The relationship between C-reactive protein/albumin ratio and mortality in hypertensive patients: A national cohort study.

BACKGROUND AND AIMS: The impact of inflammation on the prognosis of hypertension has received some attention. The current study examined the association between C-reactive protein to albumin ratio (CAR), a novel indicator of inflammatory response, and mortality in individuals with hypertension. METHODS AND RESULTS: A total of 9561 eligible individuals diagnosed with hypertension were included in the final analysis. CAR was calculated as ratio of C-reactive protein to serum albumin concentration. Patients were categorized into tertiles based on their baseline CAR levels. The Kaplan-Meier survival method was employed to compare the survival times of patients throughout the follow-up period. Multivariable analysis was conducted using the Cox proportional regression model. In the entire study population, 3262 (27%) experienced all-cause mortality. Patients in tertile 3 exhibited a higher risk of mortality (23% vs. 28% vs. 31%, P < 0.001) in comparison to those in the other tertiles. The findings from the multivariable Cox regression analysis demonstrated that when patients in tertile 1 were used as the reference group, the highest CAR tertile displayed a 60% increased risk of all-cause mortality (HR, 1.60 [95%CI, 1.23-2.09] P < 0.001). CONCLUSION: Among hypertensive patients, elevated CAR was found to be associated with an increased risk of all-cause mortality. Therefore, CAR might be used for risk stratification within this population, facilitating the implementation of closer follow-up and the optimization of treatment strategies.

The relationship between serum creatinine/cystatin C ratio and mortality in hypertensive patients.

BACKGROUND AND AIMS: Sarcopenia is a disease characterized by loss of skeletal muscle mass and function that is closely associated with cardiovascular disease. The serum creatinine/cystatin C (Cr/CysC) ratio has been shown to be a simplified indicator for identifying low muscle mass (LMM) or sarcopenia. The aim of this study was to investigate whether the Cr/CysC ratio helps to predict prognostic information in hypertensive patients. METHODS AND RESULTS: This cohort study included 2509 patients with hypertension from the National Health and Nutrition Survey 1999-2002. To evaluate the association between Cr/CysC ratio and mortality, we used Kaplan Meier estimates to calculate cumulative survival probabilities for all-cause mortality and cardiovascular mortality, Cox regression analyses, and hazard ratio (HR) and 95% confidence interval (CI) were calculated. Over a median follow-up of 11.76 years, lower Cr/CysC ratio was associated with lower risk of all-cause mortality (per 0.1 increase, HR:0.81, 95% CI: 0.77-0.85, P < 0.001) and cardiovascular mortality (per 0.1 increase, HR:0.80, 95% CI: 0.72-0.89, P < 0.001). Compared with patients with normal muscle mass, all-cause mortality, and cardiovascular mortality HR for patients with LMM diagnosed by Cr/CysC ratio were 1.57 (95% CI: 1.36-1.82, P < 0.001) and 1.64 (95% CI: 1.12-2.42, P = 0.012), respectively. CONCLUSION: We found that low muscle mass shown by lower Cr/CysC ratio was an independent risk factor for poor prognosis in hypertensive patients. We recommend routine screening of Cr/CysC ratio in hypertensive patients and early intervention for low muscle mass or sarcopenia.

Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database.

BACKGROUND: The triglyceride-glucose (TyG) index is a reliable alternative biomarker of insulin resistance (IR). However, whether the TyG index has prognostic value in critically ill patients with coronary heart disease (CHD) remains unclear. METHODS: Participants from the Medical Information Mart for Intensive Care III (MIMIC-III) were grouped into quartiles according to the TyG index. The primary outcome was in-hospital all-cause mortality. Cox proportional hazards models were constructed to examine the association between TyG index and all-cause mortality in critically ill patients with CHD. A restricted cubic splines model was used to examine the associations between the TyG index and outcomes. RESULTS: A total of 1,618 patients (65.14% men) were included. The hospital mortality and intensive care unit (ICU) mortality rate were 9.64% and 7.60%, respectively. Multivariable Cox proportional hazards analyses indicated that the TyG index was independently associated with an elevated risk of hospital mortality (HR, 1.71 [95% CI 1.25-2.33] P = 0.001) and ICU mortality (HR, 1.50 [95% CI 1.07-2.10] P = 0.019). The restricted cubic splines regression model revealed that the risk of hospital mortality and ICU mortality increased linearly with increasing TyG index (P for non-linearity = 0.467 and P for non-linearity = 0.764). CONCLUSIONS: The TyG index was a strong independent predictor of greater mortality in critically ill patients with CHD. Larger prospective studies are required to confirm these findings.

Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients.

BACKGROUND: Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population. METHODS: This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1-Q4) according to TyG index. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality. RESULTS: During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan-Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18-2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59-3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay. CONCLUSIONS: TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.

Red blood cell distribution width predicts gastrointestinal bleeding after coronary artery bypass grafting.

BACKGROUND: Red blood cell distribution width (RDW) is highly associated with adverse clinical outcomes in many diseases. The present study aimed to evaluate the relationship between RDW and gastrointestinal bleeding (GIB) after isolated coronary artery bypass grafting (CABG). METHODS: This was a retrospective observational study that included 4473 patients who received CABG, and all the data were extracted from the Medical Information Mart for Intensive Care III database. Data collected included patient demographics, associated comorbid illnesses, laboratory parameters, and medications. The receiver operating characteristic (ROC) curve was used to determine the best cutoff value of RDW for the diagnosis of GIB. Multivariable logistic regression analysis was used to analyze the relationship between RDW and GIB. RESULTS: The incidence of GIB in patients receiving CABG was 1.1%. Quartile analyses showed a significant increase in GIB incidence at the fourth RDW quartile (> 14.3%; P < 0.001). The ROC curve analysis revealed that an RDW level > 14.1% measured on admission had 59.6% sensitivity and 69.4% specificity in predicting GIB after CABG. After adjustment for confounders, high RDW was still associated with an increased risk of GIB in patients with CABG (odds ratio = 2.83, 95% confidence interval 1.46-5.51, P = 0.002). CONCLUSIONS: Our study indicates that the elevated RDW level is associated with an increased risk of GIB after CABG, and it can be an independent predictor of GIB. The introduction of RDW to study GIB enriches the diagnosis method of GIB and ensures the rapid and accurate diagnosis of GIB.

RPC-Based Orthorectification for Satellite Images Using FPGA.

Conventional rational polynomial coefficients (RPC)-based orthorectification methods are unable to satisfy the demands of timely responses to terrorist attacks and disaster rescue. To accelerate the orthorectification processing speed, we propose an on-board orthorectification method, i.e., a field-programmable gate array (FPGA)-based fixed-point (FP)-RPC orthorectification method. The proposed RPC algorithm is first modified using fixed-point arithmetic. Then, the FP-RPC algorithm is implemented using an FPGA chip. The proposed method is divided into three main modules: a reading parameters module, a coordinate transformation module, and an interpolation module. Two datasets are applied to validate the processing speed and accuracy that are achievable. Compared to the RPC method implemented using Matlab on a personal computer, the throughputs from the proposed method and the Matlab-based RPC method are 675.67 Mpixels/s and 61,070.24 pixels/s, respectively. This means that the proposed method is approximately 11,000 times faster than the Matlab-based RPC method to process the same satellite images. Moreover, the root-mean-square errors (RMSEs) of the row coordinate (ΔI), column coordinate (ΔJ), and the distance ΔS are 0.35 pixels, 0.30 pixels, and 0.46 pixels, respectively, for the first study area; and, for the second study area, they are 0.27 pixels, 0.36 pixels, and 0.44 pixels, respectively, which satisfies the correction accuracy requirements in practice.

A New FPGA Architecture of FAST and BRIEF Algorithm for On-Board Corner Detection and Matching.

Although some researchers have proposed the Field Programmable Gate Array (FPGA) architectures of Feature From Accelerated Segment Test (FAST) and Binary Robust Independent Elementary Features (BRIEF) algorithm, there is no consideration of image data storage in these traditional architectures that will result in no image data that can be reused by the follow-up algorithms. This paper proposes a new FPGA architecture that considers the reuse of sub-image data. In the proposed architecture, a remainder-based method is firstly designed for reading the sub-image, a FAST detector and a BRIEF descriptor are combined for corner detection and matching. Six pairs of satellite images with different textures, which are located in the Mentougou district, Beijing, China, are used to evaluate the performance of the proposed architecture. The Modelsim simulation results found that: (i) the proposed architecture is effective for sub-image reading from DDR3 at a minimum cost; (ii) the FPGA implementation is corrected and efficient for corner detection and matching, such as the average value of matching rate of natural areas and artificial areas are approximately 67% and 83%, respectively, which are close to PC's and the processing speed by FPGA is approximately 31 and 2.5 times faster than those by PC processing and by GPU processing, respectively.

FPGA-Based On-Board Geometric Calibration for Linear CCD Array Sensors.

With increasing demands in real-time or near real-time remotely sensed imagery applications in such as military deployments, quick response to terrorist attacks and disaster rescue, the on-board geometric calibration problem has attracted the attention of many scientists in recent years. This paper presents an on-board geometric calibration method for linear CCD sensor arrays using FPGA chips. The proposed method mainly consists of four modules-Input Data, Coefficient Calculation, Adjustment Computation and Comparison-in which the parallel computations for building the observation equations and least squares adjustment, are implemented using FPGA chips, for which a decomposed matrix inversion method is presented. A Xilinx Virtex-7 FPGA VC707 chip is selected and the MOMS-2P data used for inflight geometric calibration from DLR (Köln, Germany), are employed for validation and analysis. The experimental results demonstrated that: (1) When the widths of floating-point data from 44-bit to 64-bit are adopted, the FPGA resources, including the utilizations of FF, LUT, memory LUT, I/O and DSP48, are consumed at a fast increasing rate; thus, a 50-bit data width is recommended for FPGA-based geometric calibration. (2) Increasing number of ground control points (GCPs) does not significantly consume the FPGA resources, six GCPs is therefore recommended for geometric calibration. (3) The FPGA-based geometric calibration can reach approximately 24 times faster speed than the PC-based one does. (4) The accuracy from the proposed FPGA-based method is almost similar to the one from the inflight calibration if the calibration model and GCPs number are the same.

Urban green and blue infrastructure: unveiling the spatiotemporal impact on carbon emissions in China's Yangtze River Delta.

Blue-green infrastructure (BGI) plays a crucial role in regulating urban carbon cycles. Nonetheless, the spatiotemporal effect of BGI on carbon emissions has not received extensive attention. This study used the Yangtze River Delta (YRD) region as the study area and quantified the landscape patterns of BGI. Using a spatiotemporal geographically weighted regression model, we analyzed the impact of evolving spatiotemporal characteristics of BGI on carbon emissions. Additionally, we constructed a spatiotemporal weight matrix using the Moran index ratio to examine the spillover effects of BGI among different regions. Our results show that the aggregation effect of carbon emissions in the YRD region is gradually increasing while BGI has a dynamic impact on carbon emissions. In terms of spatial and temporal spillovers, under the influence of economic connections between regions, patch fragmentation and distance exert a persistent positive influence on carbon emissions, while shape complexity has a negative impact, with area and layout characteristics showing no significant effects. However, area and patch distance have a persistent positive influence on carbon emissions in adjacent areas, while shape complexity exhibits a negative impact. Therefore, optimizing urban BGI through a regional synergistic governance system is important to promote low-carbon urban development.

Association of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and acute kidney disease in patients undergoing coronary angiography: a cohort study.

BACKGROUND: Acute kidney disease (AKD) following coronary angiography (CAG) indicates a higher risk of chronic kidney disease and follow-up cardiovascular comorbidities. However, the predictive risk factor of AKD is not clear. We sought to verify whether preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) level was associated with AKD in patients undergoing CAG. METHOD: We analyzed 7602 patients underwent CAG in this multi-center registry cohort study. Cardiorenal ImprovemeNt II (CIN-II) in five Chinese tertiary hospitals from 2007 to 2020. The primary outcome was AKD, defined as a ≥ 50% increase of serum creatinine within 7-90 days. Multivariable logistic regressions were used to assess the association between NT-proBNP and AKD. RESULT: 1009 patients (13.27%) eventually developed AKD, who were more likely to be female, older, and with comorbidities of chronic heart failure and anemia. After adjusting to the potential confounders, the NT-proBNP level remained an independent predictor of AKD (lnNT-proBNP OR: 1.20, 95% CI 1.13-1.28, p < 0.005). Restricted cubic spline analysis demonstrated a linear relationship between elevated NT-proBNP and AKD (p for trend < 0.001). In the subgroup analysis, elevated NT-proBNP level in patients with percutaneous coronary intervention (p for interaction < 0.001) or without previous congestive heart failure (p for interaction = 0.0346) has a more significant value of AKD prediction. CONCLUSION: Pre-operative NT-proBNP level was independently associated with the risk of AKD in patients following CAG. Perioperative strategies are warranted to prevent AKD in patients with elevated NT-proBNP levels.

High-resolution 3D demonstration of regional heterogeneity in the glymphatic system.

Accumulating evidence indicates that the glymphatic system has a critical role in maintaining brain homeostasis. However, the detailed anatomy of the glymphatic pathway is not well understood, mostly due to a lack of high spatial resolution 3D visualization. In this study, a fluorescence micro-optical sectioning tomography (fMOST) was used to characterize the glymphatic architecture in the mouse brain. At 30 and 120 min after intracisternal infusion with fluorescent dextran (Dex-3), lectin was injected to stain the cerebral vasculature. Using fMOST, a high-resolution 3D dataset of the brain-wide distribution of Dex-3 was acquired. Combined with fluorescence microscopy and microplate array, the heterogeneous glymphatic flow and the preferential irrigated regions were identified. These cerebral regions containing large-caliber penetrating arteries and/or adjacent to the subarachnoid space had more robust CSF flow compared to other regions. Moreover, the major glymphatic vessels for CSF influx and fluid efflux in the entire brain were shown in 3D. This study demonstrates the regional heterogeneity in the glymphatic system and provides an anatomical resource for further investigation of the glymphatic function.

Prevalence and Prognosis of HFimpEF Developed From Patients With Heart Failure With Reduced Ejection Fraction: Systematic Review and Meta-Analysis.

Background: Heart failure with improved ejection fraction (HFimpEF) is classified as a new type of heart failure, and its prevalence and prognosis are not consistent in previous studies. There is no systematic review and meta-analysis regarding the prevalence and prognosis of the HFimpEF. Method: A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library from inception to May 22, 2021 (PROSPERO registration: CRD42021260422). Studies were included for analysis if the prognosis of mortality or hospitalization were reported in HFimpEF or in patients with heart failure with recovered ejection fraction (HFrecEF). The primary outcome was all-cause mortality. Cardiac hospitalization, all-cause hospitalization, and composite events of mortality and hospitalization were considered as secondary outcomes. Result: Nine studies consisting of 9,491 heart failure patients were eventually included. During an average follow-up of 3.8 years, the pooled prevalence of HFimpEF was 22.64%. HFimpEF had a lower risk of mortality compared with heart failure patients with reduced ejection fraction (HFrEF) (adjusted HR: 0.44, 95% CI: 0.33-0.60). HFimpEF was also associated with a lower risk of cardiac hospitalization (HR: 0.40, 95% CI: 0.20-0.82) and the composite endpoint of mortality and hospitalization (HR: 0.56, 95% CI: 0.44-0.73). Compared with patients with preserved ejection fraction (HFpEF), HFimpEF was associated with a moderately lower risk of mortality (HR: 0.42, 95% CI: 0.32-0.55) and hospitalization (HR: 0.73, 95% CI: 0.58-0.92). Conclusion: Around 22.64% of patients with HFrEF would be treated to become HFimpEF, who would then obtain a 56% decrease in mortality risk. Meanwhile, HFimpEF is associated with lower heart failure hospitalization. Further studies are required to explore how to promote left ventricular ejection fraction improvement and improve the prognosis of persistent HFrEF in patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260422, identifier: CRD42021260422.

Monoterpenoid indole alkaloids from Alstonia yunnanensis.

Eight new monoterpenoid indole alkaloids, alstoyunines A-H (1-8), along with 17 known analogues, were isolated from Alstonia yunnanensis. The structures of the new alkaloids were established by means of extensive spectroscopic methods. Alstoyunines C (3), E (5), and F (6) showed selective inhibition of Cox-2 (>75%). Alstoyunine F (6) showed weak cytotoxicity against the human myeloid leukemia HL-60 (IC50 = 3.89 microM) and hepatocellular carcinoma SMMC-7721 (IC50 = 21.73 microM) cell lines.

Quantitative photoacoustic imaging of two-photon absorption.

Photoacoustic tomography (PAT) is a hybrid imaging modality where we intend to reconstruct optical properties of heterogeneous media from measured ultrasound signals generated by the photoacoustic effect. In recent years, there have been considerable interests in using PAT to image two-photon absorption, in addition to the usual single-photon absorption, inside diffusive media. We present a mathematical model for quantitative image reconstruction in two-photon photoacoustic tomography (TP-PAT). We propose a computational strategy for the reconstruction of the optical absorption coefficients and provide some numerical evidences based on synthetic photoacoustic acoustic data to demonstrate the feasibility of quantitative reconstructions in TP-PAT.