Discovery of natural-product-derived sequanamycins as potent oral anti-tuberculosis agents.

The emergence of drug-resistant tuberculosis has created an urgent need for new anti-tubercular agents. Here, we report the discovery of a series of macrolides called sequanamycins with outstanding in vitro and in vivo activity against Mycobacterium tuberculosis (Mtb). Sequanamycins are bacterial ribosome inhibitors that interact with the ribosome in a similar manner to classic macrolides like erythromycin and clarithromycin, but with binding characteristics that allow them to overcome the inherent macrolide resistance of Mtb. Structures of the ribosome with bound inhibitors were used to optimize sequanamycin to produce the advanced lead compound SEQ-9. SEQ-9 was efficacious in mouse models of acute and chronic TB as a single agent, and it demonstrated bactericidal activity in a murine TB infection model in combination with other TB drugs. These results support further investigation of this series as TB clinical candidates, with the potential for use in new regimens against drug-susceptible and drug-resistant TB.

Fabrication of Oriented MOF-Based Mixed Matrix Membrane via Ion-Induced Synchronous Synthesis.

Developing a facile strategy for constructing oriented mixed matrix membranes (MMMs) with uniformly dispersed and high-loading metal-organic frameworks (MOFs) is a crucial scientific challenge in probing the enhanced capability and potential applications of MOF-polymer MMMs. Herein, a novel synchronous synthetic method for constructing oriented CuBDC/poly(m-phenylenediamine) (CuBDC/PmPD) MMM with uniform MOF dispersion at high loading at the air-solution interface via the dual function of metal ions is reported. The resulting MMM exhibits excellent separation performance in ion sieving and seawater desalination due to the structural integrity of the proposed membrane and the highly interconnected channels created through the oriented distribution of MOF in a polymer matrix. Such a cutting-edge approach may provide promising insights into the development of advanced MMMs with optimized structure and superior performances.

Micropeptides: potential treatment strategies for cancer.

Some noncoding RNAs (ncRNAs) carry open reading frames (ORFs) that can be translated into micropeptides, although noncoding RNAs (ncRNAs) have been previously assumed to constitute a class of RNA transcripts without coding capacity. Furthermore, recent studies have revealed that ncRNA-derived micropeptides exhibit regulatory functions in the development of many tumours. Although some of these micropeptides inhibit tumour growth, others promote it. Understanding the role of ncRNA-encoded micropeptides in cancer poses new challenges for cancer research, but also offers promising prospects for cancer therapy. In this review, we summarize the types of ncRNAs that can encode micropeptides, highlighting recent technical developments that have made it easier to research micropeptides, such as ribosome analysis, mass spectrometry, bioinformatics methods, and CRISPR/Cas9. Furthermore, based on the distribution of micropeptides in different subcellular locations, we explain the biological functions of micropeptides in different human cancers and discuss their underestimated potential as diagnostic biomarkers and anticancer therapeutic targets in clinical applications, information that may contribute to the discovery and development of new micropeptide-based tools for early diagnosis and anticancer drug development.

Triisocyanate Derived Interlayer and High-Melting-Point Doping Promoter Boost Operational Stability of Perovskite Solar Cells.

Formamidinium lead triiodide serves as the optimal light-absorbing layer in single-junction perovskite solar cells. However, achieving operational stability of high-efficiency n-i-p type devices at elevated temperatures remains challenging. In this work, we implemented effective surface modifications on microcrystalline perovskite films. This involved the nucleophilic addition of formamidinium cations and coordination of residual PbI2 with triphenylmethane triisocyanate as well as subsequent polymerization. The in situ growth of a cross-linking network chemically anchored on the perovskite film in this approach effectively reduced trap densities, favorably altered surface work function, suppressing interface charge recombination and thus enhancing cell efficiency. Coupled with a high-melting-point air-doping promoter, we fabricated n-i-p type perovskite solar cells surpassing 25 % efficiency, demonstrating excellent operational stability at 65 °C.

DeepCAC: a deep learning approach on DNA transcription factors classification based on multi-head self-attention and concatenate convolutional neural network.

Understanding gene expression processes necessitates the accurate classification and identification of transcription factors, which is supported by high-throughput sequencing technologies. However, these techniques suffer from inherent limitations such as time consumption and high costs. To address these challenges, the field of bioinformatics has increasingly turned to deep learning technologies for analyzing gene sequences. Nevertheless, the pursuit of improved experimental results has led to the inclusion of numerous complex analysis function modules, resulting in models with a growing number of parameters. To overcome these limitations, it is proposed a novel approach for analyzing DNA transcription factor sequences, which is named as DeepCAC. This method leverages deep convolutional neural networks with a multi-head self-attention mechanism. By employing convolutional neural networks, it can effectively capture local hidden features in the sequences. Simultaneously, the multi-head self-attention mechanism enhances the identification of hidden features with long-distant dependencies. This approach reduces the overall number of parameters in the model while harnessing the computational power of sequence data from multi-head self-attention. Through training with labeled data, experiments demonstrate that this approach significantly improves performance while requiring fewer parameters compared to existing methods. Additionally, the effectiveness of our approach  is validated in accurately predicting DNA transcription factor sequences.

DL-PPI: a method on prediction of sequenced protein-protein interaction based on deep learning.

PURPOSE: Sequenced Protein-Protein Interaction (PPI) prediction represents a pivotal area of study in biology, playing a crucial role in elucidating the mechanistic underpinnings of diseases and facilitating the design of novel therapeutic interventions. Conventional methods for extracting features through experimental processes have proven to be both costly and exceedingly complex. In light of these challenges, the scientific community has turned to computational approaches, particularly those grounded in deep learning methodologies. Despite the progress achieved by current deep learning technologies, their effectiveness diminishes when applied to larger, unfamiliar datasets. RESULTS: In this study, the paper introduces a novel deep learning framework, termed DL-PPI, for predicting PPIs based on sequence data. The proposed framework comprises two key components aimed at improving the accuracy of feature extraction from individual protein sequences and capturing relationships between proteins in unfamiliar datasets. 1. Protein Node Feature Extraction Module: To enhance the accuracy of feature extraction from individual protein sequences and facilitate the understanding of relationships between proteins in unknown datasets, the paper devised a novel protein node feature extraction module utilizing the Inception method. This module efficiently captures relevant patterns and representations within protein sequences, enabling more informative feature extraction. 2. Feature-Relational Reasoning Network (FRN): In the Global Feature Extraction module of our model, the paper developed a novel FRN that leveraged Graph Neural Networks to determine interactions between pairs of input proteins. The FRN effectively captures the underlying relational information between proteins, contributing to improved PPI predictions. DL-PPI framework demonstrates state-of-the-art performance in the realm of sequence-based PPI prediction.

A double-edged sword: role of apoptosis repressor with caspase recruitment domain (ARC) in tumorigenesis and ischaemia/reperfusion (I/R) injury.

Apoptosis repressor with caspase recruitment domain (ARC) acts as a potent and multifunctional inhibitor of apoptosis, which is mainly expressed in postmitotic cells, including cardiomyocytes. ARC is special for its N-terminal caspase recruitment domain and caspase recruitment domain. Due to the powerful inhibition of apoptosis, ARC is mainly reported to act as a cardioprotective factor during ischaemia‒reperfusion (I/R) injury, preventing cardiomyocytes from being devastated by various catastrophes, including oxidative stress, calcium overload, and mitochondrial dysfunction in the circulatory system. However, recent studies have found that ARC also plays a potential regulatory role in tumorigenesis especially in colorectal cancer and renal cell carcinomas, through multiple apoptosis-associated pathways, which remains to be explored in further studies. Therefore, ARC regulates the body and maintains the balance of physiological activities with its interesting duplex. This review summarizes the current research progress of ARC in the field of tumorigenesis and ischaemia/reperfusion injury, to provide overall research status and new possibilities for researchers.

2D Ruddlesden-Popper Polycrystalline PerovskitePyro-Phototronic Photodetectors.

Two-dimensional (2D) Ruddlesden-Popper (RP) layered halide perovskite has attracted wide attentions due to its unique structure and excellent optoelectronic properties. With inserting organic cations, inorganic octahedrons are forced to extend in a certain direction, resulting in an asymmetric 2D perovskite crystal structure and causing spontaneous polarization. The pyroelectric effect resulted from spontaneous polarization exhibits a broad prospect in the application of optoelectronic devices. Herein, 2D RP polycrystalline perovskite (BA)2 (MA)3 Pb4 I13 film with excellent crystal orientation is fabricated by hot-casting deposition, and a class of 2D hybrid perovskite photodetectors (PDs) with pyro-phototronic effect is proposed, achieving temperature and light detection with greatly improved performance by coupling multiple energies. Because of the pyro-phototronic effect, the current is ≈35 times to that of the photovoltaic effect current under 0 V bias. The responsivity and detectivity are 12.7 mA W-1 and 1.73 × 1011 Jones, and the on/off ratio can reach 3.97 × 103 . Furthermore, the influences of bias voltage, light power density, and frequency on the pyro-phototronic effect of 2D RP polycrystalline perovskite PDs are explored. The coupling of spontaneous polarization and light facilitates photo-induced carrier dissociation and tunes the carrier transport process, making 2D RP perovskites a competitive candidate for next-generation photonic devices.

Tracking of Protein Adsorption on Poly(l-lactic acid) Film Surfaces: The Role of Molar Mass.

Poly(l-lactic acid) (PLLA) has been extensively utilized as a biomaterial for various biomedical applications. The first and one of the most critical steps upon contact with biological fluids is the adsorption of proteins on the material's surface. Understanding the behavior of protein adsorption is vital for guiding the synthesis and preparation of PLLA for biomedical purposes. In this study, total internal reflection fluorescence microscopy was employed to investigate the adsorption of human serum albumin (HSA) on PLLA films with different molar masses. We found that molar mass affects HSA adsorption in such a way that it affects only the adsorption rate constants, but not the desorption rate constants. Additionally, we observed that HSA adsorption is spatially heterogeneous and exhibits many strong binding sites regardless of the molar mass of the PLLA films. We found that the free volume of PLLA plays a crucial role in determining its water uptake capacity and surface hydration, consequently impacting the adsorption of HSA.

A specific visual-volumetric sensor for mercury ions based on smart hydrogel.

On the basis of the "seeing is believing" concept and the existing theory of Hg2+ coordination chemistry, for the first time, we innovatively designed and synthesized a visual-volumetric sensor platform with fluorescein and uracil functionalized polyacrylamide hydrogel. Without the aid of any complicated instruments and power sources, the sensor-enabled quantitative µM-level Hg2+ detection Hg2+ by reading graduation on a pipette with the naked eye. The sensor undergoes volumetric response and shows a wide linear response range to Hg2+ (1.0 × 10-6-5.0 × 10-5 mol L-1) with 2.8 × 10-7 mol L-1 as the detection limit. The highly selective (easily distinguished Hg2+ from other common metal ions), rapid response (∼30 min), and acceptable repeatability (RSD < 5% in all cases) demonstrated that the developed sensor is suitable for onsite practical use for the determination of Hg2+ while being low-cost, simple, and portable. The design principles of the obtained materials and the construction techniques and methods of the sensors described in our study provide a new idea for the research and development of smart materials and a series of visual-volumetric sensors for other analytes.

Chinese expert consensus on the construction of the fluoroless cardiac electrophysiology laboratory and related techniques.

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X-rays. X-rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three-dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X-rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.

Lead I R-wave indexes: A novel electrocardiographic criterion for distinguishing the origin of idiopathic premature ventricular contractions from the three subregions of the aortic sinus cusps.

PURPOSE: The current study was conducted to investigate the electrocardiographic (ECG) characteristics of idiopathic premature ventricular contractions (PVCs) originating from the aortic sinus cusp (ASC) and establish a novel ECG criterion to discriminate PVCs originating from the right coronary cusp (RCC), left coronary cusp (LCC), and the left and right coronary cusp junction (LRJ). METHODS: A retrospective analysis was performed on a total of 133 patients with idiopathic PVCs who underwent successful mapping and ablation. The sites of origin (SOO) were confirmed using fluoroscopy and a three-dimensional mapping system during radiofrequency catheter ablation (RFCA). Among the patients, 69 had PVCs originating from the LCC, 39 from the RCC, and 25 from the LRJ. Characteristics of surface 12­lead electrocardiograms (ECGs) recorded during PVCs were analyzed. Q-, R-, S, and R'-wave amplitudes were measured in lead I, and the lead I R-wave indexes (IRa, IRb, IRc, IRd, and IRe) were derived by employing multiplication, subtraction, sum, and division operations on these ECG measurements. Notably, IRb and IRe demonstrated usefulness as ECG indexes for discriminating PVCs originating from RCC, LCC, and LRJ in the ASC. RESULTS: The R- and S-wave amplitudes in lead I exhibited statistically significant differences among the three groups (P < 0.001 and P < 0.001, respectively). In discriminating PVCs originating from the RCC from the other two groups, IRb showed the largest area under the curve (AUC) of 0.813, as assessed by receiver operating characteristic (ROC) analysis, with a cutoff value of ≤0.5 indicating PVCs of RCC origin. The sensitivity and specificity were 80.3% and 78.7%, respectively. For discriminating PVCs arising from the LCC from those in the LRJ group, IRe exhibited the largest AUC of 0.801, with an optimal cutoff value of 0. An IRe value >0 indicated PVCs originating from the LRJ, while an IRe value ≤0 indicated PVCs originating from the LCC. The sensitivity and specificity of the IRe index were 84.0% and 70.7%, respectively. CONCLUSION: Lead I R-wave indexes provided simple and useful ECG criteria for discriminating PVCs originating from the LCC, RCC, and LRJ in the left ventricular outflow tract (LVOT).

DeepPN: a deep parallel neural network based on convolutional neural network and graph convolutional network for predicting RNA-protein binding sites.

BACKGROUND: Addressing the laborious nature of traditional biological experiments by using an efficient computational approach to analyze RNA-binding proteins (RBPs) binding sites has always been a challenging task. RBPs play a vital role in post-transcriptional control. Identification of RBPs binding sites is a key step for the anatomy of the essential mechanism of gene regulation by controlling splicing, stability, localization and translation. Traditional methods for detecting RBPs binding sites are time-consuming and computationally-intensive. Recently, the computational method has been incorporated in researches of RBPs. Nevertheless, lots of them not only rely on the sequence data of RNA but also need additional data, for example the secondary structural data of RNA, to improve the performance of prediction, which needs the pre-work to prepare the learnable representation of structural data. RESULTS: To reduce the dependency of those pre-work, in this paper, we introduce DeepPN, a deep parallel neural network that is constructed with a convolutional neural network (CNN) and graph convolutional network (GCN) for detecting RBPs binding sites. It includes a two-layer CNN and GCN in parallel to extract the hidden features, followed by a fully connected layer to make the prediction. DeepPN discriminates the RBP binding sites on learnable representation of RNA sequences, which only uses the sequence data without using other data, for example the secondary or tertiary structure data of RNA. DeepPN is evaluated on 24 datasets of RBPs binding sites with other state-of-the-art methods. The results show that the performance of DeepPN is comparable to the published methods. CONCLUSION: The experimental results show that DeepPN can effectively capture potential hidden features in RBPs and use these features for effective prediction of binding sites.

Roles of Small Molecules in the Stability and Sensitivity of CL-20-Based Host-Guest Explosives under Electric Fields: A Reactive Molecular Dynamics Study.

Host-guest inclusion, constructed by inserting small molecules into voids of energetic crystals, is a novel strategy for creating new energetic materials (EMs) with desired energy and safety. To provide an atomistic-level insight into the fact that small guest molecules can effectively regulate the stability and sensitivity of CL-20, we conducted ReaxFF-lg reactive molecular dynamics simulations on electric-field (EF)-induced decomposition of two typical host-guest EMs, CL-20/H2O2 and CL-20/N2O, and compared it to that of α-CL-20 and ε-CL-20. Our findings show that the sensitivity order of the CL-20-based EMs under EFs, α-CL-20/H2O2 > ε-CL-20 > α-CL-20 > α-CL-20/N2O, agrees well with the sensitivity obtained from the experiment (ε-CL-20 > α-CL-20 > α-CL-20/N2O). Different effects of H2O2 and N2O molecules were found responsible for the distinct stability and sensitivity of these materials toward EFs. On the one hand, H2O2 accelerate(s) the structural transformation of CL-20 and thus increases the sensitivity, because the wobbling NO2 group reduces the stability of CL-20 by weakening its adjacent C-N bonds, whereas N2O makes this transition less likely, resulting in low sensitivity of α-CL-20/N2O. On the other hand, H2O2 and its decomposition intermediate OH radical can promote destruction of CL-20's cage structure and produce a large amount of water molecules to release heat, making CL-20/H2O2 to decompose faster than ε-CL-20. N2O molecules rarely react with CL-20 molecules but absorb heat from the surrounding decomposed CL-20 and thus slow down CL-20's decomposition, resulting in low sensitivity of α-CL-20/N2O, as confirmed by transition-state calculations. The results provide a comprehensive understanding of the stability and sensitivity of CL-20-based host-guest explosives under EFs.

The initial attempt at home hemodialysis in mainland China.

BACKGROUND: Observational studies have shown home hemodialysis (HHD) to be associated with better survival than facility hemodialysis (HD) and peritoneal dialysis (PD). Patients on HHD have reported higher quality of life and independence. HHD is considered to be an economical way to manage end-stage kidney disease (ESKD). The coronavirus disease 2019 pandemic has had a significant impact on patients with ESKD. Patients on HHD may have an advantage over in-center HD patients because of a lower risk of exposure to infection. PARTICIPANTS AND METHODS: We enrolled HD patients from our dialysis center. We first established the HHD training center. The training center was approved by the Chinese government. Doctors, nurses and engineers train and assess patients separately. There are three forms of patient monitoring: home visits, internet remote monitoring, and outpatient services. Demographic and medical data included age, sex, blood pressure, and dialysis-related data. Laboratory tests were conducted in our central testing laboratory, including hemoglobin (Hgb), serum creatinine (Cr), urea nitrogen (BUN), uric acid (UA), albumin (Alb), calcium (Ca), phosphorus (P), parathyroid hormone (PTH), and brain natriuretic peptide (BNP) levels. RESULTS: Six patients who underwent regular dialysis in the HD center of our hospital were selected for HHD training. We enrolled 6 patients, including 4 males and 2 females. The mean age of the patients was 47.5 (34.7-55.7) years, and the mean dialysis age was 33.5 (11.2-41.5) months. After an average of 16.0 (11.2-25.5) months of training, Alb, P and BNP levels were improved compared with the baseline values. After training, three patients returned home to begin independent HD. During the follow-up, there were no serious adverse events leading to hospitalization or death, but there were several adverse events. They were solved quickly by extra home visits of the technicians or online by remote monitoring. During the follow-up time, the laboratory indicators of all the patients, including Hgb, Alb, Ca, P, PTH, BNP, and ß2-MG levels, remained stable before and after HHD treatment. CONCLUSION: HHD is feasible and safe for ESKD in China, but larger-scale and longer-term studies are needed for further confirmation.

Clinical Characteristics of Patients with Arrhythmias of the Idiopathic Outflow Tract Ventricular: Age, Gender, Comorbidities, Laboratory Test Results, and Echocardiographic Parameters.

Context: Idiopathic ventricular arrhythmias (IVAs) are a spectrum of ventricular arrhythmia (VA) without structural heart disease (SHD), that includes premature ventricular contractions (PVCs) and ventricular tachycardia (VT). The clinical characteristics of patients with PVCs or VT remain unclear, including distribution of the origin of arrhythmias, age and gender differences, comorbidities, laboratory tests, and electrocardiographic parameters. Objective: The study intended to compare the clinical characteristics of the right ventricular outflow tract (RVOT)- and left ventricular outflow tract (LVOT)-VT of a large group of consecutive patients, to investigate the distribution of the origin of the arrhythmias, age and gender differences, comorbidities, laboratory-examination results, and echocardiographic parameters. Methods: The research team designed a retrospective study to collect data on the above-mentioned variables. Setting: The study occurred at the Second Hospital of Hebei Medical University in Shijiazhuang, China. Participants: Participants were 774 patients with symptomatic ventricular arrhythmias, 328 males and 446 females with the mean age of 48.6 ± 15.7 years, who underwent catheter ablation between January 2015 and January 2019. Participants were divided into the right ventricular outflow tract (RVOT) group and left ventricular outflow tract (LVOT) group, according to the different origins of their arrhythmias, with 428 participants in the RVOT group and 180 in the LVOT group. Outcome Measures: The research team collected and analyzed the data for the original sites of the IVAs; ages; genders; comorbidities; laboratory examinations, including routine blood tests, liver function, kidney function, blood lipid and potassium; and echocardiographic parameters. Results: Among the 774 participants, 76 had experienced VTs and 698 PVCs. The original site of IVAs was 2.38 times more likely to be in the RVOT than the LVOT, with the ratio for RVOT/LVOT = 2.38. IVAs usually occurred in participants between 50 and 70 years old and exhibited a decreasing incidence after 70 years of age. IVAs derived from the His bundle were more common in older participants, with a mean age of 60.4 ± 10.4 years, while IVAs derived from the fascicular were more common in younger patients, with a mean age of 36.08 ± 16.01 years. Compared with the LVOT group, the RVOT group was younger, 51.91 ± 14.65 years vs 46.95 ± 14.95 years, respectively (P < .001). PVCs in the RVOT group were more common in women, with the ratio of females/males = 2.10, and no gender difference existed in the overall incidence of IVAs in the LVOT group (P > .05). The most common cardiovascular comorbidities of outflow tract ventricular arrhythmias (OTVAs) were hypertension, coronary heart disease, and hyperlipidemia, while the most common noncardiovascular comorbidities were diabetes, ischemic stroke, and thyroid disease. The red-blood-cell counts, hemoglobin, creatinine, and gamma-glutamyl transpeptidase (GGT) of the LVOT group were higher than those from the RVOT, with P = .008, P = .009, P = .001, and P < .001, respectively. The left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVS), and left ventricular posterior wall thickness (LVPWT) in the LVOT group were larger than those in the RVOT group (P <.001), while the LVOT group's left ventricular ejection fraction (LVEF%) was lower than that of the RVOT group. Conclusions: The outflow tract served as the major original site of IVAs, and significant differences existed between participants in the LVOT and RVOT groups in age; gender; comorbidities; results of laboratory examinations, including red-blood-cell counts, hemoglobin, creatinine, and GGT; and echocardiographic parameters, including LVEF%, LAD, LVEDD, IVS, and LVPWT.

S-R index in V1/V3 serves as a novel criterion to discriminate idiopathic premature ventricular contractions originating from posteroseptal right ventricular outflow tract versus right coronary cusp.

AIM: The current study aimed to establish a novel electrocardiographic (ECG) criterion for discrimination of idiopathic premature ventricular contractions (PVCs) originating from posteroseptal right ventricular outflow tract (sRVOT-p) versus right coronary cusp (RCC). METHODS: A total of 76 patients with idiopathic PVCs who underwent mapping and successful ablation were retrospectively included. Among them, 37 patients had PVCs from sRVOT-p origin and 39 patients from RCC origin. The surface ECGs during PVCs were recorded. S-R different index in V1/V3 was calculated with the following formula of 0.134*V3R-0.133*V1S. RESULTS: ECG characteristics showed wider total QRS duration, smaller R-wave amplitude on lead V2-V5, and larger S-wave amplitude on lead V1-V3 in sRVOT-p origin than RCC origin. Lead V3 was the most common transitional lead in two groups. Receiver operating characteristic (ROC) curve analysis showed that S-wave amplitude on lead V1 exhibited the largest AUC of 0.772, followed by the AUC of R-wave amplitude on lead V3 of 0.771. Subsequently, 0.134*V3R-0.133*V1S index was obtained by multiplication, subtraction, sum, and division of these ECG measurements, which exhibited the largest AUC of 0.808. The optimal cut-off value was -0.26 for differentiating RCC from sRVOT-p origin, with the sensitivity of 78.4% and specificity of 77.8%. Moreover, 0.134*V3R-0.133*V1S index was superior to previous criteria in analysis of PVCs originating from sRVOT-p and RCC. CONCLUSIONS: 0.134*V3R-0.133*V1S is a novel ECG criterion to discriminate sRVOT-p from RCC origin in patients with idiopathic PVCs, which may provide guidance for approach of radiofrequency catheter ablation.

The role of electric field on decomposition of CL-20/HMX cocrystal: A reactive molecular dynamics study.

Electric field can initiate decomposition or detonation of explosives, but underlying mechanism is unclear. Here, we performed ReaxFF molecular dynamics simulation for decomposition of a cocrystal, formed by 2,4,6,8,10,12-hexanitro-2,4,6,8,10,12-hexaazaisowurtzitane (CL-20) and 1,3,5,7-tetranitro-1,3,5,7-tetrazacyclooctane (HMX), solely induced by electric field. A new analytical method was proposed to obtain detailed decomposition mechanism. Results show that electric fields play important roles in decomposition of CL-20/HMX cocrystal, such as heating the system and causing the explosive to decompose. Strong constant field makes CL-20 molecules in the cocrystal decompose at significantly lower temperature, which greatly increases sensitivity. This is ascribed to the distinct decomposition mechanism that CN bond rupture dominates the initial step of CL-20's decomposition. Contrarily, oscillating field has a stronger heating effect but weaker influence on sensitivity. Moreover, HMX exhibits desensitizing effect in CL-20/HMX cocrystal under electric field. These results enhance our understanding of sensitivity mechanism beyond mechanical stimuli in explosives.

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation.

BACKGROUND: The primary aim was to observe the predictive value of P-wave ECG index and left atrial appendage volume (LLAV) for atrial fibrillation recurrence after first radiofrequency catheter ablation. METHODS: A total of 196 patients with paroxysmal atrial fibrillation were enrolled. The preoperative LLAV was measured by cardiac enhanced CT. The P-wave ECG index including minimum P-wave duration (P-min), maximum P-wave duration (P-max), mean P-wave duration (mPWD), P-wave dispersion (PWD), P-wave terminal force in lead V1 (PtfV1), PR interval prolongation, and interatrial block (IAB) were analyzed and recorded in 12-lead ECG of sinus rhythm. RESULTS: According to the follow-up results, the patients were divided into two groups: the non-recurrence group and the recurrence group. P-min, PWD, P-max, PtfV1 ≥ 0.04 mV·s, PR interval prolongation, and the ratio of first and third-degree IAB in the recurrence group were higher than those in the non-recurrence group, with significant statistical differences (P < 0.05). Kaplan-Meier curve analysis was performed on time to atrial fibrillation recurrence after catheter ablation when PtfV1 ≥ 0.04 mv s by comparison between groups (Log Rank test: 2 = 4.739, P < 0.001). Kaplan-Meier curve analysis showed that the survival rate without recurrence of atrial fibrillation after catheter ablation was lower when the LLAV exceeded 8.0 mL (log-rank test P < 0.001). CONCLUSION: PWD, P-max, PtfV1, PR interval prolongation, first and third-degree IAB, and LLAV can effectively predict atrial fibrillation recurrence after radiofrequency catheter ablation. The combination might be a valid and alternative independent predictor of recurrence.

Prediction of total hospital expenses of patients undergoing breast cancer surgery in Shanghai, China by comparing three models.

BACKGROUND: Breast cancer imposes a considerable burden on both the health care system and society, and becomes increasingly severe among women in China. To reduce the economic burden of this disease is crucial for patients undergoing the breast cancer surgery, hospital managers, and medical insurance providers. However, few studies have evidenced the prediction of the total hospital expenses (THE) for breast cancer surgery. The aim of the study is to predict THE for breast cancer surgery and identify the main influencing factors. METHODS: Data were retrieved from the first page of medical records of 3699 patients undergoing breast cancer surgery in one tertiary hospital from 2017 to 2018. Multiple liner regression (MLR), artificial neural networks (ANNs), and classification and regression tree (CART) were constructed and compared. RESULTS: The dataset from 3699 patients were randomly divided into training and test sets at a 70:30 ratio (2599 and 1100 records, respectively). The average total hospital expenses were 12520.54 ± 7844.88 ¥ (US$ 1929.20 ± 1208.11). MLR results revealed six factors to be significantly associated with THE: age, LOS, type of disease, having medical insurance, minimally invasive surgery, and receiving general anesthesia. After comparing three models, ANNs was the best model to predict THEs in patients undergoing breast cancer surgery, and its strong predictive performance was also validated. CONCLUSIONS: To reduce the THEs, more attention should be paid to related factors of LOS, major and minimally invasive surgeries, and general anesthesia for these patient groups undergoing breast cancer surgery. This may reduce the information asymmetry between doctors and patients and provide more reliable cost, practical inpatient medical consumption standards and reimbursement standards reference for patients, hospital managers, and medical insurance providers ,respectively.