A broad wastewater screening and clinical data surveillance for virus-related diseases in the metropolitan Detroit area in Michigan.

BACKGROUND: Periodic bioinformatics-based screening of wastewater for assessing the diversity of potential human viral pathogens circulating in a given community may help to identify novel or potentially emerging infectious diseases. Any identified contigs related to novel or emerging viruses should be confirmed with targeted wastewater and clinical testing. RESULTS: During the COVID-19 pandemic, untreated wastewater samples were collected for a 1-year period from the Great Lakes Water Authority Wastewater Treatment Facility in Detroit, MI, USA, and viral population diversity from both centralized interceptor sites and localized neighborhood sewersheds was investigated. Clinical cases of the diseases caused by human viruses were tabulated and compared with data from viral wastewater monitoring. In addition to Betacoronavirus, comparison using assembled contigs against a custom Swiss-Prot human virus database indicated the potential prevalence of other pathogenic virus genera, including: Orthopoxvirus, Rhadinovirus, Parapoxvirus, Varicellovirus, Hepatovirus, Simplexvirus, Bocaparvovirus, Molluscipoxvirus, Parechovirus, Roseolovirus, Lymphocryptovirus, Alphavirus, Spumavirus, Lentivirus, Deltaretrovirus, Enterovirus, Kobuvirus, Gammaretrovirus, Cardiovirus, Erythroparvovirus, Salivirus, Rubivirus, Orthohepevirus, Cytomegalovirus, Norovirus, and Mamastrovirus. Four nearly complete genomes were recovered from the Astrovirus, Enterovirus, Norovirus and Betapolyomavirus genera and viral species were identified. CONCLUSIONS: The presented findings in wastewater samples are primarily at the genus level and can serve as a preliminary "screening" tool that may serve as indication to initiate further testing for the confirmation of the presence of species that may be associated with human disease. Integrating innovative environmental microbiology technologies like metagenomic sequencing with viral epidemiology offers a significant opportunity to improve the monitoring of, and predictive intelligence for, pathogenic viruses, using wastewater.

Toward High-Performance Mg/S Batteries with M4-Assisted Mg(AlCl4 )2 /PYR14TFSI/DME Electrolyte and MoS2 @CMK/S Cathode.

Rechargeable magnesium batteries (RMBs) are considered as one of the most promising candidates for next-generation batteries. However, the popularization of RMBs is seriously plagued due to the lack of suitable non-nucleophilic electrolytes and the passivation of Mg anode. Herein, a novel non-nucleophilic electrolyte is developed by introducing (s)-1-methoxy-2-propylamine (M4) into themagnesium aluminum chloride complex (MACC)-like electrolyte. The as-synthesizes Mg(AlCl4 )2 -IL-DME-M4 electrolyte enables robust reversible cycling of Mg plating/stripping with low overpotential, high anodic stability, and ionic conductivity (8.56 mS cm-1 ). These features should be mainly attributed to the in situ formation of an MgF2 containing Mg2+ -conducting interphase, which dramatically suppresses the passivation and parasitic reaction of Mg anode with electrolyte. Remarkably, the Mg/S batteries assemble with as-synthesize electrolyte and a new type MoS2 @CMK/S cathode deliver unprecedented electrochemical performance. Specifically, the Mg/S battery exhibited the highest reversible capacity up to 1210 mAh g-1 at 0.1 C, excellent rate capability and satisfactory long-term cycling stability with a reversible capacity of 370 mAh g-1 (coulombic efficiency of ≈100%) at 1.0 C for 600 cycles. The study findings provide a novel strategy and inspiration for designing efficient non-nucleophilic Mg electrolyte and suitable sulfur-host materials for practical Mg/S battery applications.

Electrocardiographic left atrial abnormality and risk of heart failure.

INTRODUCTION: The association and the racial differences of the electrocardiographic markers of left atrial abnormality (ECG-LAA) with heart failure (HF) are unclear. METHODS: We examined the cross-sectional association of ECG-LAA, defined as deep terminal negativity of P wave in V1 (DTNPV1) with HF in 8460 participants (51.5% women, 60.3 ± 13.5 age and 49.8% Whites) from the US Third National Health and Nutrition Examination Survey. We excluded participants without P-wave in their ECG or with ECG findings that interfere with measurements of P-wave. DTNPV1 was automatically measured from ECGs processed at a central lab. Values of DTNPV1 ≥ 100 µV were considered abnormal. Past medical history of HF was identified through health interviews. Multivariable logistic regression analysis was used to examine the associations of DTNPV1 with HF. RESULTS: Abnormal DTNPV1 was detected in 3.2% (n = 271) of the participants. HF was significantly more common in individuals with abnormal, compared to those with normal, DTNPV1 (14.7% vs. 4.8%, respectively; p-value <0.001). In a model adjusted for socio-demographics and cardiovascular risk factors, ECG-LAA was associated with 98% increased odds of HF (OR (95% CI): 1.98 (1.30-3.01), p < 0.001). This association was stronger in non-White (vs. White) participants (OR (95% CI): 3.14 (1.82-5.43) vs. 1.01 (0.51-1.97), respectively; interaction p-value =0.01), but consistent in subgroups stratified by age and sex. CONCLUSIONS: ECG-LAA, defined as abnormal DTNPV1, is associated with an increased risk of HF, underscoring the role of atrial disease in developing HF. Racial differences in this association exist, possibly suggesting considering ECG-LAA in personalized assessments of HF risk.

Digital versus conventional full-arch impressions in linear and 3D accuracy: a systematic review and meta-analysis of in vivo studies.

OBJECTIVES: The purpose of this systematic review was to compare the accuracy of digital and conventional full-arch impressions in vivo. MATERIALS AND METHODS: This systematic review was conducted according to the PRISMA and registered at the PROSPERO (CRD42021232736). Electronic and hand searches were performed to identify in vivo studies comparing the linear or 3D accuracy of digital and conventional impressions. The risk of bias (ROB) of included studies was assessed by QUADAS-2, and the overall quality of evidence was assessed by GRADE. RESULTS: Twenty-two studies met the inclusion criteria, and 13 studies were included in the meta-analysis. There was no significant difference between digital and conventional impressions in the linear measurements of tooth width, anterior Bolton ratio, overall Bolton ratio, intercanine distance (ICD), and intermolar distance (IMD). The repeated measurement mean errors (RMEs) were less than 0.1 mm, the intra-examiner intraclass correlation coefficient (ICC) values were more than 0.9, and the inter-examiner ICC values were more than 0.87 for both impression techniques. The 3D deviation between digital and alginate impressions was 0.09 mm. The 3D precision of both impression techniques was less than 0.1 mm. CONCLUSIONS: The trueness of digital and alginate full-arch impressions was similar, and both impression techniques showed high precision. More research was needed to compare digital impressions and other conventional impression materials. CLINICAL RELEVANCE: For patients with completely natural dentition, the digital impressions obtained directly from intraoral scanning can be considered a viable alternative to alginate impressions.

Exploring differences for motor imagery using Teager energy operator-based EEG microstate analyses.

In this paper, the differences between two motor imagery tasks are captured through microstate parameters (occurrence, duration and coverage, and mean spatial correlation (Mspatcorr)) derived from a novel method based on electroencephalogram microstate and Teager energy operator. The results show that the significance between microstate parameters for two tasks is different (P < 0.05) with paired t-test. Furthermore, these microstate parameters are utilized as features. Support vector machine is utilized to classify the two tasks with a mean accuracy of 93.93%, which yielded superior performance compared to the other methods.

The fertilization effect of global dimming on crop yields is not attributed to an improved light interception.

Global dimming, a decadal decrease in incident global radiation, is often accompanied with an increase in the diffuse radiation fraction, and, therefore, the impact of global dimming on crop production is hard to predict. A popular approach to quantify this impact is the statistical analysis of historical climate and crop data, or use of dynamic crop simulation modelling approach. Here, we show that statistical analysis of historical data did not provide plausible values for the effect of diffuse radiation versus direct radiation on rice or wheat yield. In contrast, our field experimental study of 3 years demonstrated a fertilization effect of increased diffuse radiation fraction, which partly offset yield losses caused by decreased global radiation, in both crops. The fertilization effect was not attributed to any improved canopy light interception but mainly to the increased radiation use efficiency (RUE). The increased RUE was explained not only by the saturating shape of photosynthetic light response curves but also by plant acclimation to dimming that gradually increased leaf nitrogen concentration. Crop harvest index slightly decreased under dimming, thereby discounting the fertilization effect on crop yields. These results challenge existing modelling paradigms, which assume that the fertilization effect on crop yields is mainly attributed to an improved light interception. Further studies on the physiological mechanism of plant acclimation are required to better quantify the global dimming impact on agroecosystem productivity under future climate change.

Electrocardiographic myocardial injury and stroke mortality in the general population.

BACKGROUND: Recent evidence suggests a link between myocardial infarction and stroke risk, but it is unclear whether such risk exists with electrocardiographic myocardial injury in otherwise healthy individuals. Therefore, we explored the association of myocardial injury with stroke mortality in participants free of cardiovascular disease. METHODS: This analysis included 6017 participants (58.4 ± 13.4 years, 54.1% women, 50.3% white) from the Third National Health and Nutrition Examination Survey. Cardiac infarction/injury score (CIIS), a weighted scoring system composed of several electrocardiographic waveform components related to myocardial injury and ischemia, was used to define myocardial injury. Stroke mortality was ascertained using the National Death Index during follow-up. Multivariable adjusted Cox proportional hazard analysis was used to examine the association between baseline myocardial injury and risk of stroke mortality. RESULTS: Over a median follow-up of 14 years, 152 stroke deaths occurred. Stroke mortality was more common in those with than those without myocardial injury (3.8% vs. 2.1%, respectively; p = 0.0003). In a model adjusted for potential confounders, the myocardial injury was associated with a 44% increased risk of stroke mortality (HR (95%CI):1.44(1.02-2.03)). In a similar model, each 1 CIIS score point increase was associated with a 2% increase in the risk of stroke mortality (HR (95%CI):1.02 (1.00-1.04), p = 0.01). CONCLUSIONS: Electrocardiographic myocardial injury in cardiovascular disease-free adults is associated with an increased risk of stroke mortality suggesting a potential link between asymptomatic myocardial injury and risk of cardiac thromboembolism. Whether screening and management of myocardial injury would reduce such risk requires further investigation.

EEG effective connectivity networks for an attentive task requiring vigilance based on dynamic partial directed coherence.

An effective network perspective focused on measuring directional interactions of electroencephalographic in different cortical regions during a sustained attentive task requiring vigilance. A novel measure referred to as dynamic partial directed coherence was used to map the cognitive state of vigilance based on graph theory. In the right parieto-occipital area, the area is significantly higher than in other regions of interest (the areas are 0.601 and 0.632 for out-degree and in-degree, respectively). A similar analysis in the right fronto-central area revealed significant differences in the different cognitive states. Across the six regions of interest, significant differences of in-degree and out-degree based alpha band are observed in the right fronto-central and the right parieto-occipital (P < 0.05). The performance was compared with those from a support vector machine using different network-based phase-locking values, partial directed coherence, and dynamic partial directed coherence. Results show that dynamic partial directed coherence can provide more information about direction (compared with phase-locking values) and accuracy (when compared with partial directed coherence). The graph theoretical analysis shows that the effective network based dynamic partial directed coherence has a small-world property for synchronizing neural activity between brain regions. Moreover, the alpha band is well correlated with the cognitive state compared to other frequency bands.

[Analysis of imagery motor effective networks based on dynamic partial directed coherence].

The research on brain functional mechanism and cognitive status based on brain network has the vital significance. According to a time-frequency method, partial directed coherence (PDC), for measuring directional interactions over time and frequency from scalp-recorded electroencephalogram (EEG) signals, this paper proposed dynamic PDC (dPDC) method to model the brain network for motor imagery. The parameters attributes (out-degree, in-degree, clustering coefficient and eccentricity) of effective network for 9 subjects were calculated based on dataset from BCI competitions IV in 2008, and then the interaction between different locations for the network character and significance of motor imagery was analyzed. The clustering coefficients for both groups were higher than those of the random network and the path length was close to that of random network. These experimental results show that the effective network has a small world property. The analysis of the network parameter attributes for the left and right hands verified that there was a significant difference on ROI2 ( P = 0.007) and ROI3 ( P = 0.002) regions for out-degree. The information flows of effective network based dPDC algorithm among different brain regions illustrated the active regions for motor imagery mainly located in fronto-central regions (ROI2 and ROI3) and parieto-occipital regions (ROI5 and ROI6). Therefore, the effective network based dPDC algorithm can be effective to reflect the change of imagery motor, and can be used as a practical index to research neural mechanisms.

Association between serum cotinine levels and electrocardiographic left atrial abnormality.

BACKGROUND: Although the harmful effect of tobacco exposure on cardiovascular disease (CVD) and its risk factors are well established, the constituents of cigarette-smoke and the pathophysiological mechanism involved are unknown. Recently, deep terminal negativity of P wave in V1 (DTNPV1) has emerged as a marker of left atrial abnormality that predicts atrial fibrillation, stroke, and death due to all-cause or CVD. Therefore, we examined the association between serum cotinine levels with abnormal DTNPV1 using the Third National Health and Nutrition Examination Survey. METHODS: This analysis included 4,507 participants (mean age 58 ± 13 years, 53% women, 49% non-Hispanic white) of NHANES III, without history of CVD or major electrocardiographic abnormalities and not on heart rate modifying medications. Multivariable logistic regression analysis was used to examine the association between serum cotinine and abnormal DTNPV1-defined from automatically processed electrocardiograms as values of the amplitude of the terminal negative phase of P wave in lead V1 exceeding 100 µV. RESULTS: Abnormal DTNPV1 was detected in 2.3% (n = 105) of the participants. In a model adjusted for demographics and CVD risk factors, each 10 ng/ml serum cotinine was associated with 2% increased odds of abnormal DTNPV1 (odds ratio 1.02, 95% confidence interval 1.01-1.03, p-value < 0.001). This association was consistent in subgroups stratified by age, sex, race, smoking status, hypertension, diabetes, dyslipidemia, and chronic obstructive pulmonary disease. CONCLUSION: Elevated serum cotinine levels are associated with an abnormal DTNPV1. This suggests that nicotine exposure can lead to left atrial abnormalities, a possible mechanism for increased risk of CVD.

Association of vitamin D deficiency with electrocardiographic markers of left atrial abnormalities.

OBJECTIVE: Electrocardiographic markers of left atrial (LA) abnormalities are linked to increased risk of cardiovascular disease (CVD). We examined the relationship of vitamin D deficiency with prolonged P wave duration and PR interval as markers of LA abnormalities. METHODS: This analysis included 5,894 participants (58.12 ± 12.9 years; 54.7% women; 49.8% non-Hispanic Whites) without clinical CVD from NHANES III. A multivariable logistic regression model was used to examine the association of vitamin D categories (<20 ng/ml, 20-29 ng/ml and >30 ng/ml (reference) with prolonged P wave duration (≥120 ms) and PR interval (≥200 ms). RESULTS: There was an incremental increase in the prevalence of prolonged P wave duration and PR interval across vitamin D categories with the highest prevalence in study participants with vitamin D levels <20 ng/ml, followed by 20-29 ng/ml and then >30 ng/ml (trend p-value < 0.0001). Vitamin D deficiency (<20 ng/ml) was associated with prolonged P wave duration (OR [95% CI]: 1.22 [1.03-1.45], p = 0.02) and prolonged PR interval (OR [95% CI]: 1.48 [1.12-1.97], p = 0.006) in multivariable logistic regression models adjusted for demographics, CVD risk factors, and other potential confounders. These associations were consistent across subgroups stratified by age, sex, and race. CONCLUSIONS: Vitamin D deficiency is associated with an increased risk of LA abnormalities. This association elucidates an alternate pathway through which vitamin D deficiency may increase CVD risk. Whether vitamin D supplementation would improve LA abnormalities requires further investigation.

Prognostic significance of electrocardiographic right ventricular hypertrophy in the general population.

BACKGROUND: Echocardiographically detected right ventricular hypertrophy (RVH) is associated with cardiovascular disease (CVD) and mortality. However, the prognostic significance of electrocardiographic (ECG)RVH criteria as predictors of poor outcomes in the general population is unclear. METHODS: This study included 7857 participants (59.8 ±â€¯13.4 years, 52.6% women) from the Third National Health and Nutrition Examination Survey. Sixteen different ECG-RVH criteria were created from digitally recorded and centrally processed electrocardiograms. All-cause mortality was ascertained using the National Death Index. Cox proportional hazards analysis was used to examine the association between baseline ECG-RVH criteria and all-cause mortality. RESULTS: The prevalence of RVH varied widely among the criteria. The lowest ECG-RVH prevalence was 0.09% (using S > R in I, II, III) while the highest prevalence was 20.7% (using (R I + S III) - (S I + R III) < 15 mm). During a median follow-up of 14 years, 2812 deaths occurred. The mortality rate was highest among participants with ECG-RVH defined as R:S ratio V5 < 0.75. In multivariable adjusted models, 9 out of the 16 ECG-RVH criteria were significantly associated with all-cause mortality. When ECG-RVH was defined as the presence of any ECG-RVH criteria, each additional ECG-RVH criteria was associated with 6% increased risk of all-cause mortality (HR (95% CI):1.06(1.03,1.10)). CONCLUSIONS: There is a wide variation in the prevalence of ECG-RVH when different criteria are applied in the general population. However, the presence of ECG-RVH by most criteria regardless of prevalence was associated with poor prognosis suggesting that appropriate choice of criteria may enhance the utilization of these ECG markers in risk stratification.

A new CFD based non-invasive method for functional diagnosis of coronary stenosis.

BACKGROUND: Accurate functional diagnosis of coronary stenosis is vital for decision making in coronary revascularization. With recent advances in computational fluid dynamics (CFD), fractional flow reserve (FFR) can be derived non-invasively from coronary computed tomography angiography images (FFRCT) for functional measurement of stenosis. However, the accuracy of FFRCT is limited due to the approximate modeling approach of maximal hyperemia conditions. To overcome this problem, a new CFD based non-invasive method is proposed. METHODS: Instead of modeling maximal hyperemia condition, a series of boundary conditions are specified and those simulated results are combined to provide a pressure-flow curve for a stenosis. Then, functional diagnosis of stenosis is assessed based on parameters derived from the obtained pressure-flow curve. RESULTS: The proposed method is applied to both idealized and patient-specific models, and validated with invasive FFR in six patients. Results show that additional hemodynamic information about the flow resistances of a stenosis is provided, which cannot be directly obtained from anatomy information. Parameters derived from the simulated pressure-flow curve show a linear and significant correlations with invasive FFR (r > 0.95, P < 0.05). CONCLUSION: The proposed method can assess flow resistances by the pressure-flow curve derived parameters without modeling of maximal hyperemia condition, which is a new promising approach for non-invasive functional assessment of coronary stenosis.

Association of obesity phenotypes with electrocardiographic left ventricular hypertrophy in the general population.

OBJECTIVE: Increasing evidence doubts the benign nature of metabolically healthy obesity (MHO). An investigation of the association of MHO and other obesity phenotypes with electrocardiographic left ventricular hypertrophy (ECG-LVH), a risk factor for cardiovascular disease (CVD), can give insight into the pathophysiological basis for increased risk of CVD linked to these phenotypes. METHODS: This analysis included 3997 participants (58.7 ±â€¯13.6 years; 51.8% women) without CVD from the NHANES-III. Metabolic syndrome was defined according to the Adult Treatment Panel III. Obesity was defined as body mass index ≥30 kg/m2. Multivariable logistic regression was used to examine the cross-sectional association between 4 obesity phenotypes (metabolically healthy non-obese (MHNO) (reference), metabolically unhealthy non-obese (MUNO), MHO and metabolically unhealthy obese (MUO) with Cornell voltage ECG-LVH. RESULTS: There was an incremental increase in the prevalence of ECG-LVH across obesity phenotypes with the highest prevalence in the MUO followed by MHO, MUNO and then MHNO (ECG-LVH = 6.45%, 5%, 4.71%, and 1.69%, respectively, trend p-value < 0.001). Also, there was incremental increase in the strength of associations with ECG-LVH across obesity phenotypes with higher odds of ECG-LVH in the MUO (OR (95% CI): 4.12 (2.30-7.39) followed by MUNO (OR (95% CI): 2.62 (1.45-4.73) then MHO (OR (95% CI): 2.45 (1.11-5.43) compared to MHNO. The MHO association with ECG-LVH was stronger in men than women (OR (95% CI): 5.55 (1.49-20.70) vs. 1.94 (0.71-5.24) respectively; interaction p-value = 0.04). CONCLUSIONS: Obesity phenotypes including MHO are associated with ECG-LVH, thus further questioning the concept of benign obesity.

Racial Differences in Heart Age and Impact on Mortality.

BACKGROUND: Heart age is an estimate of the age of a person's cardiovascular system given their cardiovascular disease (CVD) risk factors. The difference between a person's chronological age and heart age (excess heart age) represents their added CVD risk. OBJECTIVE: To examine racial differences in excess heart age and whether race impacts the association between excess heart age and CVD mortality. METHODS: This analysis included 5110 participants (2449 non-Hispanic white, 1287 non-Hispanic black, and 1374 Mexican-American) from the NHANES III who were free of CVD. Heart age was calculated using the sex-specific non-laboratory-based Framingham risk prediction functions. Multivariable Cox proportional-hazards regression models were used to evaluate the relationship (overall and by race) between excess heart age and CVD mortality. RESULTS: Mean excess heart age was greatest in non-Hispanic blacks (13.0 years), followed by Mexican-Americans (10.5 years), and non-Hispanic whites (8.5 years); p < 0.001 for pairwise differences. Over a mean follow-up of 13.0 years, 394 CVD deaths occurred. Each 10 years of excess heart age was associated with 65% increased risk of CVD mortality (HR, 95% CI: 1.65, 1.53-1.78). This association was stronger in non-Hispanic whites (1.83, 1.63-2.02) compared to non-Hispanic blacks (1.50, 1.29-1.72) and Mexican American (1.60, 1.33-1.87), interaction p = 0.065. CONCLUSIONS: Compared to non-Hispanic whites, non-Hispanic blacks and Mexican Americans have more excess heart age, but the risk of CVD death for the same level of excess heart age appears more pronounced in non-Hispanic whites. Further investigation is needed to show the usefulness of these findings in directing future efforts and resource allocation for reduction of health disparities between ethnic groups.

Spatial and temporal ecological risk assessment of unionized ammonia nitrogen in Tai Lake, China (2004-2015).

Ammonia toxicity varies largely due to its pH- and temperature-dependent speciation (unionized ammonia nitrogen, NH3-N). The seasonal and long-term trend of ammonia risk in ecologically significant sections of Tai Lake, China was unknown. In this study, a two-level (deterministic and quantitative) method was developed to assess the special ecological risks posed by NH3-N at 37 sites during two seasons (February and September) of 2014 in Tai Lake. The long-term temporal (2004-2015) risk posed by NH3-N was also assessed by comparing annual quantitative risk values (probability of exceeding acute or chronic threshold values) in three key sections of Tai Lake. The results indicated the species living in the Tai Lake were at a 0.04% and 32.45% chance of risk due to acute exposure, and a 1.97% and 92.05% chance of risk due to chronic exposure in February and September of 2014, respectively. Alarmingly, the chronic ecological risks of NH3-N in the Lanshanzui section of the Tai Lake remained >30% from 2004 to 2011. The chronic risk of NH3-N in all three key sections of Tai Lake started to decrease in 2011. This was likely the consequence of the control practice of eutrophication implemented in the Tai Lake. A significant decline in diversity of the benthic invertebrate community of the Tai Lake could be associated with continuous exposure to ammonia over decades given different sensitivity of taxa to ammonia. The results laid a scientific foundation for risk assessment and management of ammonia in Tai Lake, China, and the developed two-level risk assessment approach can also be applied to other similar aquatic regions.

Alisol A 24-Acetate Prevents Hepatic Steatosis and Metabolic Disorders in HepG2 Cells.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic disorders including hepatic lipid accumulation and inflammation. Alisol A 24-acetate, a triterpene from Alismatis rhizome, has multiple biologic activities such as hypolipidemic, anti-inflammatory and anti-diabetic. Thus we hypothesized that Alisol A 24 -acetate would have effect on NAFLD. The present study was conducted to investigate the therapeutic effects and potential mechanisms of Alisol A 24-acetate against hepatic steatosis in a free fatty acids (FFAs) induced NAFLD cell model. METHODS: This study was divided into four groups including Control group, Model group (FFA group), Alisol A 24-acetate (FFA+A) group, Fenofibrate (FFA+F) group. Preventive role of Alisol A 24-acetate was evaluated using 10µM Alisol A 24-acetate plus 1 mM FFA (oleate:palmitate=2:1) incubated with HepG2 cells for 24 h, which was determined by Oil Red O Staining, Oil Red O based colorimetric assay and intracellular triglyceride (TG) content. Besides, the inflammatory cytokines tumor necrosis factor (TNF)- α, interleukin (IL)-6 levels as well as the protein and mRNA expressions that were involved in fatty acid synthesis and oxidation including Adiponectin, AMP-activated protein kinase (AMPK) α, peroxisome proliferator-activated receptor (PPAR) α, sterol regulatory element binding protein 1c (SREBP-1c), acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), carnitine palmitoyltransferase 1 (CPT1) and acyl coenzyme A oxidase 1 (ACOX1) were detected. RESULTS: Alisol A 24-acetate significantly decreased the numbers of lipid droplets, Oil Red O lipid content, and intracellular TG content. Besides, inflammatory cytokines TNF-α, IL-6 levels were markedly inhibited by Alisol A 24-acetate. Furthermore, Alisol A 24-acetate effectively increased the protein and mRNA expressions of Adiponectin, the phosphorylation of AMPKα, CPT1 and ACOX1, whereas decreased SREBP-1c, the phosphorylation of ACC and FAS at both protein and mRNA levels. However, there was no significant effect on the protein and mRNA expressions of PPARα by Alisol A 24-acetate. CONCLUSIONS: These results demonstrated that Alisol A 24-acetate effectively ameliorated hepatic steatosis likely through Adiponectin, which activated AMPKα signaling pathways via down-regulating SREBP-1c, ACC, FAS and up-regulating CPT1 and ACOX1, and inhibited inflammation. Thereby, Alisol A 24-acetate could be a promising candidate for the treatment of NAFLD.

Individual components of the Romhilt-Estes left ventricular hypertrophy score differ in their prediction of cardiovascular events: The Atherosclerosis Risk in Communities (ARIC) study.

BACKGROUND: It has been recently reported that the Romhilt-Estes (R-E) score, originally proposed for detection of left ventricular hypertrophy from the electrocardiogram, is a strong predictor of all-cause mortality. Whether the R-E score is also predictive of cardiovascular disease (CVD) and whether its individual components differ in their ability to predict different CVD outcomes are not well established. METHODS: This analysis includes 13,261 participants from the ARIC study who were free of CVD at baseline (1987-1989). Incident CVD, coronary heart disease (CHD), heart failure (HF), and stroke were ascertained by an adjudication committee through December 2010. The R-E left ventricular hypertrophy score was measured from automatically processed baseline electrocardiogram data. Cox proportional hazard models were used to examine the association between baseline the R-E overall score (overall) and each of its 6 individual components separately, with each of the CVD outcomes. RESULTS: During a median follow-up of 21.8 years, 3,579, 2,205, 1,814, and 731 CVD, CHD, HF, and stroke events, respectively, occurred. In multivariable adjusted models, R-E score ≥4 points (compared with 0 points) was associated with increased risk of CVD, CHD, HF, and stroke (hazard ratio [95% CI] 1.66 [1.41-1.96], 1.66 [1.34-2.07], 1.97 [1.60-2.43], and 1.49 [1.07-2.07], respectively). The 6 component of the R-E score varied in their relationship to different CVD outcomes. CONCLUSIONS: The R-E score is predictive of CVD outcomes. The 6 R-E score components differ in their associations with different CVD outcomes, indicating that they may be electrical biomarkers of different physiological events within the myocardium.

The Romhilt-Estes left ventricular hypertrophy score and its components predict all-cause mortality in the general population.

BACKGROUND: The same electrocardiographic (ECG) criteria that have been used for detection of left ventricular hypertrophy (LVH) have recently been recognized as predictors of adverse clinical outcomes, but this predictive ability is inadequately explored and understood. METHODS: A total of 14,984 participants from the ARIC study were included in this analysis. Romhilt-Estes (R-E) LVH score was measured from the automatically processed baseline (1987-1989) ECG data. All-cause mortality was ascertained up to December 2010. Cox proportional hazard models were used to examine the association between baseline R-E score, overall and each of its 6 individual components separately, with all-cause mortality. The associations between change in R-E score between baseline and first follow-up visit with mortality were also examined. RESULTS: During a median follow-up of 21.7 years, 4,549 all-cause mortality events occurred during follow-up. In multivariable-adjusted models, increasing levels of the R-E score was associated with increasing risk of mortality both as a baseline finding and as a change between the baseline and the first follow-up visit. Of the 6 ECG components of the score, 4 were predictive of all-cause mortality (P-terminal force, QRS amplitude, LV strain, and intrinsicoid deflection), whereas 2 of the components were not (left axis deviation and prolonged QRS duration). Differences in the strengths of the associations between the individual components of the score and mortality were observed. CONCLUSIONS: The R-E score, traditionally used for detection of LVH, could be used as a useful tool for predication of adverse outcomes.

RSR' pattern and the risk of mortality in men and women free of cardiovascular disease.

This study included 6,398 participants (mean age 55 ± 0.34 years; 54% female; 49% white; 22% black; 24% Mexican; 4.3% other) free of clinical cardiovascular disease (CVD) and major ECG abnormalities. Cox regression was used to examine the association between the RSR' (incomplete right bundle branch block (RBBB) or right ventricular conduction delay) pattern and CVD and all-cause mortalities. The RSR' pattern was not associated with an increased risk of CVD (HR=1.10; 95%CI=0.63, 1.91) mortality or all-cause (HR=0.95; 95%CI=0.66, 1.35) mortality. The results were similar when the RSR' pattern was further separated into incomplete RBBB and right ventricular conduction delay. In conclusion, the RSR' pattern is a benign finding in older adults free of clinical CVD.