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1.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 50(1): 41-51, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-34117858

RESUMO

To explore early prevention and control of coronavirus disease 2019 (COVID-19) outbreak based on system dynamics model analysis. The data of early outbreak of COVID-19 were collected from the World Health Organization,covering countries of the China,United States,United Kingdom,Australia,Serbia and Italy. The susceptible-exposed-infected-recovered (SEIR) model was generalized and then its parameters were optimized. According to the parameters in the basic infection number expression,the sensitivity in the system dynamics model was used to quantitatively analyze the influence of the protection rate,infection rate and average quarantine time on the early spread of the outbreak. Based on the analysis results,targeted prevention and control measures for the early outbreak of COVID-19 were proposed. The generalized SEIR model had a good fit for the early prediction and evaluation of COVID-19 outbreaks in six countries. The spread of COVID-19 was mainly affected by the protection rate,infection rate and average quarantine time. The improvement of the protection rate in the first ays was the most important:the greater the protection rate,the fewer the number of confirmed cases. The infection rate in the first 5 days was the most critical:the smaller the infection rate,the fewer the number of confirmed cases. The average quarantine time in the first 5 days was very important:the shorter the average quarantine time,the fewer the number of confirmed cases. Through the comparison of key parameters of six countries,Australia and China had implemented strict epidemic prevention policies,which had resulted in good epidemic prevention effects. In the early stage of the outbreak,it is necessary to improve the protection rate,shorten the average quarantine time,and implement strict isolation policies to curb the spread of COVID-19.


Assuntos
COVID-19 , China/epidemiologia , Surtos de Doenças , Humanos , Quarentena , SARS-CoV-2
2.
Nat Commun ; 12(1): 3619, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34131130

RESUMO

L-2-Hydroxyglutarate (L-2-HG) plays important roles in diverse physiological processes, such as carbon starvation response, tumorigenesis, and hypoxic adaptation. Despite its importance and intensively studied metabolism, regulation of L-2-HG metabolism remains poorly understood and none of regulator specifically responded to L-2-HG has been identified. Based on bacterial genomic neighborhood analysis of the gene encoding L-2-HG oxidase (LhgO), LhgR, which represses the transcription of lhgO in Pseudomonas putida W619, is identified in this study. LhgR is demonstrated to recognize L-2-HG as its specific effector molecule, and this allosteric transcription factor is then used as a biorecognition element to construct an L-2-HG-sensing FRET sensor. The L-2-HG sensor is able to conveniently monitor the concentrations of L-2-HG in various biological samples. In addition to bacterial L-2-HG generation during carbon starvation, biological function of the L-2-HG dehydrogenase and hypoxia induced L-2-HG accumulation are also revealed by using the L-2-HG sensor in human cells.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34129085

RESUMO

PURPOSE: This study was conducted to evaluate outcomes in patients presenting with fungus ball of the maxillary sinus (MSFB) and frontal sinusitis who were treated via middle meatal antrostomy alone. METHODS: This was a randomized, controlled study with a parallel group design. Patients with MSFB and frontal sinusitis were randomly assigned to the maxillary middle meatal antrostomy (MMMA) or control (MMMA + frontal sinusotomy) groups. Patient demographics, complaints, imaging findings were analyzed, and surgical outcomes were evaluated using the Lund-Kennedy endoscopic score (LKES) and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire. RESULTS: In total, 40 patients were separated into two groups, with similar symptoms including nasal obstruction, mucopurulent rhinorrhea, maxillary or frontal pain, blood stained nasal discharge, nasal cacosmia and orbital pain being observed in both groups. Total LKES and SNOT-22 scores were significantly improved in both groups at 6 months post-treatment, with no significant differences in these scores between groups within a mean 6.8-month follow-up. CONCLUSION: These results suggest that frontal sinusotomy is not required to resolve frontal sinusitis associated with MSFB. As such frontal sinusitis appears to be a reactive process caused by fungal ball obstruction, it regresses spontaneously following fungus ball removal, drainage of the maxillary sinus, and middle meatal antrostomy.

4.
Sci Adv ; 7(24)2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34108208

RESUMO

The recognition of oligomannose-type glycans in innate and adaptive immunity is elusive due to multiple closely related isomeric glycan structures. To explore the functions of oligomannoses, we developed a multifaceted approach combining mass spectrometry assignments of oligomannose substructures and the development of a comprehensive oligomannose microarray. This defined microarray encompasses both linear and branched glycans, varying in linkages, branching patterns, and phosphorylation status. With this resource, we identified unique recognition of oligomannose motifs by innate immune receptors, including DC-SIGN, L-SIGN, Dectin-2, and Langerin, broadly neutralizing antibodies against HIV gp120, N-acetylglucosamine-1-phosphotransferase, and the bacterial adhesin FimH. The results demonstrate that each protein exhibits a unique specificity to oligomannose motifs and suggest the potential to rationally design inhibitors to selectively block these protein-glycan interactions.

5.
Nano Lett ; 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34126742

RESUMO

Achieving high spinning speed is critical to the production efficiency and viable application of fiber species. Graphene fiber (GF) has recently emerged as a carbonaceous fiber with excellent functionality. However, the extremely low wet spinning speed of GF has limited its applications. We realized high-speed blow spinning of neat GF and fabric by modulating the rheological properties of the graphene oxide (GO) dispersion. We achieved a speed of 556 m min-1, 2 orders of magnitude faster than that for wet spinning. We chose ultrahigh molecular weight polymers as transient additives to circumvent the intrinsic barrier effect of GO and achieve high spinning dope stretchability at low polymer percentages-down to 25 wt %. Minimizing the polymer additive content ensures the high electrical/thermal conductivity of the blow-spun fiber and fabric. This work provides insight into the unique flow properties of 2D sheets and will promote the efficient production of graphene-based fibrous materials.

6.
Cell Mol Life Sci ; 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34089345

RESUMO

The macrophage mannose receptor (CD206, MR) is an endocytic lectin receptor which plays an important role in homeostasis and innate immunity, however, the endogenous glycan and glycoprotein ligands recognized by its C-type lectin domains (CTLD) have not been well studied. Here we used the murine MR CTLD4-7 coupled to the Fc-portion of human IgG (MR-Fc) to investigate the MR glycan and glycoprotein recognition. We probed 16 different cancer and control tissues using the MR-Fc, and observed cell- and tissue-specific binding with varying intensity. All cancer tissues and several control tissues exhibited MR-Fc ligands, intracellular and/or surface-located. We further confirmed the presence of ligands on the surface of cancer cells by flow cytometry. To characterize the fine specificity of the MR for glycans, we screened a panel of glycan microarrays. Remarkably, the results indicate that the CTLD4-7 of the MR is highly selective for specific types of pauci- and oligomannose N-glycans among hundreds of glycans tested. As lung cancer tissue and the lung cancer cell line A549 showed intense MR-Fc binding, we further investigated the MR glycoprotein ligands in those cells by immunoprecipitation and glycoproteomic analysis. All enriched glycoproteins, of which 42 were identified, contained pauci- or oligomannose N-glycans, confirming the microarray results. Our study demonstrates that the MR CTLD4-7 is highly selective for pauci- and oligomannosidic N-glycans, structures that are often elevated in tumor cells, and suggest a potential role for the MR in tumor biology.

7.
J Am Coll Cardiol ; 77(22): 2761-2773, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34082905

RESUMO

BACKGROUND: The optimal revascularization strategy for the elderly with complex coronary artery disease remains unclear. OBJECTIVES: The goal of this study was to investigate 10-year all-cause mortality, life expectancy, 5-year major adverse cardiac or cerebrovascular events (MACCE), and 5-year quality of life (QOL) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in elderly individuals (>70 years old) with 3-vessel disease (3VD) and/or left main disease (LMD). METHODS: In the present pre-specified analysis on age of the SYNTAX Extended Survival study, 10-year all-cause death and 5-year MACCE were compared with Kaplan-Meier estimates and Cox proportional hazards models among elderly or nonelderly patients. Life expectancy was estimated by restricted mean survival time within 10 years, and QOL status according to the Seattle Angina Questionnaire up to 5 years was assessed by linear mixed-effects models. RESULTS: Among 1,800 randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality did not differ significantly between PCI and CABG in elderly (44.1% vs. 41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to 1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to 1.69; pinteraction = 0.332). Among elderly patients, 5-year MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95% CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to 2.10; pinteraction = 0.043). There were no significant difference in life expectancy (mean difference: 0.2 years in favor of CABG; 95% CI: -0.4 to 0.7) and 5-year QOL status between PCI and CABG among elderly patients. CONCLUSIONS: Elderly patients with 3VD and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year MACCE, and 5-year QOL status irrespective of revascularization mode. (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972).

8.
J Sep Sci ; 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34117714

RESUMO

Ionic chiral selectors have been received much attention in the field of asymmetric catalysis, chiral recognition, and preparative separation. It has been shown that the addition of ionic chiral selectors can enhance the recognition efficiency dramatically due to the presence of multiple intermolecular interactions, including hydrogen bond, π-π interaction, van der Waals' force, electrostatic ion-pairing interaction, and ionic-hydrogen bond. In the initial research stage of the ionic chiral selectors, most of work center on the application in chromatographic separation (CE, HPLC, and GC). Differently, more and more attention has been paid on the spectroscopy (nuclear magnetic resonance, fluorescence, ultraviolet and visible absorption spectrum, and circular dichroism spectrum) and electrochemistry in recent years. In this tutorial review as regards the ionic chiral selectors, we discuss in detail the structural features, properties, and their application in chromatography, spectroscopy, and electrochemistry. This article is protected by copyright. All rights reserved.

9.
Chin J Integr Med ; 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34060025

RESUMO

OBJECTIVE: To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities. METHODS: The data set was collected from the Chinese medicine (CM) electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017. Then, a hypertension disease comorbidity network (HDCN) was built to investigate the complicated associations between hypertension and their comorbidities. Moreover, a hypertension patient similarity network (HPSN) was constructed with patients' shared symptoms, and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms. In addition, the significant symptoms, diseases, CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis. RESULTS: The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension. Additionally, the specific phenotypic features (symptoms, diseases, and CM syndromes) were consistent with specific molecular features (pathways) in the same patient subgroup. CONCLUSION: The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

10.
Elife ; 102021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33970104

RESUMO

Dimethylsulfoniopropionate (DMSP) is an abundant and ubiquitous organosulfur molecule in marine environments with important roles in global sulfur and nutrient cycling. Diverse DMSP lyases in some algae, bacteria, and fungi cleave DMSP to yield gaseous dimethyl sulfide (DMS), an infochemical with important roles in atmospheric chemistry. Here, we identified a novel ATP-dependent DMSP lyase, DddX. DddX belongs to the acyl-CoA synthetase superfamily and is distinct from the eight other known DMSP lyases. DddX catalyses the conversion of DMSP to DMS via a two-step reaction: the ligation of DMSP with CoA to form the intermediate DMSP-CoA, which is then cleaved to DMS and acryloyl-CoA. The novel catalytic mechanism was elucidated by structural and biochemical analyses. DddX is found in several Alphaproteobacteria, Gammaproteobacteria, and Firmicutes, suggesting that this new DMSP lyase may play an overlooked role in DMSP/DMS cycles.

11.
Adv Mater ; : e2008116, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-33988260

RESUMO

Processing 2D sheets into desired structures with high precision is of great importance for fabrication and application of their assemblies. Solution processing of 2D sheets from dilute dispersions is a commonly used method but offers limited control over feature size precision owing to the extreme volume shrinkage. Plastic processing from the solid state is therefore a preferable approach to achieve high precision. However, plastic processing is intrinsically hampered by strong interlayer interactions of the 2D sheet solids. Here, a hydroplastic molding method to shape layered solids of 2D sheets with micrometer-scale precision under ambient conditions is reported. The dried 2D layered solids are plasticized by intercalated solvents, affording plastic near-solid compounds that enable local plastic deformation. Such an intercalated solvent-induced hydroplasticity is found in a broad family of 2D materials, for example graphene, MoS2 , and MXene. The hydroplastic molding enables fabrication of complex spatial structures (knurling, origami) and microimprinted tubular structures down to diameters of 390 nm with good fidelity. The method enhances the structural accuracy and enriches the structural diversity of 2D macroassemblies, thus providing a feasible strategy to tune their electrical, optical, and other functional properties.

12.
J Healthc Eng ; 2021: 6684954, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995984

RESUMO

Acquiring electrocardiographic (ECG) signals and performing arrhythmia classification in mobile device scenarios have the advantages of short response time, almost no network bandwidth consumption, and human resource savings. In recent years, deep neural networks have become a popular method to efficiently and accurately simulate nonlinear patterns of ECG data in a data-driven manner but require more resources. Therefore, it is crucial to design deep learning (DL) algorithms that are more suitable for resource-constrained mobile devices. In this paper, KecNet, a lightweight neural network construction scheme based on domain knowledge, is proposed to model ECG data by effectively leveraging signal analysis and medical knowledge. To evaluate the performance of KecNet, we use the Association for the Advancement of Medical Instrumentation (AAMI) protocol and the MIT-BIH arrhythmia database to classify five arrhythmia categories. The result shows that the ACC, SEN, and PRE achieve 99.31%, 99.45%, and 98.78%, respectively. In addition, it also possesses high robustness to noisy environments, low memory usage, and physical interpretability advantages. Benefiting from these advantages, KecNet can be applied in practice, especially wearable and lightweight mobile devices for arrhythmia classification.

13.
Artigo em Inglês | MEDLINE | ID: mdl-34000088

RESUMO

OBJECTIVES: This study aimed to assess the predictive ability of the Global Registry of Acute Coronary Events (GRACE) risk score 2.0 in contemporary acute coronary syndrome (ACS) patients, and its relation to antiplatelet strategies. BACKGROUND: The predictive value of the GRACE risk score in the contemporary ACS cohort and the appropriate antiplatelet regimen according to the risk remain unclear. METHODS: This is a subgroup analysis of the all-comers, randomized GLOBAL LEADERS trial, comparing ticagrelor monotherapy versus conventional dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). The GRACE risk score 2.0 with 1-year mortality prediction was implemented. The randomized antiplatelet effect was assessed in predefined three GRACE risk-groups; low-risk (GRACE <109), moderate-risk (GRACE 109-140), and high-risk (GRACE >140). RESULTS: The GRACE risk score was available in 6,594 out of 7,487 ACS patients among whom 1,743, 2,823, and 2,028 patients were classified as low-risk, moderate-risk, and high-risk, respectively. At 1 year, all-cause mortality occurred in 120 patients (1.8%). The discrimination ability of the GRACE model was moderate (C-statistic = 0.742), whereas 1-year mortality risk was overestimated (mean predicted mortality rate: 3.9%; the Hosmer-Lemeshow chi-square: 21.47; p = 0.006). There were no significant interactions between the GRACE risk strata and effects of the ticagrelor monotherapy on ischemic or bleeding outcomes at 1 year compared to the reference strategy. CONCLUSION: The GRACE risk score 2.0 is valuable in discriminating high risk ACS patients, however, the recalibration of the score is recommended for better risk stratification. There is no significant differences in efficacy and safety of ticagrelor monotherapy across the three GRACE risk strata.

14.
Science ; 372(6542): 614-617, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33958473

RESUMO

Stimuli-responsive fusion and fission are widely observed in both bio-organizations and artificial molecular assemblies. However, the design of a system with structure and property persistence during repeated fusion and fission remains challenging. We show reversible fusion and fission of wet-spun graphene oxide (GO) fibers, in which a number of macroscopic fibers can fuse into a thicker one and can also separate into original individual fibers under stimulation of solvents. The dynamic geometrical deformation of GO fiber shells, caused by solvent evaporation and infiltration, is the key to the reversible fusion-fission cycles. This principle is extended to implement flexible transitions between complex fiber assemblies and the inclusion or expulsion of guest compounds.

15.
Glycobiology ; 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-33978739

RESUMO

Glycan microarrays have played important roles in detection and specificity assignment of glycan-recognition by proteins. However, the size and diversity of glycan libraries in current microarray systems are small compared to estimated glycomes, and these may lead to missed detection or incomplete assignment. For microarray construction, covalent and non-covalent immobilization are the two types of methods used, but a direct comparison of results from the two platforms is required. Here we develop a chemical strategy to prepare lipid-linked probes from both naturally-derived aldehyde-terminating and synthetic amino-terminating glycans that addresses the two aspects: expansion of sequence-defined glycan libraries and comparison of the two platforms. We demonstrate the specific recognition by plant and mammalian lectins, carbohydrate-binding modules and antibodies, and the overall similarities from the two platforms. Our results provide new knowledge on unique glycan-binding specificities for the immune-receptor Dectin-1 towards ß-glucans and the interaction of rotavirus P[19] adhesive protein with mucin O-glycan cores.

16.
Anal Chem ; 93(22): 7879-7888, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34038093

RESUMO

A nanoflare, a conjugate of Au nanoparticles (NPs) and fluorescent nucleic acids, is believed to be a powerful nanoplatform for diagnosis and therapy. However, it highly suffers from the nonspecific detachment of nucleic acids from the AuNP surface because of the poor stability of Au-S linkages, thereby leading to the false-positive signal and serious side effects. To address these challenges, we report the use of covalent amide linkage and functional Au@graphene (AuG) NP to fabricate a covalent conjugate system of DNA and AuG NP, label-rcDNA-AuG. Covalent coating of abundant amino groups (-NH2) onto the graphitic shell of AuG NP efficiently facilitates the coupling with carboxyl-labeled capture DNA sequences through simple, but strong, amide bonds. Importantly, such an amide-bonded nanoflare possesses excellent stability and anti-interference capability against the biological agents (nuclease, DNA, glutathione (GSH), etc.). By accurately monitoring the intracellular miR-21 levels, this covalent nanoflare is able to identify the positive cancer cells even in a mix of cancer and normal cells. Moreover, it allows for efficient photodynamic therapy of the targeted cancer cells with minimized side effects on normal cells. This work provides a facile approach to develop a superstable nanosystem showing promising potential in clinical diagnostics and therapy.

17.
PLoS One ; 16(5): e0252190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34038487

RESUMO

Mercury exists naturally and mainly as a man-made pollutant in the environment, where it exerts adverse effects on local ecosystems and living organisms. It is important to develop an appropriate synthetic biological device that recognizes, detects and removes the bioavailable fraction of environmental mercury. Both single-signal and double-signal output mercury biosensors were assembled using a natural mer operon as a template. Selectivity and sensitivity of whole-cell biosensors based on artificial mer operons were determined. Three whole-cell biosensors were highly stable at very high concentrations of mercuric chloride, and could detect bioavailable Hg(II) in the concentration range of 6.25-200 µM HgCl2. A novel Hg(II) bioadsorption coupled with biosensing artificial mer operon was assembled. This would allow Hg(II)-induced Hg(II) binding protein cell surface display and green fluorescence emission to be achieved simultaneously while retaining the linear relationship between fluorescent signal and Hg(II) exposure concentration. The present study provides an innovative way to simultaneously detect, quantify, and remove bioavailable heavy metal ions using an artificially reconstructed heavy metal resistance operon.

18.
Cell Prolif ; 54(6): e13052, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33963627

RESUMO

OBJECTIVES: Senescence, characterized by permanent cycle arrest, plays an important role in diabetic nephropathy (DN). However, the mechanism of renal senescence is still unclear, and the treatment targeting it remains to be further explored. MATERIALS AND METHODS: The DN mice were induced by HFD and STZ, and 3 types of renal cells were treated with high glucose (HG) to establish in vitro model. Senescence-related and autophagy-related markers were detected by qRT-PCR and Western blot. Further, autophagy inhibitors and co-immunoprecipitation were used to clarify the mechanism of CO. Additionally, the specific relationship between autophagy and senescence was explored by immunofluorescence triple co-localization and ELISA. RESULTS: We unravelled that senescence occurred in vivo and in vitro, which could be reversed by CO. Mechanistically, we demonstrated that CO inhibited the dysfunction of autophagy in DN mice partly through dissociating Beclin-1-Bcl-2 complex. Further results showed that autophagy inhibitors blocked the improvement of CO on senescence. In addition, the data revealed that autophagy regulated the degradation of senescence-related secretory phenotype (SASP) including Il-1ß, Il-6, Tgf-ß and Vegf. CONCLUSIONS: These results suggested that CO protects DN mice from renal senescence and function loss via improving autophagy partly mediated by dissociating Beclin-1-Bcl-2 complex, which is possibly ascribed to the degradation of SASP. These findings bring new ideas for the prevention and treatment of DN and the regulation of senescence.


Assuntos
Antimetabólitos/farmacologia , Autofagia/efeitos dos fármacos , Monóxido de Carbono/farmacologia , Senescência Celular/efeitos dos fármacos , Nefropatias Diabéticas/tratamento farmacológico , Animais , Antimetabólitos/uso terapêutico , Monóxido de Carbono/uso terapêutico , Linhagem Celular , Nefropatias Diabéticas/metabolismo , Humanos , Rim/citologia , Rim/efeitos dos fármacos , Rim/metabolismo , Masculino , Camundongos Endogâmicos C57BL
19.
Artigo em Inglês | MEDLINE | ID: mdl-33963658

RESUMO

To avoid the energy-consuming step of direct N≡N bond cleavage, photocatalytic N2 fixation undergoing the associative pathways has been developed for mild-condition operation. However, it is a fundamental yet challenging task to gain comprehensive understanding on how the associative pathways (i.e., alternating vs. distal) are influenced and altered by the fine structure of catalysts, which eventually holds the key to significantly promote the practical implementation. Herein, we introduce Fe dopants into TiO2 nanofibers to stabilize oxygen vacancies and simultaneously tune their local electronic structure. The combination of in situ characterizations with first-principles simulations reveals that the modulation of local electronic structure by Fe dopants turns the hydrogenation of N2 from associative alternating pathway to associative distal pathway. This work provides fresh hints for rationally controlling the reaction pathways toward efficient photocatalytic nitrogen fixation.

20.
Am J Cardiol ; 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34049676

RESUMO

Numerous studies have demonstrated a paradoxical association between higher baseline body mass index (BMI) and lower long-term mortality risk after coronary revascularization, known as the "obesity paradox", possibly relying on the single use of BMI. The current study is a post-hoc analysis of the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended follow-up of the SYNTAX trial comparing percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with left-main coronary artery disease (LMCAD) or three-vessel disease (3VD). Patients were stratified according to baseline BMI and/or waist circumference (WC). Out of 1,800 patients, 1,799 (99.9%) and 1,587 (88.2%) had available baseline BMI and WC data, respectively. Of those, 1,327 (73.8%) patients had High BMI (≥25 kg/m2), whereas 705 (44.4%) patients had High WC (>102 cm for men or >88 cm for women). When stratified by both BMI and WC, 10-year mortality risk was significantly higher in patients with Low BMI/Low WC (adjusted hazard ratio [HR]: 1.65; 95% confidence interval [CI]: 1.09 to 2.51), Low BMI/ High WC (adjusted HR: 2.74; 95% CI: 1.12 to 6.69), or High BMI/High WC (adjusted HR: 1.59; 95% CI: 1.11 to 2.27) compared to those with High BMI/Low WC. In conclusion, the "obesity paradox" following coronary revascularization would be driven by low long-term mortality risk of the High BMI/Low WC group. Body composition should be assessed by the combination of BMI and WC in the appropriate evaluation of the long-term risk of obesity in patients with LMCAD or 3VD.

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