted to our medical center, we found some clinical characteristic factors associated with the occurrence of irAEs as well as the efficacy and prognosis: the presence or absence of hypertension, whether or not to receive targeted therapies can predict the occurrence of immune-related adverse events (irAEs), and the more the presence of irAEs, the better the prognosis. These can help clinicians in clinical drug selection.

CONCLUSIONS

The results of this paper show that the occurrence of irAEs is associated with patients' OS. irAEs occurrence can prolong patients' OS. irAEs occurrence may serve as a surrogate marker for ICIs.

Case report: A case of advanced gastric cancer with multiple skin metastases, with significant relief from immunotherapy

Gastric cancer is the fifth leading cause of cancer-related mortality worldwide, with a low 5-year survival rate in advanced stages. Cutaneous metastasis is rare in gastric cancer, with only 0.8-1% incidence. We reported a rare case of female gastric cancer. The patient had undergone subtotal gastrectomy and chemotherapy 13 years ago, followed by a subsequent surgery of residual stomach, partial jejunum, and partial colon resection 11 years later. The pathological examination revealed poorly differentiated stomach adenocarcinoma, Lauren classification: diffuse type. The patient received 2 cycles of SOX chemotherapy. Two years later, cauliflower-like skin nodules, which were surgically excised, appeared on the back. The histopathological examination showed a spindle cell tumor; no specific anti-tumor treatment was administered. Six months later, the skin lesions increased in size and number, spreading to the neck, chest, and abdomen, presenting as erythematous patches with some cauliflower-like elevations. A skin biopsy of a 1cm0.5cm0.3cm lesion on the left abdomen was performed, and based on the immunohistochemistry, clinical history, and the possibility of metastatic or infiltrating adenocarcinoma, the gastrointestinal origin was highly suspected. Genetic testing was performed on the gastric recurrence and skin lesions, revealing 103 shared genetic variations, further suggesting the skin metastasis originated from gastric cancer. Subsequently, the patient received 10 cycles of immunotherapy combined with intravenous chemotherapy (200mg Tislelizumab and 100mg albumin-bound paclitaxel). The treatment response was evaluated as partial remission, with significant improvement in the skin lesions compared to before. This case highlights the possibility of tumor metastasis in patients with extensive skin lesions in advanced gastric cancer. Early examination, diagnosis, skin biopsy, immunohistochemistry, and genetic sequencing are recommended.

Dual decline in subjective gait speed and domain-specific cognition is associated with higher risk of incident dementia in older Japanese adults: A 15-year age-specific cohort study

OBJECTIVES

Dual decline in gait speed and cognition has been found to have higher dementia risk than no decline or pure decline. However, evidence from the Asian population is lacking. Therefore, we aimed to investigate the association of dual decline from age 65 to 70 years with late-life dementia in older Japanese adults with different personal characteristics.

METHODS

Data were collected from an age-specific cohort study conducted in 482 Japanese 65-year-old adults. We investigated participant demographics, medical histories, lifestyles, subjective gait speed, and cognition at both 64/65 and 70/71 years old, and confirmed dementia until age of 85 years. Cox proportion hazard models were used to estimate the risk of dementia, with adjustments for covariates, and death was treated as a competing risk.

RESULTS

After a mean follow-up period of 12.5-years, 111 participants developed dementia. Older adults with dual decline are more likely to have hyperlipidemia, diabetes, and smoking habits. And we found that dual decline in gait speed and domain-specific cognition was associated with a higher risk of dementia compared with no decline in most cognitive tests, with the highest risk observed for gait speed combined with memory (sub-distribution hazard ratio:3.89, 95 %, confidence intervals: [1.68-9.01]). However, significant differences only existed in men after stratification by sex.

CONCLUSIONS

A dual decline in subjective gait speed and cognition may serve as a robust predictor of dementia over a decade prior to its onset, particularly in men. These findings highlighted the importance of screening for dual decline at an early age.

The association of lipoprotein (a) with coronary artery calcification: A systematic review and meta-analysis

BACKGROUND AND AIMS

Coronary artery calcification (CAC) is a crucial pathophysiological characteristic of atherosclerosis. The association between lipoprotein (a) [Lp(a)] and CAC is inconsistent. We aimed to assess the relationship between Lp(a) and CAC by exploring the association between elevated Lp(a) and CAC prevalence, the relationship between Lp(a) level and CAC prevalence, and the correlation between elevated Lp(a) and CAC progression.

METHODS

We searched the PubMed, Web of Science, and EMBASE databases up to November 01, 2023. Studies exploring the association between serum Lp(a) and CAC (quantified using the Agatston score) were included. Association between Lp(a) level or elevated Lp(a) (higher than the cutoff values of 30 mg/dL, 50 mg/dL, or the highest quartile ranging from 33 to 38.64 mg/dL) and prevalence [CAC score >0 or >100, log (CAC score+1) >0] or progression (an increase in CAC score >0 or ≥100) of CAC were analysed. Odds ratios and 95% confidence intervals were calculated using a random-effects model.

RESULTS

40,073 individuals from 17 studies were included. Elevated Lp(a) was associated with a higher prevalence of CAC (OR, 1.31; 95% CI, 1.06 to 1.61; p = 0.01). As a continuous variable, Lp(a) level was positively correlated with the prevalence of CAC (OR, 1.05; 95% CI, 1.02 to 1.08; p = 0.003). Furthermore, elevated Lp(a) was associated with greater CAC progression (OR, 1.54; 95% CI, 1.23 to 1.92; p = 0.0002).

CONCLUSIONS

This meta-analysis suggested that Lp(a) is associated with prevalence and progression of CAC. Further studies are required to explore whether Lp(a)-lowering therapy could prevent or inhibit CAC, ultimately reducing coronary artery disease risk.

Personalized Computational Causal Modeling of the Alzheimer Disease Biomarker Cascade

BACKGROUND

Mathematical models of complex diseases, such as Alzheimer's disease, have the potential to play a significant role in personalized medicine. Specifically, models can be personalized by fitting parameters with individual data for the purpose of discovering primary underlying disease drivers, predicting natural history, and assessing the effects of theoretical interventions. Previous work in causal/mechanistic modeling of Alzheimer's Disease progression has modeled the disease at the cellular level and on a short time scale, such as minutes to hours. No previous studies have addressed mechanistic modeling on a personalized level using clinically validated biomarkers in individual subjects.

OBJECTIVES

This study aimed to investigate the feasibility of personalizing a causal model of Alzheimer's Disease progression using longitudinal biomarker data.

DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS

We chose the Alzheimer Disease Biomarker Cascade model, a widely-referenced hypothetical model of Alzheimer's Disease based on the amyloid cascade hypothesis, which we had previously implemented mathematically as a mechanistic model. We used available longitudinal demographic and serial biomarker data in over 800 subjects across the cognitive spectrum from the Alzheimer's Disease Neuroimaging Initiative. The data included participants that were cognitively normal, had mild cognitive impairment, or were diagnosed with dementia (probable Alzheimer's Disease). The model consisted of a sparse system of differential equations involving four measurable biomarkers based on cerebrospinal fluid proteins, imaging, and cognitive testing data.

RESULTS

Personalization of the Alzheimer Disease Biomarker Cascade model with individual serial biomarker data yielded fourteen personalized parameters in each subject reflecting physiologically meaningful characteristics. These included growth rates, latency values, and carrying capacities of the various biomarkers, most of which demonstrated significant differences across clinical diagnostic groups. The model fits to training data across the entire cohort had a root mean squared error (RMSE) of 0.09 (SD 0.081) on a variable scale between zero and one, and were robust, with over 90% of subjects showing an RMSE of < 0.2. Similarly, in a subset of subjects with data on all four biomarkers in at least one test set, performance was high on the test sets, with a mean RMSE of 0.15 (SD 0.117), with 80% of subjects demonstrating an RMSE < 0.2 in the estimation of future biomarker points. Cluster analysis of parameters revealed two distinct endophenotypic groups, with distinct biomarker profiles and disease trajectories.

CONCLUSION

Results support the feasibility of personalizing mechanistic models based on individual biomarker trajectories and suggest that this approach may be useful for reclassifying subjects on the Alzheimer's clinical spectrum. This computational modeling approach is not limited to the Alzheimer Disease Biomarker Cascade hypothesis, and can be applied to any mechanistic hypothesis of disease progression in the Alzheimer's field that can be monitored with biomarkers. Thus, it offers a computational platform to compare and validate various disease hypotheses, personalize individual biomarker trajectories and predict individual response to theoretical prevention and therapeutic intervention strategies.

Five-year changes of social activity and incident long-term care needs among depressed older adults: A 15-year follow up

OBJECTIVES

To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms.

METHODS

Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals.

RESULTS

Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models.

CONCLUSIONS

Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.

Obstructive sleep apnea is associated with the long-term prognosis of patients in acute coronary syndromes with prior myocardial infarction: Insights from OSA-ACS study

OBJECTIVE

The prognostic significance of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS) according to prior myocardial infarction (MI) remains unclear. We aimed to investigate the association between OSA and long-term cardiovascular outcomes in ACS patients with or without prior MI.

METHODS

We prospectively recruited eligible 2160 ACS patients with portable sleep monitoring in Beijing Anzhen Hospital between June 2015 and January 2020. OSA was defined as an apnea hypopnea index (AHI) ≥15 events/hour. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.

RESULTS

Among 1927 patients enrolled, 1014 (52.6%) had OSA and 316 (16.4%) had prior MI. During 2.9 (1.5, 3.6) years of follow-up, multivariate analysis showed that OSA was associated with 1.7 times the risk of MACCE in patients with prior MI (50 events [28.2%] vs 24 events [17.3%]; adjusted HR = 1.74, 95%CI 1.04-2.90, P = 0.034), but not in patients without prior MI group (177 events [21.1%] vs 138 events [17.8%]; adjusted HR = 1.19, 95%CI 0.94-1.51, P = 0.15). There was no significant interaction between prior MI and OSA for MACCE (interaction P = 0.14).

CONCLUSIONS

OSA was independently associated with an increased risk of MACCE among ACS patients, particularly among ACS patients with prior MI. Further trials exploring the efficacy of OSA treatment in high-risk patients with ACS characterized by prior MI are warranted.

Association between dietary carbohydrate intake and risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies

Background

Previous meta-analyses have assessed the relationship between carbohydrate intake and type 2 diabetes (T2D) risk; however, they included few studies of Asian populations who have a higher carbohydrate intake and lower insulin secretory capacity than non-Asians. Since the publication of the previous meta-analyses, three further studies of Asian populations have been conducted. Based on this background, the present study aimed to perform an updated systematically examine observational studies concerning the link between dietary carbohydrate intake and T2D risk.

Methods

We conducted a systematic search for cohort studies that investigated the target association. For each analyzed study, parameter-adjusted risk ratios were used to compare the lowest and highest carbohydrate-intake groups in terms of their risk of incident T2D. The risk ratios were calculated using a random-effects model.

Results

Ten publications were analyzed. Overall, carbohydrate intake was found not to be associated with increased risk ratios of incident T2D (risk ratio [RR] = 1.07; 95% confidence interval [95% CI] = 0.94, 1.21; P < 0.01, I2 = 61.9%). However, studies of Asian populations reported that high carbohydrate intake is significantly associated with this risk (RR = 1.29; 95% CI 1.15, 1.45; P = 0.59, I2 = 0.0%).

Conclusions

This updated meta-analysis showed that, overall, carbohydrate intake is not associated with the risk of T2D; nevertheless, a significant association exists among Asian populations. To confirm the association between dietary carbohydrate intake and T2D risk observed in this study, further evidence from long-term observational studies of Asian populations is required.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13340-023-00642-0.

ERCP management of acute cholangitis caused by rupture of Echinococcus hepaticus into the biliary tract

Background

Hepatic cystic echinococcosis (HCE) rupture into the biliary tract, one of the most common and refractory complications, is treated by laparotomy to remove hydatid lesions. The aim of this article was to investigate the role of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of this particular disease.

Patients and Methods

This was is a retrospective analysis of 40 patients with HCE ruptured into the biliary tract in our hospital from September 2014 to October 2019. They were divided into two groups, ERCP group (group A, n = 14) and conventional surgery group (group B, n = 26). Group A was treated with ERCP first to control infection and improve the general condition before undergoing laparotomy at an optional stage while group B was treated with laparotomy directly. First, the infection parameters and liver, kidney and coagulation functions of group A patients before and after ERCP were compared to evaluate treatment effectiveness. Second, the intraoperative and post-operative parameters during the laparotomy of group A were compared with group B to evaluate the impact of ERCP treatment on laparotomy.

Results and Conclusions

White blood cell, NE%, platelet, procalcitonin, C-reactive protein, interleukin-6, Total bilirubin (TBIL), alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate transaminase, alanine transaminase (ALT), ALT and Cr in group A significantly improved by ERCP (P < 0.05); during laparotomy, the bleeding amount and hospital stay in group A were better (P < 0.05); moreover, concerning the post-operative complications, the incidence of acute renal failure and coagulation dysfunction in group A was significantly less (P < 0.05). ERCP, which not only quickly and effectively controls infection and improves the patient's systemic condition but also provides good support for subsequent radical surgery, enjoys good prospects for clinical application.

Association Between Obstructive Sleep Apnea and Cardiovascular Events in Acute Coronary Syndrome Patients With or Without Revascularization - A Prospective Cohort Study

BACKGROUND

The effects of obstructive sleep apnea (OSA) on the prognosis of acute coronary syndrome (ACS) without revascularization remain unclear, so the aim of the present study was to elucidate the association of OSA with subsequent cardiovascular events in ACS patients with and without revascularization.Methods and Results: We prospectively recruited hospitalized ACS patients undergoing sleep monitoring between June 2015 and January 2020. OSA was defined as an apnea-hypopnea index ≥15 events/h. The primary endpoint was a major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure. Among 1,927 patients, 52.6% had OSA and 69.4% underwent revascularization. During a 2.9-year follow-up (1.5-3.6 years), the risk of MACCE was similar in patients with or without revascularization. OSA was an independent predictor of MACCE in the non-revascularization group (22.6% vs. 14.6%; hazard ratio (HR) 1.861; 95% confidence interval (CI) 1.239-2.796; P=0.003) but not in revascularization group (22.3% vs. 19.3%; HR 1.135; 95% CI 0.882-1.460; P=0.324). The incremental risk in the non-revascularization group was attributable to more hospitalizations for unstable angina (14.2% vs. 8.6%; HR 1.896; 95% CI 1.124-3.199; P=0.016).

CONCLUSIONS

For patients with ACS, OSA was independently associated with higher risk of recurrent cardiovascular events among patients without revascularization but not among patients undergoing revascularization. The benefits of suitable OSA treatment for patients without revascularization need further investigation.

Association of obstructive sleep apnoea with long-term cardiovascular events in patients with acute coronary syndrome with or without hypertension: insight from the OSA-ACS project

BACKGROUND

A close relationship exists between obstructive sleep apnoea (OSA) and hypertension. However, the impact of hypertension on the prognostic significance of OSA in patients with acute coronary syndrome (ACS) remains unclear.

METHODS

This is a post hoc analysis of the OSA-ACS project, which consecutively included patients with ACS and receiving overnight sleep study from June 2015 to January 2020. OSA was defined as AHI ≥15 events/hour. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), including a composite of cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularisation or hospitalisation for unstable angina or heart failure.

RESULTS

A total of 1927 patients with ACS were finally enrolled in this study. The mean patient age was 56.4±10.5 years. Among them, 1247 (64.7%) patients had hypertension, and 1014 (52.6%) patients had OSA. During 2.9 (1.5, 3.6) years of follow-up, OSA was associated with an increased risk of MACCE among patients with hypertension (HR=1.35, 95% CI 1.04 to 1.75, p=0.02), but not in patients without hypertension (HR=1.15, 95% CI 0.79 to 1.68, p=0.47). The interaction between OSA and hypertension for MACCE was not statistically significant (interaction p=0.29). For patients with pre-existing hypertension, OSA was associated with an increased risk of MACCE only among those with grade 3 hypertension (HR 1.54, 95% CI 1.12 to 2.13, p=0.008), but not those with grade 1 or 2 hypertension.

CONCLUSIONS

OSA was associated with an increased risk of MACCE following ACS in patients with hypertension, especially in patients with pre-existing severe hypertension. These findings highlight the importance of identifying OSA in ACS patients with hypertension.

TRIAL REGISTRATION NUMBER

NCT03362385.

Melamine-Ag with dual functions of electrochemiluminescence luminophore and coreactant accelerators: Construction of MIP/M-Ag@MoS2-QDs sensing platform for specific detection of thiabendazole

A novel self-enhancement molecularly imprinted electrochemiluminescence (ECL) sensor (MIP/M-Ag@MoS₂-QDs/GCE) was constructed to detect thiabendazole (TBZ) in food. Melamine was used as template to chelate Ag⁺ to prepare composite nanomaterials (M-Ag). M-Ag possesses both ECL properties and coreactant catalytic properties, which can realize the self-enhancement of ECL luminophore. MoS₂-QDs with excellent edge activity and electrochemical reaction catalytic activity were used to accelerate the reaction rate of the microsystem and further enhance the ECL intensity. The specific detection method of TBZ was established by investigating the ECL response mechanism and specific recognition mechanism of MIP/M-Ag@MoS₂-QDs/GCE. The ECL intensity was proportioned to the lg C_(TBZ) in the linear range 5 × 10^-8 mol L^-1-5 × 10^-5 mol L^-1 with a limit detection of 1.42 × 10^-8 mol L^-1. The satisfactory recovery rate (83.57%-101.03%) was obtained in sample analysis, which was in good agreement with the analysis result of HPLC.

Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study

BACKGROUND

Standard modifiable risk factors (SMuRFs) increase the risk of cardiovascular events in patients with acute coronary syndrome (ACS) and are also strongly associated with obstructive sleep apnea (OSA) in a bidirectional relationship. However, the association of OSA with recurrent cardiovascular events in ACS patients based on the number of SMuRFs remains unclear. Hence, we aimed to elucidate the prognostic implication of OSA in ACS patients stratified by the number of SMuRFs.

METHODS

This was a post hoc analysis of the OSA-ACS study (NCT03362385), including 1927 patients admitted for ACS and undergoing portable sleep monitoring. OSA was defined as an apnea hypopnea index ≥ 15 events/h. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE) including cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or heart failure, and ischemia-driven revascularization. Cox proportional hazards model and Kaplan-Meier analysis were used to investigated the relationship between OSA and subsequent cardiovascular events after patients were stratified by the number of SMuRFs.

RESULTS

Among 1927 patients enrolled, 130 (6.7%) had no SMuRF, 1264 (65.6%) exhibited 1-2 SMuRFs and 533 (27.7%) presented 3-4 SMuRFs. With the increase of the number of SMuRFs, the proportion of OSA in ACS patients tended to increase (47.7% vs. 51.5% vs. 56.6%), but there was no significant difference between them (P = 0.08). After the stratification of ACS patients via SMuRF numbers and adjustment for confounding factors, fully adjusted Cox regression indicated that OSA increased the risk of MACCE (adjusted HR, 1.65; 95%CI, 1.06-2.57; P = 0.026) and ischemia-driven revascularization (adjusted HR, 2.18; 95%CI, 1.03-4.65; P = 0.042) in ACS patients with 3-4 SMuRFs.

CONCLUSIONS

In hospitalized ACS patients, OSA is associated with an increased risk of MACCE and ischemia-driven revascularization among patients with 3-4 SMuRFs. Therefore, screening for OSA should be emphasized in ACS patients with 3-4 SMuRFs, and intervention trials should be prioritized in these high-risk patients.

"Blocking-effect" detection strategy of clenbuterol by molecularly imprinted electrochemiluminescence sensor based on multiple synergistic excitation of AgNW luminophores signal with highly active BNQDs@AuNFs nanoscale co-reaction accelerator

A molecularly imprinted electrochemiluminescence sensor (MIECLS) is constructed to selectively detect clenbuterol (CLB) based on boron nitride quantum dots@gold nanoflowers/silver nanowires (BNQDs@AuNFs/AgNWs). The abundant amino and hydroxyl groups on the surface of the BNQDs generate an electrostatic self-assembly effect with the multi-tipped spatial structure of AuNFs, constituting a novel nanoscale co-reaction accelerator (NCRA) with high activity and large load capacity. An NCRA embedded in the network structure of the AgNW luminophores significantly promotes the reduction of peroxydisulfate (S₂O₈^2-) to sulfate anion radicals (SO₄^-•) through the catalysis of amino groups and boron radicals (B^•) and the electron acceleration of AuNFs while also reducing the reaction distance between SO₄^-• and AgNWs^-•, realizing the multiple synergistic amplification of the electrochemiluminescence (ECL) signal. Imprinted cavities in the molecularly imprinted polymers (MIPs) prepared by electropolymerization can generate a "blocking-effect" by recognizing CLB, realizing ECL signal quenching. Analytical results indicate that the established MIECLS detects CLB in a line concentration range of 0.5-50000 nM and detection limit of 0.00693 nM. The spiked recoveries are 85.90%-97.77%, with the relative standard deviations (RSD) under 5.1%, consistent with those of high-performance liquid chromatography (HPLC). This work demonstrates that an efficient NCRA can significantly enhance the output of the ECL signal in collaboration with the original luminophore, providing a new method to realize the ultra-detection of targeted substances by MIECLS.

Comorbid obstructive sleep apnea is associated with adverse cardiovascular outcomes in female patients with acute coronary syndrome complicating metabolic syndrome

BACKGROUND

Obstructive sleep apnea (OSA) and metabolic syndrome (MetS) are each increasingly common in patients with acute coronary syndrome (ACS). Whether OSA increases cardiovascular consequences in ACS patients with MetS has not been investigated.

HYPOTHESIS

OSA increases cardiovascular risk in ACS patients with MetS. We aimed to examine the association between OSA and cardiovascular consequences in ACS patients with MetS.

METHODS

In this prospective cohort study, we consecutive recruited 2160 ACS patients who underwent portable sleep breathing monitoring. OSA is defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.

RESULTS

A total of 1927 patients with ACS were enrolled. Among them, 1486 (77.1%) had MetS and 1014 (52.6%) had OSA. During 2.9 years of follow-up, the cumulative incidence of MACCE was similar between OSA and non-OSA groups in patients with MetS (21.9% vs. 17.9%, adjusted hazard ratio [HR] = 1.29 95% confidence interval [CI]: 0.99-1.67, p = .06) and patients without MetS (24.4% vs. 17.3%, adjusted HR = 1.21 95% CI: 0.73-2.03, p = .46). Patients with MetS and OSA had a significantly higher risk of MACCE than patients with MetS and without OSA in women (27.8% vs. 18.1%, adjusted HR = 1.70, 95% CI: 1.01-3.09, p = .04) but not in men (21.0% vs. 17.9%, adjusted HR = 1.19, 95% CI: 0.91-1.59, p = .21).

CONCLUSIONS

In hospitalized ACS patients with MetS, comorbid OSA was associated with increased risk of cardiovascular consequences among women.

Clinical significance of obstructive sleep apnea in patients with acute coronary syndrome with or without prior stroke: a prospective cohort study

BACKGROUND AND OBJECTIVE

Whether obstructive sleep apnea (OSA) is associated with worse prognosis in patients with acute coronary syndrome (ACS) with or without prior stroke remains unclear. We investigated the association of OSA with cardiovascular events in ACS patients with or without prior stroke.

METHODS

Between June 2015 and January 2020, we prospectively recruited eligible ACS patients who underwent cardiorespiratory polygraphy during hospitalization. We defined OSA as an apnea hypopnea index (AHI) ≥ 15 events/hour. The primary composite end point was major adverse cardiovascular and cerebrovascular events (MACCEs), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.

RESULTS

Among 1927 patients enrolled, 207 patients had prior stroke (10.7%) and 1014 had OSA (52.6%). After a mean follow-up of 2.9 years, patients with stroke had significantly higher risk of MACCEs than those without stroke (hazard ratio [HR]:1.49; 95% confidence interval [CI]: 1.12-1.98, P = 0.007). The multivariate analysis showed that patients with OSA had 2.0 times the risk of MACCEs in prior stroke group (41 events [33.9%] vs 18 events [20.9%]; HR:2.04, 95% CI:1.13-3.69, P = 0.018), but not in non-prior stroke group (186 events [20.8%] vs 144 events [17.4]; HR:1.21, 95% CI 0.96-1.52, P = 0.10). No significant interaction was noted between prior stroke and OSA for MACCE (interaction P = 0.17).

CONCLUSIONS

Among ACS patients, the presence of OSA was associated with an increased risk of cardiovascular events in patients with prior stroke. Further trials exploring the efficacy of OSA treatment in high-risk patients with ACS and prior stroke are warranted. Trial registration Clinicaltrials.gov identifier NCT03362385.

Association of obstructive sleep apnoea with cardiovascular events in women and men with acute coronary syndrome

BACKGROUND

The impact of sex on the association of obstructive sleep apnoea (OSA) with recurrent cardiovascular events following acute coronary syndrome (ACS) remains uncertain. This study sought to examine the association between OSA and long-term cardiovascular outcomes in women and men with ACS.

METHODS

In this prospective cohort study, we recruited 2160 ACS patients undergoing portable sleep monitoring between June 2015 and January 2020. The primary end-point was major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischaemia-driven revascularisation or hospitalisation for unstable angina or heart failure.

RESULTS

After exclusion of patients with failed sleep studies, central sleep apnoea, regular continuous positive airway pressure therapy and loss of follow-up, 1927 patients were enrolled. Among them, 298 (15.5%) were women and 1014 (52.6%) had OSA (apnoea-hypopnoea index ≥15 events·h^-1). The prevalence of OSA was 43.0% and 54.4% in women and men, respectively. In 4339 person-years (median 2.9 years, interquartile range 1.5-3.6 years), the cumulative incidence of MACCE was significantly higher in OSA versus non-OSA groups in the overall population (22.4% versus 17.7%; adjusted hazard ratio (HR) 1.29, 95% CI 1.04-1.59; p=0.018). OSA was associated with greater risk of MACCE in women (28.1% versus 18.8%; adjusted HR 1.68, 95% CI 1.02-2.78; p=0.042), but not in men (21.6% versus 17.5%; adjusted HR 1.22, 95% CI 0.96-1.54; p=0.10). No significant interaction was noted between sex and OSA for MACCE (interaction p=0.32). The incremental risk in women was attributable to higher rates of hospitalisation for unstable angina and ischaemia-driven revascularisation.

CONCLUSIONS

In hospitalised ACS patients, OSA was associated with increased risk of subsequent events, particularly among women. Female patients with ACS should not be neglected for OSA screening and dedicated intervention studies focusing on women with ACS and comorbid OSA should be prioritised.

HPM-Net: Hierarchical progressive multiscale network for liver vessel segmentation in CT images

BACKGROUND AND OBJECTIVE

The segmentation and visualization of liver vessels in 3D CT images are essential for computer-aided diagnosis and preoperative planning of liver diseases. Due to the irregular structure of liver vessels and image noise, accurate extraction of liver vessels is difficult. In particular, accurate segmentation of small vessels is always a challenge, as multiple single down-sampling usually results in a loss of information.

METHODS

In this paper, we propose a hierarchical progressive multiscale learning network (HPM-Net) framework for liver vessel segmentation. Firstly, the hierarchical progressive multiscale learning network combines internal and external progressive learning methods to learn semantic information about liver vessels at different scales by acquiring receptive fields of different sizes. Secondly, to better capture vessel features, we propose a dual-branch progressive 3D Unet, which uses a dual-branch progressive (DBP) down-sampling strategy to reduce the loss of detailed information in the process of network down-sampling. Finally, a deep supervision mechanism is introduced into the framework and backbone network to speed up the network convergence and achieve better training of the network.

RESULTS

We conducted experiments on the public dataset 3Dircadb for liver vessel segmentation. The average dice coefficient and sensitivity of the proposed method reached 75.18% and 78.84%, respectively, both higher than the original network.

CONCLUSION

Experimental results show that the proposed hierarchical progressive multiscale network can accurately segment the labeled liver vessels from the CT images.

Changes in behavioral activities and transition of depressive symptoms among younger-old community-dwelling adults during 6 years: An age-specific prospective cohort study

OBJECTIVE

Regular engagement in behavioral activities plays a crucial role against depressive symptoms in older adults. This study aims to explore the relationship between behavioral activities and the temporal evolution of depressive symptoms.

METHODS

We included community-dwelling Japanese adults aged 64 or 65 years with and without depressive symptoms enrolled in the New Integrated Suburban Seniority Investigation (NISSIN) project. Depressive symptoms at baseline and follow-up were assessed using the 15-item Geriatric Depression Scale. Behavioral activities were measured by self-reported questions. Risk ratios and 95% confidence intervals were calculated using modified Poisson regression, adjusting for relevant sociodemographic variables and health-related confounders.

RESULTS

During the 6 year follow-up period, 139 (10.1%) without depressive symptoms at baseline developed such symptoms over time, while 174 (51.6%) with depressive symptoms improved to the point of these symptoms being absent. The participants without depressive symptoms at baseline and those who engaged in social activity or daily walking at a continued regular frequency (CRF) or an increased frequency (IF) and exercise habits at CRF were the least likely to have depressive symptoms onset at follow-up. There was no significant difference between the changes in behavioral activities and the improvement of depressive symptoms after controlling for confounders. Participants engaging in a greater variety of behavioral activities at CRF were less likely to experience a new onset of depressive symptoms.

CONCLUSIONS

Consistent and regular participation in one or more behavioral activities was significantly associated with the onset of depressive symptoms in Japanese community-dwelling older adults.

A new inoculation method of sulfur autotrophic denitrification reactor for accelerated start-up and better low-temperature adaption

Elemental sulfur (S⁰) autotrophic denitrification (SAD) has been proved feasible for nitrate removal from aquatic environments. The long start-up period up to weeks of the SAD reactor impedes its industrial application. To accelerate the start-up process, this study employed S⁰ powder packed sequencing batch reactor operated for 10 days to obtain a seed biofilm, which was inoculated into a regular S⁰ flake packed bed reactor afterwards. Merely two days after inoculation, the reactor inoculated with seed biofilm was well started up and outperformed the control reactor, which was inoculated with regular anaerobic sludge and operated for more than 10 days, delivering much increased denitrification rate of 126 ± 0.68 mg N/(L·d) and a high nitrate removal efficiency of 93.0%. Batch tests during the start-up period showed that the seed biofilm developed well on S⁰ flakes and delivered improved nitrate removal performance than the control. Extracellular polymeric substance (EPS) analysis revealed an abundant content of protein in tightly bound EPS in the biofilm developed from the seed biofilm, which was recognized as a major contributor to facilitate the biofilm's attachment and growth onto S⁰ flakes. After operating under moderate temperature, the reactors were tested at a reduced temperature of 15 °C. Results indicated that the reactor inoculated with seed biofilm showed stronger adaptation ability towards low temperature and sustained better denitrification performance than the control, which was attributed to increased protein content in tightly bound EPS produced by the microbes against low-temperature. Determination of the microbial communities in tested reactors when the whole experiment was closing found that sulfur-related genera were dominating in the packed-bed reactor inculcated with seed biofilm, which played an important role in the S⁰-based denitrification process.

Effect of obstructive sleep apnoea on coronary collateral vessel development in patients with ST-segment elevation myocardial infarction

BACKGROUND AND OBJECTIVE

The impact of obstructive sleep apnoea (OSA) in the setting of acute ST-segment elevation myocardial infarction (STEMI) is complex and divergent. This study aimed to investigate the association between OSA and coronary collateral vessel (CCV) development in patients with STEMI.

METHODS

The present study prospectively screened 282 STEMI patients with an overnight sleep study. OSA was defined as apnoea-hypopnoea index (AHI) ≥15 events/h. The coronary angiograms were used for the assessment of Rentrop grades representing CCVs.

RESULTS

Among 119 patients enrolled, 60 patients had OSA (50.4%). The prevalence of CCV development (Rentrop grade ≥ 2) was significantly higher in OSA group than in the non-OSA group (43.3% vs. 5.1%, p < 0.001). There was a parallel increase in the Rentrop grades associated with OSA severity and worsening of hypoxaemia indicators (minimum arterial oxygen saturation [SaO₂ ], mean SaO₂ and time with SaO₂ below 90%). After adjustment for clinical and angiographic characteristics, and pre-procedure medications that might interact with OSA, AHI as a continuous variable (OR 1.11, 95% CI 1.08-1.21, p < 0.001) and the presence of OSA (OR 11.41, 95% CI 2.70-48.15, p = 0.001) were both associated with dramatically higher incidence of CCV development.

CONCLUSION

Our study demonstrated that the presence of OSA might augment CCV development in STEMI patients. The potential protective effects and mechanisms of OSA in the acute setting of STEMI should be further investigated in larger studies.

Efficient production of medium chain fatty acids in microbial electrosynthesis with simultaneous bio-utilization of carbon dioxide and ethanol

Microbial electrosynthesis (MES) is a promising technology for chemicals production driven by renewable energy. However, how the medium chain fatty acids (MCFAs) production in MES is affected by the method of chain elongation is not clear, and no direct evidence is provided yet for a simultaneous bio-utilization of CO₂ and ethanol. In this study, different methods of chain elongation in MES reactors were investigated. During in-situ chain elongation, a maximum caproate concentration of 11.9 ± 0.6 g L^-1 was achieved, while the C6 specificity (56.4% ± 0.5%) was much lower than that of ex-situ chain elongation (78.7% ± 1.5%). Carbon distribution and reduction degree balance indicated a simultaneous bio-utilization of CO₂ and ethanol, and it was validated by the isotope tracer technique. MCFAs-forming microbes, acetogens, and electrochemically active microorganisms were enriched. This study provides fundamental insights relevant to the carbon and electron fluxes driven by electricity.

Osthole Blocks HMGB1 Release From the Nucleus and Confers Protective Effects Against Renal Ischemia-Reperfusion Injury

Renal ischemia-reperfusion (IR) is one of the main causes of renal injury. In severe cases with serious consequences, IR-related renal damage progresses rapidly and can even lead to acute renal failure. Its clinical treatment is currently difficult. According to various studies at home and abroad, HMGB1 is released from the nucleus into the cytoplasm or extracellular space by damaged parenchymal cells during ischemia and hypoxia, and this plays an important role in the initiation of reperfusion injury as an early inflammatory factor and is closely related to the occurrence and development of renal diseases. In recent years, the protective effect of osthole on IR of tissues and organs has been a key topic among clinical researchers. Osthole can inhibit the inflammatory response, reduce cell apoptosis the progression, and improve the prognosis of IR, thus protecting the kidney. During the development of renal IR, finding a mechanism through which the osthole blocks the release of HMGB1 from the nucleus would be helpful in detecting targets for clinical treatment.

Indicators of water biotoxicity obtained from turn-off microbial electrochemical sensors

The development of biosensors is critical to reducing potential risks associated with contamination accidents. However, the application of microbial electrochemical sensors for water biotoxicity monitoring is hampered by the lack of an indicator with high response magnitudes. In this study, microbial electrochemical sensors were fabricated with interdigitated electrode arrays (IDAs), and indicators from various electrochemical analyses were comprehensively investigated. Only the peak of cyclic voltammetry (CV) was highly linearly correlated with the commonly used current indicator during the enrichment of the electroactive biofilm. The resistance fitted from the electrochemical impedance spectroscopy (EIS) data provided a comparable and even higher inhibition ratio (IR) than the current during toxicity assessments. The differential pulse voltammetry (DPV) did not exhibit a higher sensitivity than the CV peak. However, no clear response was observed in the real-time impedance analysis for use in water biotoxicity monitoring. Most of the microbes were in the propidium iodide (PI)-permeable state after the toxicity assessments, although the current was fully recovered. This study demonstrates the potential to use EIS data as indicators of water biotoxicity using microbial electrochemical sensors.

Association between apnea-hypopnea index and coronary artery calcification: a systematic review and meta-analysis

BACKGROUND

The present study aimed to evaluate the association between presence and severity of obstructive sleep apnoea (OSA) and the presence of subclinical coronary artery disease (CAD) as assessed by coronary calcium score.

METHODS

Medline, Cochrane, and Google Scholar databases were searched. The presence of coronary artery calcification (CAC) and CAC score were assessed.

RESULTS

Irrespective of the cut-off value of apnoea-hypopnea index (AHI) (5 or 15 events/h), patients in the OSA group had higher rate of CAC presence and mean CAC score than those in the control group. Subgroup analyses of patients monitored with home sleep apnoea testing (HSAT) or in-hospital/laboratory polysomnography showed that the OSA group had higher rate of CAC presence and mean CAC score than the control group, except in the comparison of mean CAC score between AHI ≥5 vs. <5 events/h for patients using HSAT, which was not significant. Pair-wise comparison showed that CAC score may increase with increased OSA severity.

CONCLUSIONS

In participants without symptomatic coronary disease, the presence of OSA was associated with the presence and extent of CAC. However, potential confounders such as age, gender, and BMI and the diversity of CAC scores may affect the association.

Association of gait with global cognitive function and cognitive domains detected by MoCA-J among community-dwelling older adults: a cross-sectional study

BACKGROUND

Gait was proved to be strongly associated with global cognitive function and multiple cognitive domains; however, previous research usually concentrated on individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and cognitive domains.

METHODS

The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70-81 years. Gait was measured by asking participants to walk a 6-m course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and cognitive domains adjusted for several confounding factors.

RESULTS

Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β = - 0.487, [- 0.890, - 0.085]) and executive function (P = 0.049); initial contact was associated with executive function (P = 0.017).

CONCLUSION

General cycle of gait might be the better marker of global cognitive function and gait is most strongly associated with executive function. The longitudinal relationships should be examined in future cohort studies.

[Impact of obstructive sleep apnea on the long-term cardiovascular outcomes in patients with acute coronary syndrome]

Objective: To investigate the impact of obstructive sleep apnea (OSA) on long-term cardiovascular outcomes in patients with acute coronary syndrome (ACS). Methods: This is a single-center, prospective cohort study. Between June 2015 to January 2020, consecutive ACS patients hospitalized at Beijing Anzhen Hospital, Capital Medical University were enrolled. All patients underwent portable sleep breathing monitoring, and they were then divided into moderate/severe OSA group (apnea-hypopnea index (AHI)≥15 events/hour) and no/mild OSA group (AHI<15 events/hour). The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, ischemia-driven revascularization and hospital admission for unstable angina or heart failure. MACCE were compared yearly by the log-rank test. Multivariable Cox regression analyses were performed to determine the independent predictors of MACCE. Results: A total of 1 927 patients with ACS were enrolled, including 1 629 males (84.5%), aged (56.4±10.5) years. Moderate/severe OSA was present in 1 014 (52.6%) patients. Compared with no/mild OSA group, moderate/severe OSA group exhibited a higher body mass index (P<0.05). Hypertension, prior PCI were more prevalent in moderate/severe OSA group (both P<0.05). The difference of ACS category between the two groups was statistically significant (P=0.021). The rate of patients who underwent PCI and the number of stents were higher in the moderate/severe OSA group. During a 5-year follow-up (median 2.9 years (IQR 1.5-3.6 years)), the cumulative incidence of MACCE was significantly higher in the moderate/severe OSA group than in the no/mild OSA group (34.0% vs. 24.0%, HR=1.346, 95%CI 1.100-1.646, log-rank P=0.004). The cumulative incidence of MACCE remained statistically higher at 4 and 5 year in the moderate/severe OSA group as compared to the no/mild OSA group (33.3% vs. 22.9%, HR=1.397, 95%CI 1.141-1.710, log-rank P=0.001; 34.0% vs. 24.0%, HR=1.341, 95%CI 1.096-1.640, log-rank P=0.004, respectively). Multivariate analysis showed that moderate/severe OSA (HR=1.312, 95%CI 1.054-1.631, P=0.015) was an independent predictor of long-term MACCE in ACS patients. Conclusions: Moderate/severe OSA is observed in more than 52% ACS patients. Moderate/severe OSA is an independent predictor of long-term MACCE.

Additional polypyrrole as conductive medium in artificial electrochemically active biofilm (EAB) to increase the sensitivity of EAB based biosensor in water quality early-warning

Researchers believe that adding conductive mediums in electrochemically active biofilms (EABs) would improve the sensitivity of EAB-based biosensor for real-time water quality early-warning through facilitating the extracellular electron transfer (EET), which has been hardly evidenced mostly because naturally formed EABs employed in previous biosensor studies were recognized distinct and incapable of delivering comparable electrical signals. By preparing artificial EABs where Shewanella oneidensis MR-1 was encapsulated in sodium alginate (SA), this study solved how polypyrrole (PPy) as conductive medium would affect the sensitivity of EAB-based biosensor, as well as mass transfer of toxicant during this process. Different mass ratios (0.125:1, 0.25:1 and 1:1) of PPy over SA were tested, and the sensitivity promoted by 20%, 15% and 6%, respectively. Results indicated that a small amount of PPy addition (PPy: SA = 0.125: 1 in mass ratio) was more effective to increase the biosensor's sensitivity compared to larger amount of PPy employed in EAB. This was when improved conductivity introduced by PPy would dominate in affecting the sensitivity over contrarily weakened mass transfer in the meantime.

Artificial electrochemically active biofilm for improved sensing performance and quickly devising of water quality early warning biosensors

A major challenge for devising an electrochemically active biofilm (EAB)-based biosensor for real-time water quality early-warning is the formation of EAB that requires several days to weeks. Besides the onerous and time-consuming preparation process, the naturally formed EABs are intensively concerned as they can hardly deliver repeatable electrical signals even at identical experimental conditions. To address these concerns, this study employed sodium alginate as immobilization agent to encapsulate Shewanella oneidensis MR-1 and prepared EAB for devising a biosensor in a short period of less than 1 h. The artificial EAB were found capable of delivering highly consistent electrical signals with each other when fed with the same samples. Morphology and bioelectrochemical properties of the artificial EAB were investigated to provide interpretations for these findings. Different concentrations of bacteria and alginate in forming the EAB were investigated for their effects on the biosensor's sensitivity. Results suggested that lower concentration of bacteria would be beneficial until it increased to 0.06 (OD₆₆₀). Concentration of sodium alginate affected the sensitivity as well and 1% was found an optimum amount to serve in the formation of EAB. A long-term operation of the biosensor with artificial EAB for 110 h was performed. Clear warning signals for incoming toxicants were observed over random signal fluctuations. All results suggested that the artificial EAB electrode would support a rapid devised and highly sensitivity biosensor.

Rechargeable microbial fuel cell based on bidirectional extracellular electron transfer

Rechargeable microbial electrochemical systems can be used as renewable energy storage systems or as potable bioelectronics devices. In this study, a bioelectrode capable of bidirectional extracellular electron transfer was firstly introduced to construct the rechargeable microbial fuel cell (MFC). The performance of rechargeable MFC was enhanced with the increase of charge/discharge cycles, and a maximum energy efficiency of 4.5 ± 0.2% and Coulombic efficiency of 29.4 ± 4.1% were obtained. H₂ was the main charge carrier, while the accumulated acetate was only about 10 mg L^-1. The charge time under constant current mode largely affected the energy recovery. A decreased abundance of Mycobacteria, Geobacter, and Azospirillum, accompanied by an increase of Azonexus and Rhodococcus was observed in the rechargeable MFC, compared to control tests fueled with acetate. This study demonstrates the potential of bioelectrode for energy storage and recovery.

Utilization of Elemental Sulfur in Constructed Wetlands Amended with Granular Activated Carbon for High-Rate Nitrogen Removal

To investigate the role of granular activated carbon (GAC) on nitrogen removal performance of elemental sulfur-based constructed wetlands (S⁰-based CWs), three systems were constructed according to the different configurations in the functional layer, namely S-CW (S⁰ added in the functional layer), CSC-CW (GAC, S⁰ and GAC placed in layers in the functional layer) and SC-CW (S⁰ and GAC mixed evenly in the functional layer). In CSC-CW and SC-CW, the volumetric ratio of S⁰:GAC was 9:1. Three CWs were operated under four different hydraulic retention times (HRTs) ranged from 48 h to 6 h. Over the experiment, total inorganic nitrogen (TIN) removal rates of the three CWs were 3.1 - 23.6 g m^-2 d^-1, 3.5 - 24.1 g m^-2 d^-1 and 3.4 - 11.5 g m^-2 d^-1, respectively; CSC-CW remained high TIN removal efficiency (from 74.7 ± 20.2 % to 93.4 ± 1.9 %) while SC-CW had significant lower values when HRT = 6 h (29.8 ± 30.1 %). Mass balance and high-throughput sequencing analysis revealed that mixotrophic denitrification at the sulfur layer and simultaneous nitrification-denitrification (SND) at the rhizosphere played the major role in N removal from CSC-CW (> 95 %). GAC addition facilitated the growth of Iris pseudacorus with the final fresh weight increased from 33.9 g_FW ind^-1 to 82.3 g_FW ind^-1 in CSC-CW and 82.7 g_FW ind^-1 in SC-CW. This study optimizes the practical application of S⁰-based CWs amended with GAC for N removal from carbon-limited wastewater.

Effects of oral sialic acid on gut development, liver function and gut microbiota in mice

Sialic acid (N-acetylneuraminic acid), a 9-carbon monosaccharide, has been widely studied in immunology, oncology and neurology. However, the effects of sialic acid on organ and intestinal development, liver function and gut microbiota were rarely studied. In this study, we found that oral sialic acid tended to increase the relative weight of liver and decreased the serum aspartate aminotransferase (GPT) activity. In addition, sialic acid treatment markedly reduced gut villus length, depth, the ratio of villus length/depth (L/D), areas, width and the number of goblet cells. Furthermore, gut microbes were changed in response to oral sialic acid, such as Staphylococcus lentus, Corynebacterium stationis, Corynebacterium urealyticum, Jeotgalibaca sp_PTS2502, Ignatzschineria indica, Sporosarcina pasteurii, Sporosarcina sp_HW10C2, Facklamia tabacinasalis, Oblitimonas alkaliphila, Erysipelatoclostridium ramosum, Blautia sp_YL58, Bacteroids thetaiotaomicron, Morganella morganii, Clostridioides difficile, Helicobacter tryphlonius, Clostridium sp_Clone47, Alistipes finegoldii, [pseudomonas]_geniculata and Pseudomonas parafulva at the species level. In conclusion, oral sialic acid altered the intestinal pathological state and microbial compositions, and the effect of sialic acid on host health should be further studied.

Micro-microbial electrochemical sensor equipped with combined bioanode and biocathode for water biotoxicity monitoring

The development of low-cost biosensors for water monitoring is expected to reduce potential risks from contamination accidents. This study reported a novel micro-microbial electrochemical sensor using combined bioanode and biocathode as the sensing element, characterized by a sequential flowing membrane-free channel and a bilateral passive oxygen supply. A decrease in the ratio of number of bioanode to biocathode resulted in a lower power generation, whereas, achieving a similar or even higher toxic response. The voltage was affected by both the flow rate and the acetate concentration. With the increased acetate concentration, a clear trade-off was observed between the electroactivity stimulation of bioanode vs. the electroactivity maintenance of biocathode. Biosensors made good response to the injection of formaldehyde (10 µL of 0.25%, and 100 µL of 0.025%) into the inlet. A high microbial diversity was observed. This work can lead to a revolutionizing way of water monitoring using self-powered micro-biosensors.

Analysis of the prevalence and influencing factors of depression and anxiety among maintenance dialysis patients during the COVID-19 pandemic

Objective

Currently, the COVID-19 outbreak and its spread around the globe is significantly affecting mental health and health in general, worldwide. During the COVID-19 pandemic, the general medical complications have received the most attention, whereas only a few studies address the potential direct impact of SARS-CoV-2 on mental health.

Methods

A total of 321 maintenance hemodialysis (MHD) patients were selected using random sampling from the hemodialysis center of the second people’s Hospital of Yibin. They completed Zung’s self-rating anxiety scale (SAS) for anxiety, Zung’s self-rating depression scale (SDS) for depression, and the activity of daily living scale (ADL) for the ability of living. Demographic data and laboratory tests were used to analyze the risk factors.

Results

The proportions of the prevalence of anxiety and depression symptoms were between 34.89% and 30.02%, respectively, among the MHD patients. The SAS and SDS scores of the 321 patients were 45.42(± 10.99) and 45.23(± 11.59), respectively. The results show that monthly income, medical insurance, vascular access, the duration of dialysis, complication, hemoglobin (HGB), immunoreactive parathyroid hormone (iPTH) and blood phosphorus (P) are factors that influence anxiety among patients (p < 0.05 for all). Vascular access, monthly income, medical insurance, complication, CRP, Alb, are factors that influence depression among patients (p < 0.05 for all).

Conclusion

Our results suggest that during the pandemic period, the prevalence of anxiety and depression symptoms among MHD patients increased. Some demographic and clinical variables were associated with it. We should, therefore, pay more attention to the patients’ psychology, start targeted intervention to alleviate the patients’ anxiety and further improve their quality of life.

Organic carbon coupling with sulfur reducer boosts sulfur based denitrification by Thiobacillus denitrificans

Sulfur autotrophic denitrification utilizes elemental sulfur as the electron donor for nitrate removal from aquatic environments. Organic carbon could stimulate the conversion of sulfur and facilitates the S⁰-based denitrification process in the mix-trophic. In this study, the co-cultured system of sulfur reducer (Geobacter sulfurreducens) and Thiobacillus denitrificans was used to investigate that how organic carbon could boost the S⁰-based denitrification. The results showed that the rate of S⁰-based denitrification was improved with C/N ratio of 0.13 and this improvement continued even after the acetate was exhausted. Sulfur probe test and Raman analysis suggested that reduced sulfur species (S_x^2-) were formed with the addition of organic carbon. The S_x^2- could recombine with element sulfur and the bioavailability of S⁰ would be improved, as a result, the rate of S⁰-based denitrification increased as well. Nitrate reduction rate could further increase with the C/N ratio of 0.88, but it would decrease significantly when the C/N ratio increased to 1.50 as the high concentration of generated S^2-. Our results provided explanations that why organic carbon addition would improve the bioavailability of S⁰ which could further promote the S⁰-dominant denitrification process.

High-rate nitrogen removal from carbon limited wastewater using sulfur-based constructed wetland: Impact of sulfur sources

This study aims to explore the application of sulfur-based constructed wetlands (CWs) for effective nitrogen (N) removal from wastewater. Two solid sulfur sources namely elemental sulfur (S⁰) and pyrite (FeS₂) were used as substrates in two CWs, i.e. S-CW and P-CW, respectively. The CWs were vegetated with a common wetland plant Iris pseudacorus, and were operated to investigate the effects of hydraulic retention time (HRT) and temperature on N removal. The use of S⁰ resulted in the highest denitrification rate (19.0 ± 7.5 g m^-2 d^-1), whereas up to 20 times slower total inorganic nitrogen (TIN) removal was observed with FeS₂. Different sulfur sources had negligible effects on the growth of I. pseudacorus, but the element contents (e.g., N, S, and P) within the plant tissues were different. Iris roots in S-CW had higher S content compared with those in P-CW, which resulted in the difference in shoots colors. The characteristics of rhizospheric microbial communities were closely related to the sulfur and nitrogen sources. Briefly, denitrifying and sulfur-oxidizing genera (e.g., Denitratisoma, Sulfurimonas, Thiobacillus) were dominating in the S-CW, suggesting the occurrence of both autotrophic and heterotrophic denitrification processes in the wetland. On the other hand, nitrifying bacteria were more abundant (e.g. Nitrospira, Piscinibacter) in the P-CW. S⁰ layer and rhizosphere accounted for 99.3% of nitrogen removal and the former part most likely played important roles with a decrease in HRT. Low temperature strongly affected the rate and efficiency of denitrification but recovered to 49.2 ± 25.8% when added with 30 mg L^-1 sodium acetate. This study broadens the applications of sulfur-based CWs and provides a promising management strategy for denitrification at low temperatures.

A slurry electrode integrated with membrane electrolysis for high-performance acetate production in microbial electrosynthesis

Microbial electrosynthesis (MES) technology employs electrotrophic microbes as biocatalysts to produce chemicals from CO₂. The application of a slurry electrode can enlarge the surface area to volume ratio, and membrane electrolysis (ME) for on-line extraction can solve the problem of product inhibition. This study constructed a novel dual-chamber ME-MES integrated system equipped with a slurry electrode, and the effect of concentration of powder-activated carbon (AC) in the catholyte on chemical production was also evaluated. The integrated system amended with 5 g L^-1 AC produced up to 13.4 g L^-1 acetate, showing a 179% increase compared with the control group without AC (4.8 g L^-1). However, further increasing the AC concentration to 10 and 20 g L^-1 resulted in decreased acetate production. A high concentration of AC showed higher antimicrobial activity to methanogens, as compared to acetogens. Amending AC exacerbated the process of electroosmosis. Also, amending AC with 0 to 10 g L^-1 decreased the electrochemical losses via both the membrane and electrolyte. The chemical production using H₂ or the electrode as electron donors showed a similar trend when amending AC. The present study provided important information for guiding future research to construct an efficient configuration of an MES bioreactor.

Application of MRI Radiomics-Based Machine Learning Model to Improve Contralateral BI-RADS 4 Lesion Assessment

Objective

This study aimed to explore the potential of magnetic resonance imaging (MRI) radiomics-based machine learning to improve assessment and diagnosis of contralateral Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions in women with primary breast cancer.

Materials and Methods

A total of 178 contralateral BI-RADS 4 lesions (97 malignant and 81 benign) collected from 178 breast cancer patients were involved in our retrospective dataset. T1 + C and T2 weighted images were used for radiomics analysis. These lesions were randomly assigned to the training (n = 124) dataset and an independent testing dataset (n = 54). A three-dimensional semi-automatic segmentation method was performed to segment lesions depicted on T2 and T1 + C images, 1,046 radiomic features were extracted from each segmented region, and a least absolute shrinkage and operator feature selection method reduced feature dimensionality. Three support vector machine (SVM) classifiers were trained to build classification models based on the T2, T1 + C, and fusion image features, respectively. The diagnostic performance of each model was evaluated and tested using the independent testing dataset. The area under the receiver operating characteristic curve (AUC) was used as a performance metric.

Results

The T1+C image feature-based model and T2 image feature-based model yielded AUCs of 0.71 ± 0.07 and 0.69 ± 0.07 respectively, and the difference between them was not significant (P > 0.05). After fusing T1 + C and T2 imaging features, the proposed model’s AUC significantly improved to 0.77 ± 0.06 (P < 0.001). The fusion model yielded an accuracy of 74.1%, which was higher than that of the T1 + C (66.7%) and T2 (59.3%) image feature-based models.

Conclusion

The MRI radiomics-based machine learning model is a feasible method to assess contralateral BI-RADS 4 lesions. T2 and T1 + C image features provide complementary information in discriminating benign and malignant contralateral BI-RADS 4 lesions.

MiR-122-3p regulates the osteogenic differentiation of mouse adipose-derived stem cells via Wnt/β catenin signaling pathway

OBJECTIVE

To explore the regulatory mechanism of micro-ribonucleic acid (miR)-122-3p in the osteogenic differentiation of mouse adipose-derived stem cells (mADSCs).

MATERIALS AND METHODS

The regulatory mechanism of miR-122-3p in the osteogenic differentiation of mesenchymal stem cells was investigated through its overexpression and knockdown.

RESULTS

The overexpression of miR-122-3p inhibited the osteogenic differentiation of mADSCs. On the contrary, its knockdown promoted the osteogenic differentiation of mADSCs. The further study on the molecular mechanism of miR-122-3p regulating mADSCs' osteogenic differentiation showed that the overexpression of miR-122-3p could activate the Wingless and int-1 (WNT)/β-catenin signaling pathway, but the knockdown of miR-122-3p could repress this signaling pathway.

CONCLUSIONS

MiR-122-3p influences the osteogenic differentiation of mADSCs by modulating the WNT/β-catenin signaling pathway.