Neuregulin-1 Promotes Myocardial Angiogenesis in the Rat Model of Diabetic Cardiomyopathy.

BACKGROUND/AIMS: Microvascular insufficiency takes a critical role in the development of diabetic cardiomyopathy (DCM). So this study was designed to investigate the effects of Neuregulin-1 (NRG-1) treatment on myocardial angiogenesis and the changes of VEGF/Flk1 and Ang-1/Tie-2 signaling in the rat model of DCM. METHODS: Diabetic rats were induced by a single intraperitoneal injection of Streptozotocin. 12 weeks after the diabetes induction, the rats with NRG-1 treatment were treated with tail vein injection of NRG-1 at the dose of 10µg/kg/d for consecutive 10 days. Cardiac function was assessed using catheter MPA cardiac function analysis system. Myocardial blood flow (MBF) was assessed with stable-isotope labeled microspheres. Capillary density was measured by CD31 immunohistochemistry. The protein expression and receptors phosphorylation were assessed using western blot. RESULTS: Left ventricular function, capillary density and MBF were significantly reduced in DCM group when compared with those in the control group (P< 0.01, P< 0.01 and P< 0.05 respectively). Left ventricular function and capillary density were significantly increased in NRG-1 treatment group when compared with those in the DCM group (P< 0.05 and P< 0.05 respectively). The expression of VEGF and Ang-1 and the phosphorylation of Flk1 and Tie-1 were significantly decreased in DCM group as compared with those in the control group. However, those in the NRG-1 treatment group were significantly increased as compared with those in the DCM group. In vitro, NRG-1 treatment increased significantly the expression of VEGF and Ang-1 in human coronary artery smooth muscle cells. CONCLUSIONS: NRG-1 can increase the myocardial angiogenesis of DCM, probably via the direct effects of NRG-1 and via the increasing expression of VEGF and Ang-1. These findings may contribute to developing a novel approach to reverse the impaired angiogenic responses in diabetes or coronary artery disease.

Influence of diabetes mellitus on long-term outcomes of patients with unprotected left main coronary artery disease treated with either drug-eluting stents or coronary artery bypass grafting.

Whether the effect of diabetes on patients with unprotected left main coronary artery (ULMCA) disease differs according to different strategies of revascularization was unknown. This study was conducted to evaluate the impact of diabetes on patients with ULMCA disease treated with either percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG).A total of 922 patients with ULMCA disease who received drug-eluting stent (DES) (n = 465) implantation or underwent CABG (n = 457) were retrospectively analyzed. We compared the effects of these 2 treatments on clinical outcomes (death, myocardial infarction, stroke, repeat revascularization, and the composite of death, myocardial infarction, or stroke), according to diabetic status.During the median follow-up of 7.1 years (interquartile range, 5.3 to 8.2 years), no difference was found between PCI and CABG in the adjusted occurrence of death (P = 0.112) and the composite endpoints of death, myocardial infarction, and stroke (P = 0.235). Significantly higher incidence of repeat revascularization (P < 0.001) was observed in the DES group, whereas the CABG group had a significantly higher rate of stroke (P = 0.001). These trends were consistent in both diabetic and nondiabetic patients. We did not observe significant interactions between treatment outcomes and the presence or absence of diabetes after adjustment for covariates (P(interaction) = 0.580 for the composite of death, MI and stroke, P(interaction) = 0.685 for death, P(interaction) = 0.416 for MI, P(interaction) = 0.470 for stroke, and P(interaction) = 0.502 for repeat revascularization).Presence of diabetes was not important for decision-making between CABG and PCI in patients with ULMCA disease.

[Clinical characteristics among CABG or PCI which to treat chronic kidney disease with unprotected left main coronary artery disease].

OBJECTIVE: To explore the clinical characteristics and prognosis of patients with chronic kidney disease with unprotected left main (ULM) coronary artery disease undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). METHODS: A total of 601 unprotected left main coronary artery disease patients were recruited. According to the values of endogenous creatinine clearance rate (Ccr), they were divided into three groups of <45 ml/min (n=40), 45-59 ml/min (n=96) and ≥60 ml/min (n=465). Retrospective comparisons were made for the clinical parameters and prognosis of ULM patients in different Ccr groups with different therapies. RESULTS: In Ccr≥60 ml/min group, the valves of left ventricular ejection fraction (LVEF) were lower in patients undergoing CABG. Patients with complete total occlusion (CTO) and complete revascularizations were much more than those undergoing PCI. In Ccr≥60 ml/min and Ccr 45-59 ml/min groups, multivessel disease was frequent in CABG-treated patients. No significant difference existed among three groups in major adverse cardiac and cerebrovascular event (MACCE), overall mortality or cardiac mortality. CONCLUSION: PCI is both safe and efficacious for chronic renal insufficiency patients with ULM.

[Long-term outcomes of patients with unprotected left main coronary artery disease post revascularization].

OBJECTIVE: To compare the long-term real-world outcomes of consecutive patients with unprotected left main coronary artery disease (ULMCA) underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and coronary artery bypass grafting (CABG). METHODS: Consecutive patients with ULMCA (defined as stenosis ≥ 50%) undergoing DES implantation or CABG between January 2003 to July 2009 in Beijing Anzhen Hospital were enrolled. The follow-up period extended through August 2013. The end points of the study were death, cardiac death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization). RESULTS: From January 2003 to July 2009, 922 ULMCA patients were enrolled in this study (465 PCI patients, and 457 CABG patients). The median follow-up was 7.1 years (interquartile range 5.3 to 8.2 years). The crude relative risk was as follows: overall death rate (13.0% (41/465) vs. 22.1% (72/457), P = 0.009), stroke rate (5.8% (11/465) vs. CABG 18.9% (46/457), P < 0.001) were significantly lower whereas the rate of repeat revascularization (32.3% (110/465) vs. CABG 19.2% (58/457), P < 0.001) was significantly higher in PCI group than in CABG group. MI rate was similar between PCI and CABG group (13.9% (33/465) vs. 6.7% (26/457), P = 0.196). MACCE rate was also similar between the 2 groups (42.9% (145/465) vs. 42.5% (142/457), P = 0.122). After multivariate adjusting, there was no significant difference in rates of death, MI and a composite of serious outcomes (cardiac death, MI, or stroke) between the 2 groups. Rates of MACCE were significantly higher in the PCI group (P = 0.009) due to increased rate of repeat revascularization (P < 0.001). However, stroke rate was still significantly higher in CABG group (P = 0.001) after multivariate adjusting. CONCLUSION: During a follow-up up to 8.2 years, the survival rate is similar between the PCI and the CABG group in patients with ULMCA disease. The rate of repeat revascularization is significantly higher and stroke rate is significantly lower in the PCI group compared to CABG group.

Projecting global biological N2 fixation under climate warming across land and ocean.

Biological N2 fixation sustains the global inventory of nitrogenous nutrients essential for the productivity of terrestrial and marine ecosystems. Like most metabolic processes, rates of biological N2 fixation vary strongly with temperature, making it sensitive to climate change, but a global projection across land and ocean is lacking. Here we use compilations of field and laboratory measurements to reveal a relationship between N2 fixation rates and temperature that is similar in both domains despite large taxonomic and environmental differences. Rates of N2 fixation increase gradually to a thermal optimum around ~25°C, and decline more rapidly toward a thermal maximum, which is lower in the ocean than on land. In both realms, the observed temperature sensitivities imply that climate warming this century could decrease N2 fixation rates by ~50% in the tropics while increasing rates by ~50% in higher latitudes. We propose a conceptual framework for understanding the physiological and ecological mechanisms that underpin and modulate the observed temperature dependence of global N2 fixation rates, facilitating cross-fertilization of marine and terrestrial research to assess its response to climate change.

Diurnally dynamic iron allocation promotes N2 fixation in marine dominant diazotroph Trichodesmium.

Trichodesmium is the dominant photoautotrophic dinitrogen (N2) fixer (diazotroph) in the ocean. Iron is an important factor limiting growth of marine diazotrophs including Trichodesmium mainly because of high iron content of its N2-fixing enzyme, nitrogenase. However, it still lacks a quantitative understanding of how dynamic iron allocation among physiological processes acts to regulate growth and N2 fixation in Trichodesmium. Here, we constructed a model of Trichodesmium trichome in which intracellular iron could be dynamically re-allocated in photosystems and nitrogenase during the daytime. The results demonstrate that the dynamic iron allocation enhances modeled N2 fixation and growth rates of Trichodesmium, especially in iron-limited conditions, albeit having a marginal impact under high iron concentrations. Although the reuse of iron during a day is an apparent cause that dynamic iron allocation can benefit Trichodesmium under iron limitation, our model reveals two important mechanisms. First, the release of iron from photosystems downregulates the intracellular oxygen (O2) production and reduces the demand of respiratory protection, a process that Trichodesmium wastefully respires carbohydrates to create a lower O2 window for N2 fixation. Hence, more carbohydrates can be used in growth. Second, lower allocation of iron to nitrogenase during early daytime, a period when photosynthesis is active and intracellular O2 is high, reduces the amount of iron that is trapped in the inactivated nitrogenase induced by O2. This mechanism further increases the iron use efficiency in Trichodesmium. Overall, our study provides mechanistic and quantitative insight into the diurnal iron allocation that can alleviate iron limitation to Trichodesmium.

Local-Global Context Aware Transformer for Language-Guided Video Segmentation.

We explore the task of language-guided video segmentation (LVS). Previous algorithms mostly adopt 3D CNNs to learn video representation, struggling to capture long-term context and easily suffering from visual-linguistic misalignment. In light of this, we present Locater (local-global context aware Transformer), which augments the Transformer architecture with a finite memory so as to query the entire video with the language expression in an efficient manner. The memory is designed to involve two components - one for persistently preserving global video content, and one for dynamically gathering local temporal context and segmentation history. Based on the memorized local-global context and the particular content of each frame, Locater holistically and flexibly comprehends the expression as an adaptive query vector for each frame. The vector is used to query the corresponding frame for mask generation. The memory also allows Locater to process videos with linear time complexity and constant size memory, while Transformer-style self-attention computation scales quadratically with sequence length. To thoroughly examine the visual grounding capability of LVS models, we contribute a new LVS dataset, A2D-S +, which is built upon A2D-S dataset but poses increased challenges in disambiguating among similar objects. Experiments on three LVS datasets and our A2D-S + show that Locater outperforms previous state-of-the-arts. Further, we won the 1st place in the Referring Video Object Segmentation Track of the 3rd Large-scale Video Object Segmentation Challenge, where Locater served as the foundation for the winning solution.

A Competitive Advantage of Middle-Sized Diatoms From Increasing Seawater CO2.

Diatoms, one of the most important phytoplankton groups, fulfill their carbon demand from seawater mainly by obtaining passively diffused carbon dioxide (CO2) and/or actively consuming intracellular energy to acquire bicarbonate (HCO3 -). An anthropogenically induced increase in seawater CO2 reduces the HCO3 - requirement of diatoms, potentially saving intracellular energy and benefitting their growth. This effect is commonly speculated to be most remarkable in larger diatoms that are subject to a stronger limitation of CO2 supply because of their smaller surface-to-volume ratios. However, we constructed a theoretical model for diatoms and revealed a unimodal relationship between the simulated growth rate response (GRR, the ratio of growth rates under elevated and ambient CO2) and cell size, with the GRR peaking at a cell diameter of ∼7 µm. The simulated GRR of the smallest diatoms was low because the CO2 supply was nearly sufficient at the ambient level, while the decline of GRR from a cell diameter of 7 µm was simulated because the contribution of seawater CO2 to the total carbon demand greatly decreased and diatoms became less sensitive to CO2 increase. A collection of historical data in CO2 enrichment experiments of diatoms also showed a roughly unimodal relationship between maximal GRR and cell size. Our model further revealed that the "optimal" cell size corresponding to peak GRR enlarged with the magnitude of CO2 increase but diminished with elevating cellular carbon demand, leading to projection of the smallest optimal cell size in the equatorial Pacific upwelling zone. Last, we need to emphasize that the size-dependent effects of increasing CO2 on diatoms are multifaceted, while our model only considers the inorganic carbon supply from seawater and optimal allocation of intracellular energy. Our study proposes a competitive advantage of middle-sized diatoms and can be useful in projecting changes in the diatom community in the future acidified high-CO2 ocean.

Assessment of Explicit Representation of Dynamic Viral Processes in Regional Marine Ecological Models.

Viruses, the most abundant microorganisms in the ocean, play important roles in marine ecosystems, mainly by killing their hosts and contributing to nutrient recycling. However, in models simulating ecosystems in real marine environments, the virus-mediated mortality (VMM) rates of their hosts are implicitly represented by constant parameters, thus ignoring the dynamics caused by interactions between viruses and hosts. Here, we construct a model explicitly representing marine viruses and the VMM rates of major hosts, heterotrophic bacteria, and apply it to two sites in the oligotrophic North Pacific and the more productive Arabian Sea. The impacts of the viral processes were assessed by comparing model results with the viral processes enabled and disabled. For reliable assessments, a data assimilation method was used to objectively optimize the model parameters in each run. The model generated spatiotemporally variable VMM rates, generally decreasing in the subsurface but increasing at the surface. Although the dynamics introduced by viruses could be partly stabilized by the ecosystems, they still caused substantial changes to the bacterial abundance, primary production and carbon export, with the changes greater at the more productive site. Our modeling experiments reveal the importance of explicitly simulating dynamic viral processes in marine ecological models.

N2 Fixation in Trichodesmium Does Not Require Spatial Segregation from Photosynthesis.

The dominant marine filamentous N2 fixer, Trichodesmium, conducts photosynthesis and N2 fixation during the daytime. Because N2 fixation is sensitive to O2, some previous studies suggested that spatial segregation of N2 fixation and photosynthesis is essential in Trichodesmium. However, this hypothesis conflicts with some observations where all the cells contain both photosystems and the N2-fixing enzyme nitrogenase. Here, we construct a systematic model simulating Trichodesmium metabolism, showing that the hypothetical spatial segregation is probably useless in increasing the Trichodesmium growth and N2 fixation, unless substances can efficiently transfer among cells with low loss to the environment. The model suggests that Trichodesmium accumulates fixed carbon in the morning and uses that in respiratory protection to reduce intracellular O2 during the mid-daytime, when photosynthesis is downregulated, allowing the occurrence of N2 fixation. A cell membrane barrier against O2 and alternative non-O2 evolving electron transfer also contribute to maintaining low intracellular O2. Our study provides a mechanism enabling N2 fixation despite the presence of photosynthesis across Trichodesmium. IMPORTANCE The filamentous Trichodesmium is a globally prominent marine nitrogen fixer. A long-standing paradox is that the nitrogen-fixing enzyme nitrogenase is sensitive to oxygen, but Trichodesmium conducts both nitrogen fixation and oxygen-evolving photosynthesis during the daytime. Previous studies using immunoassays reported that nitrogenase was limited in some specialized Trichodesmium cells (termed diazocytes), suggesting the necessity of spatial segregation of nitrogen fixation and photosynthesis. However, attempts using other methods failed to find diazocytes in Trichodesmium, causing controversy on the existence of the spatial segregation. Here, our physiological model shows that Trichodesmium can maintain low intracellular O2 in mid-daytime and achieve feasible nitrogen fixation and growth rates even without the spatial segregation, while the hypothetical spatial segregation might not be useful if substantial loss of substances to the environment occurs when they transfer among the Trichodesmium cells. Our study then suggests a possible mechanism by which Trichodesmium can survive without the spatial segregation.

Category-Level Adversarial Adaptation for Semantic Segmentation Using Purified Features.

We target the problem named unsupervised domain adaptive semantic segmentation. A key in this campaign consists in reducing the domain shift, so that a classifier based on labeled data from one domain can generalize well to other domains. With the advancement of adversarial learning method, recent works prefer the strategy of aligning the marginal distribution in the feature spaces for minimizing the domain discrepancy. However, based on the observance in experiments, only focusing on aligning global marginal distribution but ignoring the local joint distribution alignment fails to be the optimal choice. Other than that, the noisy factors existing in the feature spaces, which are not relevant to the target task, entangle with the domain invariant factors improperly and make the domain distribution alignment more difficult. To address those problems, we introduce two new modules, Significance-aware Information Bottleneck (SIB) and Category-level alignment (CLA), to construct a purified embedding-based category-level adversarial network. As the name suggests, our designed network, CLAN, can not only disentangle the noisy factors and suppress their influences for target tasks but also utilize those purified features to conduct a more delicate level domain calibration, i.e., global marginal distribution and local joint distribution alignment simultaneously. In three domain adaptation tasks, i.e., GTA5 → Cityscapes, SYNTHIA → Cityscapes and Cross Season, we validate that our proposed method matches the state of the art in segmentation accuracy.

Recursive Copy and Paste GAN: Face Hallucination From Shaded Thumbnails.

Existing face hallucination methods based on convolutional neural networks (CNNs) have achieved impressive performance on low-resolution (LR) faces in a normal illumination condition. However, their performance degrades dramatically when LR faces are captured in non-uniform illumination conditions. This paper proposes a Recursive Copy and Paste Generative Adversarial Network (Re-CPGAN) to recover authentic high-resolution (HR) face images while compensating for non-uniform illumination. To this end, we develop two key components in our Re-CPGAN: internal and recursive external Copy and Paste networks (CPnets). Our internal CPnet exploits facial self-similarity information residing in the input image to enhance facial details; while our recursive external CPnet leverages an external guided face for illumination compensation. Specifically, our recursive external CPnet stacks multiple external Copy and Paste (EX-CP) units in a compact model to learn normal illumination and enhance facial details recursively. By doing so, our method offsets illumination and upsamples facial details progressively in a coarse-to-fine fashion, thus alleviating the ambiguity of correspondences between LR inputs and external guided inputs. Furthermore, a new illumination compensation loss is developed to capture illumination from the external guided face image effectively. Extensive experiments demonstrate that our method achieves authentic HR face images in a uniform illumination condition with a 16× magnification factor and outperforms state-of-the-art methods qualitatively and quantitatively.

Phosphate limitation intensifies negative effects of ocean acidification on globally important nitrogen fixing cyanobacterium.

Growth of the prominent nitrogen-fixing cyanobacterium Trichodesmium is often limited by phosphorus availability in the ocean. How nitrogen fixation by phosphorus-limited Trichodesmium may respond to ocean acidification remains poorly understood. Here, we use phosphate-limited chemostat experiments to show that acidification enhanced phosphorus demands and decreased phosphorus-specific nitrogen fixation rates in Trichodesmium. The increased phosphorus requirements were attributed primarily to elevated cellular polyphosphate contents, likely for maintaining cytosolic pH homeostasis in response to acidification. Alongside the accumulation of polyphosphate, decreased NADP(H):NAD(H) ratios and impaired chlorophyll synthesis and energy production were observed under acidified conditions. Consequently, the negative effects of acidification were amplified compared to those demonstrated previously under phosphorus sufficiency. Estimating the potential implications of this finding, using outputs from the Community Earth System Model, predicts that acidification and dissolved inorganic and organic phosphorus stress could synergistically cause an appreciable decrease in global Trichodesmium nitrogen fixation by 2100.

Diverse Subclade Differentiation Attributed to the Ubiquity of Prochlorococcus High-Light-Adapted Clade II.

Prochlorococcus is the key primary producer in marine ecosystems, and the high-light-adapted clade II (HLII) is the most abundant ecotype. However, the genomic and ecological basis of Prochlorococcus HLII in the marine environment has remained elusive. Here, we show that the ecologically coherent subclade differentiation of HLII corresponds to genomic and ecological characteristics on the basis of analyses of 31 different strains of HLII, including 12 novel isolates. Different subclades of HLII with different core and accessory genes were identified, and their distribution in the marine environment was explored using the TARA Oceans metagenome database. Three major subclade groups were identified, viz., the surface group (HLII-SG), the transition group (HLII-TG), and the deep group (HLII-DG). These subclade groups showed different temperature ranges and optima for distribution. In regression analyses, temperature and nutrient availability were identified as key factors affecting the distribution of HLII subclades. A 35% increase in the relative abundance of HLII-SG by the end of the 21st century was predicted under the Representative Concentration Pathway 8.5 scenario. Our results show that the ubiquity and distribution of Prochlorococcus HLII in the marine environment are associated with the differentiation of diverse subclades. These findings provide insights into the large-scale shifts in the Prochlorococcus community in response to future climate change. IMPORTANCEProchlorococcus is the most abundant oxygenic photosynthetic microorganism on Earth, and high-light-adapted clade II (HLII) is the dominant ecotype. However, the factors behind the dominance of HLII in the vast oligotrophic oceans are still unknown. Here, we identified three distinct groups of HLII subclades, viz., the surface group (HLII-SG), the transition group (HLII-TG), and the deep group (HLII-DG). We further demonstrated that the ecologically coherent subclade differentiation of HLII corresponds to genomic and ecological characteristics. Our study suggests that the differentiation of diverse subclades underlies the ubiquity and distribution of Prochlorococcus HLII in the marine environment and provides insights into the shifts in the Prochlorococcus community in response to future climate change.

[Coronary artery bypass grafting for elderly with unprotected left main coronary artery disease: a clinical analysis].

OBJECTIVE: To study the correlation between the clinical features and the prognosis in elderly patients with unprotected left main coronary artery disease (ULMCA) after coronary artery bypass grafting (CABG). METHODS: The clinical parameters and prognosis data from 176 patients received CABG for ULM were retrospectively analyzed for comparison of elderly (age≥65) and against non-elderly (age < 65). RESULTS: The elderly patients were found to have significantly higher level of blood high density lipoprotein cholesterin (HDL-C, mmol/L: 28.36 ± 17.20 vs. 13.68 ± 7.78, P < 0.01), lower level of blood low density lipoprotein cholesterin (LDL-C, mmol/L: 1.21 ± 0.77 vs. 2.48 ± 1.27, P < 0.01) and higher level of coronary stenosis [(94.56 ± 8.01)% vs. (87.96 ± 11.10)%, P < 0.01]. The incidence of multi-vessel disease (75.9% vs. 58.1%, P < 0.05) and chronic total occlusion (55.4% vs. 29.0%, P < 0.05) were both significantly higher in the elderly. No significant difference was found between the two groups in major adverse cardiac and cerebral events (MACCE), cerebral infarction, myocardial infarction, cardiac mortality, and total mortality (16.9% vs 17.2%, 3.6% vs 3.2%, 3.6% vs 5.4%, 6.0% vs 9.7%, and 12.0% vs 8.6%, all P > 0.05). CONCLUSION: In the elderly ULMCA patients the coronary lesions are more severe, but CABG is still a safe and efficient therapy for these patients.

Few-Shot Common-Object Reasoning Using Common-Centric Localization Network.

In the few-shot common-localization task, given few support images without bounding box annotations at each episode, the goal is to localize the common object in the query image of unseen categories. The few-shot common-localization task involves common object reasoning from the given images, predicting the spatial locations of the object with different shapes, sizes, and orientations. In this work, we propose a common-centric localization (CCL) network for few-shot common-localization. The motivation of our common-centric localization network is to learn the common object features by dynamic feature relation reasoning via a graph convolutional network with conditional feature aggregation. First, we propose a local common object region generation pipeline to reduce background noises due to feature misalignment. Each support image predicts more accurate object spatial locations by replacing the query with the images in the support set. Second, we introduce a graph convolutional network with dynamic feature transformation to enforce the common object reasoning. To enhance the discriminability during feature matching and enable a better generalization in unseen scenarios, we leverage a conditional feature encoding function to alter visual features according to the input query adaptively. Third, we introduce a common-centric relation structure to model the correlation between the common features and the query image feature. The generated common features guide the query image feature towards a more common object-related representation. We evaluate our common-centric localization network on four datasets, i.e., CL-VOC-07, CL-VOC-12, CL-COCO, CL-VID. We obtain significant improvements compared to state-of-the-art. Our quantitative results confirm the effectiveness of our network.

Discriminative Feature Learning for Thorax Disease Classification in Chest X-ray Images.

This paper focuses on the thorax disease classification problem in chest X-ray (CXR) images. Different from the generic image classification task, a robust and stable CXR image analysis system should consider the unique characteristics of CXR images. Particularly, it should be able to: 1) automatically focus on the disease-critical regions, which usually are of small sizes; 2) adaptively capture the intrinsic relationships among different disease features and utilize them to boost the multi-label disease recognition rates jointly. In this paper, we propose to learn discriminative features with a two-branch architecture, named ConsultNet, to achieve those two purposes simultaneously. ConsultNet consists of two components. First, an information bottleneck constrained feature selector extracts critical disease-specific features according to the feature importance. Second, a spatial-and-channel encoding based feature integrator enhances the latent semantic dependencies in the feature space. ConsultNet fuses these discriminative features to improve the performance of thorax disease classification in CXRs. Experiments conducted on the ChestX-ray14 and CheXpert dataset demonstrate the effectiveness of the proposed method.

[Angiographic characteristics and long term clinical outcomes post coronary stenting in non-diabetic and type 2 diabetic patients with coronary artery disease].

OBJECTIVE: To observe the angiographic characteristics and the long-term clinical outcomes following coronary stenting in non-diabetic (non-DM) and type 2 diabetic (DM) patients with coronary artery disease. METHODS: This cohort study enrolled 1172 consecutive patients with coronary heart disease underwent elective coronary stenting (249 type 2 DM and 923 non-DM). The angiographic characteristics and the long-term clinical follow-up results were compared between non-DM and DM patients. RESULTS: The follow-up period was (39.2 +/- 6.4) months (6 - 83 months), follow-up rate was 90.3% in DM and 91.0% in non-DM group (P > 0.05). Compared with non-diabetic patients, there were significantly higher incidences of 2-vessel (P = 0.029) and 3-vessel (P = 0.013) diseases of coronary artery, severe stenosis lesion (P = 0.012), chronic total obstructive lesion (P = 0.044) and long lesion (P = 0.001), in-stent restenosis (ISR, P = 0.000) and revascularization (P = 0.000) and MACE (P = 0.000) in DM patients. COX multiple factorial analysis showed that DM is independent risk factor for ISR (P = 0.000), revascularization (P = 0.001) and MACE (P = 0.003). CONCLUSIONS: CHD patients with type 2 DM are associated with multi- and more severe vessel lesions. Type 2 DM is also an independent risk factor for increased ISR, revascularization and MACE post stenting.

Reduced nitrogenase efficiency dominates response of the globally important nitrogen fixer Trichodesmium to ocean acidification.

The response of the prominent marine dinitrogen (N2)-fixing cyanobacteria Trichodesmium to ocean acidification (OA) is critical to understanding future oceanic biogeochemical cycles. Recent studies have reported conflicting findings on the effect of OA on growth and N2 fixation of Trichodesmium. Here, we quantitatively analyzed experimental data on how Trichodesmium reallocated intracellular iron and energy among key cellular processes in response to OA, and integrated the findings to construct an optimality-based cellular model. The model results indicate that Trichodesmium growth rate decreases under OA primarily due to reduced nitrogenase efficiency. The downregulation of the carbon dioxide (CO2)-concentrating mechanism under OA has little impact on Trichodesmium, and the energy demand of anti-stress responses to OA has a moderate negative effect. We predict that if anthropogenic CO2 emissions continue to rise, OA could reduce global N2 fixation potential of Trichodesmium by 27% in this century, with the largest decrease in iron-limiting regions.

Contribution of structural recalcitrance to the formation of the deep oceanic dissolved organic carbon reservoir.

The origin of the recalcitrant dissolved organic carbon (RDOC) reservoir in the deep ocean remains enigmatic. The structural recalcitrance hypothesis suggests that RDOC is formed by molecules that are chemically resistant to bacterial degradation. The dilution hypothesis claims that RDOC is formed from a large diversity of labile molecules that escape bacterial utilization due to their low concentrations, termed as RDOCc . To evaluate the relative contributions of these two mechanisms in determining the long-term persistence of RDOC, we model the dynamics of both structurally recalcitrant DOC and RDOCc based on previously published data that describes deep oceanic DOC degradation experiments. Our results demonstrate that the majority of DOC (84.5 ± 2.2%) in the deep ocean is structurally recalcitrant. The intrinsically labile DOC (i.e., labile DOC that rapidly consumed and RDOCc ) accounts for a relatively small proportion and is consumed rapidly in the incubation experiments, in which 47.8 ± 3.2% of labile DOC and 21.9 ± 4.6% of RDOCc are consumed in 40 days. Our results suggest that the recalcitrance of RDOC is largely related to its chemical properties, whereas dilution plays a minor role in determining the persistence of deep-ocean DOC.