Assessment of subclinical LV myocardial dysfunction in T2DM patients with diabetic peripheral neuropathy: a cardiovascular magnetic resonance study.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most prevalent complication of diabetes, and has been demonstrated to be independently associated with cardiovascular events and mortality. This aim of this study was to investigate the subclinical left ventricular (LV) myocardial dysfunction in type 2 diabetes mellitus (T2DM) patients with and without DPN. METHODS: One hundred and thirty T2DM patients without DPN, 61 patients with DPN and 65 age and sex-matched controls who underwent cardiovascular magnetic resonance (CMR) imaging were included, all subjects had no symptoms of heart failure and LV ejection fraction ≥ 50%. LV myocardial non-infarct late gadolinium enhancement (LGE) was determined. LV global strains, including radial, circumferential and longitudinal peak strain (PS) and peak systolic and diastolic strain rates (PSSR and PDSR, respectively), were evaluated using CMR feature tracking and compared among the three groups. Multivariable linear regression analyses were performed to determine the independent factors of reduced LV global myocardial strains in T2DM patients. RESULTS: The prevalence of non-infarct LGE was higher in patients with DPN than those without DPN (37.7% vs. 19.2%, p = 0.008). The LV radial and longitudinal PS (radial: 36.60 ± 7.24% vs. 33.57 ± 7.30% vs. 30.72 ± 8.68%; longitudinal: - 15.03 ± 2.52% vs. - 13.39 ± 2.48% vs. - 11.89 ± 3.02%), as well as longitudinal PDSR [0.89 (0.76, 1.05) 1/s vs. 0.80 (0.71, 0.93) 1/s vs. 0.77 (0.63, 0.87) 1/s] were decreased significantly from controls through T2DM patients without DPN to patients with DPN (all p < 0.001). LV radial and circumferential PDSR, as well as circumferential PS were reduced in both patient groups (all p < 0.05), but were not different between the two groups (all p > 0.05). Radial and longitudinal PSSR were decreased in patients with DPN (p = 0.006 and 0.003, respectively) but preserved in those without DPN (all p > 0.05). Multivariable linear regression analyses adjusting for confounders demonstrated that DPN was independently associated with LV radial and longitudinal PS (ß = - 3.025 and 1.187, p = 0.014 and 0.003, respectively) and PDSR (ß = 0.283 and - 0.086, p = 0.016 and 0.001, respectively), as well as radial PSSR (ß = - 0.266, p = 0.007). CONCLUSIONS: There was more severe subclinical LV dysfunction in T2DM patients complicated with DPN than those without DPN, suggesting further prospective study with more active intervention in this cohort of patients.

The impacts of casual environmental regulation on carbon intensity in China: Dual mediating pathways of energy low-carbon reconstitution and industrial structure upgrading.

In the new era of global net zero, how to reduce carbon intensity became a hot topic, while few attentions had been paid to the impacts of casual environmental regulation, especially in the emerging economy such as China. In this regard, this study uses the panel data of 30 provinces in China from 2003 to 2019 to study the impacts of causal environmental regulation on the carbon intensity, with the adoption of multiple econometric models. The empirical results show that causal environmental regulation has a significant inhibitory effect on carbon intensity, while at current stage, causal environmental regulation cannot inhibit carbon intensity through the mediating of green innovation and renewable energy production. Fortunately, energy low-carbon reconstitution and industrial structure upgrading are proved to effectively act as the intermediary channels. In addition, the spatial spillover effects and the spatial heterogeneity are supported in the empirical analysis. In a summary, this study starts with the case of China to provide a realistic reference case for the international community, enriches the theory, policy and practice related to environmental regulation, and provides a realistic reference example for emerging economics in a developing country.

SmartSpring: A Low-Cost Wearable Haptic VR Display with Controllable Passive Feedback.

With the development of virtual reality, the practical requirements of the wearable haptic interface have been greatly emphasized. While passive haptic devices are commonly used in virtual reality, they lack generality and are difficult to precisely generate continuous force feedback to users. In this work, we present SmartSpring, a new solution for passive haptics, which is inexpensive, lightweight and capable of providing controllable force feedback in virtual reality. We propose a hybrid spring-linkage structure as the proxy and flexibly control the mechanism for adjustable system stiffness. By analyzing the structure and force model, we enable a smart transform of the structure for producing continuous force signals. We quantitatively examine the real-world performance of SmartSpring to verify our model. By asymmetrically moving or actively pressing the end-effector, we show that our design can further support rendering torque and stiffness. Finally, we demonstrate the SmartSpring in a series of scenarios with user studies and a just noticeable difference analysis. Experimental results show the potential of the developed haptic display in virtual reality.

Sex-related Differences in Left Ventricular Deformation in Patients With Hypertensive Heart Failure With Reduced Ejection Fraction: Assessment by Cardiac Magnetic Resonance Tissue Tracking.

We aimed to investigate sex-related differences in left ventricular (LV) deformation in heart failure with reduced ejection fraction (HFrEF) patients with comorbid hypertension (HTN) by cardiac MRI. A total of 281 patients with HFrEF who underwent cardiac MRI were enrolled in this study. Sex-related differences in LV structure, function and strains derived from cardiac cine MRI in the context of HTN were measured and compared. The clinical variables associated with LV strains in HFrEF patients with comorbid HTN and determinants of impaired LV strains were investigated for both sexes. The prevalence of HTN did not differ between the sexes (P > 0.05). Despite having a similar LVEF, hypertensive men displayed decreased LV deformation in all 3 directions compared with hypertensive women (all P < 0.05). Male sex and its interaction with HTN were associated with higher LV mass index, reduced LV GCPS and GLPS compared with hypertensive women (all P < 0.05). Male sex was associated with LV deformation impairment in hypertensive HFrEF patients (all P < 0.05). After adjustment for covariates in HFrEF patients, HTN was found to be an independent determinant of impaired LV GCPS [ß = 0.17; P = 0.022] and GLPS [ß = 0.25; P < 0.001]) in men but not in women (all P > 0.05). Sex had a modifying effect on LV deformation in hypertensive HFrEF patients, with greater adverse effects on LV strains in men than in women. Sex-tailored treatment approaches may be considered in the future for HFrEF patients with comorbid HTN.

Reactive membranes for groundwater remediation of chlorinated aliphatic hydrocarbons: competitive dechlorination and cost aspects.

A nanocomposite membrane incorporating reactive Pd-Fe nanoparticles (NPs) was developed to remediate chlorinated aliphatic hydrocarbons (CAHs) from groundwater. Other than recapturing the produced Fen+ for in-situ regeneration, the functionalized polyanions prevented NPs agglomeration and resulting in a spherical Fe0 core (55 nm, O/Fe = 0.05) and an oxidized shell (4 nm, O/Fe = 1.38). The reactive membranes degraded 92% of target CAHs with a residence time of 1.7 seconds. After long-term treatment and regeneration, reusability was confirmed through recovered reactivity, recurrence of Fe0 in X-ray photoelectron spectroscopy, and >96% remaining of Fe and Pd. The total cost (adjusted present value for 20 years) was estimated to be 13.9% lower than the granular activated carbon system, following an EPA work breakdown structure-based cost model. However, non-target CAHs from groundwater can compete for active sites, leading to decreased surface-area normalized dechlorination rate (ksa) by 28.2-79.9%. A hybrid nanofiltration (NF)/reactive membrane was proposed to selectively intercept larger competitors, leading to 54% increased dechlorination efficiency and 1.3 to 1.9-fold enlarged ksa. Overall, the practical viability of the developed reactive membranes was demonstrated by the stability, reusability, and cost advantages, while the optional NF strategy could alleviate competitive degradation towards complex water chemistry.

How Do Environmental Technology Standards Affect the Green Transformation? New Evidence from China.

During the period of high-quality development in China, environmental regulations have been regarded as powerful exogenous forces, especially for accelerating the green transformation of the manufacturing industry. Treating the first implementation of cleaner production industry standard policies in 2003 as a quasi-natural experiment, and employing the difference-in-differences (DID) model, this paper discusses the impacts of environmental technology standards on the green transformation of the manufacturing industry in China, with systematic consideration of three technological modification mechanisms, including terminal governance, capital renewal, and resource structure adjustments. The results show that: (1) environmental technology standards can have "win-win" effects, i.e., environmental technology standards can simultaneously improve the environmental performance and the economic performance; (2) the dynamic effects of environmental technology standards are proven in the parallel trend test; (3) environmental technology standards can not only promote the green transformation of the manufacturing industry directly, but can also mediate the effects of terminal governance, capital renewal, and resource structure adjustments. In summary, this paper makes four suggestions for government actions, namely re-examining command-and-control environmental regulations, paying attention to environmental regulation tools, changing the mechanism from technological modification to technological innovation, and updating environmental technology standards regularly.

Effects of diabetes mellitus on left ventricular function and remodeling in hypertensive patients with heart failure with reduced ejection fraction: assessment with 3.0 T MRI feature tracking.

BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) is a major health burden worldwide with high morbidity and mortality. Comorbidities of HFrEF complicate treatment and lead to poor prognosis, among which hypertension (HTN) and diabetes mellitus (DM) are common and frequently cooccur. DM was found to have additive effects on cardiac function and structure in hypertensive patients, while its effects on the HFrEF cohort in the context of HTN remain unclear. METHODS: A total of 171 patients with HFrEF were enrolled in our study, consisting of 51 HFrEF controls, 72 hypertensive HFrEF patients (HTN-HFrEF [DM-]) and 48 hypertensive HFrEF patients with comorbid DM (HTN-HFrEF [DM+]). Cardiac MRI-derived left ventricular (LV) strains, including global radial (GRPS), circumferential (GCPS) and longitudinal (GLPS) peak strain, and remodeling parameters were measured and compared among groups. The determinants of impaired LV function and LV remodeling in HFrEF patients were investigated by multivariable linear regression analyses. RESULTS: Despite a similar LV ejection fraction, patients in the HTN-HFrEF (DM+) and HTN-HFrEF (DM-) groups showed a higher LV mass index and LV remodeling index than those in the HFrEF control group (all p < 0.05). Compared with the HTN-HFrEF (DM-) and HFrEF control groups, the HTN-HFrEF (DM+) group exhibited the most severe GLPS impairment (p < 0.001). After adjustment for covariates in HFrEF patients, DM was found to be an independent determinant of impaired LV strains in all three directions (GRPS [ß = - 0.189; p = 0.011], GCPS [ß = 0.217; p = 0.005], GLPS [ß = 0.237; p = 0.002]). HTN was associated with impaired GLPS (ß = 0.185; p = 0.016) only. However, HTN rather than DM was associated with LV remodeling in HFrEF patients in the multivariable regression analysis (p < 0.05). CONCLUSIONS: DM aggravated LV longitudinal dysfunction in hypertensive HFrEF patients without further changes in LV remodeling, indicating that HFrEF patients with comorbid HTN and DM may have a hidden high-risk phenotype of heart failure that requires more advanced and personalized management.

Nutritional assessment in esophageal fast-track surgery: comparisons of 4 objective malnutrition screening tools.

BACKGROUND: This cohort study aimed to compare the performance of the 2015 diagnostic criteria for malnutrition of the European Society of Clinical Nutrition and Metabolism (ESPEN), the Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Universal Screening Tool (MUST), and Short-Form of Mini-Nutritional Assessment (MNA-SF) in detecting malnutrition risk and predicting postoperative complications and the failure of early oral feeding (EOF) programs in esophageal cancer patients. METHODS: The 4 tools were used to conduct malnutrition assessments before surgery. The patients were divided into the groups of severe malnutrition and mild/moderate malnutrition and the incidences of the endpoints were observed. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were conducted. RESULTS: Two hundred and nineteen consecutive esophageal cancer patients were included in the study. The prevalence rates of severe malnutrition as determined by the ESPEN 2015 criteria, MUST, NRS 2002, and MNA-SF were 24.7%, 29.7%, 23.7%, and 16.0%, respectively. The moderate/severe malnutrition risk screened by the MUST had a high sensitivity (100.0%) with malnutrition identified by the ESPEN 2015 criteria. In total, 42 (19.2%) patients experienced major complications, and the incidence rate of EOF failure was 7.3%. The severe malnutrition identified by the ESPEN 2015 criteria, MUST, and NRS 2002 were comparable in predicting the incidence of postoperative pulmonary complications, anastomotic leakage, readmission to intensive care units (ICUs), and EOF failure, but the ESPEN 2015 criteria was better in predicting postoperative overall complications, major complications, and delayed hospital discharge. CONCLUSIONS: The ESPEN 2015 criteria specializes in identifying severe malnutrition and is better in predicting adverse surgical outcomes; however, the MUST and NRS 2002 are better superior in detecting early malnutrition and are also valuable in the perioperative management in esophageal surgery. It is recommended that the MUST be used as the malnutrition screening tool before the ESPEN 2015 criteria is applied.

Risk assessment of coal mine water inrush based on PCA-DBN.

To provide an effective risk assessment of water inrush for coal mine safety production, a BP neural network prediction method for water inrush based on principal component analysis and deep confidence network optimization was proposed. Because deep belief network (DBN) is disadvantaged by a long training time when establishing a high-dimensional data classification model, the principal component analysis (PCA) method is used to reduce the dimensionality of many factors affecting the water inrush of the coal seam floor, thus reducing the number of variables of the research object, redundancy and the difficulty of feature extraction and shortening the training time of the model. Then, a DBN network was used to extract secondary features from the processed nonlinear data, and a more abstract high-level representation was formed by combining low-level features to find the expression of the nonlinear relationship between the characteristics of water in bursts. Finally, a prediction model was established to predict the water inrush in coal mines. The superiority of this method was verified by comparing the prediction of the actual working face with the actual situation in typical mining areas of North China. The prediction accuracy of coal mine water inrush obtained by this algorithm is 94%, while the prediction accuracy of traditional BP algorithm is 70%, and the prediction accuracy of SVM algorithm is 88%.

[Early Assessment of Myocardial Fibrosis of Hypertrophic Cardiomyopathy with Native-T1-Mapping-Based Deep Learning: A Preliminary Study].

OBJECTIVE: To explore the diagnostic performance of deep learning (DL) model in early detection of the interstitial myocardial fibrosis using native T1 maps of hypertrophic cardiomyopathy (HCM) without late gadolinium enhancement (LGE). METHODS: Sixty HCM patients and 44 healthy volunteers who underwent cardiac magnetic resonance were enrolled in this study. Each native T1 map was labeled according to its LGE status. Then, native T1 maps of LGE (-) and those of the controls were preprocessed and entered in the SE-ResNext-50 model as the matrix for the DL model for training, validation and testing. RESULTS: A total of 241 native T1 maps were entered in the SE-ResNext-50 model. The model achieved a specificity of 0.87, sensitivity of 0.79, and area under curve ( AUC) of 0.83 ( P<0.05) in distinguishing native T1 maps of LGE (-) from those of the controls in the testing set. CONCLUSION: The DL model based on SE-ResNext-50 could be used for identifying native T1 maps of LGE (-) with relatively high accuracy. It is a promising approach for early detection of myocardial fibrosis in HCM without the use of contrast agent.

Noninvasive oxygenation assessment after acute myocardial infarction with breathing maneuvers-induced oxygenation-sensitive magnetic resonance imaging.

The safety profiles when performing stress oxygenation-sensitive magnetic resonance imaging (OS-MRI) have raised concerns in clinical practice. Adenosine infusion can cause side effects such as chest pain, dyspnea, arrhythmia, and even cardiac death. The aim of this study was to investigate the feasibility of breathing maneuvers-induced OS-MRI in acute myocardial infarction (MI). This was a prospective study, which included 14 healthy rabbits and nine MI rabbit models. This study used 3 T MRI/modified Look-Locker inversion recovery sequence for native T1 mapping, balanced steady-state free precession sequence for OS imaging, and phase-sensitive inversion recovery sequence for late gadolinium enhancement. The changes in myocardial oxygenation (ΔSI) were assessed under two breathing maneuvers protocols in healthy rabbits: a series of extended breath-holding (BH), and a combined maneuver of hyperventilation followed by the extended BH (HVBH). Subsequently, OS-MRI with HVBH in acute MI rabbits was performed, and the ΔSI was compared with that of adenosine stress protocol. Student's t-test, Wilcoxon rank test, and Friedman test were used to compare ΔSI in different subgroups. Pearson and Spearman correlation was used to obtain the association of ΔSI between breathing maneuvers and adenosine stress. Bland-Altman analysis was used to assess the bias of ΔSI between HVBH and adenosine stress. In healthy rabbits, BH maneuvers from 30 to 50 s induced significant increase in SI compared with the baseline (all p < 0.05). By contrast, hyperventilation for 60 s followed by 10 s-BH (HVBH 10 s) exhibited a comparable ΔSI to that of stress test (p = 0.07). In acute MI rabbits, HVBH 10 s-induced ΔSIs among infarcted, salvaged, and the remote myocardial area were no less effectiveness than adenosine stress when performing OS-MRI (r = 0.84; p < 0.05). Combined breathing maneuvers with OS-MRI have the potential to be used as a nonpharmacological alternative for assessing myocardial oxygenation in patients with acute MI. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

Modelling the effects of media coverage and quarantine on the COVID-19 infections in the UK.

A new COVID-19 epidemic model with media coverage and quarantine is constructed. The model allows for the susceptibles to the unconscious and conscious susceptible compartment. First, mathematical analyses establish that the global dynamics of the spread of the COVID-19 infectious disease are completely determined by the basic reproduction number R0. If R0 ≤ 1, then the disease free equilibrium is globally asymptotically stable. If R0 > 1, the endemic equilibrium is globally asymptotically stable. Second, the unknown parameters of model are estimated by the MCMC algorithm on the basis of the total confirmed new cases from February 1, 2020 to March 23, 2020 in the UK. We also estimate that the basic reproduction number is R0 = 4.2816(95%CI: (3.8882, 4.6750)). Without the most restrictive measures, we forecast that the COVID-19 epidemic will peak on June 2 (95%CI: (May 23, June 13)) (Figure 3a) and the number of infected individuals is more than 70% of UK population. In order to determine the key parameters of the model, sensitivity analysis are also explored. Finally, our results show reducing contact is effective against the spread of the disease. We suggest that the stringent containment strategies should be adopted in the UK.

Assessment of intracardiac and extracardiac anomalies associated with coarctation of aorta and interrupted aortic arch using dual-source computed tomography.

To evaluate the value of dual-source computed tomography (DSCT) compared with transthoracic echocardiography (TTE) in assessing intracardiac and extracardiac anomalies in patients with coarctation of aorta (CoA) and interrupted aortic arch (IAA). Seventy-five patients (63 with CoA and 12 with IAA) who received preoperative DSCT and TTE were retrospectively studied. Intracardiac and extracardiac anomalies were recorded and compared by DSCT and TTE, in reference to surgical or cardiac catheterization findings. A total of 155 associated anomalies were finally found. Collateral circulation (56, 74.70%), patent ductus arteriosus (PDA; 41, 54.67%) were the most common anomalies. PDA, aortopulmonary window, and collateral circulation were more frequently present in patients with IAA than those with CoA (100% vs. 46.03%, 16.67% vs. 0%, and 100% vs. 69.84%, respectively, all p < 0.05). DSCT was superior to TTE in assessing associated extracardiac-vascular anomalies (sensitivity: 100% vs. 39.81%; specificity: 100% vs. 100%; positive predictive value: 100% vs. 100%; negative predictive value: 100% vs. 76.06%). Extracardiac-vascular anomalies, including collateral circulation and PDA, were the most common anomalies in patients with IAA and CoA. Compared with TTE, DSCT is more reliable in providing an overall preoperative evaluation of morphological features and extracardiac anomalies for surgical planning.

Rapid and sensitive detection of Anaplasma phagocytophilum using a newly developed recombinase polymerase amplification assay.

Anaplasma phagocytophilum, the bacterial pathogen responsible for tick-borne fever and human granulocytic anaplasmosis, can seriously affect the health of humans and a wide range of other mammals. In this study, we developed a recombinase polymerase amplification (RPA) assay to detect A. phagocytophilum in clinical samples. Following alignment of the relevant DNA sequences, a pair of specific primers based on the 16S rRNA gene was designed to specifically detect A. phagocytophilum. The assay was performed at a constant temperature of 38 °C for 30 min, with a final primer concentration of 0.4 µM. The specificity of the primers was confirmed when DNA from A. phagocytophilum was used as the positive control, and DNA from other related pathogens were used as the negative controls, with ddH2O acting as the blank control. The results showed that the primers did not cross-react with DNA from the other related pathogens. The assay's detection limit was 1.77 × 10-5 ng/µl, a 10 × higher sensitivity level than that determined for nested PCR. The RPA assay's performance was evaluated using 44 clinical samples, and the prevalence results for A. phagocytophilum were found to not differ significantly between the RPA assay and the nested PCR. Thus, we have developed a specific, sensitive, rapid and cost-effective RPA method, requiring only a water bath, for the detection of A. phagocytophilum. The assay should be especially useful in resource-limited areas where access to laboratory equipment is limited.

Dual-source computed tomography for quantitative assessment of tracheobronchial anomaly from type IIA pulmonary artery sling in pediatric patients.

PURPOSE: As an extremely rare abnormity, type IIA pulmonary artery sling (PAS) tracheobronchial anomalies should be differentiated from normal airway for therapeutic decision-making. This study aimed to investigate the quantitative characteristics of type IIA PAS tracheobronchial anomalies using dual-source computed tomography (DSCT). MATERIALS AND METHODS: From January 2009 to December 2016, there were 11 type IIA PAS patients enrolled for analysis and compared with 32 controls. The areas of the trachea, right upper lobar bronchus, left main bronchus, right intermediate bronchus [bridging bronchus (BB) in patients], and subcarinal angle [subpseudocarinal angle in patients] were measured. Measurements other than that for the angle were standardized with body surface area. RESULTS: Significant differences were found between the type IIA PAS patients and controls in terms of DSCT measurements in the trachea (0.51 ±â€¯0.32 cm2/m2 vs. 0.92 ±â€¯0.18 cm2/m2, P < 0.001); left main bronchus (0.29 ±â€¯0.14 cm2/m2 vs. 0.43 ±â€¯0.18 cm2/m2, P = 0.01); right intermediate bronchus [BB in patients] (0.36 ±â€¯0.13 cm2/m2 vs. 0.47 ±â€¯0.12 cm2/m2, P = 0.02); and subcarinal angle [subpseudocarinal angle in patients] (116.27 ±â€¯16.45° vs. 79.41 ±â€¯15.71°, P < 0.001). Receiver operating characteristic analysis further revealed that these parameters may be indicators to differentiate tracheobronchial anomalies due to type IIA PAS from controls (AUC, 0.88-0.98; sensitivity, 81.7%-100%; specificity, 91.7%-100%). CONCLUSIONS: DSCT is an alternative technique to detect tracheobronchial anomalies in pediatric patients with type IIA PAS. It can provide accurate anatomic details for surgeons to determine therapeutic strategies.

Assessment of left ventricular myocardial deformation by cardiac MRI strain imaging reveals myocardial dysfunction in patients with primary cardiac tumors.

BACKGROUND: To assess left ventricular myocardial deformation in patients with primary cardiac tumors. METHODS: MRI was retrospectively performed in 61 patients, including 31 patients with primary cardiac tumors and 30 matched normal controls. Left ventricular strain and function parameters were then assessed by MRI-tissue tracking. Differences between the tumor group and controls, left and right heart tumor groups, left ventricular wall tumor and non-left ventricular wall tumor groups, and tumors with and without LV enlargement groups were assessed. Finally, the correlations among tumor diameter, myocardial strain, and LV function were analyzed. RESULTS: Left ventricular myocardial strain was milder for tumor group than for normal group. Peak circumferential strain (PCS) and its diastolic strain rate, longitudinal strains (PLS) and its diastolic strain rates, and peak radial systolic and diastolic velocities of the right heart tumor group were lower than those of the left heart tumor group (all p<0.050), but the peak radial systolic strain rate of the former was higher than that of the latter (p=0.017). The corresponding strains were lower in the left ventricular wall tumor groups than in the non-left ventricular wall tumor group (p<0.050). Peak radial systolic velocities were generally higher for tumors with LV enlargement than for tumors without LV enlargement (p<0.050). Peak radial strain, PCS, and PLS showed important correlations with the left ventricular ejection fraction (all p<0.050). CONCLUSION: MRI-tissue tracking is capable of quantitatively assessing left ventricular myocardial strain to reveal sub-clinical abnormalities of myocardial contractile function.

An Evaluation of Common Cordyceps (Ascomycetes) Species Found in Chinese Markets.

The common Cordyceps (more than 20 species) found in Chinese markets are evaluated and illustrated. We systematically introduce their taxonomies, allied species, hosts, distributions, yields, selling statuses, and market prices. We summarize and comment on the medicinal value and food safety of Cordyceps. The concept of "cordyceps" is explained, the "best" cordyceps is explored, and Chinese cordyceps culture is analyzed. We suggest using the word "cordyceps" instead of the Latin Cordyceps to report these important edible and medicinal mushrooms.

Assessment of tetralogy of Fallot-associated congenital extracardiac vascular anomalies in pediatric patients using low-dose dual-source computed tomography.

BACKGROUND: To investigate the diagnostic value of dual-source computed tomography (DSCT) in the evaluation of tetralogy of Fallot (TOF)-associated extracardiac vascular abnormalities in pediatric patients compared with transthoracic echocardiography (TTE). METHODS: One hundred and twenty-three pediatric patients diagnosed with TOF were included in this retrospective study. All patients underwent DSCT and TTE preoperatively. All associated extracardiac vascular abnormalities and their percentages were recorded. The diagnostic performances of DSCT and TTE were compared based on the surgical results. The image quality of DSCT was rated, and the effective radiation dose (ED) was calculated. RESULTS: A total of 159 associated extracardiac vascular deformities were confirmed by surgery. Patent ductus arteriosus (36, 22.64%), right-sided aortic arch (29, 18.24%), and pulmonary valve stenosis (23, 14.47%) were the most common associated extracardiac vascular abnormalities. DSCT was superior to TTE in demonstrating associated extracardiac anomalies (diagnostic accuracy: 99.13% vs. 97.39%; sensitivity: 92.45% vs. 77.07%; specificity: 99.81% vs. 99.42%). The agreement on grading the image quality of DSCT was excellent (κ = 0.80), and the mean score of the image quality was 3.39 ± 0.50. The mean ED of DSCT was 0.86 ± 0.47 mSv. CONCLUSIONS: Compared to TTE, low-dose DSCT has high diagnostic accuracy in the depiction of associated extracardiac vascular anomalies in pediatric patients with TOF, and could provide more morphological details for surgeons.

Assessment of transposition of the great arteries associated with multiple malformations using dual-source computed tomography.

PURPOSE: To determine the value of dual-source computed tomography (DSCT) in depicting the morphological characteristics and diagnosing the associated malformations for patients with transposition of the great arteries (TGA) before surgery. MATERIALS AND METHODS: Twenty-five patients with TGA who underwent DSCT and transthoracic echocardiography (TTE) examination were retrospectively reviewed. The morphological types of TGA, the spatial relationship between the pulmonary artery and the aorta, as well as coronary artery-associated abnormalities were assessed by DSCT. In contrast to TTE, the diagnostic accuracy of associated malformations on DSCT were analyzed and calculated with reference to surgical or digital subtraction angiography (DSA) findings. Effective doses (EDs) were also calculated. RESULTS: Among the 25 patients, 12 (48%) had ventricular septal defects and left ventricular outflow tract stenosis. Sixteen patients (16/25, 64%) had great arteries with an oblique spatial relationship on DSCT. In addition, we found seven patients (7/25, 28%) with coronary artery malformation, including five with an abnormal coronary origin and two with signs of a myocardial bridge. According to DSA or surgical findings, DSCT was superior to TTE in demonstrating extracardiac anomalies (sensitivity, anomalies of great vessels: 100% vs. 93.33%, other anomalies: 100% vs. 46.15%). The mean estimated ED for those aged <10 years was <2 mSv (1.59 ± 0.95 mSv). CONCLUSIONS: DSCT can achieve an overall assessment of patients with TGA, including any associated malformations as well as the identification of the spatial relationship of the great arteries. DSCT can therefore be considered as an alternative imaging modality for surgical decision making.

Iodine-Promoted Semmler-Wolff Reactions: Step-Economic Access to meta-Substituted Primary Anilines via Aromatization.

An atom- and step-economic access to an array of unprotected meta-substituted primary anilines was disclosed using the Semmler-Wolff reaction, promoted by molecular iodine. Therein, noble metal catalysts and inert atmosphere are unnecessary while the forcing reaction conditions and the lengthy synthesis can be avoided. The synthetic utility of this approach is evident in the de novo syntheses of three bioactive molecules with good total yields.