Role of automated functional imaging and myocardial work in assessment of cardiac function in children with obstructive sleep apnea.

BACKGROUND: Early identification of abnormal left ventricular function in children with obstructive sleep apnea (OSA) is difficult using conventional echocardiographic indices and commonly used clinical markers of myocardial damage. We sought to investigate the value of automatic function imaging and myocardial work parameters in predicting early cardiac impairment in children having OSA with preserved left heart function and thereby identifying an optimal index for assessment. PATIENTS AND METHODS: Fifty-two children who presented with symptoms of nocturnal sleep snoring and open-mouth breathing and 34 healthy controls were enrolled in this study. Clinical characteristics and conventional echocardiographic data were collected, and image analysis was performed using two-dimensional speckle-tracking echocardiography to obtain left ventricular global longitudinal strain (GLS), post-systolic index, peak strain dispersion, global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. RESULTS: Children with OSA had significantly lower GLS, GWI, and GCW than those without (P < 0.05). Additionally, GWI (ß = -32.87, 95% CI: -53.47 to -12.27), and GCW (ß = -35.09, 95% CI: -55.35 to -14.84) were found to correlate with the disease severity in the multiple linear regression mode, with worsening values observed as the severity of the disease increased. ROC curve analysis revealed that GCW was the best predictor of myocardial dysfunction, with an AUC of 0.809 (P < 0.001), and the best cutoff point for diagnosing myocardial damage in children with OSA was 1965.5 mmHg%, with a sensitivity of 92.5% and a specificity of 58.7%. CONCLUSIONS: GLS, GWI, and GCW were identified as predictors of myocardial dysfunction in children with OSA, with GCW being the best predictor.

Promoting Cross-Regional Integration of Maritime Emission Management: A Euro-American Linkage of Carbon Markets.

Reducing greenhouse gas emissions from maritime transport is an urgent topic. Some regional emissions trading systems (ETSs), buoyed by the globalized market-based measures (MBMs) plan of the International maritime organization, have initially assessed the feasibility of including maritime emissions under compliance obligations. However, including maritime emissions (which are interjurisdictional) in the existing ETSs is controversial, and globalized maritime MBMs remain elusive. Therefore, this study designed a joint bilateral maritime carbon market (BMCM) model based on the European ETS (EU-ETS) and Quebec ETS (QC-ETS). The carbon costs, speed optimization, and marginal abatement costs of three container routes under BMCM were analyzed. The results show that this Euro-American linkage achieves adequate emission coverage on specific routes and generates acceptable carbon costs for charterers. This study yields a positive result for the equal division of ETSs' exercising competence in cross-regional maritime transport and provides evidence for sector-specific ETS links based on quantitative analysis.

Exploring the impact mechanism of executives' environmental attention on corporate green transformation: evidence from the textual analysis of Chinese companies' management discussion and analysis.

The allocation of executives' environmental attention (EEA) is of great significance in promoting the green upgrading of industrial structures and achieving corporate green transformation. Based on upper echelon theory and the attention-based view, we use panel data of Chinese manufacturing companies from 2015 to 2020 to construct a two-way fixed effects model to explore the impact mechanism of EEA on corporate green transformation performance (CGTP). Baseline regression shows that EEA significantly improves CGTP. The reliability of findings is verified by reducing time windows, replacing the independent variable, expanding the data source, and adding missing variables. In the heterogeneity analysis, the positive effect of EEA on CGTP is significant for eastern companies and does not differ in the property rights grouping. After propensity score matching, environmental attribute grouping shows that the positive effect of EEA on CGTP is more significant for non-heavy polluters. Extended research shows that government subsidies have a positive moderating effect, while female executives play only a symbolic role. Moreover, green innovation activities have positive partial mediating effects. Green innovation is the best way to address environmental pollution and achieve corporate green transformation. Our research provides implications for decision-makers to allocate their attention, and thereby achieve green development appropriately.

Development of an extended STIRPAT model to assess the driving factors of household carbon dioxide emissions in China.

Although the past twenty years have witnessed China's remarkable economic development, the cost in terms of greenhouse gas emissions and a deteriorating environment has been enormous. Numerous studies have revealed the influence of household factors on household carbon dioxide emissions (HCEs) and called for a reduction of HCEs to mitigate climate change, but few have focused on assessing the most significant household driving factors of HCEs. Using statistical data between 2005 and 2019 in Jiangsu, China, this study developed an extended stochastic impact by regression on population, affluence, and technology (STIRPAT) model to assess the most significant driving factors of HCEs. The results show that the most significant driving factors are household size, total population, unemployment, and urbanisation rate. The study found that HCEs are positively impacted by household size while negatively impacted by the unemployment rate. Based on the study's findings, the following suggestions are proposed to lower HCEs: (i) establish an optimal consumption concept to guide residents towards consuming reasonably; (ii) cultivate a low-carbon concept among residents and promote low-carbon emissions living; and (iii) pay close attention to population structure factors and formulate effective measures accordingly. The study provides insightful information on the key driving factors of HCEs, which can facilitate achieving carbon emissions neutrality.

How Well Are Socioeconomic Factors Associated With Improved Outcomes for Infants Diagnosed With Early Childhood Developmental Delay? An Observational Study.

Purpose: Early childhood developmental delay remains problematic worldwide in terms of weight and the five domains of child development, including gross motor, fine motor, cognition, language, and social domains. Based on the World Health Organization (WHO) guideline and the theoretical domain framework, this study identified five key socioeconomic factors, such as parenting time during hospitalization, parental educational level, medical spending, distance to hospital, and medical insurance coverage, to describe how these five factors are associated with improved outcomes of developmental quotient (DQ) values and the weight of infants in a tertiary hospital. Methods: In this prospective observational study, clinical and socioeconomic data were collected. Clinical data included the weight and DQ values of infants and other data relevant to the birth of infants. A National Developmental Scale was used to observe infants in five domains and calculate the DQ values of infants. These five domains include gross motor, fine motor, cognition, language, and social domains. Parenting time during hospitalizations was observed by a research nurse. Other socioeconomic factors were reported by parents and verified with system information. Results: A total of 75 infants' parents were approached, of which 60 were recruited. The age of infants ranged from 75 to 274 days at the first admission. Increments of their weight and DQ values improved from -0.5 to 2.5 kg and from -13 to 63, respectively. More than half of the parents (54.1%) were at the level of minimum secondary education although the results were not statistically significant. However, there was a positive correlation between weight improvement and parenting time during hospitalization (r(58) = 0.258, p < 0.05), medical spending (r(58) = 0.327, p < 0.05), distance to hospital (r(58) = 0.340, p < 0.01), but there was a negative association with medical insurance coverage (r(58) =-0.256, p < 0.05). There was also a significant relationship between the improved DQ value and distance to hospital (r(58)= 0.424, p < 0.01). Conclusion: Parenting time during hospitalization, medical spending, distance to hospital, and medical insurance coverage are important factors for early childhood developmental delay in relation to possible hospital intervention and improved accessibility to health services for families in rural areas. Therefore, changes in the current medical scheme are needed because a universal medical subsidy among regions will reduce the financial burden of families and provide families with more access to the necessary health services that their children need.

Liquid Biopsy Assessment of Circulating Tumor Cell PD-L1 and IRF-1 Expression in Patients with Advanced Solid Tumors Receiving Immune Checkpoint Inhibitor.

BACKGROUND: Reliable biomarkers that can be serially monitored to predict treatment response to immune checkpoint inhibitors (ICIs) are still an unmet need. Here, we present a multiplex immunofluorescence (IF) assay that simultaneously detects circulating tumor cells (CTCs) and assesses CTC expression of programmed death ligand-1 (PD-L1) and interferon regulatory factor 1 (IRF-1) as a candidate biomarker related to ICI use. OBJECTIVE: To assess the potential of CTC PD-L1 and IRF-1 expression as candidate biomarkers for patients with advanced epithelial solid tumors receiving ICIs. PATIENTS AND METHODS: We tested the IF CTC assay in a pilot study of 28 patients with advanced solid tumors who were starting ICI. Blood for CTC evaluation was obtained prior to starting ICI, after a single cycle of therapy, and at the time of radiographic assessment or treatment discontinuation. RESULTS: At baseline, patients with 0-1 CTCs had longer progression-free survival (PFS) compared to patients with ≥ 2 CTCs (4.3 vs 1.3 months, p = 0.01). The presence of any PD-L1+ CTCs after a single dose of ICI portended shorter PFS compared to patients with no CTCs or PD-L1- CTCs (1.2 vs 4.2 months, p = 0.02); the presence of any PD-L1+ or IRF-1+ CTCs at time of imaging assessment or treatment discontinuation also was associated with shorter PFS (1.9 vs 5.5 months, p < 0.01; 1.6 vs 4.7 months, p = 0.05). CTC PD-L1 and IRF-1 expression did not correlate with tumor tissue PD-L1 or IRF-1 expression. Strong IRF-1 expression in tumor tissue was associated with durable (≥ 1 year) radiographic response (p = 0.02). CONCLUSIONS: Based on these results, CTC PD-L1 and IRF-1 expression is of interest in identifying ICI resistance and warrants further study.

Occlusal Assessment of Zirconia Crowns Designed with the Digital Articulator and Traditional Methods.

PURPOSE: To evaluate and compare the occlusal fit of zirconia crowns designed using a digital articulator method and the traditional method in a self-controlled clinical trial. MATERIALS AND METHODS: Two zirconia crowns each were prepared for 12 patients with a single posterior tooth defect using two different methods: a digital articulator method and the traditional method. In the traditional method, casts were scanned using a model scanner, and the relative positions of the maxillary and mandibular arches were determined by the intercuspal occlusion of the casts. In the digital articulator method, casts were mounted on a mechanical articulator and scanned, and the relative positions were determined by their respective positions in the articulator. Additional dynamic occlusal adjustments of the digital articulator crowns were performed. Both groups of zirconia crowns were milled in a five-axis milling machine. The time required for occlusal adjustments, the occlusal contacts, the occlusal contact distributions, the number of occlusal contacts, the relative occlusal forces, and patient satisfaction (visual analog scale score) were evaluated. Wilcoxon test, McNemar test, and paired t test were used to compare the parameters between the two methods. RESULTS: The occlusal adjustment times for the digital articulator and traditional method crowns were 327 ± 226 seconds and 395 ± 338 seconds, respectively (P > .05). There were no significant differences in occlusal contacts, occlusal contact distributions, number of occlusal contacts, relative occlusal forces, or VAS scores between the two methods (P > .05). CONCLUSION: A digital articulator method for single-crown restoration was applied successfully. Crowns fabricated using a digital articulator or the traditional method can achieve acceptable occlusal fit for single-crown restorations.

Assessment of ADCY9 polymorphisms and colorectal cancer risk in the Chinese Han population.

BACKGROUND: Recently, ADCY9 has been found to be highly expressed in colon cancer, and high ADCY9 expressionis a poor prognostic factor of colon cancer. However, no study has reported on the relationship between single nucleotide polymorphisms (SNPs) of ADCY9 and colorectal cancer risk in the Chinese Han population. METHODS: To evaluate the association between four ADCY9 SNPs and colorectal cancer risk, we performed a case-control study including 511 colorectal cancer patients and 511 healthy controls. SNPs were genotyped using the Agena MassARRAY platform (Agena Bioscience, San Diego, CA, USA). The distributions of alleles and genotypes frequencies between the case and control groups were compared using chi-squared. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression adjusted for age and gender to assess the association between SNPs and colorectal cancer risk. RESULTS: The overall analysis found that rs2230742 was associated with an increased risk of colorectal cancer (AA versus GG: OR = 3.54, 95% CI = 1.16-10.86, p = 0.027; recessive model: OR = 3.55, 95% CI = 1.16-10.85, p = 0.027). Stratification analysis showed that rs2230742 was associated with an increased rectal cancer risk; rs11076810 was associated with a reduced colorectal cancer risk for age > 59 years. No association was observed between other two SNPs and colorectal cancer risk. CONCLUSIONS: Our findings suggest that ADCY9 polymorphisms (rs2230742 and rs11076810) have an effect on colorectal cancer risk in the Chinese Han population. Future association and functional studies are required to confirm our findings and explore the mechanism of ADCY2 in colorectal cancer.

Human induced pluripotent stem cell line with genetically encoded fluorescent voltage indicator generated via CRISPR for action potential assessment post-cardiogenesis.

Genetically encoded fluorescent voltage indicators, such as ArcLight, have been used to report action potentials (APs) in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). However, the ArcLight expression, in all cases, relied on a high number of lentiviral vector-mediated random genome integrations (8-12 copy/cell), raising concerns such as gene disruption and alteration of global and local gene expression, as well as loss or silencing of reporter genes after differentiation. Here, we report the use of clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 nuclease technique to develop a hiPSC line stably expressing ArcLight from the AAVS1 safe harbor locus. The hiPSC line retained proliferative ability with a growth rate similar to its parental strain. Optical recording with conventional epifluorescence microscopy allowed the detection of APs as early as 21 days postdifferentiation, and could be repeatedly monitored for at least 5 months. Moreover, quantification and analysis of the APs of ArcLight-CMs identified two distinctive subtypes: a group with high frequency of spontaneous APs of small amplitudes that were pacemaker-like CMs and a group with low frequency of automaticity and large amplitudes that resembled the working CMs. Compared with FluoVolt voltage-sensitive dye, although dimmer, the ArcLight reporter exhibited better optical performance in terms of phototoxicity and photostability with comparable sensitivities and signal-to-noise ratios. The hiPSC line with targeted ArcLight engineering design represents a useful tool for studying cardiac development or hiPSC-derived cardiac disease models and drug testing.

Simultaneous assessment of endogenous thiol compounds by LC-MS/MS.

Biological thiol compounds are very important molecules that participate in various physiological events. Alteration in levels of endogenous thiols has been suggested as a biomarker of early stage of pathological changes. We reported a chemical derivatization- and LC-MS/MS-based approach to simultaneously determine thiol compounds including glutathione (GSH), cysteine (Cys), N-acetyl cysteine (NAC), homocysteine (Hcy), and cysteinylglycine (CysGly) in biological samples. Thiol-containing samples were derivatized with monobromobimane (mBrB) at room temperature, followed by LC-MS/MS analysis. Assessment of the analytes with baseline separation was completed within 10min, using a gradient elution on a C18 reversed-phase column. Excellent linearity was observed for all analytes over their concentration ranges of 1-400µM. The lowest limits of detection (S/N=3) in a range from 0.31fmol (for NAC) to 4.98fmol (for CysGly) were achieved. The results indicate that this approach was sensitive, selective, and well suited for high-throughput quantitative determination of the biological thiols.

First assessment of three-dimensional quantitative photoacoustic tomography for in vivo detection of osteoarthritis in the finger joints.

PURPOSE: The purpose of this pilot clinical study is to assess three-dimensional (3-D) quantitative photoacoustic tomography (qPAT) for in vivo detection of osteoarthritis (OA) in the finger joints. METHODS: All subject data were handled in compliance with the rules and regulations concerning the privacy and security of protected health information under HIPAA. Seven female subjects (two OA patients and five healthy controls) entered the study and their distal interphalangeal (DIP) joints were examined by a 3-D photoacoustic scanner. 3-D optical absorption coefficient images of all the photoacoustically examined joints were recovered using a 3-D qPAT reconstruction algorithm. RESULTS: The recovered quantitative photoacoustic images revealed obvious difference in the optical absorption coefficient of the joint cavity (cartilage and synovial fluid) between the OA and healthy joints. Quantitative analysis of the joints also indicated an apparent difference in the recovered joint spacing between the OA and healthy subjects. CONCLUSION: This initial clinical evaluation suggests that it is feasible to detect osteoarthritis in the finger joints with our 3-D qPAT approach, which has paved the way to further statistically evaluate the diagnostic performance of the 3-D qPAT approach in comparison with radiography or magnetic resonance imaging (MRI) on a sample of hand osteoarthritis.