Computer simulation help predict the frame deformation following a Venus-A transcatheter aortic valve implantation in patients with pure aortic regurgitation: a retrospective study.

Background: Patient-specific computer simulation of transcatheter aortic valve implantation (TAVI) predicts the interaction between an implanted device and the surrounding anatomy. In this study, we validated the predictive value of computer simulation for the frame deformation following a Venus-A TAVI implant in patients with pure aortic regurgitation (AR). Furthermore, we used the validated computational model to evaluate the anchoring mechanism within the same cohort. Methods: This was a retrospective study. FEops HEARTguide technology was used to simulate the virtual implantation of a Venus-A valve model in a patient-specific geometry. The predicted frame deformation was quantitatively compared to the postoperative device deformation at multiple levels. The outward forces acting on the frame were extracted for each patient and the total outward force acting around the aortic annular (AA) and sinotubular junction (STJ) planes were recorded. Results: Thirty patients were enrolled in the study with 10 in the migration group and 20 in the non-migration group. The dimensions of the simulated and observed frames had good correlations at Dmax (R2=0.88), Dmin (R2=0.91), perimeter (R2=0.92), and area (R2=0.92). The predicted outward force acting on the frame at the AA level was comparable between the migration and no-migration groups. The predicted outward force acting on the frame at the STJ level was always significantly higher in the migration group than the no migration group at different bandwidths: 3 mm (P=0.002), 5 mm (P=0.005), 10 mm (P=0.002). Conclusions: Patient-specific computer simulation of TAVI accurately predicted frame deformation in Chinese patients with pure AR. The forces at the STJ facilitated stabilization of the device within the aortic root, which might be used as a discriminator to identify patients at risk of device migration prior to intervention.

A carbon/oxygen calculation method to improve the response sensitivity of carbon/oxygen logging.

Carbon/Oxygen logging is an effective method to perform oil layer recognition and oil saturation calculation, which plays an important role in the evaluation of remaining oil after casing. At present, there are two main methods to calculate the ratio of carbon to oxygen (C/O). Compared with the energy window count method, the element yield method can avoid the influence of background count in the gamma spectrum and calculated carbon/oxygen value has the higher sensitivity and better accuracy, but it is still greatly affected by carbon and oxygen elements in the formation skeleton. Therefore, a new carbon/oxygen calculation method is proposed in this paper to overcome the influence of formation skeleton and improve the response sensitivity of Carbon/Oxygen logging. Based on Monte Carlo method, the inelastic gamma spectrum of pure sandstone and pure limestone skeletons are obtained. Based on spectrum analysis technology, the ratio relationship of carbon, oxygen yield and skeleton mark element (Si, Ca) yield in two skeletons are obtained. Using these ratio relationships, the carbon and oxygen yields from the sandstone and limestone reservoir skeletons are deducted from the total carbon and oxygen yield. A new carbon/oxygen parameter called the residual carbon/oxygen value (C/O)R is calculated to perform oil-water recognition and a set of oil saturation calculation model suitable for the residual carbon/oxygen value is proposed. The environment application of the residual carbon/oxygen value is also analyzed. The study shows that the residual carbon/oxygen value has higher sensitivity than original carbon/oxygen value in oil layer recognition and has a great accuracy in oil saturation calculation. In environment application aspect, the residual carbon/oxygen value is basically unaffected by formation water salinity and is affected by wellbore fluid and wellbore size obviously. This new carbon/oxygen value calculation method has an important significance to improve the application effect of Carbon/Oxygen logging.

Developmental trajectories of loneliness in Chinese children: Environmental and personality predictors.

BACKGROUND: This study aimed to identify the developmental trajectories of loneliness in Chinese children and examine the predictive roles of domain-specific environmental factors (i.e., family dysfunction and satisfaction of relatedness needs at school), personality factors (i.e., neuroticism and extraversion), and their interactions in these developmental trajectories. METHODS: A total of 702 Chinese children (Mage = 8.95, SD = 0.76; 54.1 % boys) participated in assessments at six time points over three years at six-month intervals. Growth mixture modeling (GMM) was used to estimate trajectory classes for loneliness, followed by multivariate logistic regression analyses exploring associations between these classes and predictors. RESULTS: GMM analyses identified three distinct trajectories of loneliness: "low-stable" (81.5 %), "moderate-increasing" (9.4 %), and "high-decreasing" (9.1 %). Multivariate logistic regression analyses revealed that family dysfunction and neuroticism served as risk factors for adverse loneliness trajectories, while satisfaction of relatedness needs at school and extraversion acted as protective factors. Furthermore, the interaction between family dysfunction and extraversion indicated that extraversion did not mitigate the adverse effects of high family dysfunction on children's loneliness, emphasizing the vital need to support positive family functioning among all children. LIMITATIONS: This study did not incorporate biological variables (e.g., genetics), which are crucial in the evolutionary theory of loneliness. CONCLUSIONS: The identification of three distinct trajectory groups of children's loneliness, along with key environmental and personality predictors, suggests that interventions should be tailored to each group's unique characteristics.

Morphine promotes non-small cell lung cancer progression by downregulating E-cadherin via the PI3K/AKT/mTOR pathway.

Morphine has been suggested to affect cancer cell dynamics and decrease survival rates in lung cancer patients at specific doses, but the precise mechanisms poorly understood. In this study, we aimed to investigate the molecular mechanisms by which morphine modulates the malignant characteristics of non-small cell lung cancer. Cell proliferation was assessed via the Cell Counting Kit-8 assay, and cell migration and invasion were examined via wound healing and Transwell assays. We employed immunofluorescence staining to evaluate E-cadherin expression in A549 and Lewis lung cancer (LLC) cell lines and immunohistochemistry to evaluate E-cadherin expression in nude mice tumours. Additionally, the in vivo effects of morphine on lung cancer progression were explored in a xenograft tumour experiments, in which naloxone was used as a morphine antagonist. Western blot analysis was performed to detect E-cadherin, phosphorylated mTOR (p-mTOR), mTOR, phosphorylated AKT (p-AKT), AKT, phosphorylated PI3K (p-PI3K), and PI3K protein levels in A549 and LLC cells as well as in tumour samples. Morphine (10 µM) significantly increased the proliferation of A549 and LLC cells in vitro (p < 0.05). It also enhanced the migratory and invasive capacities of these cell lines (p < 0.01). Mechanistically, morphine treatment (10 µM) led to a reduction in the expression of E-cadherin, and an increase in the phosphorylation of PI3K, AKT, and mTOR in A549 and LLC cells (p < 0.01). Morphine treatment (1.5 mg/kg) also reduced E-cadherin expression in xenograft tumours and promoted tumour growth in vivo (p < 0.05). This effect was reversed by naloxone (0.1 mg/kg). The results demonstrated that morphine stimulates the malignant proliferation of A549 and LLC cell lines and promotes xenograft tumour growth. Perhaps by specifically targeting MOR, morphine triggers a signalling cascade that activates the PI3K/AKT/mTOR pathway while inhibiting the EMT marker E-cadherin, which may consequently promote the progression of lung cancer.

Exploring product maturation, microbial communities and antibiotic resistance gene abundances during food waste and cattle manure co-composting.

This study proposed combining food waste (FW) and cattle manure (CM) in composting to improve the product maturity. The findings suggested that the inclusion of CM effectively extended the thermophilic stage, facilitated the decomposition of cellulose, and enhanced the production of humus-like substances by enhancing beneficial microbial cooperation. Adding 40 % CW was optimal to reduce the nitrogen loss, increase the cellulose degradation rate to 22.07 %, increase germination index (GI) to 140 %, and reduce normalized antibiotic resistance gene (ARG) abundances. Adding CW could promote the transformation of protein-like compounds, thereby enhancing the humification process of organic substances. Structural equation modeling further verified that the temperature was the key factor affecting humification production, while the main driver for ARGs was physiochemical parameters. This study shows that co-composting of FW and CM offers the potential to promote humification, reduce ARG abundance, and improve fertilizer quality for utilization of both biowastes in the field.

Curcumin attenuates lupus nephritis by inhibiting neutrophil migration via PI3K/AKT/NF-κB signalling pathway.

OBJECTIVE: To investigate the role of curcumin in the treatment of lupus nephritis (LN) by inhibiting the migration of neutrophils and the underlying mechanism involved. METHODS: Two lupus mouse models, MRL/lpr mice and R848-treated mice, were treated with 50 mg/kg curcumin by intraperitoneal injection. H&E and Masson staining were used to estimate histopathological changes in the kidney. Immunofluorescence was used to assess the deposition of immune complexes. The expression of inflammatory factors was detected by enzyme-linked immunosorbent assay (ELISA) and real-time reverse transcription polymerase reaction (RT-PCR), and the protein expression was detected by western blotting. RESULTS: We revealed the remarkable potential of curcumin in improving inflammatory conditions in both MRL/lpr mice and R848-induced lupus mice. Curcumin effectively decelerates the progression of inflammation and diminishes the infiltration of neutrophils and their release of pivotal inflammatory factors, thereby reducing inflammation in renal tissues. Mechanistically, curcumin significantly inhibits the expression of p-PI3K, p-AKT and p-NF-κB, which are upregulated by interleukin-8 to induce neutrophil migration and renal inflammation, thereby reducing neutrophil migration and the release of inflammatory factors. CONCLUSION: Curcumin significantly inhibits the recruitment of neutrophils and the release of proinflammatory factors in the kidney by inhibiting the PI3K/AKT/NF-κB signalling pathway, providing new therapeutic targets and medication strategies for the treatment of LN.

Improving Aerobic Digestion of Food Waste by Adding a Personalized Microbial Inoculum.

In the context of China's garbage classification policy, on-site aerobic food waste (FW) digestion is crucial for reducing transportation and disposal costs. The efficiency of this process is largely determined by the microbial community structure and its functions. Therefore, this study aimed to analyze the impact of a personalized microbial consortium (MCM) on the efficiency of aerobic FW digestion and to reveal the underlying mechanisms. An MCM, sourced from naturally degrading FW, was selected to enrich degrading bacteria with relatively high hydrolyzing ability. The functionality of the MCM was evaluated by tracing the successions of microbial communities, and comparing the differences in the forms of organic compounds, metabolic functions, and hydrolase activities. X-ray photoelectron spectroscopy demonstrated that the MCM metabolized faster, and produced more acidic metabolites. Metagenomic analysis indicated that FW inoculated with the personalized MCM increased abundance of Bacillaceae producing hydrolysis enzymes and promoted glycolysis metabolic pathways, enhancing energy generation for metabolism, compared to the commercial effective bacterial agent. This paper provides both theoretical and practical evidence for the improvement of biochemical processor of FW with the personalized MCM, which has promising application prospects and economic value.

Optimal Cut-Point Selection Methods Under Binary Classification When Subclasses Are Involved.

In practice, we often encounter binary classification problems where both main classes consist of multiple subclasses. For example, in an ovarian cancer study where biomarkers were evaluated for their accuracy of distinguishing noncancer cases from cancer cases, the noncancer class consists of healthy subjects and benign cases, while the cancer class consists of subjects at both early and late stages. This article aims to provide a large number of optimal cut-point selection methods for such setting. Furthermore, we also study confidence interval estimation of the optimal cut-points. Simulation studies are carried out to explore the performance of the proposed cut-point selection methods as well as confidence interval estimation methods. A real ovarian cancer data set is analyzed using the proposed methods.

Ovarian function in patients with systemic lupus erythematosus: Pathogenesis, drug application and prospective therapies.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease in which multiple organs are damaged that prevails in fertile women. Currently, glucocorticoids and immunosuppressants are widely used to treat SLE patients. However, ovarian dysfunction occurs following the use of these drugs in women with SLE. Here, we summarize recent progress in terms of understanding ovarian injury, the effects of drug application and strategies to improve ovarian function in women with SLE. This review could be helpful to precisely cure SLE in women desiring to have offspring.

Optimization of immunosuppression strategies for the establishment of chronic hepatitis E virus infection in rabbits.

Chronic hepatitis E mostly occurs in organ transplant recipients and can lead to rapid liver fibrosis and cirrhosis. Previous studies found that the development of chronic hepatitis E virus (HEV) infection is linked to the type of immunosuppressant used. Animal models are crucial for the study of pathogenesis of chronic hepatitis E. We previously established a stable chronic HEV infection rabbit model using cyclosporine A (CsA), a calcineurin inhibitor (CNI)-based immunosuppressant. However, the immunosuppression strategy and timing may be optimized, and how different types of immunosuppressants affect the establishment of chronic HEV infection in this model is still unknown. Here, we showed that chronic HEV infection can be established in 100% of rabbits when CsA treatment was started at HEV challenge or even 4 weeks after. Tacrolimus or prednisolone treatment alone also contributed to chronic HEV infection, resulting in 100% and 77.8% chronicity rates, respectively, while mycophenolate mofetil (MMF) only led to a 28.6% chronicity rate. Chronic HEV infection was accompanied with a persistent activation of innate immune response evidenced by transcriptome analysis. The suppressed adaptive immune response evidenced by low expression of genes related to cytotoxicity (like perforin and FasL) and low anti-HEV seroconversion rates may play important roles in causing chronic HEV infection. By analyzing HEV antigen concentrations with different infection outcomes, we also found that HEV antigen levels could indicate chronic HEV infection development. This study optimized the immunosuppression strategies for establishing chronic HEV infection in rabbits and highlighted the potential association between the development of chronic HEV infection and immunosuppressants.IMPORTANCEOrgan transplant recipients are at high risk of chronic hepatitis E and generally receive a CNI-based immunosuppression regimen containing CNI (tacrolimus or CsA), MMF, and/or corticosteroids. Previously, we established stable chronic HEV infection in a rabbit model by using CsA before HEV challenge. In this study, we further optimized the immunosuppression strategies for establishing chronic HEV infection in rabbits. Chronic HEV infection can also be established when CsA treatment was started at the same time or even 4 weeks after HEV challenge, clearly indicating the risk of progression to chronic infection under these circumstances and the necessity of HEV screening for both the recipient and the donor preoperatively. CsA, tacrolimus, or prednisolone instead of MMF significantly contributed to chronic HEV infection. HEV antigen in acute infection phase indicates the development of chronic infection. Our results have important implications for understanding the potential association between chronic HEV infection and immunosuppressants.

Longitudinal associations among basic psychological need satisfaction at school, self-esteem, and suicidal ideation from middle childhood to early adolescence: Disentangling between­ and within­person associations.

INTRODUCTION: The current study aimed to examine the longitudinal associations among basic psychological need satisfaction at school (BPNSS), self-esteem, and suicidal ideation (SI), including whether self-esteem functioned as a mediator of the relations between BPNSS and SI at the within-person level after disentangling between- and within-person associations encompassing middle childhood to early adolescence. METHODS: A total of 650 Chinese students (53.54% boys, Mage = 9.95, SD = 0.75 at Time 1) completed measures on four occasions across 1.5 years, using 6-month intervals. Random intercept cross-lagged panel models were applied to disaggregate between- and within-person effects, thus providing greater confidence in elucidating the causal relations among study variables. RESULTS: The results showed that at the within-person level: (a) BPNSS negatively predicted SI; (b) BPNSS positively predicted self-esteem; (c) Self-esteem negatively predicted SI; and (d) BPNSS indirectly predicted SI via self-esteem. CONCLUSION: These findings advanced the literature by demonstrating longitudinal associations among BPNSS, self-esteem, and SI at the within-person level, and highlighting the significance of distinguishing between- and within-person effects in developing prevention and intervention programs aimed at reducing SI over time from middle childhood to early adolescence.

A longitudinal study of the relationships among competency-based teasing, positivity, and depressive symptoms in Chinese children: Highlighting gender differences.

Competency-based teasing has been identified as a risk factor for children's depressive symptoms. However, the specific psychological mechanisms mediating this relationship are not well understood, especially in the context of Chinese culture. This study examined the relationship between competency-based teasing, subsequent depressive symptoms, and the possible mediating role of positivity in Chinese children by using parallel process latent growth curve modelling. Gender differences were also explored. A sample of 4376 Chinese children (55.1% boys; age: M = 9.98 years, SD = 0.88) completed measurements of the relevant constructs on five occasions across 2 years, using half-year intervals. The findings revealed that competency-based teasing was significantly positively associated with subsequent depressive symptoms in Chinese children. Furthermore, positivity mediated this relationship in girls, but not in boys. The results suggest that positivity-cultivating and gender-specific interventions may be effective to reduce the risk of depressive symptoms in Chinese children.

Rapid and highly sensitive colorimetric LAMP assay and integrated device for visual detection of monkeypox virus.

BACKGROUND: The monkeypox virus (MPXV) is a linear double-stranded DNA virus with a large genome that causes tens of thousands of infections and hundreds of deaths in at least 40 countries and regions worldwide. Therefore, timely and accurate diagnostic testing could be an important measure to prevent the ongoing spread of MPXV and widespread epidemics. RESULTS: Here, we designed multiple sets of primers for the target region of MPXV for loop-mediated isothermal amplification (LAMP) detection and identified the optimal primer set. Then, the specificity in fluorescent LAMP detection was verified using the plasmids containing the target gene, pseudovirus and other DNA/RNA viruses. We also evaluated the sensitivity of the colorimetric LAMP detection system using the plasmid and pseudovirus samples, respectively. Besides, we used monkeypox pseudovirus to simulate real samples for detection. Subsequent to the establishment and introduction of a magnetic beads (MBs)-based nucleic acid extraction technique, an integrated device was developed, characterized by rapidity, high sensitivity, and remarkable specificity. This portable system demonstrated a visual detection limit of 137 copies/mL, achieving sample-to-answer detection within 1 h. SIGNIFICANCE: The device has the advantages of integration, simplicity, miniaturization, and visualization, which help promote the realization of accurate, rapid, portable, and low-cost testing. Meanwhile, this platform could facilitate efficient, cost-effective and easy-operable point-of-care testing (POCT) in diverse resource-limited settings in addition to the laboratory.

Psychological maltreatment by teachers and peer victimization in Chinese youth: Depression and aggression as mediators.

BACKGROUND: Psychological maltreatment by teachers and peer victimization are significant public health issues among youth. However, few studies have verified transactional associations between psychological maltreatment by teachers and peer victimization at the within-person level and the mediating roles of depression and aggression have yet to be fully evaluated. OBJECTIVE: This study examined the transactional associations between psychological maltreatment by teachers and peer victimization from middle childhood to early adolescence, separating within- and between-person variation. The study also examined whether youth's depression and aggression mediated the associations. PARTICIPANTS AND SETTING: A total of 4945 Chinese youth (Mage = 9.92 years, SD = 0.73 53 % boys) completed a packet of measures on five occasions at 6-month intervals from May of 2017 to May of 2019. METHODS: Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were used to distinguish between- and within-person effects. RESULTS: The results indicated that: (a) Psychological maltreatment by teachers predicted peer victimization, and vice versa; (b) Depression (but not aggression) mediated the associations from peer victimization to psychological maltreatment by teachers. CONCLUSIONS: The findings supported bidirectional spillover effects between adverse teacher-student and peer interactions and demonstrated at the within-person level that such effects were transmitted indirectly via youth's depression.

Range-Wide Phylogeography and Ecological Niche Modeling Provide Insights into the Evolutionary History of the Mongolian Racerunner (Eremias argus) in Northeast Asia.

The Mongolian racerunner, Eremias argus, is a small lizard endemic to Northeast Asia that can serve as an excellent model for investigating how geography and past climate change have jointly influenced the evolution of biodiversity in this region. To elucidate the processes underlying its diversification and demography, we reconstructed the range-wide phylogeographic pattern and evolutionary trajectory, using phylogenetic, population genetic, landscape genetic, Bayesian phylogeographic reconstruction and ecological niche modeling approaches. Phylogenetic analyses of the mtDNA cyt b gene revealed eight lineages that were unbounded by geographic region. The genetic structure of E. argus was mainly determined by geographic distance. Divergence dating indicated that E. argus and E. brenchleyi diverged during the Mid-Pliocene Warm Period. E. argus was estimated to have coalesced at~0.4351 Ma (Marine Isotope Stage 19). Bayesian phylogeographic diffusion analysis revealed out-of-Inner Mongolia and rapid colonization events from the end of the Last Interglacial to the Last Glacial Maximum, which is consistent with the expanded suitable range of the Last Glacial Maximum. Pre-Last Glacial Maximum growth of population is presented for most lineages of E. argus. The Glacial Maximum contraction model and the previous multiple glacial refugia hypotheses are rejected. This may be due to an increase in the amount of climatically favorable habitats in Northeast Asia. Furthermore, E. argus barbouri most likely represents an invalid taxon. The present study is the first to report a range-wide phylogeography of reptiles over such a large region in Northeast Asia. Our results make a significant contribution towards understanding the biogeography of the entire Northeast Asia.

Comparison of targeted next-generation sequencing and the Xpert MTB/RIF assay for detection of Mycobacterium tuberculosis in clinical isolates and sputum specimens.

Targeted next-generation sequencing (tNGS) can be used to perform Mycobacterium tuberculosis (MTB) complex-specific amplification or target capture directly from sputum samples, yielding simultaneous coverage of many genes and DNA regions associated with antimicrobial resistance (AMR). Performance comparisons of tNGS and another molecular testing tool, Xpert MTB/rifampicin (RIF), have been empirical. Here, using a dilution series of a RIF-resistant clinical isolate of MTB, we found that tNGS had a slightly lower limit of bacterial detection (102 CFU/mL) compared with Xpert MTB/RIF (103 CFU/mL) in culture medium. However, the minimum detection limit of the rpoB S450L mutation in this isolate was significantly lower with tNGS (102 CFU/mL) than with Xpert MTB/RIF (106 CFU/mL). Sputum samples collected from 129 suspected pulmonary tuberculosis patients were also prospectively studied with the clinical diagnosis as a reference, revealing that the sensitivity of tNGS (48.6%) was higher than those of culture (46.8%), Xpert MTB/RIF (39.4%), and smear microscopy (34.9%) testing. Notably, AMR analysis of 56 MTB-positive samples as determined by tNGS revealed high mutation frequencies of 96.4%, 35.7%, 26.8%, and 19.6% in the following AMR-associated genes: rrs, rpoB, katG, and pncA, respectively. The findings of this study provide theoretical support for the differential clinical application of tNGS and Xpert MTB/RIF and suggest that tNGS has greater application value in tuberculosis drug resistance monitoring and prevention.IMPORTANCETargeted next-generation sequencing (tNGS) can be used to perform Mycobacterium tuberculosis (MTB) complex-specific amplification or target capture directly from sputum samples, yielding simultaneous coverage of genes and DNA regions associated with antimicrobial resistance (AMR). Performance comparisons of tNGS and Xpert MTB/rifampicin (RIF) have been empirical. The Xpert MTB/RIF assay is a commercial system that uses the nucleic acid amplification detection method for rapid (2 hours) diagnosis of tuberculosis (TB). The cost of the tNGS and Xpert MTB/RIF assays in this study was similar, at USD 98 and USD 70-104 per sample, respectively, but the time required for tNGS (3 days) was much longer than that required for the Xpert MTB/RIF assay. However, tNGS yielded more accurate results and a larger number of AMR-associated gene mutations, which compensated for the extra time and highlighted the greater application value of tNGS in TB drug resistance monitoring and prevention.

Longitudinal associations between childhood victimization and neuroticism from middle childhood to early adolescence.

BACKGROUND: Previous cross-sectional and unidirectional longitudinal studies have identified positive associations between childhood victimization and neuroticism in children. However, these studies have not simultaneously examined multiple common sources of childhood victimization (family abuse, teacher abuse, and peer victimization) in relation to neuroticism nor have they distinguished between- and within-person effects. Moreover, the moderating role of child sex in their associations has yet to be fully evaluated. OBJECTIVE: This study examined the within-person longitudinal associations between three common sources of childhood victimization and neuroticism in Chinese children and whether these effects differed between boys and girls. PARTICIPANTS AND SETTING: The sample included 4315 children (55.1 % boys) with an average age of 9.93 (SD = 0.73) years from a large city in China. METHODS: Participants completed self-report measures on five occasions across two years, employing six-month intervals. Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were used to distinguish between-person and within-person effects. RESULTS: Results included: (a) Family abuse (excluding sexual abuse) and peer victimization directly predicted subsequent increases in neuroticism at the within-person level and vice versa, whereas teacher abuse and neuroticism did not reveal significant longitudinal relations at the within-person level; (b) The effect of family abuse on neuroticism at the within-person level was stronger in boys, while the effect of peer victimization on neuroticism at the within-person level was stronger in girls. CONCLUSIONS: Prevention and intervention strategies targeting high neuroticism and childhood victimization should consider the roles of both family and peer systems.

Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction.

BACKGROUND: Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain. METHODS AND RESULTS: We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03]; P<0.01), total pulmonary resistance after inhaled oxygen ≥6.5 Wood units (estimated pulmonary vascular resistance ≥5 Wood units; OR, 12.23 [95% CI, 2.12-70.46]; P<0.01), and artery oxygen saturation at rest <95% (OR, 3.34 [95% CI, 1.07-10.44]; P=0.04). We established the prediction model with the C-statistics of 0.85 (95% CI, 0.77-0.93; P<0.01), and the C-statistic was 0.83 (95% CI, 0.80-0.86) after bootstrapping 10 000 times with a good performance of the nomogram calibration curve for predicting persistent PH. CONCLUSIONS: Our study presents a multivariable risk stratification model for persistent PH after shunt correction in adults with pretricuspid shunts. This model, based on 3 hemodynamic predictors after inhaled oxygen, may assist in identifying individuals at higher risk of persistent PH after shunt correction.

Prediction of suicidal ideation among preadolescent children with machine learning models: A longitudinal study.

BACKGROUND: Machine learning (ML) has been widely used to predict suicidal ideation (SI) in adolescents and adults. Nevertheless, studies of accurate and efficient models of SI prediction with preadolescent children are still needed because SI is surprisingly prevalent during the transition into adolescence. This study aimed to explore the potential of ML models to predict SI among preadolescent children. METHODS: A total of 4691 Chinese children (54.89 % boys, Mage = 10.92 at baseline) and their parents completed relevant measures at baseline and the children provided 6-month follow-up data for SI. The current study compared four ML models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), and Multilayer Perceptron (MLP), to predict SI and to identify variables with predictive value based on the best-performing model among Chinese preadolescent children. RESULTS: The RF model achieved the highest discriminant performance with an AUC of 0.92, accuracy of 0.93 (balanced accuracy = 0.88). The factors of internalizing problems, externalizing problems, neuroticism, childhood maltreatment, and subjective well-being in school demonstrated the highest values in predicting SI. CONCLUSION: The findings of this study suggested that ML models based on the observation and assessment of children's general characteristics and experiences in everyday life can serve as convenient screening and evaluation tools for suicide risk assessment among Chinese preadolescent children. The findings also provide insights for early intervention.