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Background and Objective: Radiation therapy (RT) is one of the important components of comprehensive treatment for breast cancer and has important value in improving the control rate of local areas, reducing the chance of recurrence and metastasis after breast cancer surgery, delaying disease progression, and improving the survival of breast cancer patients. The factors that affect the RT sensitivity of breast cancer are important. The above potential predictors of radiation efficacy can provide patients with a predictive method and therefore have significant value in clinical therapy. In this paper, we have summarised the predictive factors of radiotherapy sensitivity by reviewing recent research on breast cancer and focused on the following areas: tumor immune microenvironment (TIME), cancer stem cells, noncoding RNAs, signal transduction pathways, genes, etc. This review aims to provide theoretical basis and reference for improving the efficacy of radiotherapy and experimental individualized treatment of breast cancer. Methods: We searched the Web of Science database to identify clinical studies published between 2010 and January 2024 that investigated radiotherapy sensitivity. The main findings of the validated studies were summarised. Key Content and Findings: Improving the radiosensitivity of breast cancer is essential in the treatment of breast cancer. The radiosensitivity can be improved by modulating immune cells or immunomodulatory factors in the TIME, modulating signal transduction pathways, and other innovative combination therapy strategies. And we also summarized the predictive markers of breast cancer radiosensitivity. Conclusions: In this paper, we reviewed the literature and summarized the newest research advances on the radiosensitivity of breast cancer patients. This review paper includes the following six aspects: the immune microenvironment, tumor stem cells, signaling pathways, regulation of gene/protein expression, small molecule drugs, and predictive markers for radiosensitivity.
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The second-leading cause of death, cancer, poses a significant threat to human life. Innovations in cancer therapies are crucial due to limitations in traditional approaches. Newcastle disease virus (NDV), a nonpathogenic oncolytic virus, exhibits multifunctional anticancer properties by selectively infecting, replicating, and eliminating tumor cells. To enhance NDV's antitumor activity, four oncolytic NDV viruses were developed, incorporating IL24 and/or GM-CSF genes at different gene loci using reverse genetics. In vitro experiments revealed that oncolytic NDV virus augmented the antitumor efficacy of the parental virus rClone30, inhibiting tumor cell proliferation, inducing tumor cell fusion, and promoting apoptosis. Moreover, NDV carrying the IL24 gene inhibited microvessel formation in CAM experiments. Evaluation in a mouse model of liver cancer confirmed the therapeutic efficacy of oncolytic NDV viral therapy. Tumors in mice treated with oncolytic NDV virus significantly decreased in size, accompanied by tumor cell detachment and apoptosis evident in pathological sections. Furthermore, oncolytic NDV virus enhanced T cell and dendritic cell production and substantially improved the survival rate of mice with hepatocellular carcinoma, with rClone30-IL24(P/M) demonstrating significant therapeutic effects. This study establishes a basis for utilizing oncolytic NDV virus as an antitumor agent in clinical practice.
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Interleucinas , Vírus da Doença de Newcastle , Terapia Viral Oncolítica , Vírus Oncolíticos , Animais , Vírus da Doença de Newcastle/genética , Vírus da Doença de Newcastle/fisiologia , Terapia Viral Oncolítica/métodos , Vírus Oncolíticos/genética , Vírus Oncolíticos/fisiologia , Humanos , Camundongos , Linhagem Celular Tumoral , Interleucinas/genética , Interleucinas/metabolismo , Neoplasias Hepáticas/terapia , Camundongos Endogâmicos BALB C , Carcinoma Hepatocelular/terapia , Apoptose , Neovascularização Patológica/terapia , Proliferação de Células , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Células Dendríticas/imunologia , Linfócitos T/imunologiaRESUMO
The advancement of rechargeable zinc-air batteries (RZABs) faces challenges from the pronounced polarization and sluggish kinetics of oxygen reduction and evolution reactions (ORR and OER). Single-atom catalysts offer an effective solution, yet their insufficient or singular catalytic activity hinders their development. In this work, a dual single-atom catalyst, FeCo-SAs, was fabricated, featuring atomically dispersed N3-Fe-Co-N4 sites on N-doped graphene nanosheets for bifunctional activity. Introducing Co into Fe single-atoms and secondary pyrolysis altered Fe coordination with N, creating an asymmetric environment that promoted charge transfer and increased the density of states near the Fermi level. This catalyst achieved a narrow potential gap of 0.616 V, with a half-wave potential of 0.884 V for ORR (vs the reversible hydrogen electrode) and a low OER overpotential of 270 mV at 10 mA cm-2. Owing to the superior activity of FeCo-SAs, RZABs exhibited a peak power density of 203.36 mW cm-2 and an extended cycle life of over 550 h, exceeding the commercial Pt/C + IrO2 catalyst. Furthermore, flexible RZABs with FeCo-SAs demonstrated the promising future of bimetallic pairs in wearable energy storage devices.
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As an endocrine cytokine, fibroblast growth factor 21 (FGF21) exhibits anti-inflammatory properties. With the development of lupus nephritis (LN), which is tightly related to pathogenic factors, including inflammation and immune cell dysregulation, we explored the impact of Fibroblast Growth Factor 21 (FGF21) as well as its underlying mechanism. We induced an in vivo LN model using pristane in both wild-type C57BL/6 and FGF21 knockout (FGF21-/-) mice. LN serum obtained from 32-week-old wild-type LN mice was used to stimulate RAW264.7 and human renal tubular epithelial (HK-2) cells to mimic an in vitro LN model. Moreover, our findings revealed that FGF21-/- mice showed more severe kidney injury compared to wild-type mice, as evidenced by increased levels of renal function markers, inflammatory factors, and fibrosis markers. Notably, exogenous administration of FGF21 to wild-type LN mice markedly mitigated these adverse effects. Additionally, we used tandem mass tag (TMT)-based quantitative proteomics to detect differentially expressed proteins following FGF21 treatment. Results indicated that 121 differentially expressed proteins influenced by FGF21 were involved in biological processes such as immune response and complement activation. Significantly upregulated protein Irgm 1, coupled with modulated inflammatory response, appeared to contribute to the beneficial effects of FGF21. Furthermore, Western blot analysis demonstrated that FGF21 upregulated Irgm 1 while inhibiting nucleotide-binding oligomerization domain-like receptors family pyrin domain including 3 (NLRP3) inflammasome expression. Silencing Irgm 1, in turn, reversed FGF21's inhibitory effect on NLRP3 inflammasome. In summary, FGF21 can potentially alleviate pristane-induced lupus nephritis in mice, possibly through the FGF21/Irgm 1/NLRP3 inflammasome pathway.
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Fatores de Crescimento de Fibroblastos , Inflamassomos , Nefrite Lúpica , Terpenos , Animais , Humanos , Camundongos , Inflamassomos/metabolismo , Camundongos Endogâmicos C57BL , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismoRESUMO
A reduced graphene oxide encapsulating Fe6Ni20Co2Mn2Cu1.5@rGO catalyst is prepared using a Joule heating strategy. The graphene-coated layer with high crystallinity enhances the stability of the crystal structure, resulting in superior OER activity. Rechargeable zinc-air batteries with Fe6Ni20Co2Mn2Cu1.5@rGO demonstrate remarkable performance, boasting a high specific capacity of 800 mA h gZn-1, an impressive peak power density of 154.612 mW cm-2, and a cycle life of 300 hours at a current density of 10 mA cm-2.
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BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS: The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
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Adenocarcinoma de Pulmão , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/genética , Adenocarcinoma de Pulmão/genética , China , Prognóstico , Fatores de TranscriçãoRESUMO
Owning to merits such as bandgap tunability, solution processability, large absorption coefficients, and high photoluminescence quantum yields, colloidal quantum dots (CQDs) emerged as a promising gain material to make on-chip micro/nanoscale lasers with high silicon compatibility. In this paper, we review the recent progress in CQD on-chip micro/nanoscale lasers, with a special focus on the physical properties achieved through field manipulation schemes in different types of cavities. Key aspects include manipulating and engineering wavelength, polarization, and direction as well as coupling and light extraction. Finally, we give our prospects for future research directions toward the integration of robust CQD nano/microscale lasers with photonic integrated circuits.
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Renal ischemia-reperfusion injury (IRI) is a common reason of acute kidney injury (AKI). AKI can progress to chronic kidney disease (CKD) in some survivors. Inflammation is considered the first-line response to early-stage IRI. We previously reported that core fucosylation (CF), specifically catalyzed by α-1,6 fucosyltransferase (FUT8), exacerbates renal fibrosis. However, the FUT8 characteristics, role, and mechanism in inflammation and fibrosis transition remain unclear. Considering renal tubular cells are the trigger cells that initiate the fibrosis in the AKI-to-CKD transition in IRI, we targeted CF by generating a renal tubular epithelial cell (TEC)-specific FUT8 knockout mouse and measured FUT8-driven and downstream signaling pathway expression and AKI-to-CKD transition. During the IRI extension phase, specific FUT8 deletion in the TECs ameliorated the IRI-induced renal interstitial inflammation and fibrosis mainly via the TLR3 CF-NF-κB signaling pathway. The results firstly indicated the role of FUT8 in the transition of inflammation and fibrosis. Therefore, the loss of FUT8 in TECs may be a novel potential strategy for treating AKI-CKD transition.
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Injúria Renal Aguda , Insuficiência Renal Crônica , Traumatismo por Reperfusão , Animais , Camundongos , Injúria Renal Aguda/etiologia , Fucosiltransferases/genética , Inflamação , Camundongos Knockout , NF-kappa B , Traumatismo por Reperfusão/genética , Receptor 3 Toll-LikeRESUMO
Bulk-edge correspondence, with quantized bulk topology leading to protected edge states, is a hallmark of topological states of matter and has been experimentally observed in electronic, atomic, photonic, and many other systems. While bulk-edge correspondence has been extensively studied in Hermitian systems, a non-Hermitian bulk could drastically modify the Hermitian topological band theory due to the interplay between non-Hermiticity and topology, and its effect on bulk-edge correspondence is still an ongoing pursuit. Importantly, including non-Hermicity can significantly expand the horizon of topological states of matter and lead to a plethora of unique properties and device applications, an example of which is a topological laser. However, the bulk topology, and thereby the bulk-edge correspondence, in existing topological edge-mode lasers is not well defined. Here, we propose and experimentally probe topological edge-mode lasing with a well-defined non-Hermitian bulk topology in a one-dimensional (1D) array of coupled ring resonators. By modeling the Hamiltonian with an additional degree of freedom (referred to as synthetic dimension), our 1D structure is equivalent to a 2D non-Hermitian Chern insulator with precise mapping. Our Letter may open a new pathway for probing non-Hermitian topological effects and exploring non-Hermitian topological device applications.
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Elastic strain sensor nanocomposites are emerging materials of high scientific and commercial interest. This study analyzes the major factors influencing the electrical behavior of elastic strain sensor nanocomposites. The sensor mechanisms were described for nanocomposites with conductive nanofillers, either dispersed inside the polymer matrix or coated onto the polymer surface. The purely geometrical contributions to the change in resistance were also assessed. The theoretical predictions indicated that maximum Gauge values are achieved for mixture composites with filler fractions slightly above the electrical percolation threshold, especially for nanocomposites with a very rapid conductivity increase around the threshold. PDMS/CB and PDMS/CNT mixture nanocomposites with 0-5.5 vol.% fillers were therefore manufactured and analyzed with resistivity measurements. In agreement with the predictions, the PDMS/CB with 2.0 vol.% CB gave very high Gauge values of around 20,000. The findings in this study will thus facilitate the development of highly optimized conductive polymer composites for strain sensor applications.
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Post-treatment has been recognized as one of the effective methods for passivating the underlying defects in perovskite solar cells (PSCs), but little attention has been paid to how to pick suitable passivation agents with diverse isomers for efficient PSCs, particularly for the tin-lead (Sn-Pb) mixed PSCs. Here, we introduce the dependence of the power conversion efficiency (PCE) on a dipole moment for surface passivator screening, in which we chose three trifluoromethyl-phenylethylamine hydroiodide (CF3-PEAI) isomers as surface-treatment materials for hole-transport-layer-free (HTL-free) Sn-Pb mixed PSCs. The different positions of the -CF3 group for the CF3-PEAI isomer result in different dipole moments, which influences the interaction between CF3-PEAI and lead iodide. The para position CF3 with the highest dipole moment exhibits a higher PCE than the ortho-position with a lower dipole moment, which is attributed to the large dipole moment on the surface that could tune the surface polarity from p-type to n-type, facilitating electron charge transport in the HTL-free Sn-Pb mixed PSCs. An ultrathin 2D layer is formed on the perovskite surface to passivate the surface defects, which is responsible for the enhancement of the PCE and stability of the PSCs. As a result, the open-circuit voltage (VOC) of the device is improved from 0.775 to 0.824 V, yielding a champion PCE of 20.17%, which is one of the highest PCEs among the reported HTL-free Sn-Pb mixed PSCs. The device also shows improved stability with remaining 75% of its initial PCEs after storage in N2 for 700 h.
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The functional hierarchical structures of the triply periodic minimal surface are receiving much attention in tissue engineering applications due to their lightweight and multifunctionality. However, current functionally graded structure design methods are not friendly to heterogeneous structures containing different orientations and different unit types and often face the problems of insufficient connection in the hybrid regions and low local stiffness. In this paper, an improved gradient structure design method was proposed, which solves the problem of insufficient connection between substructures by constructing hybrid region transition functions. Three improved heterogeneous structures were constructed using Primitive and Gyroid lattices and compared with the unimproved heterogeneous structure. Their mechanical properties, deformation mechanism, and energy absorption capacity were examined by finite element analysis and experiments. The results showed that the proposed design method can effectively solve the problems of insufficient connection and poor bearing capacity in the hybrid region between substructures. This method can not only ensure the full connection of the hybrid regions but also flexibly adjust the mechanical properties and energy absorption capacity as well as effectively expand the application range of the energy absorption. Overall, these findings provide valuable guidelines for designing gradient structures with disordered and hybrid features.
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Introduction: Anaerobic ammonium oxidation (anammox) plays a vital role in the global nitrogen cycle by oxidizing ammonium to nitrogen under anaerobic environments. However, the existence, abundance, and diversity of anammox bacteria between different temperatures are less studied, particularly in purple paddy soils. Methods: 13C-DNA stable-isotope probe combined with Illumina MiSeq high-throughput sequencing was employed to explore soil abundance and diversity of anammox bacteria. In doing so, 40-60âcm depth soils from typical purple paddy soils in Chongqing, southwest China, were cultured under 12CO2-labeled and 13CO2-labeled at 35°C, 25°C, 15°C, and 5°C for 56 days. Results and Discussion: Anammox bacteria were not labeled at all by 13CO2 at 5°C. The highest abundance of anammox bacteria was found at 25°C (3.52 × 106~3.66 × 106 copies·g-1 dry soil), followed by 35°C and 15°C (2.01 × 106~2.37 × 106 copies·g-1 dry soil) and almost no increase at 5°C. The relative abundance of Candidatus Jettenia sp. was higher at 25°C and 15°C, while Candidatus Brocadia sp. was higher at 35°C and 5°C. Our results revealed differences in anammox bacteria at different temperatures in purple paddy soils, which could provide a better understanding of soil N cycling regulated by anammox bacteria.
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Triply periodic minimal surface (TPMS) has a promising application in the design of bone scaffolds due to its relevance in bone structure. Notably, the mechanical properties of TPMS scaffolds can be affected by many factors, including the spatial angle and surface curvature, which, however, remain to be discovered. This paper illustrates our study on the mechanical properties of tissue scaffolds consisting of TPMS structures (Primitive and I-WP) by considering the influence of spatial angle and surface curvature. Also, the development of a novel model representative of the mechanical properties of scaffolds based on the entropy weight fuzzy comprehensive evaluation method is also presented. For experimental investigation and validation, we employed the selective laser melting technology to manufacture scaffolds with varying structures from AlSi10Mg powder and then performed mechanical testing on the scaffolds. Our results show that for a given porosity, the Gaussian curvature of the stretched TPMS structures is more concentrated and have a higher elastic modulus and fatigue life. At the spatial angle θ = 27°, the shear modulus of the primitive unit reaches its largest value; the shear modulus of the I-WP unit is positively correlated with the spatial angle. Additionally, it is found that the comprehensive mechanical properties of TPMS structures can be significantly improved after changing the surface curvature. Taken together, the identified influence of spatial angle and surface curvature and the developed models of scaffold mechanical properties would be of significant advance and guidance for the design and development of bone scaffolds.
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Engenharia Tecidual , Alicerces Teciduais , Engenharia Tecidual/métodos , Propriedades de Superfície , Alicerces Teciduais/química , Osso e Ossos , PorosidadeRESUMO
BACKGROUND: Gastroesophageal reflux disease (GERD) is often associated with esophageal stricture, particularly benign esophageal stricture. We aimed to evaluate the effects of balloon catheter dilation (BD) combined with laparoscopic fundoplication (LF) surgery and proton pump inhibitors (PPIs) in patients with reflux-induced esophageal strictures. METHODS: We retrospectively analyzed 116 patients with reflux-induced benign esophageal strictures who underwent balloon dilatation therapy combined with PPIs (BD-PPIs group, n = 58) and balloon dilatation combined with LF (BD-LF group, n = 58). Patients were followed up for 24 months. The outcomes of the patients were monitored, including clinical success, symptom improvement, adverse events, and the frequency of esophagitis. RESULTS: At the latest follow-up, the rate of clinical success was higher in BD-LF group than in BD-PPIs group (80.4% vs. 57.7%, P = 0.011). The patients in the BD-PPIs group required more dilation sessions to achieve successful dilation, as compared to those in the BD-LF group (2.1 ± 1.2 vs. 0.7 ± 0.8, P < 0.001). The DeMeester score, number of reflux episodes for which pH was < 4, and lower esophageal sphincter pressure were significantly better in the BD-LF group than in the BD-PPIs group (all P < 0.001). The incidence of reflux esophagitis was higher in the BD-PPIs group than in the BD-LF group, at 24 months (58.8% vs. 18.2%, P = 0.003). CONCLUSIONS: Balloon dilatation with concomitant LF is effective and safe for esophageal stricture secondary to GERD. Moreover, antireflux surgery techniques, such as Nissen or Toupet procedure, should be added for reflux-induced benign esophageal stricture.
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Estenose Esofágica , Refluxo Gastroesofágico , Laparoscopia , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Estenose Esofágica/cirurgia , Estudos Retrospectivos , Constrição Patológica/cirurgia , Resultado do Tratamento , Refluxo Gastroesofágico/cirurgia , Fundoplicatura/métodos , Laparoscopia/métodosRESUMO
Background: Contemporary data on atrial cardiomyopathy (ACM) markers and ischemic cerebrovascular events (ICVE) in patients with acute myocardial infarction (AMI) is lacking. We aimed to examine whether ACM markers predict ICVE among AMI patients. Materials and methods: A total of 4,206 AMI cases diagnosed in clinical examinations between January 2016 and June 2021 were assessed for markers of ACM including B-type natriuretic peptide (BNP), P-wave terminal force in ECG lead V1 (PTFV1), and left atrium diameter (LAD). Left atrial enlargement (LAE) and abnormal PTFV1 were defined by previously published cut-off points. The primary outcome was incident ICVE composed of ischemic stroke (IS) and transient ischemic attack (TIA). Receiver operating curve analyses were used to compare the predictive performance of the CHA2DS2-VASc score combined with ACM markers to the CHA2DS2-VASc score alone. Results: During a median follow-up of 44.0 months, 229 (5.44%) ICVE occurred. Of these, 156 individuals developed IS and the remaining 73 cases were diagnosed with TIAs. The ICVE group showed larger PTFV1 and increased LAD as well as elevated BNP levels at baseline. In the multivariate analysis, we found significant associations with ICVE for PTFV1 (HR per 1,000 µV*ms, 1.143; 95% CI, 1.093-1.196), LAD (HR per millimeter, 1.148; 95% CI, 1.107-1.190), but not BNP after adjusting for known ICVE risk factors and interim atrial fibrillation (AF). The addition of abnormal PTFV1 and LAE improved the predictive accuracy of the CHA2DS2-VASc score with C-statistic increasing from 0.708 to 0.761 (p < 0.001). Conclusion: Atrial cardiomyopathy markers including PTFV1 and LAD were associated with incident ICVE independent of well-established risk factors and AF occurrence. The addition of ACM markers with CHA2DS2-VASc score may well discriminate individuals at high risk of ICVE in AMI patients.
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Background: The occurrence of new-onset atrial fibrillation (NOAF) post-acute myocardial infarction (AMI) is associated with worse outcomes. In this study, we sought to assess the predictive effect of stress hyperglycemia ratio (SHR) and neutrophil to lymphocyte ratio (NLR) to predict NOAF in patients with AMI. Materials and methods: We recruited 3,194 individuals with AMI but free of atrial fibrillation (AF). AMI cases were stratified into groups according to SHR and NLR quartiles and were further categorized based on diabetes status. High SHR and high NLR were defined as the highest quartile of SHR and NLR. A nomogram incorporating risk factors for NOAF was constructed using multivariate logistic regression analyses. The performance of the novel nomogram was tested for predictive performance, agreement between the actual and predicted probability, and clinical utility using area under the curve (AUC), bootstrapped calibration curves, and decision curve analysis, respectively. Result: A total of 245 (7.67%) patients developed NOAF post-AMI. The NOAF cases had higher values of SHR and NLR than non-NOAF patients after AMI regardless of diabetes status. After adjusting for potential confounders, high SHR and NLR were independently associated with NOAF post-AMI. Moreover, the novel nomogram incorporating high NLR and high SHR for NOAF risk estimation in patients with AMI showed satisfactory performance assessed by the AUC, calibration curves, decision curve analysis. Conclusion: SHR and NLR were independently associated with NOAF in AMI patients. The constructed novel nomogram that incorporates SHR and NLR might assist in NOAF risk stratification post-AMI.
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Objective: The study aims to assess two refractive instrument-based methods of vision screening (SureSight and PlusoptiX) to detect refractive amblyopia risk factors (ARFs) and significant refractive errors in Chinese preschool children and to develop referral criteria according to the 2021 AAPOS guidelines. Methods: Eye examinations were conducted in children aged 61 to 72 months (n = 1,173) using a PlusoptiX photoscreener, SureSight autorefractor, and cycloplegic retinoscopy (CR). The Vision Screening Committee of AAPOS's preschool vision screening guidelines from 2021 were adopted for comparison. Paired t-test analysis and Bland-Altman plots were used to assess the differences and agreement between the PlusoptiX photoscreener, SureSight autorefractor, and CR. In addition, the validity of the cut-off values of the several ARFs measured with the SureSight and PlusoptiX was estimated using receiver operating characteristic (ROC) curves and compared to the age-based 2021 AAPOS examination failure levels. Results: A total of 1,173 children were tested with comprehensive eye examinations. When the referral numbers based on the 2013 (43/3.67%) and 2021 (42/3.58%) AAPOS guidelines were compared, significant differences between the values of astigmatism (72.09 vs. 52.38%) and anisometropia (11.63 vs. 38.10%) were found. The 95% limits of agreement (LOA) of the spherical value and the cylindrical value between PlusoptiX and CR were 95.08 and 96.29%. It was 93.87 and 98.10% between SureSight and CR. Considering refractive failure levels, the ROC curves obtained the optimal cut-off points. However, the PlusoptiX and the SureSight showed lower efficiency in hyperopia (Youden index, 0.60 vs. 0.83) and myopia (Youden index, 078 vs. 0.93), respectively. After adjusting the above cut-off points, the optimized NES (Nanjing Eye Study) referral criteria for myopia, hyperopia, astigmatism, and anisometropia were -0.75, 1.25, -1.0, and 0.5 with PlusoptiX and -1.25, 2.75, -1.5, and 0.75 with SureSight. Conclusions: SureSight and PlusoptiX showed a good correlation with CR and could effectively detect refractive ARFs and visually significant refractive errors. There were obvious advantages in detecting hyperopia using SureSight and myopia using PlusoptiX. We proposed instrumental referral criteria for age-based preschool children based on AAPOS 2021 guidelines.
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Ambliopia , Anisometropia , Astigmatismo , Hiperopia , Miopia , Erros de Refração , Ambliopia/diagnóstico , Anisometropia/diagnóstico , Astigmatismo/diagnóstico , Pré-Escolar , Humanos , Hiperopia/diagnóstico , Midriáticos , Miopia/diagnóstico , Encaminhamento e Consulta , Erros de Refração/diagnóstico , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Purpose: Left atrial thrombus (LAT)/left atrial spontaneous echo contrast (LASEC) still exists in CHA2DS2-VASc score-defined low/borderline risk population. The purpose of this study is to explore the risk factors that associate with LAT/SEC and to create a nomogram to predict LAT/SEC risk in NVAF patients with low/borderline CHA2DS2-VASc scores. Patients and Methods: A total of 834 NVAF patients with complete data on transesophageal echocardiography (TEE) were included in this study. Univariate and multivariate logistic regression analyses were performed to identify the risk factors that associate with LAT/SEC, and a nomogram was established based on the results. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis were performed to verify the predictive power of nomogram. Results: The rates for LAT/SEC for the training and validation cohorts were 84 (14.7%) and 30 (11.4%), respectively. Independent factors including age, left ventricular ejection fraction (LVEF), left atrial diameter (LAD), smoke, non-paroxysmal AF (NPAF), and E/e' were considered to construct the nomogram for LAT/SEC. The AUC for nomogram was 0.839 and 0.811 in the training and validation cohorts, respectively. The calibration and decision curve analysis showed that the nomogram had a good prediction capacity and would be clinically useful. Conclusion: Age, LVEF, LAD, smoke, NPAF, and E/e' are independently associated with LAT/SEC in NVAF patients with low/borderline CHA2DS2-VASc scores. The nomogram that incorporates these six variables effectively predict LAT/SEC risk in NVAF patients with low/borderline CHA2DS2-VASc scores.
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Hyperhomocysteinemia (HHcy) is positively linked with several cardiovascular diseases; however, its role and underlying mechanisms in pathological cardiac hypertrophy are still unclear. Here, we focused on the effects and underlying mechanisms of HHcy in hypertensive cardiac hypertrophy, one of the most common and typical types of pathological cardiac hypertrophy. By a retrospective analysis of the association between HHcy and cardiac hypertrophy in a hypertensive cohort, we found that the prevalence of HHcy was higher in patients with hypertrophy and significantly associated with the presence of cardiac hypertrophy after adjusting for other conventional risk factors. In mice, HHcy induced by a methionine (2% wt/wt) diet feeding significantly promoted cardiac hypertrophy as well as cardiac inflammation and fibrosis induced by 3-week angiotensin ÐÐ (AngÐÐ) infusion (1000 ng/kg/min), while folic acid (0.006% wt/wt) supplement corrected HHcy and attenuated AngII-stimulated cardiac phenotypes. Mechanistic studies further showed that homocysteine (Hcy) exacerbated AngII-stimulated expression of Calcineurin and nuclear factor of activated T cells (NFAT), which could be attenuated by folic acid both in mice and in neonatal rat cardiomyocytes. Moreover, treatment with cyclosporin A, an inhibitor of Calcineurin, blocked Hcy-stimulated Calcineurin-NFAT signaling and hypertrophy in neonatal rat cardiomyocytes. In conclusion, our study indicates that HHcy promotes cardiac hypertrophy in hypertension, and Calcineurin-NFAT pathway might be involved in the pro-hypertrophic effect of Hcy.