Association of ATG16L1 and ATG5 gene polymorphisms with susceptibility to hepatitis B virus infection and progression to HCC in central China.

Hepatitis B virus (HBV) infection is a severe public health problem worldwide. The relationship between polymorphisms of autophagy-related 16-like 1 gene (ATG16L1) and autophagy-related gene 5 (ATG5) with susceptibility to the stage of HBV infection has been reported in different populations. Nevertheless, this association is not seen in the population of central China. This study recruited 452 participants, including 246 HBV-infected patients (139 chronically infected HBV without hepatocellular carcinoma [HCC] and 107 HBV-related HCC patients) and 206 healthy controls. Genotyping of ATG16L1 rs2241880 and ATG5 rs688810 were performed using Sanger sequencing and polymerase chain reaction-restriction fragment length polymorphism, respectively. Our results indicated that the G allele of ATG16L1 rs2241880 was more frequent in healthy controls than in patients with chronicHBV infection. After adjusting for age and sex, an association between the ATG16L1 rs2241880 polymorphism and HBV infection was significant under the dominant and allele models (p = 0.009 and 0.003, respectively). However, no association between the ATG5 polymorphisms and HBV infection was observed. We also did not find a significant association between ATG16L1 and ATG5 polymorphisms and the progression of HBV-related HCC. Therefore, the genetic polymorphism of ATG16L1 rs2241880 may be associated with susceptibility to HBV infection in the population of central China.

Molecular Insights into the Accelerated Sprouting of and Apical Dominance Release in Potato Tubers Subjected to Post-Harvest Heat Stress.

Climate change-induced heat stress (HS) increasingly threatens potato (Solanum tuberosum L.) production by impacting tuberization and causing the premature sprouting of tubers grown during the hot season. However, the effects of post-harvest HS on tuber sprouting have yet to be explored. This study aims to investigate the effects of post-harvest HS on tuber sprouting and to explore the underlying transcriptomic changes in apical bud meristems. The results show that post-harvest HS facilitates potato tuber sprouting and negates apical dominance. A meticulous transcriptomic profiling of apical bud meristems unearthed a spectrum of differentially expressed genes (DEGs) activated in response to HS. During the heightened sprouting activity that occurred at 15-18 days of HS, the pathways associated with starch metabolism, photomorphogenesis, and circadian rhythm were predominantly suppressed, while those governing chromosome organization, steroid biosynthesis, and transcription factors were markedly enhanced. The critical DEGs encompassed the enzymes pivotal for starch metabolism, the genes central to gibberellin and brassinosteroid biosynthesis, and influential developmental transcription factors, such as SHORT VEGETATIVE PHASE, ASYMMETRIC LEAVES 1, SHOOT MERISTEMLESS, and MONOPTEROS. These findings suggest that HS orchestrates tuber sprouting through nuanced alterations in gene expression within the meristematic tissues, specifically influencing chromatin organization, hormonal biosynthesis pathways, and the transcription factors presiding over meristem fate determination. The present study provides novel insights into the intricate molecular mechanisms whereby post-harvest HS influences tuber sprouting. The findings have important implications for developing strategies to mitigate HS-induced tuber sprouting in the context of climate change.

Mixed stitching interferometry with correction from one-dimensional profile measurements for high-precision X-ray mirrors.

This work presents a mixed stitching interferometry method with correction from one-dimensional profile measurements. This method can correct the error of stitching angles among different subapertures using the relatively accurate one-dimensional profiles of the mirror, e.g., provided by the contact profilometer. The measurement accuracy is simulated and analyzed. The repeatability error is decreased by averaging multiple measurements of the one-dimensional profile and using multiple profiles at different measurement positions. Finally, the measurement result of an elliptical mirror is presented and compared with the global algorithm-based stitching, and the error of the original profiles is reduced to one-third. This result shows that this method can effectively suppress the accumulation of stitching angle errors in classic global algorithm-based stitching. The accuracy of this method can be further improved by using high-precision one-dimensional profile measurements such as the nanometer optical component measuring machine (NOM).

Distinct Denitrifying Phenotypes of Predominant Bacteria Modulate Nitrous Oxide Metabolism in Two Typical Cropland Soils.

Denitrifying nitrous oxide (N2O) emissions in agroecosystems result from variations in microbial composition and soil properties. However, the microbial mechanisms of differential N2O emissions in agricultural soils are less understood. In this study, microcosm experiments using two main types of Chinese cropland soil were conducted with different supplements of nitrate and glucose to simulate the varying nitrogen and carbon conditions. The results show that N2O accumulation in black soil (BF) was significantly higher than that in fluvo-aquic soil (FF) independent of nitrogen and carbon. The abundance of most denitrifying genes was significantly higher in FF, but the ratios of genes responsible for N2O production (nirS and nirK) to the gene responsible for N2O reduction (nosZ) did not significantly differ between the two soils. However, the soils showed obvious discrepancies in denitrifying bacterial communities, with a higher abundance of N2O-generating bacteria in BF and a higher abundance of N2O-reducing bacteria in FF. High accumulation of N2O was verified by the bacterial isolates of Rhodanobacter predominated in BF due to a lack of N2O reduction capacity. The dominance of Castellaniella and others in FF led to a rapid reduction in N2O and thus less N2O accumulation, as demonstrated when the corresponding isolate was inoculated into the studied soils. Therefore, the different phenotypes of N2O metabolism of the distinct denitrifiers predominantly colonized the two soils, causing differing N2O accumulation. This knowledge would help to develop a strategy for mitigating N2O emissions in agricultural soils by regulating the phenotypes of N2O metabolism.

Simulation and measurement of systematic errors of stitching interferometry for high precision X-ray mirrors with large radius of curvature.

To accurately measure the surface figure of curved mirrors with large radius of curvature (RoC) using stitching interferometry methods, three types of measurement errors are systematically studied, including retrace error, defocusing error within a single subaperture, and stitching angle error among different subapertures. It was found that part of the retrace error caused by the mismatch between the reference wavefront and reflected wavefront has little effect, while the overall retrace error, including the influence of the imperfect optical elements, will cause an error of 1-2 nm RMS within a single subaperture. Defocusing error will enlarge the error due to amplification of optical path error caused by the deviation of the position of the CCD. Because the error is mainly in the edge area, a slope threshold, which controls the maximum surface slope of each subaperture, can be optimized to reduce the effect of the defocus on stitching measurement error. Constant angle error among neighboring subapertures has the biggest accumulation effect on the final stitched figure. For the spherical mirror with RoC of 100 m of 80mm×40mm, the error of the one-dimensional residual profile is 4.67 nm PV, assuming a constant angle error of 2×10-7rad. For the elliptical mirror with RoC of 60-140 m, it is more than 15 nm peak-to-valley (PV). It is because the profile difference caused by constant angle error is closer to a circle, which can be mostly removed after subtraction of a best-fit sphere. Based on the above error analysis, the developed algorithm-based stitching method was used to measure an elliptical cylindrical mirror of 74mm×40mm with RoC of 60-140 m, and the result was compared with a slope measurement instrument from the Beijing Synchrotron Radiation Facility. After removing the best fitting ellipse profile, the one-dimensional difference between the two results is only 0.77 nm RMS, which demonstrated good measurement accuracy.

The Difference Se Makes: A Bio-Inspired Dppf-Supported Nickel Selenolate Complex Boosts Dihydrogen Evolution with High Oxygen Tolerance.

Inspired by the metal active sites of [NiFeSe]-hydrogenases, a dppf-supported nickel(II) selenolate complex (dppf=1,1'-bis(diphenylphosphino)ferrocene) shows high catalytic activity for electrochemical proton reduction with a remarkable enzyme-like H2 evolution turnover frequency (TOF) of 7838 s-1 under an Ar atmosphere, which markedly surpasses the activity of a dppf-supported nickel(II) thiolate analogue with a low TOF of 600 s-1 . A combined study of electrochemical experiments and DFT calculations shed light on the catalytic process, suggesting that selenium atom as a bio-inspired proton relay plays a key role in proton exchange and enhancing catalytic activity of H2 production. For the first time, this type of Ni selenolate-containing electrocatalyst displays a high degree of O2 and H2 tolerance. Our results should encourage the development of the design of highly efficient oxygen-tolerant Ni selenolate molecular catalysts.

Association between preoperative renin-angiotensin system inhibitor use and postoperative acute kidney injury risk in patients with hypertension
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PURPOSE: To determine whether preoperative renin-angiotensin system (RAS) inhibitor use within 7 days of noncardiac surgery is associated with a lower incidence of postoperative acute kidney injury (AKI) in hypertensive patients. MATERIALS AND METHODS: We retrospectively analyzed 12,545 hypertensive patients undergoing noncardiac surgery at the Third Xiangya Hospital of Central South University from February 2007 to November 2015. According to the use of RAS inhibitors within 7 days of surgery, the patients were divided into a RASI group and a non-RASI group. We used a multivariable logistic regression model and propensity score matching (PSM) analysis to examine the association between preoperative RAS inhibitor use and postoperative AKI incidence. RESULTS: Among the 12,545 hypertensive patients undergoing noncardiac surgery who met the inclusion/exclusion criteria, 18.74% received preoperative RAS inhibitor treatment within 7 days of surgery. After PSM, 2,192 patients in each group were matched successfully. The incidence of postoperative AKI in the RASI group was significantly lower than that in the non-RASI group (7.39% vs. 12.32%, p < 0.001). The multivariable logistic regression analysis and the PSM analysis demonstrated similar associations between preoperative RAS inhibitor use and postoperative AKI incidence. This association was modified by the presence of preoperative congestive heart failure (CHF) (p-value for the interaction: 0.027), and the observed association was not evident in patients without CHF (CHF: adjusted odds ratios (ORs): 0.47; 95% CI: 0.31 - 0.70 vs. no CHF: adjusted OR: 0.80; 95% CI: 0.62 - 1.03). CONCLUSION: The preoperative use of RAS inhibitors in hypertensive patients was associated with a lower incidence of AKI following noncardiac surgery, and this association was not significant in the subgroup population without CHF.
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Silver-Sulfur Hybrid Supertetrahedral Clusters: The Hitherto Missing Members in the Metal-Chalcogenide Tetrahedral Clusters.

The synthesis of Group 11 metal chalcogenide supertetrahedral clusters (SCs) still remains a great challenge mainly due to the high tendency of metal aggregation through metallophilicity and global charge balance. Demonstrated herein are the preparation, crystallographic characterization, and optical properties of two stable silver-sulfur SCs through ligand-control; one as a discrete zero-dimensional (0D) V3,4-type cluster and the other as a one-dimensional (1D) zigzag chain extended by alternating V3,2-type clusters. The notation Vn,m (where n is the number of metal layers, and m is the number of vacant corners) is used to describe a new series of vacant-corner SCs, which can be derived from the regular Tn clusters. The existence of vacant-corner-type SCs may be ascribed to the low valence and tri-coordinated environment of silver ions. These are the first representatives of structurally determined silver-sulfur tetrahedral clusters thus far. This work enriches the coinage-metal chalcogenide tetrahedral cluster portfolio, discovers vacant-corner SCs present in silver-sulfur hybrid tetrahedral clusters, and provides effective means for further development of Group 11 coinage-metal chalcogenide SCs.

Causal associations between circulation ß-carotene and cardiovascular disease: A Mendelian randomization study.

The causal association between circulating ß-carotene concentrations and cardiovascular disease (CVD) remains controversial. We conducted a Mendelian randomization study to explore the effects of ß-carotene on various cardiovascular diseases, including myocardial infarction, atrial fibrillation, heart failure, and stroke. Three single nucleotide polymorphisms (SNPs) associated with the ß-carotene levels were obtained by searching published data and used as instrumental variables. Genetic association estimates for 4 CVDs (including myocardial infarction, atrial fibrillation, heart failure, and stroke) in the primary analysis, blood pressure and serum lipids (high-density lipoprotein [HDL] cholesterol, LDL cholesterol, and triglycerides) in the secondary analysis were obtained from large-scale genome-wide association studies (GWASs). We applied inverse variance-weighted as the primary analysis method, and 3 others were used to verify as sensitivity analysis. Genetically predicted circulating ß-carotene levels (natural log-transformed, µg/L) were positively associated with myocardial infarction (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.02-1.18, P = .011) after Bonferroni correction. No evidence supported the causal effect of ß-carotene on atrial fibrillation (OR 1.02, 95% CI 0.96-1.09, P = .464), heart failure (OR 1.07, 95% CI 0.97-1.19, P = .187), stroke (OR 1.03, 95% CI 0.93-1.15, P = .540), blood pressure (P > .372) and serum lipids (P > .239). Sensitivity analysis produced consistent results. This study provides evidence for a causal relationship between circulating ß-carotene and myocardial infarction. These findings have important implications for understanding the role of ß-carotene in CVD and may inform dietary recommendations and intervention strategies for preventing myocardial infarction.

Utility of recombinant fusion protein ESAT6-CFP10 skin test for differential diagnosis of active tuberculosis: A prospective study.

Background: The recombinant mycobacterium tuberculosis fusion protein ESAT6-CFP10 skin test (ECST) is a novel test for tuberculosis (TB) infection; however, its accuracy in active tuberculosis (ATB) remains uncertain. This study aimed to evaluate the accuracy of ECST in the differential diagnosis of ATB for an early real-world assessment. Methods: This prospective cohort study recruited patients suspected of ATB in Shanghai Public Health Clinical Center from January 2021 to November 2021. The diagnostic accuracy of the ECST was evaluated under the gold standard and composite clinical reference standard (CCRS) separately. The sensitivity, specificity, and corresponding confidence interval of ECST results were calculated, and subgroup analyses were conducted. Results: Diagnostic accuracy was analyzed using data from 357 patients. Based on the gold standard, the sensitivity and specificity of the ECST for patients were 72.69% (95%CI 66.8%-78.5%) and 46.15% (95%CI 37.5%-54.8%), respectively. Based on the CCRS, the sensitivity and specificity of the ECST for patients were 71.52% (95%CI 66.4%-76.6%) and 65.45% (95%CI 52.5%-78.4%), respectively. The consistency between the ECST and the interferon-γ release (IGRA) test is moderate (Kappa = 0.47). Conclusion: The ECST is a suboptimum tool for the differential diagnosis of active tuberculosis. Its performance is similar to IGRA, an adjunctive diagnostic test for diagnosing active tuberculosis. Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR2000036369.

Patatin primary structural properties and effects on lipid metabolism.

Patatin, the major protein found in potatoes, was purified and shows several isoforms. The essential amino acid content of patatin was ashighas 76%, indicating that it is a valuable protein source. Patatin was an O-linked glycoprotein that contained fucose monosaccharides, as well as mannose, rhamnose, glucose, galactose, xylose, and arabinose. Patatin had a fucosylated glycan structural feature, which strongly bound AAL (Aleuria aurantia Leukoagglutinin), a known fucose binding lectin. Moreover, thelipid metabolism regulatory effects of patatin on the fat catabolism, fat absorption, and inhibition of lipase activity were measured after high-fat feeding of zebrafish larvae. Results revealed that 37.0 µg/mL patatin promoted 23% lipid decomposition metabolism. Meanwhile patatin could inhibite lipase activity and fat absorption, whose effects accounted for half that of a positive control drug. Our findings suggest that patatin, a fucosylated glycoprotein, could potentially be used as a naturalactiveconstituent with anti-obesity effects.

Cross-Feeding between Members of Thauera spp. and Rhodococcus spp. Drives Quinoline-Denitrifying Degradation in a Hypoxic Bioreactor.

The complex bacterial community in a quinoline-degrading denitrifying bioreactor is predominated by several taxa, such as Thauera and Rhodococcus However, it remains unclear how the interactions between the different bacteria mediate quinoline metabolism under denitrifying conditions. In this study, we designed a sequence-specific amplification strategy to isolate the most predominant bacteria and obtained four strains of Thauera aminoaromatica, a representative of a key member in the bioreactor. Tests on these isolates demonstrated that all were unable to degrade quinoline but efficiently degraded 2-hydroxyquinoline, the hypothesized primary intermediate of quinoline catabolism, under nitrate-reducing conditions. However, another isolate, Rhodococcus sp. YF3, corresponding to the second most abundant taxon in the same bioreactor, was found to degrade quinoline via 2-hydroxyquinoline. The end products and removal rate of quinoline by isolate YF3 largely varied according to the quantity of available oxygen. Specifically, quinoline could be converted only to 2-hydroxyquinoline without further transformation under insufficient oxygen conditions, e.g., less than 0.5% initial oxygen in the vials. However, resting YF3 cells aerobically precultured in medium with quinoline could anaerobically convert quinoline to 2-hydroxyquinoline. A two-strain consortium constructed with isolates from Thauera (R2) and Rhodococcus (YF3) demonstrated efficient denitrifying degradation of quinoline. Thus, we experimentally verified that the metabolic interaction based on 2-hydroxyquinoline cross-feeding between two predominant bacteria constitutes the main quinoline degradation mechanism. This work uncovers the mechanism of quinoline removal by two cooperative bacterial species existing in denitrifying bioreactors.IMPORTANCE We experimentally verified that the second most abundant taxon, Rhodococcus, played a role in degrading quinoline to 2-hydroxyquinoline, while the most abundant taxon, Thauera, degraded 2-hydroxyquinoline. Metabolites from Thauera further served to provide metabolites for Rhodococcus Hence, an ecological guild composed of two isolates was assembled, revealing the different roles that keystone organisms play in the microbial community. This report, to the best of our knowledge, is the first on cross-feeding between the initial quinoline degrader and a second bacterium. Specifically, the quinoline degrader (Rhodococcus) did not benefit metabolically from quinoline degradation to 2-hydroxyquinoline but instead benefited from the metabolites produced by the second bacterium (Thauera) when Thauera degraded the 2-hydroxyquinoline. These results could be a significant step forward in the elucidation of the microbial mechanism underlying quinoline-denitrifying degradation.

Elevated triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio increased risk of hyperuricemia: a 4-year cohort study in China.

PURPOSE: Previous studies revealed that high serum uric acid (SUA) levels correlated with increased triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio. However, evidence is lacking regarding whether TG/HDL-C is an independent risk factor or just a simple marker of hyperuricemia. We aimed to investigate the relationship between TG/HDL-C and the risk of hyperuricemia in Chinese population. METHODS: This retrospective cohort study involved 15,198 subjects (43.14 ± 13.13 years, 54.9% men) who were free of hyperuricemia at baseline. The association between TG/HDL-C and the risk of hyperuricemia, in the total sample and stratified by subgroups, was examined by multiple logistic regression analyses. RESULTS: During 4 years follow-up, hyperuricemia occurred in 2365 (15.6%) participants. The cumulative incidence of hyperuricemia was significantly elevated with increasing TG/HDL-C quartiles (5.9, 10.8, 18.4, and 27.5%, respectively). After multivariate adjustment, the odds ratio for hyperuricemia in the highest compared with the lowest quartile of TG/HDL-C was 1.80 (95% confidence interval [CI] 1.49, 2.18), and each SD increment of TG/HDL-C ratio caused a 10% additional risk for hyperuricemia. Moreover, subgroup analyses showed that the association between TG/HDL-C and the risk of hyperuricemia was more pronounced in women and normal-weight adults. The results were consistent when analyses were restricted to participants without metabolic syndrome. CONCLUSIONS: TG/HDL-C ratio was positively related to the risk of hyperuricemia in Chinese population, particularly in women and normal-weight individuals. These findings suggested the potential of TG/HDL-C ratio to serve as an independent risk indicator in the prevention of hyperuricemia.

Response of treatment performance and microbial community structure to the temporary suspension of an industrial anaerobic bioreactor.

In this study, a novel type of mesophilic anaerobic bioreactor-an expanded granular sludge bed (EGSB)-was utilized to explore the effect of suspending reactor operation on the treatment performance and the microbial community structure. The parameters of performance and bacterial community before and after a four-week suspension were compared for the starch processing wastewater treatment bioreactor. The results indicate that the removal rate of the organic matter remained higher than 90%, although the biomass significantly decreased after restarting the reactor. However, the relatively stable microbial community structure before the suspension was altered significantly during the restart and post-running stages. This change was primarily due to variability in satellite species and the substitution effect of different dominant bacteria. For example, some non-major carbohydrate-degrading bacteria that were sensitive to nutrition deficiency, such as Desulfovibrio and Geobacter, were dramatically reduced after the suspension. In contrast, the stress of starvation stimulated the reproduction of hydrolytic bacteria, such as Macellibacteroides. However, the high bacterial diversity index (6.12-6.65) and the longstanding core species, including Chloroflexi, Cloacimonetes, Ignavibacteriae, Thermotogae and Euryarchaeota, maintained the functional stability of the reactor. Consequently, although the total bacteria decreased significantly after reactor operation was suspended, sufficient functional bacteria supported by the high diversity, as well as the longstanding core species, guaranteed the effective degradation after suspension.

Non-synchronous Structural and Functional Dynamics During the Coalescence of Two Distinct Soil Bacterial Communities.

Soil is a unique environment in which the microbiota is frequently subjected to community coalescence. Additions of organic fertilizer and precipitation of dust induce coalescent events in soil. However, the fates of these communities after coalescence remain uncharted. Thus, to explore the effects of microbiota coalescence, we performed reciprocal inoculation and incubation experiments in microcosms using two distinct soils. The soils were, respectively, collected from a cropland and an industrial site, and the reciprocal inoculation was performed as models for the incursion of highly exotic microbiota into the soil. After incubation under either aerobic or anaerobic conditions for two months, the soils were assayed for their bacterial community structure and denitrification function. According to the 16S rRNA gene sequencing results, the inoculated soil showed a significant shift in bacterial community structure after incubation-particularly in the industrial soil. The structures of the bacterial communities changed following the coalescence but were predicted to have the same functional potential, e.g., nitrogen metabolism, as determined by the quantification of denitrifying genes and nitrogen gas production in the inoculated soil samples, which showed values equivalent those in the original recipient soil samples regardless of inoculum used. The functional prediction based on the known genomes of the taxa that shifted in the incubated sample communities indicates that the high functional overlap and redundancy across bacteria acted as a mechanism that preserved all the metabolic functions in the soil. These findings hint at the mechanisms underlying soil biodiversity maintenance and ecosystem function.

Duration of dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent: systematic review and network meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of standard term (12 months) or long term (>12 months) dual antiplatelet therapy (DAPT) versus short term (<6 months) DAPT after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). DESIGN: Systematic review and network meta-analysis. DATA SOURCES: Relevant studies published between June 1983 and April 2018 from Medline, Embase, Cochrane Library for clinical trials, PubMed, Web of Science, ClinicalTrials.gov, and Clinicaltrialsregister.eu. REVIEW METHODS: Randomised controlled trials comparing two of the three durations of DAPT (short term, standard term, and long term) after PCI with DES were included. The primary study outcomes were cardiac or non-cardiac death, all cause mortality, myocardial infarction, stent thrombosis, and all bleeding events. RESULTS: 17 studies (n=46 864) were included. Compared with short term DAPT, network meta-analysis showed that long term DAPT resulted in higher rates of major bleeding (odds ratio 1.78, 95% confidence interval 1.27 to 2.49) and non-cardiac death (1.63, 1.03 to 2.59); standard term DAPT was associated with higher rates of any bleeding (1.39, 1.01 to 1.92). No noticeable difference was observed in other primary endpoints. The sensitivity analysis revealed that the risks of non-cardiac death and bleeding were further increased for ≥18 months of DAPT compared with short term or standard term DAPT. In the subgroup analysis, long term DAPT led to higher all cause mortality than short term DAPT in patients implanted with newer-generation DES (1.99, 1.04 to 3.81); short term DAPT presented similar efficacy and safety to standard term DAPT with acute coronary syndrome (ACS) presentation and newer-generation DES placement. The heterogeneity of pooled trials was low, providing more confidence in the interpretation of results. CONCLUSIONS: In patients with all clinical presentations, compared with short term DAPT (clopidogrel), long term DAPT led to higher rates of major bleeding and non-cardiac death, and standard term DAPT was associated with an increased risk of any bleeding. For patients with ACS, short term DAPT presented similar efficacy and safety with standard term DAPT. For patients implanted with newer-generation DES, long term DAPT resulted in more all cause mortality than short term DAPT. Although the optimal duration of DAPT should take personal ischaemic and bleeding risks into account, this study suggested short term DAPT could be considered for most patients after PCI with DES, combining evidence from both direct and indirect comparisons. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018099519.

Small size yet big action: a simple sulfate anion templated a discrete 78-nuclearity silver sulfur nanocluster with a multishell structure.

A discrete 78-nucleus silver-sulfur nanocluster with a sulfate-centered multishell structure was isolated and characterized. Its crystal structure revealed 18 and 60 Ag atoms in the inner and outer shell, respectively. The inner shell of 18-nuclearity Ag atoms is a very rare convex polyhedron featuring an elongated triangular orthobicupola. The incorporation of a sulfate anion and multishell arrangement in the nanocluster led to a dramatic decrease in the band gap (Eg = 1.40 eV). Our study showed that simple anions can also induce the formation of high-nuclearity silver clusters with excellent optical properties.

Remote home management for chronic kidney disease: A systematic review.

Background Remote home management is a new healthcare model that uses information technology to enhance patients' self-management of disease in a home setting. This study is designed to identify the effects of remote home management on patients with chronic kidney disease (CKD). Methods A comprehensive search of PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was performed in January 2015. The reference listings of the included articles in this review were also manually examined. Randomized controlled trials (RCTs) designed to evaluate the effects of remote home management on patients with CKD were included. Results Eight trials were identified. The results of this study suggest that the quality of life (QOL) enabled by remote home management was higher than typical care in certain dimensions. However, the effects of remote home management on blood pressure (BP) remain inconclusive. The studies that assessed health service utilization demonstrated a significant decrease in hospital readmission, emergency room visits, and number of days in the hospital. Another favorable result of this study is that regardless of their gender, age or nationality, patients tend to comply with remote home management programs and the use of related technologies. Conclusions The available data indicate that remote home management may be a novel and effective disease management strategy for improving CKD patients' QOL and influencing their attitudes and behaviors. And, relatively little is known about BP and cost-effectiveness, so future research should focus on these two aspects for the entire population of patients with CKD.

Diagnostic models of the pre-test probability of stable coronary artery disease: A systematic review.

A comprehensive search of PubMed and Embase was performed in January 2015 to examine the available literature on validated diagnostic models of the pre-test probability of stable coronary artery disease and to describe the characteristics of the models. Studies that were designed to develop and validate diagnostic models of pre-test probability for stable coronary artery disease were included. Data regarding baseline patient characteristics, procedural characteristics, modeling methods, metrics of model performance, risk of bias, and clinical usefulness were extracted. Ten studies involving the development of 12 models and two studies focusing on external validation were identified. Seven models were validated internally, and seven models were validated externally. Discrimination varied between studies that were validated internally (C statistic 0.66-0.81) and externally (0.49-0.87). Only one study presented reclassification indices. The majority of better performing models included sex, age, symptoms, diabetes, smoking, and hyperlipidemia as variables. Only two diagnostic models evaluated the effects on clinical decision making processes or patient outcomes. Most diagnostic models of the pre-test probability of stable coronary artery disease have had modest success, and very few present data regarding the effects of these models on clinical decision making processes or patient outcomes.

A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study.

BACKGROUND: Acute kidney injury (AKI) is a serious post-surgery complication; however, few preoperative risk models for AKI have been developed for hypertensive patients undergoing general surgery. Thus, in this study involving a large Chinese cohort, we developed and validated a risk model for surgery-related AKI using preoperative risk factors. METHODS AND FINDINGS: This retrospective cohort study included 24,451 hypertensive patients aged ≥18 years who underwent general surgery between 2007 and 2015. The endpoints for AKI classification utilized by the KDIGO (Kidney Disease: Improving Global Outcomes) system were assessed. The most discriminative predictor was selected using Fisher scores and was subsequently used to construct a stepwise multivariate logistic regression model, whose performance was evaluated via comparisons with models used in other published works using the net reclassification index (NRI) and integrated discrimination improvement (IDI) index. RESULTS: Surgery-related AKI developed in 1994 hospitalized patients (8.2%). The predictors identified by our Xiang-ya Model were age, gender, eGFR, NLR, pulmonary infection, prothrombin time, thrombin time, hemoglobin, uric acid, serum potassium, serum albumin, total cholesterol, and aspartate amino transferase. The area under the receiver-operating characteristic curve (AUC) for the validation set and cross validation set were 0.87 (95% CI 0.86-0.89) and (0.89; 95% CI 0.88-0.90), respectively, and was therefore similar to the AUC for the training set (0.89; 95% CI 0.88-0.90). The optimal cutoff value was 0.09. Our model outperformed that developed by Kate et al., which exhibited an NRI of 31.38% (95% CI 25.7%-37.1%) and an IDI of 8% (95% CI 5.52%-10.50%) for patients who underwent cardiac surgery (n = 2101). CONCLUSIONS/SIGNIFICANCE: We developed an AKI risk model based on preoperative risk factors and biomarkers that demonstrated good performance when predicting events in a large cohort of hypertensive patients who underwent general surgery.