Stress hyperglycemia ratio as a prognostic indicator for long-term adverse outcomes in heart failure with preserved ejection fraction.

BACKGROUND: Recent studies highlighted that stress hyperglycemia ratio (SHR) is a potential predictor for future risk in heart failure (HF) patients. However, its implications specifically in HF with preserved ejection fraction (HFpEF) are not yet fully elucidated. We aimed to investigate the association between SHR and long-term clinical outcomes in HFpEF patients. METHODS: HFpEF patients enrolled between 2015 and 2023, were followed (mean 41 months) for a composite outcome of all-cause, cardiovascular mortality, and HF rehospitalization. SHR was established as the ratio of acute-chronic glycemia from admission blood glucose and glycated hemoglobin. The optimal cut-off for SHR to predict outcomes based on event prediction was determined through ROC analysis, and the cutoff was identified at 0.99. The effect of SHR on adverse risk was examined through the Cox hazards and Kaplan-Meier survival methods. A Pearson correlation analysis was conducted to assess the relationship between SHR and the severity of HF, as indicated by N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Furthermore, the incremental prognostic value of SHR was further assessed by the integrated discrimination improvement (IDI) and the net reclassification improvement (NRI). RESULTS: Among the 400 enrolled patients, 190 individuals (47.5%) encountered composite events over the 41-month follow-up period. SHR was significantly elevated in patients with events compared with those without (p < 0.001). All patients were stratified into high SHR (n = 124) and low SHR (n = 276) groups based on the SHR cutoff. The high SHR group had a significantly higher incidence of adverse events than the low SHR group (log-rank; p < 0.001). Additional analysis indicated a poorer prognosis in patients with low left ventricular EF (LVEF) levels (50 < LVEF < 60) and high SHR (SHR > 0.99) in comparison to the other groups (log-rank p < 0.001). In adjusted analysis, after accounting for age, sex, diabetes, and NT-proBNP, elevated SHR remained independently predictive of adverse outcomes (adjusted HR: 2.34, 95% CI 1.49-3.67; p < 0.001). Furthermore, adding SHR to a model with MAGGIC score provided an incremental improvement in predicting adverse events. Additionally, SHR displayed a slight correlation with NT-proBNP. CONCLUSION: Elevated SHR was independently associated with an increased risk for composite events of all-cause, cardiovascular mortality, and HF readmission than those with lower SHR. SHR is a valuable tool for predicting and stratifying long-term adverse risks among HFpEF patients.

Differences in urban heat island and its driving factors between central and new urban areas of Wuhan, China.

Urban heat island (UHI) is one of the important effects of urbanization on built environment. Land surface temperature data was taken from moderate-resolution imaging spectroradiometer (MODIS) to investigate the long-term spatiotemporal patterns of UHI in Wuhan during 2001~2018 and, the UHI intensity changes of built-up land in 13 administrative regions in Wuhan were analyzed. Furthermore, 34 spatial error models and 34 ordinary least squares models were established and compared. Spatial error models showed good fitting effect, which were used to determine the influence of normalized difference vegetation index (NDVI), normalized difference building index (NDBI), and social-economic factors (population and nighttime light) on UHI intensity in central urban area and new urban area. The explanatory power changes of these four indicators during 2001~2018 were explored as well. The average UHI intensity in 2014~2018 has increased by about 0.45 °C compared to that in 2001~2005. NDBI is the most dominant factor contributing to the increase in temperature. The impact of NDVI on UHI intensity changes from negative to positive, and the impact of NDBI on UHI intensity in central urban area is weakened during 2001-2018. Social-economic factors have a greater impact on new urban area than on central urban area. These findings show the effects and the explanatory power changes of driving factors during 18 years, which can provide a better understanding of the formation and development of UHI and support for the future urban planning of Wuhan.

SAMBA: A Multicolor Digital Melting PCR Platform for Rapid Microbiome Profiling.

During the past decade, breakthroughs in sequencing technology have provided the basis for studies of the myriad ways in which microbial communities in and on the human body influence human health and disease. In almost every medical specialty, there is now a growing interest in accurate and quantitative profiling of the microbiota for use in diagnostic and therapeutic applications. However, the current next-generation sequencing approach for microbiome profiling is costly, requires laborious library preparation, and is challenging to scale up for routine diagnostics. Split, Amplify, and Melt analysis of BActeria-community (SAMBA), a novel multicolor digital melting polymerase chain reaction platform with unprecedented multiplexing capability is presented, and the capability to distinguish and quantify 16 bacteria species in mixtures is demonstrated. Subsequently, SAMBA is applied to measure the compositions of bacteria in the gut microbiome to identify microbial dysbiosis related to colorectal cancer. This rapid, low cost, and high-throughput approach will enable the implementation of microbiome diagnostics in clinical laboratories and routine medical practice.

Novel Stereoselective Syntheses of (+)-Streptol and (-)-1-epi-Streptol Starting from Naturally Abundant (-)-Shikimic Acid.

Novel highly stereoselective syntheses of (+)-streptol and (-)-1-epi-streptol starting from naturally abundant (-)-shikimic acid were described in this article. (-)-Shikimic acid was first converted to the common key intermediate by 11 steps in 40% yield. It was then converted to (+)-streptol by three steps in 72% yield, and it was also converted to (-)-1-epi-streptol by one step in 90% yield. In summary, (+)-streptol and (-)-1-epi-streptol were synthesized from (-)-shikimic acid by 14 and 12 steps in 29 and 36% overall yields, respectively.

The Protective Effects of Maresin 1 in the OVA-Induced Asthma Mouse Model.

Asthma is a chronic inflammatory disease that cannot be cured. Maresin 1 (MaR1) is a specific lipid synthesized by macrophages that exhibits powerful anti-inflammatory effects in various inflammatory diseases. The goal of this study was to evaluate the effect of MaR1 on allergic asthma using an ovalbumin- (OVA-) induced asthma model. Thirty BALB/c mice were randomly allocated to control, OVA, and MaR1 + OVA groups. Mice were sacrificed 24 hours after the end of the last challenge, and serum, bronchoalveolar lavage fluid (BALF), and lung tissue were collected for further analysis. Western blotting was used to measure the protein level of IκBα, the activation of the NF-κB signaling pathway, and the expression of NF-κB downstream inflammatory cytokines. Quantitative real-time polymerase chain reactions (qRT-PCRs) were used to evaluate the expression levels of COX-2 and ICAM-1 in lung tissues. We found that high doses of MaR1 were most effective in preventing OVA-induced inflammatory cell infiltration and excessive mucus production in lung tissue, reducing the number of inflammatory cells in the BALF and inhibiting the expression of serum or BALF-associated inflammatory factors. Furthermore, high-dose MaR1 treatment markedly suppressed the activation of the NF-κB signaling pathway, the degradation of IκBα, and the expression of inflammatory genes downstream of NF-κB, such as COX-2 and ICAM-1, in the OVA-induced asthma mouse model. Our findings indicate that MaR1 may play a critical role in OVA-induced asthma and may be therapeutically useful for the management of asthma.

New drug approvals for 2020: Synthesis and clinical applications.

53 New drugs including 38 chemical entities and 15 biologics were approved by the U.S. Food and Drug Administration during 2020. Among the marketed drugs, 34 new small molecule drugs and 4 new diagnostic agents with privileged structures and novel clinical applications represent as promising leads for the development of new drugs with the similar indications and improved therapeutic efficacy. This review is mainly focused on the clinical applications and synthetic methods of 34 small-molecule drugs newly approved by the FDA in 2020.

Copper(ii)-catalyzed and acid-promoted highly regioselective oxidation of tautomerizable C(sp3)-H bonds adjacent to 3,4-dihydroisoquinolines using air (O2) as a clean oxidant.

A mild, efficient and eco-friendly method for the oxidation of 1-Bn-DHIQs to 1-Bz-DHIQs without concomitant excessive oxidation of 1-Bz-DHIQs to 1-Bz-IQs is very important for the syntheses of 1-Bz-DHIQ alkaloids and analogues. In this article, we developed a novel Cu(ii)-catalyzed and acid-promoted highly regioselective oxidation of tautomerizable C(sp3)-H bonds adjacent to the C-1 positions of various 1-Bn-DHIQs. It was observed that when 0.2 equiv. of Cu(OAc)2·2H2O was used as the catalyst, 3.0 equiv. of AcOH was used as the additive and air (O2) was used as a clean oxidant, various 1-Bn-DHIQs could be efficiently oxidized to corresponding 1-Bz-DHIQs at 25 °C in DMSO. Especially, almost no concomitant excessive oxidation of 1-Bz-DHIQs to 1-Bz-IQs was observed during the above reaction. In addition, this method was successfully applied in the first total synthesis of the alkaloid canelillinoxine.

Chemical composition of hydrosol volatiles of flowers from ten Paeonia × suffruticosa Andr. cultivars from Luoyang, China.

Hydrosol volatiles from flowers of ten Paeonia × suffruticosa Andr. cultivars were analysed by gas chromatography-mass spectrometry (GC-MS) and GC-flame ionisation detector (GC-FID) for the first time. Fifty components were identified representing 97.6-99.8% of total composition, in which oxygenated compounds (87.4-99.8%) predominated. Hydrosol volatiles of five and two cultivars presented chemotypes of 2-phenylethanol (48.0-79.5%) and 1,3,5-trimethoxybenzene (72.8%, 50.2%), respectively. Hydrosol volatiles of 'XYTH' rich in ß-citronellol (57.2%) probably represented a newly defined chemotype with ß-citronellol percentage over 50%. 'GFCC' hydrosol volatiles presented a balanced profile with 1,3,5-trimethoxybenzene (31.9%), ß-citronellol (31.5%) and 2-phenylethanol (23.0%). 'LHZL' hydrosol volatiles were distinct from others due to occurrence of 6,9-heptadecadiene (2.0%), 2-heptanol (1.8%), pentadecane (1.5%), (Z)-3-nonen-1-ol (1.1%) and geraniol (15.7%). Chemotype characterisation of P. × suffruticosa Andr. hydrosols was of significance considering numerous cultivars of the species and potential applications of the hydrosols.

Massively parallel single-molecule telomere length measurement with digital real-time PCR.

Telomere length is a promising biomarker for age-associated diseases and cancer, but there are still substantial challenges to routine telomere analysis in clinics because of the lack of a simple and rapid yet scalable method for measurement. We developed the single telomere absolute-length rapid (STAR) assay, a novel high-throughput digital real-time PCR approach for rapidly measuring the absolute lengths and quantities of individual telomere molecules. We show that this technique provides the accuracy and sensitivity to uncover associations between telomere length distribution and telomere maintenance mechanisms in cancer cell lines and primary tumors. The results indicate that the STAR assay is a powerful tool to enable the use of telomere length distribution as a biomarker in disease and population-wide studies.

Study on dynamic thermal characteristics of thermoelectric radiant cooling panel system through a hybrid method.

Thermoelectric radiant panel system (TERP), requires no hydronic pipes, pumps and chillers and the size is compact in solid form. In this study, the main results include a new system model of TERP and some new findings on the system dynamic characteristics. The new model integrates finite difference method and state-space matrix, which is an integration of great simulation accuracy, high speed, and easy implementation. The thermal response time (TRT) and its asynchronism are confirmed and a new concept of AM (Asynchronism Magnitude) is defined to measure the degree of TRT asynchronism. Some new observations are obtained: (1) Under a certain environment, AM becomes a constant even when different step changes of current are imposed; (2) The TRT asynchronism disappeared at the second stage when environmental condition is step changed. Three new definitions of TRT are proposed and compared. Finally, in order to realize the fast and accurate prediction of TRT for the use of system on-line control or fast evaluation under dynamic state, an artificial neural network-based model is proved to be effective. The dynamic analysis can offer a new paradigm to the evaluation, control and optimization of radiant cooling and other dynamic systems.

Efficient and Highly Stereoselective Syntheses of (+)-proto-Quercitol and (-)-gala-Quercitol Starting from the Naturally Abundant (-)-Shikimic Acid.

Efficient and highly stereoselective syntheses of (+)-proto-quercitol and (-)-gala-quercitol starting from the naturally abundant (-)-shikimic acid were described in this article. (-)-Shikimic acid was first converted to the key intermediate by eight steps in 53% yield. It was then converted to (+)-proto-quercitol by three steps in 78% yield and was also converted to (-)-gala-quercitol by five steps in 63% yield. In summary, (+)-proto-quercitol and (-)-gala-quercitol were synthesized from (-)-shikimic acid by 11 and 13 steps in 41 and 33% overall yields, respectively.

Experimental study and performance analysis of solar-driven exhaust air thermoelectric heat pump recovery system.

Exhaust air heat recovery is of great significance for building energy conservation. Since passive heat recovery systems use temperature or enthalpy difference between outdoor air and indoor air to drive the system, the temperature of fresh air supply cannot meet indoor requirements and the exhaust heat is not fully recovered. In this study, a solar-driven exhaust air thermoelectric heat pump recovery (SDEATHP) system is tested and evaluated for its ability to recover thermal energy from exhaust air to cool or heat fresh air. An experimental platform was established to test its performance. Results show that the SDEATHP system can obtain higher fresh air supply temperature in winter and lower fresh air supply temperature in summer. The system requires only 3.12 W of power for the fans, and the average relative cooling coefficient in summer and the average relative heating coefficient can reach 50.6 and 57.9, respectively. The optimal operating current and voltage of TE modules and photovoltaic system is analyzed, and then the number and types of electrical connections for the TE modules in SDEATHP system are discussed. The SDEATHP system provides a new method for building energy recovery and fresh air supply.

Laparoscopic cholecystectomy for acute cholecystitis: early or delayed?: Evidence from a systematic review of discordant meta-analyses.

The laparoscopic cholecystectomy (LC) is an important approach of treating acute cholecystitis and the timing of performing this given treatment is associated with clinical outcomes. Although several meta-analyses have been done to investigate the optimal timing of implementing this treatment, the conflicting findings from these meta-analyses still confuse decision-making. And thus, we performed this systematic review to assess discordant meta-analyses and generate conclusive findings to facilitate informed decision-making in clinical context eventually. We electronically searched the PubMed, Cochrane Library, and EMBASE to include meta-analysis comparing early (within 7 days of the onset of symptoms) with delayed LC (at least 1 week after initial conservative treatment) for acute cholecystitis through August 2015. Two independent investigators completed all tasks including scanning and appraising eligibility, abstracting essential information using prespecified extraction form, assessing methodological quality using Oxford Levels of Evidence and Assessment of Multiple Systematic Reviews (AMSTAR) tool, and assessing the reporting quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), as well as implementing Jadad algorithm in each step for the whole process. A heterogeneity degree of ≤50% is accepted. Seven eligible meta-analyses were included eventually. Only one was Level I of evidence and remaining studies were Level II of evidence. The AMSTAR scores varied from 8 to 11 with a median of 9. The PRISMA scores varied from 19 to 26. The most heterogeneity level fell into the desired criteria. After implementing Jadad algorithm, 2 meta-analyses with more eligible RCTs were selected based on search strategies and implication of selection. The best available evidence indicated a nonsignificant difference in mortality, bile duct injury, bile leakage, overall complications, and conversion to open surgery, but a significant reduction in wound infection, hospitalization, and operation duration and improvement of the quality of life when compared early LC with delayed LC. However, number of work days lost, hospital costs, and patient satisfaction are warranted to be assessed further. With the best available evidence, we recommend early LC to be as the standard treatment option in treating acute cholecystitis.