Mycobacterium Infection of Abscess with Hemoptysis as the Initial Manifestation.

BACKGROUND: Mycobacterium abscessus is a new pathogen in recent years, which belongs to non-tuberculosis mycobacterium. Mycobacterium abscessus is widely involved in many nosocomial infections and secondary aggravation of genetic respiratory diseases. Mycobacterium abscessus is naturally resistant to most antibiotics and is difficult to treat. We report a case of mycobacterium abscessus infection with hemoptysis as the first manifestation. METHODS: Bronchoscopy, next-generation sequencing (NGS). RESULTS: Acid-fast staining of bronchoscopic lavage fluid showed that a small amount of acid-fast bacilli could be seen. NGS test showed the presence of Mycobacterium abscess, sequence number 137 (reference range ≥ 0), and symptomatic treatment against non-tuberculosis mycobacteria. CONCLUSIONS: For the follow-up infection of patients with hemoptysis, the treatment effect of antibiotics is not good, so the pathological tissue should be obtained by bronchoscopy or percutaneous lung biopsy in time, and the diagnosis should be confirmed by NGS if necessary.

A splicing mutation in VPS4B causes dentin dysplasia I.

BACKGROUND: Dentin dysplasia I (DDI) is a genetically heterogeneous autosomal-dominant disorder characterised by rootless teeth with abnormal pulpal morphology, the aetiology of which presents as genetically heterogeneous. METHODS AND RESULTS: Using a cohort of a large Chinese family with 10 patients with DDI, we mapped to a 9.63 Mb candidate region for DDI on chromosome 18q21.2-q21.33. We then identified a mutation IVS7+46C>G which resulted in a novel donor splice site in intron 7 of the VPS4B gene with co-segregation of all 10 affected individuals in this family. The aberrant transcripts encompassing a new insert of 45 bp in size were detected in gingival cells from affected individuals. Protein structure prediction showed that a 15-amino acid insertion altered the ATP-binding cassette of VPS4B. The mutation resulted in significantly reduced expression of mRNA and protein and altered subcellular localisation of VPS4B, indicating a loss of function of VPS4B. Using human gingival fibroblasts, the VPS4B gene was found to act as an upstream transducer linked to Wnt/ß-catenin signalling and regulating odontogenesis. Furthermore, knockdown of vps4b in zebrafish recapitulated the reduction of tooth size and absence of teeth similar to the tooth phenotype exhibited in DDI index cases, and the zebrafish mutant phenotype could be partially rescued by wild-type human VPS4B mRNA. We also observed that vps4b depletion in the zebrafish negatively regulates the expression of some major genes involved in odontogenesis. CONCLUSIONS: This study identifies VPS4B as a disease-causing gene for DDI, which is one of the important contributors to tooth formation, through the Wnt/ß-catenin signalling pathway.

Visual effect of a linear Fresnel lens illuminated with a directional backlight.

A linear Fresnel lens illuminated by a directional backlight is studied. The light distribution on the lens surface visualized by a retina is simulated with a Monte Carlo ray-tracing technique, and the visualized display uniformity on the lens surface is found to depend critically on the lens quality as well as on the viewing position away from the light propagation axis. The effect of the light source configuration as well as the deviation of the microstructures of the Fresnel lens from ideal structure are studied. The simulation is verified with an experimental study, and good agreement between numerical and experimental results is obtained. Design guidelines are presented for a backlight-illuminated system to achieve high-quality uniform flat-panel two-dimensional and autostereoscopic displays.

Dentin dysplasia type I-novel findings in deciduous and permanent teeth.

BACKGROUND: Dentin dysplasia type I (DD-I) is a rare autosomal dominant hereditary disorder which seriously affects the root development of teeth, causing spontaneous tooth loss (in teenagers). At present, the study of DD-I focuses on familial and phenotypic analyses and reports regarding the ultrastructural study of DD-I are few. The purpose of this study was to clarify and discuss the clinical, histopathological, and ultrastructural features of the dentin defects in DD-I. In addition, the study further explores the root development and provides clues for uncovering virulent genes associated with the disease. METHODS: We recruited 31 members of a four-generation Chinese family, including eleven with dentin defects. Four permanent teeth and four deciduous teeth were obtained from individuals affected by DD-I. At the same time, two caries-free like-numbered permanent teeth and deciduous teeth served as controls, respectively. Analyses of these teeth were carried out using stereomicroscopy, light microscopy, and scanning and transmission electron microscopy, respectively. RESULTS: Similar to previous reports, extracted teeth showed typical histopathological and ultrastructural features of DD-I and teeth had short roots with obliterated pulp chambers. Furthermore, several novel discoveries were found in teeth affected by DD-I, including; (1) thinner dentin; (2) larger scalloped dentinoenamel junctions; (3) teardrop-shaped lacunae in the enamel; (4) rodless enamel and (5) irregular collagen fibers. CONCLUSIONS: The results exhibited defined features of DD-I in the family and further confirmed that abnormal dentin structure affected both the deciduous and permanent dentitions. In addition, these findings may contribute to a better understanding of the pathogenesis of DD-I as well as aid in the subclassification of this disease.

Chemical characteristics, distribution patterns, and source apportionment of particulate elements and inorganic ions in snowpack in Harbin, China.

Snowpack, which serves as a natural archive of atmospheric deposition of multiple pollutants, is a practical environmental media that can be used for assessing atmospheric records and input of the pollutants to the surface environments and ecosystems. A total of 29 snowpack samples were collected at 20 sampling sites covering three different functional areas of a major city (Harbin) in Northeast China. Two samples at the "snow layer" and one or two samples at the "particulate layer" were collected at each sampling site in the industrial areas characterized by multi-layer snowpack, and only one sample at the "snow layer" was collected at each sampling site in the cultural and recreational as well as agricultural areas. The snow contents of 31 elements (Na, Mg, Al, K, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Y, Cd, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, and Pb) and six major water-soluble inorganic ions (WSIIs, NH4+, K+, Ca2+, NO2-, NO3-, and SO42-) were analyzed. The total mass of the measured elements is dominated (95.8%-99.2%) by crustal elements. Heavy metals only account for 0.77%-4.07% of the total mass of the elements, but are occasionally close to or even above the standard limit in the "Environmental Quality Standards for Surface Water" of China (GB3838-2002). SO42- and Ca2+ are the main anion and cation, accounting for 34.9%-81.1% and 1.43%-29.9%, respectively, of the measured total ions. Total atmospheric deposition of crustal elements and heavy metals is dominated by wet deposition in areas near the petrochemical plant and by dry deposition in areas near the cement plant. Coal combustion, industrial emissions, and traffic-related activities lead to the enrichment of heavy metals in the snowpacks of urban and suburban areas, while coal combustion and biomass burning contribute to pollution in rural areas. The cities and regions situated in the western, northwestern, northern, and northeastern directions from Harbin are potential source regions of these pollutant species.

Crosstalk between intestinal flora and human iron metabolism: the role in metabolic syndrome-related comorbidities and its potential clinical application.

The interaction of iron and intestinal flora, both of which play crucial roles in many physiologic processes, is involved in the development of Metabolic syndrome (MetS). MetS is a pathologic condition represented by insulin resistance, obesity, dyslipidemia, and hypertension. MetS-related comorbidities including type 2 diabetes mellitus (T2DM), obesity, metabolism-related fatty liver (MAFLD), hypertension polycystic ovary syndrome (PCOS), and so forth. In this review, we examine the interplay between intestinal flora and human iron metabolism and its underlying mechanism in the pathogenesis of MetS-related comorbidities. The composition and metabolites of intestinal flora regulate the level of human iron by modulating intestinal iron absorption, the factors associated with iron metabolism. On the other hand, the iron level also affects the abundance, composition, and metabolism of intestinal flora. The crosstalk between these factors is of significant importance in human metabolism and exerts varying degrees of influence on the manifestation and progression of MetS-related comorbidities. The findings derived from these studies can enhance our comprehension of the interplay between intestinal flora and iron metabolism, and open up novel potential therapeutic approaches toward MetS-related comorbidities.

Low temperature, solution-processed alumina for organic solar cells.

In this work, we have reported for the first time a facile route for developing solution-processed Al2O3 film at a greatly reduced processing temperature and studied its applications in producing inverted polymer solar cells (PSCs). These PSCs using Al2O3 thin film as the electron-extraction layer demonstrated improved diode characteristics and achieved a 20% higher power conversion efficiency than devices using the conventional ZnO buffer layer. Furthermore, the low temperature processing of the Al2O3 film makes it compatible with fabrication of flexible organic electronic devices based on plastic substrates.

Study on the Compromise Effect Under the Influence of Normative Reference Group.

The compromise effect is an important context effect, but its research is still insufficient under the influence of social factors and purchase tasks. This study explores the change of compromise effect in different group norm scenarios by constructing three different group norm reference points. Three conclusions were drawn. First, the compromise effect always exists under the influence of different groups' normative reference points if there is a compromise effect in a product set. Second, the effect value of the compromise effect will be significantly different with the change of group norm reference point. Third, group norms can indeed induce the compromise effect. Therefore, these findings would help to further enrich the literature results of the compromise effect and strengthen its application in marketing practice.

Disturbance of glutamate metabolism and inhibition of CaM-CaMKII-CREB signaling pathway in the hippocampus of mice induced by 1,2-dichloroethane exposure.

1,2-Dichloroethane (1,2-DCE) is a highly toxic neurotoxicity, and the brain tissue is the main target organ. At present, long-term exposure to 1,2-DCE has been shown to cause cognitive dysfunction in some studies, but the mechanism is not clear. The results of this study showed that long-term 1,2-DCE exposure decreased learning and memory abilities in mice and impaired the structure and morphology of neurons in the hippocampal region. Moreover, except for the mRNA level of PAG, the enzymatic activities and protein levels of GS and PAG, as well as the mRNA level of GS were inhibited. With increasing dose of exposure, the protein and mRNA expression of GLAST and GLT-1 also decreased. Contrarily, there were protein and mRNA expression upregulation of GluN1, GluN2A and GluN2B in the hippocampus, as well as increased levels of extracellular Glu and intracellular Ca2+. In addition, 1,2-DCE exposure also downregulated the protein expression levels of CaM, CaMKII and CREB. Taken together, our results suggest that long-term 1,2-DCE exposure impairs the learning and memory capacity in mice, which may be attributed to the disruption of Glu metabolism and the inhibition of CaM- CaMKII-CREB signaling pathway in the hippocampus.

A network meta-analysis to evaluate the efficacy of traditional Chinese medicine on intestinal flora in patients with gastrointestinal cancer.

Background and Purpose: Traditional Chinese medicine (TCM) can regulate intestinal flora so as to affect the occurrence, progression, and prognosis of gastrointestinal cancer. According to clinical studies, TCM oral administration, TCM external treatment, and TCM injections, can adjust intestinal flora disorders in patients with gastrointestinal cancer. This network meta-analysis aims to evaluate the effect of three treatments on the intestinal flora in gastrointestinal cancer patients. Methods: This meta-analysis was registered in PROSPERO (CRD42022332553). Six electronic databases, namely CNKI, Wanfang, CSTJ, PubMed, Cochrane Library, and EMBASE, were searched from their inception to 1 April 2022. We identified randomized controlled trials (RCT) used to compare the efficacy of three TCM treatment methods-oral administration, external therapy and injections-on the intestinal flora in gastrointestinal cancer patients. The main outcome indicators were Bifidobacteria, Lactobacilli, Escherichia coli, and Enterococci. Stata (15.1) and the Cochrane risk of bias assessment tool were employed. Results: We identified 20 eligible RCTs with a total of 1,774 patients. According to network meta-analysis results, TCM injection plus common treatment (CT) or oral administration of TCM plus CT was superior to CT alone for supporting Bifidobacterium. In supporting Lactobacillus, TCM injection plus CT demonstrated more obvious effect relative to oral administration of TCM plus CT; TCM injection plus CT was more effective than CT only; and oral administration of TCM plus CT was superior to CT only.The inhibitory effect of TCM injection plus CT on Escherichia coli was better compared with CT only. In terms of inhibiting Enterococci, oral administration of TCM plus CT was superior to CT only.The difference in efficacy among the above treatments was statistically significant. In the SUCRA probability ranking, TCM injection plus CT had the best ranking curve among the three treatments and was the most effective in supporting Bifidobacteria (Sucra = 90.08%), Lactobacilli (Sucra = 96.4%), and regulating Escherichia coli (Sucra = 86.1%) and Enterococci (Sucra = 87.1%). Conclusion: TCM injections plus CT is the most effective therapy in balancing the intestinal flora of gastrointestinal cancer patients. However, the current results deserve further validation through high-quality research. Systematic Review Registration: http://www.prisma-statement.org/, identifier 10.1136/bmj.n71.

Occurrence, variations, and risk assessment of neonicotinoid insecticides in Harbin section of the Songhua River, northeast China.

Neonicotinoid insecticides (NNIs) have been intensively used and exploited, resulting in their presence and accumulation in multiple environmental media. We herein investigated the current levels of eight major NNIs in the Harbin section of the Songhua River in northeast China, providing the first systematic report on NNIs in this region. At least four NNIs in water and three in sediment were detected, with total concentrations ranging from 30.8 to 135 ng L-1 and from 0.61 to 14.7 ng g-1 dw, respectively. Larger spatial variations in surface water NNIs concentrations were observed in tributary than mainstream (p < 0.05) due to the intensive human activities (e.g., horticulture, urban landscaping, and household pet flea control) and the discharge of wastewater from many treatment plants. There was a significant positive correlation (p < 0.05) between the concentrations of residual imidacloprid (IMI), clothianidin (CLO), and Σ4NNIs in the sediment and total organic carbon (TOC). Due to its high solubility and low octanol-water partition coefficient (K ow), the sediment-water exchange behavior shows that NNIs in sediments can re-enter into the water body. Human exposure risk was assessed using the relative potency factor (RPF), which showed that infants have the highest exposure risk (estimated daily intake (ΣIMIeq EDI): 31.9 ng kg-1 bw·d-1). The concentration thresholds of NNIs for aquatic organisms in the Harbin section of the Songhua River were determined using the species sensitivity distribution (SSD) approach, resulting in a value of 355 ng L-1 for acute hazardous concentration for 5% of species (HC5) and 165 ng L-1 for chronic HC5. Aquatic organisms at low trophic levels were more vulnerable to potential harm from NNIs.

Rapid, accurate, multifunctional and self-assisted vision assessment and screening with interactive desktop autostereoscopy.

BACKGROUND: This study aimed to develop an interactive vision screening tool based on desktop autostereoscopy and evaluate its feasibility for testing visual acuity, colour vision, stereo vision and binocular balance clinically. METHODS: An interactive desktop autostereoscopy vision test was developed making it remarkably convenient for individuals to undergo multiple visual function assessments in a single test. With this rapid screening process, an individual's visual acuity, colour vision, stereo vision and binocular balance can be assessed within several minutes. A total of 155 healthy subjects were enrolled to compare the clinical repeatability, accuracy, inter-visit variability, likeability and efficiency between the autostereoscopy and traditional method. RESULTS: In the repeatability test, the visual acuity measured with autostereoscopy was 0.045±0.018 and 0.035±0.018 (P=0.702) for the first and second tests, respectively. The mean logarithm of the Minimum Angle of Resolution (logMAR) visual acuities measured with the Early Treatment Diabetic Retinopathy Study (EDTRS) chart and autostereoscopy test were 0.04±0.02 and 0.05±0.02, respectively, which were not significantly different (P=0.849). The correlation between these two kinds of tests was statistically significant (Spearman correlation coefficient =0.829, P<0.001). The results for colour vision, stereo vision, and binocular vision are presented, and the effectiveness of the autostereoscopic method is supported with qualitative data comparing its results with those of the traditional methods. In the likeability test, the EDTRS chart and autostereoscopy test had scores of 2.21±0.53 and 3.04±0.07, while the traditional and autostereoscopy tests for colour vision, stereo vision, and binocular vision had scores of 2.02±0.59 and 3.36±0.93, respectively (P<0.001). Regarding visual fatigue, the mean scores were 0.69±0.04 and 0.42±0.04 (P<0.001) with the EDTRS chart and autostereoscopy test, respectively. Regarding work efficiency, the average testing times per person was 59.65±0.66 and 48.92±0.86 s (P<0.001) with the EDTRS chart and autostereoscopy test, respectively. CONCLUSIONS: The autostereoscopy test was conclusively shown to be valid, efficient and repeatable for the measurement of visual acuity, colour vision, stereo vision, and binocular vision, and the process was subjectively well-liked and comfortable.

circ_BICD2 acts as a ceRNA to promote tumor progression and Warburg effect in oral squamous cell carcinoma by sponging miR-107 to enhance HK2.

Numerous studies have proved that the Warburg effect serves a vital role involved in regulating the progression of malignant tumors. Previous studies confirmed that circRNAs act as a novel biomarker for diagnostic and therapeutic in various tumors. However, the functional role and mechanism of circ_BICD2 for the regulation of tumor growth and metastasis in oral squamous cell carcinoma (OSCC) via mediating the Warburg effect are largely unknown. In this study, we found that circ_BICD2 was upregulated in OSCC tumor tissues and cell lines. Inhibition of circ_BICD2 significantly decreased glycolysis, cell proliferation, migration and invasion of OSCC. Moreover, dual-luciferase reporter assay confirmed that circ_BICD2 directly targeted miR-107, as well as a targeted binding between miR-107 and HK2. Mechanistically, upregulation of miR-107 by circ_BICD2-silenced inhibited tumor growth by downregulating the HK2-mediated Warburg effect in OSCC. In conclusion, our findings suggested that circ_BICD2-deficient exerted anti-tumorigenesis and anti-glycolysis in OSCC by sponging miR-107 to downregulate HK2 expression, which provided a new potential therapeutic biomarker for OSCC clinical treatment.

Concentrations, Possible Sources and Health Risk of Heavy Metals in Multi-Media Environment of the Songhua River, China.

Heavy metal pollution in the river environment has been a source of widespread interest due to potential threats to human health and ecosystem security. Many studies have looked at heavy metal pollution in the context of single source-pathway-receptor relationships, however few have sought to understand pollution from a more wholistic multi-media perspective. To investigate potential risks in a more wholistic way, concentrations of six heavy metals (Cd, Cr, Ni, Cu, Zn and Pb) were detected in multi-media (water, sediment and riparian soil) collected from 14 sampling sites in the main stream of the Songhua River. Chemical analyses indicated that the average concentration of heavy metals in water followed: Zn > Cr > Cu > Pb > Ni > Cd, with a different trend observed in sediments and riparian soil: Zn > Cr > Ni > Pb > Cu > Cd. The potential risk was evaluated using the heavy metal pollution index (HPI), Nemerow pollution index (PN), hazard index (HI) and carcinogenic risk (CR) metrics. Results showed that all HPI values were lower than the critical level of 100 indicating that the levels of these targeted heavy metals were within drinking water safety limits. The PN indicated that both sediment (2.64) and soil (2.95) could be considered "moderately polluted", with Cd and Zn providing the most significant contributions. A human health risk assessment suggested that the non-carcinogenic risks were within acceptable levels (HI < 1), as was the cancer risk associated with dermal adsorption (CR <10-6). However, the CR associated with ingestion exposure (4.58 × 10-6) exceeded the cancer risk threshold (10-6) indicative of elevated cancer incidence in exposed populations. Health-risk estimates were primarily associated with Cd in the Songhua River. Source apportionment was informed by Pearson correlation analysis coupled with principal component analysis (PCA) which indicated that Cu was mainly derived from natural (geogenic) sources; Cr and Ni were associated with industrial emissions; Pb might be derived from agricultural and transportation sources; Zn might be from industrial, agricultural activities and transportation; while Cd is likely from industrial and agricultural emissions. The source apportionment information could provide the basis for a risk-management strategy focused on reducing Cd and Zn emissions to the riverine environment. Results from this study will provide the scientific knowledge that is needed for measuring and controlling heavy metals sources and pollution characteristics, and identifying the potential cancer risk with different exposure pathways, as well as making effective environmental management policies at catchment or regional scales.

Sliding Trend Fuzzy Approximate Entropy as a Novel Descriptor of Heart Rate Variability in Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a common sleep disorder that is often associated with reduced heart rate variability (HRV), thus reflecting modulation of the autonomic system. Sliding trend fuzzy approximate entropy (SlTr-fApEn), which is based on the empirical mode decomposition (EMD) method, has been proposed as a novel index for analyzing HRV with OSA. This study included 60 electrocardiogram recordings from the PhysioNet database (40 OSA recordings and 20 healthy recordings) with apnea or no apnea in 5-minute segments. HRV indices obtained by sliding trend analysis were compared to those obtained by time-frequency domain analysis. Among all indices, the ratio of low-frequency power and high-frequency power (LF/HF) and sliding trend indices could significantly differentiate OSA recordings from normal recordings (p < 0.05). The OSA screening accuracy of SlTr-fApEn (85%) was higher than that of LF/HF (80%). Disease state analysis showed significant differences in SlTr-fApEn among the control group, normal OSA group, and apnea OSA group (p < 0.05). Therefore, SlTr-fApEn can reflect the complexity of autonomic changes during a short time period.

Heavy Metals in Sediment from the Urban and Rural Rivers in Harbin City, Northeast China.

The concentrations and ecological risk of six widespread heavy metals (Cu, Cr, Ni, Zn, Cd and Pb) were investigated and evaluated in sediments from both urban and rural rivers in a northeast city of China. The decreasing trend of the average concentration of heavy metals was Zn > Cr > Cu > Pb > Ni > Cd in Majiagou River (urban) and was Zn > Cr > Pb > Cu > Ni > Cd in Yunliang River (rural). The results showed that the concentrations of Cd and Zn were significantly elevated compared to the environmental background value (p < 0.05). Half of all sampling locations were deemed 'contaminated' as defined by the improved Nemerow pollution index (PN' > 1.0). Applying the potential ecological risk index (RI) indicated a 'high ecological risk' for both rivers, with Cd accounting for more than 80% in both cases. Source apportionment indicated a significant correlation between Cd and Zn in sediments (R = 0.997, p < 0.01) in Yunliang River, suggesting that agricultural activities could be the major sources. Conversely, industrial production, coal burning, natural sources and traffic emissions are likely to be the main pollution sources for heavy metals in Majiagou River. This study has improved our understanding of how human activities, industrial production, and agricultural production influence heavy metal pollution in urban and rural rivers, and it provides a further weight of evidence for the linkages between different pollutants and resulting levels of heavy metals in riverine sediments.

[Effects of enzyme inhibitors on the pigment synthesis in Monascus anka].

Monascus pigment is a natural, safe pigment and preservative. Six inhibitors of key enzymes from three metabolic pathways were chosen according to databases, and were used in basic medium to study their effects on the pigment synthesis in Monascus anka strain M5034. Trimethylamine, inhibitor of shikimic acid pathways, and anthranilic acid and 3,4-dihydroxybenzoic acid, inhibitors of mevalonic acid pathways, had no effects on the pigment biosynthesis. Pigment biosynthesis was severely inhibited by three inhibitors of the key enzymes in the polyketide pathways at the concentrations with no effects for growth of the strain. lodiacetamide (lower than 0.5 mmol/L), specific inhibitor of beta-ketoacyl-acylcarrier protein (ACP) synthase, reduced remarkably the pigment synthesis by 64.7%; 1.0 mmol/L imidazole, being nonspecific inhibitor of ACP synthase, could strongly suppress the synthesis of pigment by 60%, and 0.5 mmol/L 2,4-dinitrofluorobenzene, inhibiting the activity of thioesterase, strongly limited the pigment production with inhibitory extent up to 91.5%. All data implied that Monascus pigments might be synthesized through polyketide pathway.

Differences in grip force control between young and late middle-aged adults.

Grip force control is a crucial function for human to guarantee the quality of life. To examine the effects of age on grip force control, 10 young adults and 11 late middle-aged adults participated in visually guided tracking tasks using different target force levels (25, 50, and 75% of the subject's maximal grip force). Multiple measures were used to evaluate the tracking performance during force rising phase and force maintenance phase. The measurements include the rise time, fuzzy entropy, mean force percentage, coefficient of variation, and target deviation ratio. The results show that the maximal grip force was significantly lower in the late middle-aged adults than in the young adults. The time of rising phase was systematically longer among late middle-aged adults. The fuzzy entropy is a useful indicator for quantitating the force variability of the grip force signal at higher force levels. These results suggest that the late middle-aged adults applied a compensatory strategy that allow allows for sufficient time to reach the required grip force and reduce the impact of the early and subtle degenerative changes in hand motor function.

A Novel and Effective Method for Congestive Heart Failure Detection and Quantification Using Dynamic Heart Rate Variability Measurement.

Risk assessment of congestive heart failure (CHF) is essential for detection, especially helping patients make informed decisions about medications, devices, transplantation, and end-of-life care. The majority of studies have focused on disease detection between CHF patients and normal subjects using short-/long-term heart rate variability (HRV) measures but not much on quantification. We downloaded 116 nominal 24-hour RR interval records from the MIT/BIH database, including 72 normal people and 44 CHF patients. These records were analyzed under a 4-level risk assessment model: no risk (normal people, N), mild risk (patients with New York Heart Association (NYHA) class I-II, P1), moderate risk (patients with NYHA III, P2), and severe risk (patients with NYHA III-IV, P3). A novel multistage classification approach is proposed for risk assessment and rating CHF using the non-equilibrium decision-tree-based support vector machine classifier. We propose dynamic indices of HRV to capture the dynamics of 5-minute short term HRV measurements for quantifying autonomic activity changes of CHF. We extracted 54 classical measures and 126 dynamic indices and selected from these using backward elimination to detect and quantify CHF patients. Experimental results show that the multistage risk assessment model can realize CHF detection and quantification analysis with total accuracy of 96.61%. The multistage model provides a powerful predictor between predicted and actual ratings, and it could serve as a clinically meaningful outcome providing an early assessment and a prognostic marker for CHF patients.

Smart pH-responsive nanocarriers based on nano-graphene oxide for combined chemo- and photothermal therapy overcoming drug resistance.

A pH-responsive nanocarrier is developed by coating nanoscale graphene oxide (NGO) with dual types of polymers, polyethylene glycol (PEG) and poly(allylamine hydrochloride) (PAH), the latter of which is then modified with 2,3-dimethylmaleic anhydride (DA) to acquire pH-dependent charge reversibility. After loading with doxorubicin (DOX), a chemotherapy drug, the obtained NGO-PEG-DA/DOX complex exhibits a dual pH-responsiveness, showing markedly enhanced cellular uptake under the tumor microenvironmental pH, and accelerated DOX release under a further lowered pH inside cell lysosomes. Combining such a unique behavior with subsequently slow efflux of DOX, NGO-PEG-DA/DOX offers remarkably improved cell killing for drug-resistant cancer cells under the tumor microenvironmental pH in comparison with free DOX. Exploiting its excellent photothermal conversion ability, combined chemo- and photothermal therapy is further demonstrated using NGO-PEG-DA/DOX, realizing a synergistic therapeutic effect. This work presents a novel design of surface chemistry on NGO for the development of smart drug delivery systems responding to the tumor microenvironment and external physical stimulus, with the potential to overcome drug resistance.