Coping as a mediator of the relationship between kinesiophobia and illness perception in atrial fibrillation patients: A cross-sectional mediation analysis.

AIM(S): To explore the mediating role of coping styles in the association between illness perception and kinesiophobia in atrial fibrillation patients. DESIGN: A cross-sectional survey. METHODS: Between June 2021 and November 2022, data were collected using a self-designed demographic questionnaire, the Brief Illness Perception Questionnaire (BIPQ), Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) and Medical Coping Modes Questionnaire (MCMQ). The sample comprised 474 atrial fibrillation patients recruited from three hospitals in China. To analyse the data, multiple linear regression models with forced entry were employed, and the mediation Mode 4 of the PROCESS macro in SPSS was implemented. RESULTS: In total, 57.8% of patients exhibited a high level of kinesiophobia. Regression analyses uncovered associations between kinesiophobia and various demographic and disease characteristics, as well as assessments of both illness perception and coping styles. Path analysis results indicated that illness perception reduced kinesiophobia through the mediating effect of confrontation, while avoidance and resignation intensified kinesiophobia. The mediating factor of coping styles explained a significant 53% of the overall effect. CONCLUSIONS: Coping styles mediate the relationship between illness perception and kinesiophobia, resulting in a shift in coping styles as illness perception decreases and ultimately leading to reduced kinesiophobia. IMPACT: Coping styles play a mediating role in the relationship between kinesiophobia and illness perception. The results suggest healthcare providers in identifying high-risk individuals and tailoring interventions to effectively break the vicious cycle of kinesiophobia. Therefore, screening and intervening with patients showcasing heightened illness perception aims to promote a transformation in coping styles, subsequently reducing atrial fibrillation kinesiophobia. REPORTING METHOD: The results of the observations were reported in adherence to the STROBE criteria. PATIENT OR PUBLIC CONTRIBUTION: No patient and public involvement.

Association of per- and polyfluoroalkyl substances (PFAS) with periodontitis: the mediating role of sex hormones.

OBJECTIVES: To investigate the association between serum per- and polyfluoroalkyl substances (PFAS) and periodontitis, and further explore the possible mediating role of sex hormones in this association. METHODS: We extracted data from National Health and Nutrition Examination Survey (NHANES) 2009-2014. Univariable and multivariable logistic regression models were performed to investigate the association between serum levels of seven PFASs and periodontitis. Bayesian kernel machine regression (BKMR) was conducted to assess the joint effect of PFASs in mixtures. Mediation analyses were used to explore the potential mediating role of sex hormones. RESULTS: Participants with periodontitis had higher concentrations of serum perfluorooctane sulfonate (PFOS) and perfluorononanoic acid (PFNA) than those without periodontitis (both P < 0.05). In fully adjusted models, high serum concentrations of PFOS and PFNA were positively associated with periodontitis (tertile 3 vs. tertile 1: prevalence ratio (PR) = 1.19 for PFOS, 95% CI: 1.01-1.39; PR = 1.17 for PFNA, 95% CI: 1.02-1.34). The results from the BKMR models consistently showed a positive association between PFAS mixtures and periodontitis. Of note, testosterone and the ratio of testosterone to estradiol significantly mediated the relationship between high level of PFOS and periodontitis, accounting for 16.5% and 31.7% of the total effect, respectively. Sensitivity analyses yielded similar results when using periodontal clinical indices (mean loss of attachment, mean periodontal probing depth, and the number of teeth) as dependent variables. CONCLUSIONS: These findings provide evidence to support a positive association between certain PFASs and periodontitis, which might be partially mediated by sex hormones.

Multiple configurations of the plastid and mitochondrial genomes of Caragana spinosa.

MAIN CONCLUSION: In this study, we assembled the complete plastome and mitogenome of Caragana spinosa and explored the multiple configurations of the organelle genomes. Caragana spinosa belongs to the Papilionoidea subfamily and has significant pharmaceutical value. To explore the possible interaction between the organelle genomes, we assembled and analyzed the plastome and mitogenome of C. spinosa using the Illumina and Nanopore DNA sequencing data. The plastome of C. spinosa was 129,995 bp belonging to the inverted repeat lacking clade (IRLC), which contained 77 protein-coding genes, 29 tRNA genes, and four rRNA genes. The mitogenome was 378,373 bp long and encoded 54 unique genes, including 33 protein-coding, three ribosomal RNA (rRNA), and 18 transfer RNA (tRNA) genes. In addition to the single circular conformation, alternative conformations mediated by one and four repetitive sequences in the plastome and mitogenome were identified and validated, respectively. The inverted repeat (PDR12, the 12th dispersed repeat sequence in C. spinosa plastome) of plastome mediating recombinant was conserved in the genus Caragana. Furthermore, we identified 14 homologous fragments by comparing the sequences of mitogenome and plastome, including eight complete tRNA genes. A phylogenetic analysis of protein-coding genes extracted from the plastid and mitochondrial genomes revealed congruent topologies. Analyses of sequence divergence found one intergenic region, trnN-GUU-ycf1, exhibiting a high degree of variation, which can be used to develop novel molecular markers to distinguish the nine Caragana species accurately. This plastome and mitogenome of C. spinosa could provide critical information for the molecular breeding of C. spinosa and be used as a reference genome for other species of Caragana. In this study, we assembled the complete plastome and mitogenome of Caragana spinosa and explored the multiple configurations of the organelle genomes.

Association of remnant cholesterol with hypertension, type 2 diabetes, and their coexistence: the mediating role of inflammation-related indicators.

PURPOSE: Cholesterol metabolism is a risk factor for cardiovascular disease, and recent studies have shown that cholesterol metabolism poses a residual risk of cardiovascular disease even when conventional lipid risk factors are in the optimal range. The association between remnant cholesterol (RC) and cardiovascular disease has been demonstrated; however, its association with hypertension, type 2 diabetes mellitus (T2DM), and the concomitance of the two diseases requires further study. This study aimed to evaluate the association of RC with hypertension, T2DM, and both in a large sample of the U.S. population, and to further explore the potential mechanisms involved. METHODS: This cross-sectional study used data from the 2005-2018 cycles of the National Health and Nutrition Examination Survey (N = 17,749). Univariable and multivariable logistic regression analyses were performed to explore the relationships of RC with hypertension, T2DM, and both comorbidities. A restricted cubic spline regression model was used to reveal the dose effect. Mediation analyses were performed to explore the potential mediating roles of inflammation-related indicators in these associations. RESULTS: Of the 17,749 participants included (mean [SD] age: 41.57 [0.23] years; women: 8983 (50.6%), men: 8766 (49.4%)), the prevalence of hypertension, T2DM, and their co-occurrence was 32.6%, 16.1%, and 11.0%, respectively. Higher RC concentrations were associated with an increased risk of hypertension, T2DM, and their co-occurrence (adjusted odds ratios for per unit increase in RC were 1.068, 2.259, and 2.362, and 95% confidence intervals were 1.063-1.073, 1.797-2.838, and 1.834-3.041, respectively), with a linear dose-response relationship. Even when conventional lipids were present at normal levels, positive associations were observed. Inflammation-related indicators (leukocytes, lymphocytes, monocytes, and neutrophils) partially mediated these associations. Among these, leukocytes had the greatest mediating effect (10.8%, 14.5%, and 14.0%, respectively). CONCLUSION: The results of this study provide evidence that RC is associated with the risk of hypertension, T2DM, and their co-occurrence, possibly mediated by an inflammatory response.

Association of demographics, cardiovascular indicators and disability characteristics with 7-year coronary heart disease incident in persons with disabilities.

OBJECTIVE: Previous studies had demonstrated that disability increases mortality in patients with coronary heart disease (CHD). However, for people who had been disabled but do not have baseline cardiovascular disease, there is still limited data on how they might develop CHD. This study aimed to investigate the incidence and predictors of CHD in people with disabilities. METHODS: We conducted a 7-year retrospective study utilizing data from the Shanghai Comprehensive Information Platform for Persons with Disabilities Rehabilitation. Subjects aged over 18 years with at least four annual complete electronic health records were included. The primary outcome was CHD, defined as ischemic heart disease or myocardial infarction. Kaplan-Meier analysis and log-rank tests were used to compare cumulative CHD for sub-populations, stratified by age, gender, and the classification of disabilities. Cox regression was used to identify the potentially important factors. RESULTS: Out of 6419 persons with disabilities, 688 CHD cases (mean age 52.95 ± 7.17 years, male 52.2%) were identified, with a cumulative incidence of 10.72% and an incidence density of 15.15/1000 person-years. The incidence density of CHD is higher in the male gender, people over 45 years, and those with physical disabilities. Male (HR = 1.294, 95% CI, 1.111-1.506), hypertension (HR = 1.683, 95% CI, 1.405-2.009), diabetes mellitus (HR = 1.488, 95% CI, 1.140-1.934), total cholesterol (HR = 1.110, 95% CI, 1.023-1.204), and physical disabilities (HR = 1.122, 95% CI, 1.019-1.414) were independently associated with CHD. CONCLUSION: The findings indicate that the incidence of CHD differs across disability categories rather than the severity of disability. People with physical disabilities had significantly higher risks for the development of CHD. The underlying physiological and pathological factors need to be further studied.

A Prospective Study Comparing Cancer Detection Rates of Transperineal Prostate Biopsies Performed by Junior Urologists versus a Senior Consultant in a Real-World Setting.

INTRODUCTION: Prostate biopsy (PB) is a typical daily practice method for the diagnosis of prostate cancer (PCa). This study aimed to compare the PCa detection rates and peri- and postoperative complications of PB among 3 residents and a consultant. PATIENTS AND METHODS: A total of 343 patients who underwent PB between August 2018 and July 2019 were involved in this study. Residents were systematically trained for 2 weeks by a consultant for performing systematic biopsy (SB) and targeted biopsy (TB). And then, 3 residents and the consultant performed PB independently every quarter due to routine rotation in daily practice. The peri- and postoperative data were collected from a prospectively maintained database (www.pc-follow.cn). The primary outcome and secondary outcome were to compare the PCa detection rates and complications between the residents and consultant, respectively. RESULTS: There was no significant difference between the residents and consultant in terms of overall PCa detection rates of SB and TB or further stratified by prostate-specific antigen value and prostate imaging reporting and data system (PI-RADS) scores. We found the consultant had more TB cores (175 cores vs. 86-114 cores, p = 0.043) and shorter procedural time (mean 16 min vs. 19.7-20.1 min, p < 0.001) versus the residents. The complication rate for the consultant was 6.7% and 5%-8.2% for the residents, respectively (p = 0.875). CONCLUSIONS: The residents could get similar PCa detection and complication rates compared with that of the consultant after a 2-week training. However, the residents still need more cases to shorten the time of the biopsy procedure.

Subtypes of nurses' mental workload and interaction patterns with fatigue and work engagement during coronavirus disease 2019 (COVID-19) outbreak: A latent class analysis.

BACKGROUND: Nurses play critical roles when providing health care in high-risk situations, such as during the COVID-19 outbreak. However, no previous study had systematically assessed nurses' mental workloads and its interaction patterns with fatigue, work engagement and COVID-19 exposure risk. METHODS: A cross-sectional study was conducted via online questionnaire. The NASA Task Load Index, Fatigue Scale-14, and Utrecht Work Engagement Scale were used to assess nurses' mental workload, fatigue and work engagement, respectively. A total of 1337 valid questionnaires were received and analyzed. Nurses were categorized into different subgroups of mental workload via latent class analysis (LCA). Cross-sectional comparisons, analysis of covariance (ANCOVA), and multivariate (or logistic) regression were subsequently performed to examine how demographic variables, fatigue and work engagement differ among nurses belonging to different subgroups. RESULTS: Three latent classes were identified based on the responses to mental workload assessment: Class 1 - low workload perception & high self-evaluation group (n = 41, 3.1%); Class 2 - medium workload perception & medium self-evaluation group (n = 455, 34.0%); and Class 3 - high workload perception & low self-evaluation group (n = 841, `62.9%). Nurses belonging into class 3 were most likely to be older and have longer professional years, and displayed higher scores of fatigue and work engagement compared with the other latent classes (p < 0.05). Multivariate analysis showed that high cognitive workload increased subjective fatigue, and mental workload may be positively associated with work engagement. Group comparison results indicated that COVID-19 exposure contributed to significantly higher mental workload levels. CONCLUSIONS: The complex scenario for the care of patients with infectious diseases, especially during an epidemic, raises the need for improved consideration of nurses' perceived workload, as well as their physical fatigue, work engagement and personal safety when working in public health emergencies.

A Novel Prediction Tool Based on Multiparametric Magnetic Resonance Imaging to Determine the Biopsy Strategy for Clinically Significant Prostate Cancer in Patients with PSA Levels Less than 50 ng/ml.

PURPOSE: To develop and internally validate nomograms to help choose the optimal biopsy strategy among no biopsy, targeted biopsy (TB) only, or TB plus systematic biopsy (SB). PATIENTS AND METHODS: This retrospective study included a total of 385 patients who underwent magnetic resonance imaging (MRI)-guided TB and/or SB at our institute after undergoing multiparametric MRI (mpMRI) between 2015 and 2018. We developed models to predict clinically significant prostate cancer (csPCa) based on suspicious lesions from a TB result and based on the whole prostate gland from the results of TB plus SB or SB only. Nomograms were generated using logistic regression and evaluated using receiver-operating characteristic (ROC) curve analysis, calibration curves and decision analysis. The results were validated using ROC curve and calibration on 177 patients from 2018 to 2019 at the same institute. RESULTS: In the multivariate analyses, prostate-specific antigen level, prostate volume, and the Prostate Imaging Reporting and Data System score were predictors of csPCa in both nomograms. Age was also included in the model for suspicious lesions, while obesity was included in the model for the whole gland. The area under the curve (AUC) in the ROC analyses of the prediction models was 0.755 for suspicious lesions and 0.887 for the whole gland. Both models performed well in the calibration and decision analyses. In the validation cohort, the ROC curve described the AUCs of 0.723 and 0.917 for the nomogram of suspicious lesions and nomogram of the whole gland, respectively. Also, the calibration curve detected low error rates for both models. CONCLUSION: Nomograms with excellent discriminative ability were developed and validated. These nomograms can be used to select the optimal biopsy strategy for individual patients in the future.

Deep reinforcement learning of cell movement in the early stage of C.elegans embryogenesis.

Motivation: Cell movement in the early phase of Caenorhabditis elegans development is regulated by a highly complex process in which a set of rules and connections are formulated at distinct scales. Previous efforts have demonstrated that agent-based, multi-scale modeling systems can integrate physical and biological rules and provide new avenues to study developmental systems. However, the application of these systems to model cell movement is still challenging and requires a comprehensive understanding of regulatory networks at the right scales. Recent developments in deep learning and reinforcement learning provide an unprecedented opportunity to explore cell movement using 3D time-lapse microscopy images. Results: We present a deep reinforcement learning approach within an agent-based modeling system to characterize cell movement in the embryonic development of C.elegans. Our modeling system captures the complexity of cell movement patterns in the embryo and overcomes the local optimization problem encountered by traditional rule-based, agent-based modeling that uses greedy algorithms. We tested our model with two real developmental processes: the anterior movement of the Cpaaa cell via intercalation and the rearrangement of the superficial left-right asymmetry. In the first case, the model results suggested that Cpaaa's intercalation is an active directional cell movement caused by the continuous effects from a longer distance (farther than the length of two adjacent cells), as opposed to a passive movement caused by neighbor cell movements. In the second case, a leader-follower mechanism well explained the collective cell movement pattern in the asymmetry rearrangement. These results showed that our approach to introduce deep reinforcement learning into agent-based modeling can test regulatory mechanisms by exploring cell migration paths in a reverse engineering perspective. This model opens new doors to explore the large datasets generated by live imaging. Availability and implementation: Source code is available at https://github.com/zwang84/drl4cellmovement. Supplementary information: Supplementary data are available at Bioinformatics online.

Variations in concentrations and bioavailability of heavy metals in rivers caused by water conservancy projects: Insights from water regulation of the Xiaolangdi Reservoir in the Yellow River.

Water regulation of the Xiaolangdi Reservoir of the Yellow River was chosen as a case to investigate variations in concentrations and bioavailability of heavy metals caused by water conservancy projects in rivers. Water and suspended sediment (SPS) samples were collected at downstream sampling sites along the river during this period. Concentrations and speciation of Zn, Cr, Cu, Ni, and Pb in water and SPS samples were analyzed, and their bioaccumulation was studied with Daphnia magna. This study indicated that the exchangeable and carbonate-bound fractions of heavy metals in SPS decreased along the studied stretch, and the dissolved heavy metal concentrations increased along the river with 1.6-15 folds. This is because sediment resuspension increased along the river during water regulation, giving rise to the increase of heavy metal release from SPS. The dissolved Zn, Cu, Ni, and Pb concentrations were significantly positively correlated with SPS concentrations, and their increase along the river was greater than Cr. The body burdens of heavy metals in D. magna exposed into samples collected from the reservoir outlet were 1.3-3.0 times lower than those from downstream stations, suggesting that the heavy metal bioavailability increased during water regulation. This should be considered in the reservoir operation.

Bioavailability of Pyrene Associated with Suspended Sediment of Different Grain Sizes to Daphnia magna as Investigated by Passive Dosing Devices.

Suspended sediment (SPS) is widely present in rivers around the world. However, the bioavailability of hydrophobic organic compounds (HOCs) associated with SPS is not well understood. In this work, the influence of SPS grain size on the bioavailability of SPS-associated pyrene to Daphnia magna was studied using a passive dosing device, which maintained a constant freely dissolved pyrene concentration (Cfree) in the exposure systems. The immobilization and protein as well as enzymatic activities of Daphnia magna were investigated to study the bioavailability of SPS-associated pyrene. With Cfree of pyrene ranging from 20.0 to 60.0 µg L(-1), the immobilization of Daphnia magna in the presence of 1 g L(-1) SPS was 1.11-2.89 times that in the absence of SPS. The immobilization caused by pyrene associated with different grain size SPS was on the order of 50-100 µm > 0-50 µm > 100-150 µm. When pyrene Cfree was 20.0 µg L(-1), the immobilization caused by pyrene associated with 50-100 µm SPS was 1.42 and 2.43 times that with 0-50 and 100-150 µm SPS, respectively. The protein and enzymatic activities of Daphnia magna also varied with the SPS grain size. The effect of SPS grain size on the bioavailability of SPS-associated pyrene was mainly due to the difference in SPS ingestion by Daphnia magna and SPS composition, especially the organic carbon type, among the three size fractions. This study suggests that not only the concentration but also the size distribution of SPS should be considered for the development of a biological effect database and establishment of water quality criteria for HOCs in natural waters.

How does predation affect the bioaccumulation of hydrophobic organic compounds in aquatic organisms?

It is well-known that the body burden of hydrophobic organic compounds (HOCs) increases with the trophic level of aquatic organisms. However, the mechanism of HOC biomagnification is not fully understood. To fill this gap, this study investigated the effect of predation on the bioaccumulation of polycyclic aromatic hydrocarbons (PAHs), one type of HOC, in low-to-high aquatic trophic levels under constant freely dissolved PAH concentrations (1, 5, or 10 µg L(-1)) maintained by passive dosing systems. The tested PAHs included phenanthrene, anthracene, fluoranthene, and pyrene. The test organisms included zebrafish, which prey on Daphnia magna, and cichlids, which prey on zebrafish. The results revealed that for both zebrafish and cichlids, predation elevated the uptake and elimination rates of PAHs. The increase of uptake rate constant ranged from 20.8% to 39.4% in zebrafish with the amount of predation of 5 daphnids per fish per day, and the PAH uptake rate constant increased with the amount of predation. However, predation did not change the final bioaccumulation equilibrium; the equilibrium concentrations of PAHs in fish only depended on the freely dissolved concentration in water. Furthermore, the lipid-normalized water-based bioaccumulation factor of each PAH was constant for fish at different trophic levels. These findings infer that the final bioaccumulation equilibrium of PAHs is related to a partition between water and lipids in aquatic organisms, and predation between trophic levels does not change bioaccumulation equilibrium but bioaccumulation kinetics at stable freely dissolved PAH concentrations. This study suggests that if HOCs have not reached bioaccumulation equilibrium, biomagnification occurs due to enhanced uptake rates caused by predation in addition to higher lipid contents in higher trophic organisms. Otherwise, it is only due to the higher lipid contents in higher trophic organisms.

Echocardiography E/A Abnormality is Associated with the Development of Primary Left Ventricle Remodeling in Middle-Aged and Elderly Women: A Longitudinal Study.

Background: Impaired left ventricular (LV) relaxation is indicative of grade I diastolic dysfunction, which is mainly assessed by late diastolic transmitral flow velocity (E/A ratio). Although the E/A ratio has important diagnostic and prognostic implications with cardiac outcomes, the causal link between abnormal E/A ratio and left ventricle remodeling (LV remodeling) remains unclear. Methods: A longitudinal analysis of 869 eligible women aged ≥45 years, who had received echocardiography scans as well as 5-year follow-up assessments between 2015 and 2020. Women with pre-existing cardiac abnormalities including grade II/III diastolic dysfunction as diagnosed by echocardiography, or structural heart disease were excluded. E/A abnormality was defined as baseline E/A ratio <0.8. The classification of LV remodeling was based on the measurements of left ventricular mass index (LVMI) and relative wall thickness (RWT). Logistic and linear regression models were used. Results: Among the 869 women (60.71±10.01 years), 164 (18.9%) had developed LV remodeling after the 5-year follow-up. The proportion of women with E/A abnormality versus non-abnormality was also significantly different (27.13% vs 16.59%, P=0.007). Multivariable-adjusted regression models showed that E/A abnormality (OR: 4.14, 95%Cl:1.80-9.20, P=0.009) was significantly associated with higher risk of concentric hypertrophy (CH) after follow-up. No such association was found in either concentric remodeling (CR) or eccentric hypertrophy (EH). Higher baseline E/A ratio was correlated with lower ΔRWT during the 5-year follow-up (ß=-0.006 m/s, 95% CI: -0.012 to -0.002, P=0.025), which was independent of demographics and biological factors. Conclusion: E/A abnormality is associated with a higher risk of CH. Higher baseline E/A ratio may be associated with decreased relative changes in RWT.

Factors contributing to exercise tolerance in patients with coronary artery disease undergoing percutaneous coronary intervention.

BACKGROUND: Exercise tolerance plays a vital role in the process of cardiac rehabilitation in patients undergoing percutaneous coronary intervention (PCI). The study sought to determine the characteristics, risks and correlates of post-PCI exercise tolerance in patients with coronary artery disease (CAD). METHODS: We analyzed clinical data of 299 CAD patients undergoing elective PCI and completing cardiopulmonary exercise testing (CPET). According to the Weber classification, post-PCI exercise tolerance was evaluated by peak oxygen uptake (VO2 peak). We assessed the impact of 34 predefined clinical features, cardiac functional parameters, and blood biochemistry data on exercise tolerance by univariate analysis and logistics regression analysis. RESULTS: Of 299 patients, 74.92% were men and average age was 60.90 ± 10.68 years. VO2 peak in the entire population was 17.54 ± 3.38 ml/kg/min, and 24.41% (n = 73) were less than 16 ml/kg/min, who were considered to have exercise intolerance. Multivariate logistics regression results showed that sex, diabetes mellitus, number of stents, left atrial diameter (LAD), end-diastolic volume (EDV), and hemoglobin influenced the peak oxygen uptake of CAD patients undergoing elective PCI. (All p < 0.05). CONCLUSIONS: Nearly one quarter of CAD patients have exercise intolerance in the early post-PCI period. Female, diabetes mellitus, number of stents, LAD, EDV might negatively impacted post-PCI exercise tolerance, which need further warrant by large scale cohort study.

Smartphone recognition-based immune microparticles for rapid on-site visual data-sharing detection of Newcastle disease virus.

Since the last century, animal viruses have posed great threats to the health of humans and the farming industry. Therefore, virus control is of great urgency, and regular, timely, and accurate detection is essential to it. Here, we designed a rapid on-site visual data-sharing detection method for the Newcastle disease virus with smartphone recognition-based immune microparticles. The detection method we developed includes three major modules: preparation of virus detection vectors, sample detection, and smartphone image analysis with data upload. First, the hydrogel microparticles containing active carboxyl were manufactured, which coated nucleocapsid protein of NDV. Then, HRP enzyme-labeled anti-NP nanobody was used to compete with the NDV antibody in the serum for color reaction. Then the rough detection results were visible to the human eyes according to the different shades of color of the hydrogel microparticles. Next, the smartphone application was used to analyze the image to determine the accurate detection results according to the gray value of the hydrogel microparticles. Meanwhile, the result was automatically uploaded to the homemade cloud system. The total detection time was less than 50 min, even without trained personnel, which is shorter than conventional detection methods. According to experimental results, this detection method has high sensitivity and accuracy. And especially, it uploads the detection information via a cloud platform to realize data sharing, which plays an early warning function. We anticipate that this rapid on-site visual data-sharing detection method can promote the development of virus self-checking at home.

Sleep behaviour and cardiorespiratory fitness in patients after percutaneous coronary intervention during cardiac rehabilitation: protocol for a longitudinal study.

INTRODUCTION: Most patients with coronary heart disease experience sleep disturbances and low cardiorespiratory fitness (CRF), but their relationship during cardiac rehabilitation (CR) is still unclear. This article details a protocol for the study of sleep trajectory in patients with coronary heart disease during CR and the relationship between sleep and CRF. A better understanding of the relationship between sleep and CRF on patient outcomes can improve sleep management strategies. METHODS AND ANALYSIS: This is a longitudinal study with a recruitment target of 101 patients after percutaneous cardiac intervention from the Seventh People's Hospital of Shanghai, China. Data collection will include demographic characteristics, medical history, physical examination, blood sampling, echocardiography and the results of cardiopulmonary exercise tests. The information provided by a 6-min walk test will be used to supplement the CPET. The Pittsburgh Sleep Quality Index will be used to understand the sleep conditions of the participants in the past month. The Patient Health Questionnaire and General Anxiety Disorder Scale will be used to assess depression and anxiety, respectively. All participants will be required to wear an actigraphy on their wrists for 72 hours to monitor objective sleep conditions. This information will be collected four times within 6 months of CR, and patients will be followed up for 1 year. The growth mixture model will be used to analyse the longitudinal sleep data. The generalised estimating equation will be used to examine the associations between sleep and CRF during CR. ETHICS AND DISSEMINATION: Ethical approval for this observational longitudinal study was granted by the Shanghai Seventh People's Hospital Ethics Committee on 23 April 2021 (2021-7th-HIRB-012). Study results will be disseminated in peer-reviewed journal articles.

Effect of Exercise on Carotid Artery Intima-Media Thickness in Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: Carotid intima-media thickness (cIMT) is a validated surrogate marker of atherosclerosis that is independently associated with the risk for cardiovascular disease. Recent studies on the effect of exercise on cIMT have yielded conflicting results. METHODS: Studies that were available up until October 30, 2021 from the PubMed, Cochrane Library, Embase, and Web of Science databases were included in the analysis. Subgroup analyses were performed to determine the effects of the type, intensity, and duration of exercise on cIMT. RESULTS: This review included 26 studies with 1370 participants. Compared with control participants, those who engaged in exercise showed a decline in cIMT (weighted mean difference [WMD] -0.02; 95% confidence interval [CI], -0.03 to -0.01; I2 = 90.1%). Participants who engaged in aerobic (WMD -0.02; 95% CI, -0.04 to -0.01; I2 = 52.7%) or resistance (WMD -0.01; 95% CI, -0.02 to -0.00; I2 = 38.5%) exercise showed lower cIMT compared with control participants. An exercise duration of >6 months was associated with a 0.02 mm reduction in cIMT. In participants with low cIMT at baseline (<0.7 mm), exercise alone was not associated with a change in cIMT (WMD -0.01; 95% CI, -0.03 to 0.00; I2 = 93.9%). CONCLUSIONS: Exercise was associated with reduced cIMT in adults. Aerobic exercise is associated with a greater decline in cIMT than other forms of exercise. Large, multicenter, randomized controlled trials are required to establish optimal exercise protocols for improving the pathological process of atherosclerosis.

Transperineal Parallel Biopsy of the Prostate: A New Approach of Tissue Sampling for Precision Medicine.

PURPOSE: Through an observational study to present a new approach for obtaining high-quality samples for the targeted therapy of prostate cancer. PATIENTS AND METHODS: Parallel biopsy, which was defined as collecting the tissue from the same site by two biopsies, was performed on patients with elevated PSA. Each tissue was stained by ink to identify the pathological characteristics, including Gleason score and tumor tissue ratio. Kendall tau-b test and intraclass correlation coefficient test were used to compare the consistency between each paired sample. Then, based on the pathology of the biopsies, high-quality tissues would be selected for sequencing, and PyClone model was used to track the clonal evolution. RESULTS: In total, 252 pairs of biopsies were collected. The consistency of Gleason score between each paired biopsy is 0.777 (p<0.01), and the consistency of tumor tissue ratio is 0.853 (p<0.01). With the application of parallel biopsy, on average five nonsynonymous mutations could be identified in patients with castration-resistant prostate cancer. Six out of eight had at least one biology-relevant alteration in patients, guiding further treatment. Meanwhile, clonal evolution was constructed to investigate the progress of tumor. CONCLUSION: Parallel biopsy is a reliable approach to collect high-quality tissue and shows potential application in precision medicine.

A Novel Perineal Nerve Block Approach for Transperineal Prostate Biopsy: An Anatomical Analysis-based Randomized Single-blind Controlled Trial.

OBJECTIVE: To develop and validate a novel perineal nerve block approach for transperineal prostate biopsy. PATIENTS AND METHODS: Five adult male cadavers were dissected to delineate the superficial and deep branches of the perineal nerve. Afterwards, 90 out of 115 patients were selected and randomly assigned to receive periprostatic, periapical triangle, or branches of perineal nerve (BPN) block. The primary outcome was the maximal pain intensity associated with transperineal prostate biopsy, which was assessed by the 10-point visual analog scale. The secondary outcomes included the number of biopsy with visual analog scale of ≥4 in each biopsy procedure, and the incidences of complications. RESULTS: On the horizontal line of the upper anal border, the locations of the superficial branch of perineal nerve on the left and right sides were 1.87 ± 0.05 cm and 1.86 ± 0.06 cm, respectively; and the deep branch were 2.15 ± 0.07 cm and 2.16 ± 0.06 cm, respectively, from the midline, and lied between the deep layer of superficial fascia and prostate capsule. The number of cases finally enrolled in data analysis in periprostatic block, periapical triangle block, and BPN block groups were 26, 27, and 30, respectively. The maximal pain intensities were 3.4 (3.1-3.7), 3.3 (3.0-3.6), and 1.8 (1.5-2.2) in the 3 groups, respectively, and the numbers of biopsy with the pain intensity of ≥4 were 4.0 (3.2-4.9), 4.2 (3.3-5.2), and 0.7 (0.1-1.2), respectively. There were 4, 3 and 4 cases developing hematuria, and 1, 1 and 2 burdened with urine retention after biopsy in the 3 groups, respectively. CONCLUSION: Collectively, BPN block is a safe, effective and repeatable local anesthesia approach for transperineal prostate biopsy.

A Unified Multi-Functional Dynamic Spectrum Access Framework: Tutorial, Theory and Multi-GHz Wideband Testbed.

Dynamic spectrum access is a must-have ingredient for future sensors that are ideally cognitive. The goal of this paper is a tutorial treatment of wideband cognitive radio and radar-a convergence of (1) algorithms survey, (2) hardware platforms survey, (3) challenges for multi-function (radar/communications) multi-GHz front end, (4) compressed sensing for multi-GHz waveforms-revolutionary A/D, (5) machine learning for cognitive radio/radar, (6) quickest detection, and (7) overlay/underlay cognitive radio waveforms. One focus of this paper is to address the multi-GHz front end, which is the challenge for the next-generation cognitive sensors. The unifying theme of this paper is to spell out the convergence for cognitive radio, radar, and anti-jamming. Moore's law drives the system functions into digital parts. From a system viewpoint, this paper gives the first comprehensive treatment for the functions and the challenges of this multi-function (wideband) system. This paper brings together the inter-disciplinary knowledge.