Age-specific difference in the temporal relationships between updated cardiovascular health construct and arterial stiffness in middle-aged and older adults

Previous studies have found that the association between modifiable risk factors and arterial stiffness varied with age. We aimed to explore the age-specific difference in the relationship between new cardiovascular health (CVH) score and arterial stiffness and further detected the age-specific temporal relationships in a prospective cohort study. During a median 4.3 years follow-up, 3757 participants were recruited in this study. A modified AHA "Life's Essential 8" construct (mLE8 with lacking information on diet habits) was used to evaluate CVH. Branchial-ankle pulse wave velocity (baPWV) was measured to assess arterial stiffness. Data were analyzed with logistic regression models, restricted cubic splines (RCS), and cross-lagged path analysis (age < 60 vs. age ≥ 60). In age-stratified analysis, moderate (OR = 2.21, 95% CI 1.11-4.43) and low (OR = 3.37, 95% CI 1.63-7.00) CVH were related with a higher incidence of elevated baPWV compared to high CVH in middle-aged adults, while this association was not detected in older adults. RCS curve showed a steeper linear association between CVH score and elevated baPWV in middle-aged adults than older individuals. In the cross-lagged path analysis, the decline in CVH score preceded the increment in arterial stiffness in middle-aged adults, but they appeared to alter simultaneously in older adults. Our study detected an age-specific difference in the relationship between mLE8 CVH score and elevated baPWV and showed that low CVH preceded alterations of baPWV in middle-aged adults, suggesting the importance of improvement in CVH during the early stage of the lifespan.

Left Ventricular Vertical Run-Length Nonuniformity MRI Adds Prognostic Value to MACE in Patients with End-Stage Renal Disease

BACKGROUND

Vertical run-length nonuniformity (VRLN) is a texture feature representing heterogeneity within native T1 images and reflects the extent of cardiac fibrosis. In uremic cardiomyopathy, interstitial fibrosis was the major histological alteration. The prognostic value of VRLN in patients with end-stage renal disease (ESRD) remains unclear.

PURPOSE

To evaluate the prognostic value of VRLN MRI in patients with ESRD.

STUDY TYPE

Prospective.

POPULATION

A total of 127 ESRD patients (30 participants in the major adverse cardiac events, MACE group).

FIELD STRENGTH/SEQUENCE

3.0 T/steady-state free precession sequence, modified Look-Locker imaging.

ASSESSMENT

MRI image qualities were assessed by three independent radiologists. VRLN values were measured in the myocardium on the mid-ventricular short-axis slice of T1 mapping. Left ventricular (LV) mass, LV end-diastolic and end-systolic volume, as well as LV global strain cardiac parameters were measured.

STATISTICAL TESTS

The primary endpoint was the incident of MACE from enrollment time to January 2023. MACE is a composite endpoint consisting of all-cause mortality, acute myocardial infarction, stroke, heart failure hospitalization, and life-threatening arrhythmia. Cox proportional-hazards regression was performed to test whether VRLN independently correlated with MACE. The intraclass correlation coefficients of VRLN were calculated to evaluate intraobserver and interobserver reproducibility. The C-index was computed to examine the prognostic value of VRLN. P-value <0.05 were considered statistically significant.

RESULTS

Participants were followed for a median of 26 months. VRLN, age, LV end-systolic volume index, and global longitudinal strain remained significantly associated with MACE in the multivariable model. Adding VRLN to a baseline model containing clinical and conventional cardiac MRI parameters significantly improved the accuracy of the predictive model (C-index of the baseline model: 0.781 vs. the model added VRLN: 0.814).

DATA CONCLUSION

VRLN is a novel marker for risk stratification toward MACE in patients with ESRD, superior to native T1 mapping and LV ejection fraction.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY STAGE: 2.

Structure-Crack Detection and Digital Twin Demonstration Based on Triboelectric Nanogenerator for Intelligent Maintenance

The accomplishment of condition monitoring and intelligent maintenance for cantilever structure-based energy harvesting devices remains a challenge. Here, to tackle the problems, a novel cantilever-structure freestanding triboelectric nanogenerator (CSF-TENG) is proposed, which can capture ambient energy or transmit sensory information. First, with and without a crack in cantilevers, the simulations are carried out. According to simulation results, the maximum change ratios of natural frequency and amplitude are 1.1% and 2.2%, causing difficulties in identifying defects by these variations. Thus, based on Gramian angular field and convolutional neural network, a defect detection model is established to achieve the condition monitoring of the CSF-TENG, and the experimental result manifests that the accuracy of the model is 99.2%. Besides, the relation between the deflection of cantilevers and the output voltages of the CSF-TENG is first built, and then the defect identification digital twin system is successfully created. Consequently, the system is capable of duplicating the operation of the CSF-TENG in a real environment, and displaying defect recognition results, so the intelligent maintenance of the CSF-TENG can be realized.

Cell-Based Therapy for Urethral Regeneration: A Narrative Review and Future Perspectives

Urethral stricture is a common urological disease that seriously affects quality of life. Urethroplasty with grafts is the primary treatment, but the autografts used in clinical practice have unavoidable disadvantages, which have contributed to the development of urethral tissue engineering. Using various types of seed cells in combination with biomaterials to construct a tissue-engineered urethra provides a new treatment method to repair long-segment urethral strictures. To date, various cell types have been explored and applied in the field of urethral regeneration. However, no optimal strategy for the source, selection, and application conditions of the cells is available. This review systematically summarizes the use of various cell types in urethral regeneration and their characteristics in recent years and discusses possible future directions of cell-based therapies.

Evaluating the distinct pleiotropic effects of omega-3 fatty acids on type 2 diabetes mellitus: a mendelian randomization study

BACKGROUND

Observational studies and conventional Mendelian randomization (MR) studies showed inconclusive evidence to support the association between omega-3 fatty acids and type 2 diabetes. We aim to evaluate the causal effect of omega-3 fatty acids on type 2 diabetes mellitus (T2DM), and the distinct intermediate phenotypes linking the two.

METHODS

Two-sample MR was performed using genetic instruments derived from a recent genome-wide association study (GWAS) of omega-3 fatty acids (N = 114,999) from UK Biobank and outcome data obtained from a large-scale T2DM GWAS (62,892 cases and 596,424 controls) in European ancestry. MR-Clust was applied to determine clustered genetic instruments of omega-3 fatty acids that influences T2DM. Two-step MR analysis was used to identify potential intermediate phenotypes (e.g. glycemic traits) that linking omega-3 fatty acids with T2DM.

RESULTS

Univariate MR showed heterogenous effect of omega-3 fatty acids on T2DM. At least two pleiotropic effects between omega-3 fatty acids and T2DM were identified using MR-Clust. For cluster 1 with seven instruments, increasing omega-3 fatty acids reduced T2DM risk (OR: 0.52, 95%CI 0.45-0.59), and decreased HOMA-IR (β = - 0.13, SE = 0.05, P = 0.02). On the contrary, MR analysis using 10 instruments in cluster 2 showed that increasing omega-3 fatty acids increased T2DM risk (OR:1.10; 95%CI 1.06-1.15), and decreased HOMA-B (β = - 0.04, SE = 0.01, P = 4.52 × 10^-5). Two-step MR indicated that increasing omega-3 fatty acid levels decreased T2DM risk via decreasing HOMA-IR in cluster 1, while increased T2DM risk via decreasing HOMA-B in cluster 2.

CONCLUSIONS

This study provides evidence to support two distinct pleiotropic effects of omega-3 fatty acids on T2DM risk influenced by different gene clusters, which could be partially explained by distinct effects of omega-3 fatty acids on insulin resistance and beta cell dysfunction. The pleiotropic feature of omega-3 fatty acids variants and its complex relationships with T2DM need to be carefully considered in future genetic and clinical studies.

The Microbial and Metabolic Signatures of Patients with Stable Coronary Artery Disease

Growing evidence indicates an association between gut dysbiosis and coronary artery disease (CAD). However, the underlying mechanisms relevant to stable CAD (SCAD) pathogenesis, based on microbe-host metabolism interactions, are poorly explored. Here, we constructed a quasi-paired cohort based on the metabolic background of metagenomic samples by the propensity score matching (PSM) principle. Compared to healthy controls (HCs), gut microbiome disturbances were observed in SCAD patients, accompanied by differences in serum metabolome, mainly including elevated acylcarnitine and decreased unsaturated fatty acids in SCAD patients, which implicated the reduced cardiac fatty acid oxidation. Moreover, we identified Ralstonia pickettii as the core strain responsible for impaired microbial homeostasis in SCAD patientsm and may be partly responsible for the decrease of host unsaturated fatty acid levels. These findings highlight the importance of unsaturated fatty acids, R. pickettii, and their interaction in the pathogenesis of SCAD. IMPORTANCE Stable coronary artery disease (SCAD) is an early stage of CAD development. It is important to understand the pathogenesis of SCAD and find out the possible prevention and control targets for delaying the progression of CAD. We observed reduced levels of unsaturated fatty acids (USFAs) in SCAD patients. However, the reduced USFAs may be related to Ralstonia Pickettii, which was the core strain responsible for the impaired gut microbial function in SCAD patients, and further affected the host's cardiovascular health by altering amino acids, vitamin B metabolism, and LPS biosynthesis. These findings not only emphasized the importance of USFAs for cardiovascular health, but also R. Pickettii for maintaining microbial function homeostasis. More importantly, our study revealed, for the first time, that enriched R. Pickettii might be responsible for the reduced USFAs in SCAD patients, which adds new evidence on the role of altered gut microbiota for SCAD formation.

Robotic Manipulation under Harsh Conditions Using Self-Healing Silk-Based Iontronics

Progress toward intelligent human-robotic interactions requires monitoring sensors that are mechanically flexible, facile to implement, and able to harness recognition capability under harsh environments. Conventional sensing methods have been divided for human-side collection or robot-side feedback and are not designed with these criteria in mind. However, the iontronic polymer is an example of a general method that operates properly on both human skin (commonly known as skin electronics or iontronics) and the machine/robotic surface. Here, a unique iontronic composite (silk protein/glycerol/Ca(II) ion) and supportive molecular mechanism are developed to simultaneously achieve high conductivity (around 6 kΩ at 50 kHz), self-healing (within minutes), strong stretchability (around 1000%), high strain sensitivity and transparency, and universal adhesiveness across a broad working temperature range (-40-120 °C). Those merits facilitate the development of iontronic sensing and the implementation of damage-resilient robotic manipulation. Combined with a machine learning algorithm and specified data collection methods, the system is able to classify 1024 types of human and robot hand gestures under challenging scenarios and to offer excellent object recognition with an accuracy of 99.7%.

Microstructural Characteristics of the Weighted and Directed International Crop Trade Networks

With increasing global demand for food, international food trade is playing a critical role in balancing the food supply and demand across different regions. Here, using trade datasets of four crops that provide more than 50% of the calories consumed globally, we constructed four international crop trade networks (iCTNs). We observed the increasing globalization in the international crop trade and different trade patterns in different iCTNs. The distributions of node degrees deviate from power laws, and the distributions of link weights follow power laws. We also found that the in-degree is positively correlated with the out-degree, but negatively correlated with the clustering coefficient. This indicates that the numbers of trade partners affect the tendency of economies to form clusters. In addition, each iCTN exhibits a unique topology which is different from the whole food network studied by many researchers. Our analysis on the microstructural characteristics of different iCTNs provides highly valuable insights into distinctive features of specific crop trades and has potential implications for model construction and food security.

Applications of AOTF Spectrometers in In Situ Lunar Measurements

Spectrometers based on acousto-optic tunable filters (AOTFs) have several advantages, such as stable temperature adaptability, no moving parts, and wavelength selection through electrical modulation, compared with the traditional grating and Fourier transform spectrometers. Therefore, AOTF spectrometers can realize stable in situ measurement on the lunar surface under wide temperature ranges and low light environments. AOTF imaging spectrometers were first employed for in situ measurement of the lunar surface in the Chinese Chang'e project. The visible and near-infrared imaging spectrometer and the lunar mineralogical spectrometer have been successfully deployed on board the Chang'e-3/4 and Chang'e-5 missions. In this review, we investigate the performance indicators, structural design, selected AOTF performance parameters, data acquisition of the three lunar in situ spectral instruments used in the Chang'e missions. In addition, we also show the scientific achievement of lunar technology based on in situ spectral data.