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1.
Eur Spine J ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32009182

RESUMO

The authors would like to acknowledge the following funding information that was missing in.

2.
Eur Radiol ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32006167

RESUMO

OBJECTIVE: To investigate the effect of image quality of coronary CT angiography (CCTA) on the diagnostic performance of a machine learning-based CT-derived fractional flow reserve (FFRCT). METHODS: This nationwide retrospective study enrolled participants from 10 individual centers across China. FFRCT analysis was performed in 570 vessels in 437 patients. Invasive FFR and FFRCT values ≤ 0.80 were considered ischemia-specific. Four-score subjective assessment based on image quality and objective measurement of vessel enhancement was performed on a per-vessel basis. The effects of body mass index (BMI), sex, heart rate, and coronary calcium score on the diagnostic performance of FFRCT were studied. RESULTS: Among 570 vessels, 216 were considered ischemia-specific by invasive FFR and 198 by FFRCT. Sensitivity and specificity of FFRCT for detecting lesion-specific ischemia were 0.82 and 0.93, respectively. Area under the curve (AUC) of high-quality images (0.93, n = 159) was found to be superior to low-quality images (0.80, n = 92, p = 0.02). Objective image quality and heart rate were also associated with diagnostic performance of FFRCT, whereas there was no statistical difference in diagnostic performance among different BMI, sex, and calcium score groups (all p > 0.05, Bonferroni correction). CONCLUSIONS: This retrospective multicenter study supported the FFRCT as a noninvasive test in evaluating lesion-specific ischemia. Subjective image quality, vessel enhancement, and heart rate affect the diagnostic performance of FFRCT. KEY POINTS: • FFRCTcan be used to evaluate lesion-specific ischemia. • Poor image quality negatively affects the diagnostic performance of FFRCT. • CCTA with ≥ score 3, intracoronary enhancement degree of 300-400 HU, and heart rate below 70 bpm at scanning could be of great benefit to more accurate FFRCTanalysis.

3.
Nat Commun ; 11(1): 497, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31980641

RESUMO

Efficient conversion of carbon dioxide (CO2) into value-added products is essential for clean energy research. Design of stable, selective, and powerful electrocatalysts for CO2 reduction reaction (CO2RR) is highly desirable yet largely unmet. In this work, a series of metalloporphyrin-tetrathiafulvalene based covalent organic frameworks (M-TTCOFs) are designed. Tetrathiafulvalene, serving as electron donator or carrier, can construct an oriented electron transmission pathway with metalloporphyrin. Thus-obtained M-TTCOFs can serve as electrocatalysts with high FECO (91.3%, -0.7 V) and possess high cycling stability (>40 h). In addition, after exfoliation, the FECO value of Co-TTCOF nanosheets (~5 nm) is higher than 90% in a wide potential range from -0.6 to -0.9 V and the maximum FECO can reach up to almost 100% (99.7%, -0.8 V). The electrocatalytic CO2RR mechanisms are discussed and revealed by density functional theory calculations. This work paves a new way in exploring porous crystalline materials in electrocatalytic CO2RR.

4.
J Craniofac Surg ; 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31977690

RESUMO

Recently, an increasing trend of the birth prevalence of anotia/microtia is observed in China, contributed by changes of social environment and lifestyle. There seems to be no major breakthroughs in exact pathogenesis of microtia, though the research results related to molecular genetics unceasingly appear. In this review, the authors focus on the results of various research methods which the authors regard as the preferential suspicious gene pool to facilitate the exploration of the pathogenic genes of microtia, knowing that the mechanism of microtia is very complicated. The advantages and limitations of these various approaches will also be systematically delineated. The authors believe that this review will give a deep insight in the genetic research of microtia and help plastic surgeons manage congenital microtia more effectively.

5.
Phys Biol ; 17(2): 021001, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-31914432

RESUMO

The aggregation of intrinsically disordered proteins is a hallmark of neurodegenerative diseases, such as Alzheimer's, Parkinson's and Huntington's disease. Although we currently have a good molecular level understanding on how protein aggregation occurs in vitro, the details of its self-assembly in live cells are still mainly unknown. During the last ten years, we have witnessed the rapid development of advanced imaging techniques, especially super-resolution and fluorescence lifetime-based microscopy, in different areas of cell biology. These methods have been revolutionising our understanding of how proteins aggregate, providing unprecedented high spatial-temporal resolution which permits us to capture the kinetics of aggregate seeding and expansion, the motion and distribution of individual aggregates within the cells, and its structural change. In this article, we will review the study of in situ protein aggregation using advanced imaging techniques, with the focus on protein aggregate structure and its assembly dynamics.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31907538

RESUMO

OBJECTIVE: To identify major mineral and hormonal factors related to BMD in adult TM patients to provide human evidence for the proposed mechanisms. DESIGN: Retrospective study. SETTING: Referral center. PATIENTS: Twenty-nine patients with ß-TM, aged 23-44 years, who were followed-up during 2017 to 2018 were enrolled. OUTCOME MEASUREMENTS: Endocrine profiles, including thyroid, parathyroid, and pituitary function, glucose, vitamin D, calcium, phosphate, and fibroblast growth factor 23 (FGF23) were obtained. The relationships among the above parameters, body height, fractures, and BMD were analyzed. RESULTS: Abnormal BMD was observed in 42.9% of women and 23.1% of men. The mean final heights of women and men were 3.7 cm and 7.3 cm lower than the mean expected values, respectively. Fracture history was recorded in 26.7% of women and 35.7% of men. BMD was negatively correlated with parathyroid hormone, FGF23, thyrotropin, and glycated hemoglobin (HbA1c) levels, and positively correlated with testosterone, IGF-1, and corticotropin levels (all p<0.05). Moreover, hypothyroidism was associated with lower BMD in both the lumbar spine (p=0.024) and the femoral neck (p=0.004). Patients with hypothyroidism had a higher percentage of abnormal BMD (p=0.016). CONCLUSION: Hypothyroidism, higher HbA1c, and lower ACTH were predictors of abnormal BMD in patients with ß-TM. Whether the correction of these factors improves BMD warrants further research.

7.
Korean J Radiol ; 21(2): 192-202, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31997594

RESUMO

OBJECTIVE: To examine the fractional flow reserve derived from computed tomographic angiography (CT-FFR) in patients with anomalous origin of the right coronary artery from the left coronary sinus (R-ACAOS) with an interarterial course, assess the relationship of CT-FFR with the anatomical features of interarterial R-ACAOS on coronary computed tomographic angiography (CCTA), and determine its clinical relevance. MATERIALS AND METHODS: Ninety-four patients with interarterial R-ACAOS undergoing CCTA were retrospectively included. Anatomic features (proximal vessel morphology [oval or slit-like], take-off angle, take-off level [below or above the pulmonary valve], take-off type, intramural course, % proximal narrowing area, length of narrowing, minimum luminal area [MLA] at systole and diastole, and vessel compression index) on CCTA associated with CT-FFR ≤ 0.80 were analyzed. Receiver operating characteristic analysis was performed to describe the diagnostic performance of CT-FFR ≤ 0.80 in detecting interarterial R-ACAOS. RESULTS: Significant differences were found in proximal vessel morphology, take-off level, intramural course, % proximal narrowing area, and MLA at diastole (all p < 0.05) between the normal and abnormal CT-FFR groups. Take-off level, intramural course, and slit-like ostium (all p < 0.05) predicted hemodynamic abnormality (CT-FFR ≤ 0.80) with accuracies of 0.69, 0.71, and 0.81, respectively. Patients with CT-FFR ≤ 0.80 had a higher prevalence of typical angina (29.4% vs. 7.8%, p = 0.025) and atypical angina (29.4% vs. 6.5%, p = 0.016). CONCLUSION: Take-off level, intramural course, and slit-like ostium were the main predictors of abnormal CT-FFR values. Importantly, patients with abnormal CT-FFR values showed a higher prevalence of typical angina and atypical angina, indicating that CT-FFR is a potential tool to gauge the clinical relevance in patients with interarterial R-ACAOS.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31989745

RESUMO

Here, we developed a versatile strategy to covalently connect crystalline covalent organic frameworks (COFs) with semiconductors to create stable organic-inorganic Z-scheme heterojunctions for artificial photosynthesis. A series of COF-semiconductor Z-scheme photocatalysts integrating water oxidation semiconductors (TiO2, Bi2WO6 and α-Fe2O3) with CO2 reduction COFs (COF-316/318) were synthesized and exhibited high photocatalytic CO2-to-CO conversion efficiency (69.67/ 57.1/ 31.43 µmol/g/h for COF-318-TiO2/-Bi2WO6/-α-Fe2O3), with H2O as electron donor in the gas-solid CO2 reduction without additional photosensitizers and sacrificial agents. This is the first report of covalent bonded COF-inorganic semiconductor Z-scheme applied for artificial photosynthesis. Experiments and density functional theory confirmed the efficient electron transfer from semiconductors to COFs by covalent coupling, resulting in the electrons accumulated in cyano/pyridine of COF for CO2 reduction and positive holes leave in semiconductor for H2O oxidation, thus mimicking the natural photosynthesis. This work developed a new method to create covalent bond linked organic-inorganic Z-scheme heterojunction and demonstrated a breakthrough on the field of artificial photosynthesis.

9.
Soft Matter ; 16(1): 270-275, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31782471

RESUMO

The robust cell-in-shell structure is highly desirable for endowing living cells with an artificial exoskeleton to defend them from many environmental factors such as osmotic pressure, shear force, heat, UV radiation, and enzymes. Cell encapsulation has shown potential applications in many fields and attracted increasing interest. However, the influences of the precursors on the cell viability during the shell formation process are not clear and seldom investigated. Here, zinc nitrite, zinc acetate and zinc sulfate were applied individually to synthesize zeolitic imidazolate framework-8 (ZIF-8) shells on living cells. All the zinc salt precursors could convert to a ZIF-8 layer on the living cell surface. The zinc salts and organic ligand did not exhibit obvious toxicity to yeast cells when applied individually. However, dead cells were observed during the living cell encapsulation process using different zinc precursors. Compared with zinc nitrate and zinc acetate, ZIF-8 formed by zinc sulfate led to a higher percentage of cell death, especially under high concentrations of zinc sulfate. Cell division was suppressed by the ZIF-8 shell but restored fully upon shell removal by EDTA solution or pH 4.0 buffer. Escherichia coli (E. coli) cells showed a lower percentage of cell death, indicating excellent tolerance to the ZIF-8 encapsulation process. This work illustrates the cell toxicity during the formation of ZIF-8 cell shells by different zinc salts and engineering of the cell growth by MOF coating, which could provide a foundation for further quantitative analysis and potential applications in biomedicine and bioengineering.

10.
Abdom Radiol (NY) ; 45(2): 393-402, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31797027

RESUMO

PURPOSE: To identify the predictors for recovery of pyogenic liver abscess (PLA) patients treated with percutaneous catheter drainage (PCD) and antibiotics, and then develop an effective nomogram to predict the recovery time. MATERIALS AND METHODS: The retrospective study included consecutive PLA patients treated with PCD and antibiotics. We defined the overall recovery time (ORT) as the time from the PCD procedure to the time of clinical success or failure. Based on the ORT, its predictors were identified with univariate and multivariate analyses. Then, a nomogram was developed to predict the ORT, and was internally validated by using Harrell's c statistic. RESULTS: A total of 116 patients and 142 PCD procedures with a median ORT of 15.0±10.6 days were included. Gas-formation (GF; HR: 0.486 [95% CI 0.312-0.757]; P = 0.001), diabetes mellitus (DM; HR: 0.455 [95% CI 0.303-0.682]; P<0.001), and preinterventional septic shock (PSS; HR: 0.276 [95% CI 0.158-0.483]; P < 0.001) were identified as predictors for the ORT of combination therapy after univariate and multivariate analyses, which indicated a significantly longer ORT than those patients without. The prognostic analyses demonstrated that the more predictors (GF, DM, and PSS) a patient exhibited, the longer ORT for the combination therapy. A nomogram was developed to predict the ORT and revealed high accuracy, with Harrell's c statistic of 0.73. CONCLUSION: GF, DM, and PSS were predictors for the recovery of PLA patients treated with PCD and antibiotics. The nomogram was effective in predicting the ORT of combination therapy.

11.
Cancer Sci ; 111(1): 229-238, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729120

RESUMO

TP53 alterations are frequent relapse-acquired mutations in childhood acute lymphoblastic leukemia (ALL). The present study evaluated the clinical significance of relapsed childhood ALL in Taiwan. Diagnostic and/or relapsed bone marrow or peripheral blood was obtained from 111 children with relapsed ALL who were initially treated by using Taiwan Pediatric Oncology Group (TPOG) ALL protocols from January 1997 to May 2018. Mutations were detected by PCR and sequencing, as well as by multiplex ligation-dependent probe amplification to detect copy number alterations. Copy number and/or sequence alterations of TP53 were detected in 29% (28 of 98) and in 46% (6 of 13) of patients with relapsed B-cell and T-cell ALL, respectively. This incidence was much higher than that in several similar studies conducted in Caucasian populations. Seventy percent of all TP53 alterations were gained at relapse in 67 matched samples by back-tracking matched diagnostic samples. TP53 alterations were associated with lower 5-year event-free survival (EFS) and overall survival (OS) rates (P = .013 and P = .0002, respectively). Multivariate analysis confirmed the prognostic significance of TP53 alterations. Forty-five patients received hematopoietic stem-cell transplantations post-relapse. Patients with TP53 alterations (14/45) had inferior 5-year EFS and OS than patients without TP53 alterations after transplantation (P = .002 and P = .001, respectively). The significance of these TP53 alterations for patients who received transplantations was confirmed by multivariate analysis. In conclusion, TP53 alterations were enriched and useful as prognostic markers in relapsed childhood ALL.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Proteína Supressora de Tumor p53/genética , Criança , Pré-Escolar , Variações do Número de Cópias de DNA/genética , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Mutação/genética , Prognóstico , Recidiva , Taxa de Sobrevida , Taiwan
12.
New Phytol ; 225(4): 1516-1530, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31120133

RESUMO

Brassinosteroids have been implicated in the differentiation of vascular cell types in herbaceous plants, but their roles during secondary growth and wood formation are not well defined. Here we pharmacologically and genetically manipulated brassinosteroid levels in poplar trees and assayed the effects on secondary growth and wood formation, and on gene expression within stems. Elevated brassinosteroid levels resulted in increases in secondary growth and tension wood formation, while inhibition of brassinosteroid synthesis resulted in decreased growth and secondary vascular differentiation. Analysis of gene expression showed that brassinosteroid action is positively associated with genes involved in cell differentiation and cell-wall biosynthesis. The results presented here show that brassinosteroids play a foundational role in the regulation of secondary growth and wood formation, in part through the regulation of cell differentiation and secondary cell wall biosynthesis.

13.
New Phytol ; 225(4): 1531-1544, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31257603

RESUMO

Wood formation is the terminal differentiation of xylem mother cells derived from cambial initials, and negative regulators play important roles in xylem differentiation. The molecular mechanism of the negative regulator of xylem differentiation PagKNAT2/6b was investigated. PagKNAT2/6b is an ortholog of Arabidopsis KNAT2 and KNAT6 that is highly expressed in phloem and xylem. Compared to nontransgenic control plants, transgenic poplar plants overexpressing PagKNAT2/6b present with altered vascular patterns, characterized by decreased secondary xylem with thin cell walls containing less cellulose, xylose and lignin. RNA sequencing analyses revealed that differentially expressed genes are enriched in xylem differentiation and secondary wall synthesis functions. Expression of NAM/ATAF/CUC (NAC) domain genes including PagSND1-A1, PagSND1-A2, PagSND1-B2 and PagVND6-C1 is downregulated by PagKNAT2/6b, while PagXND1a is directly upregulated. Accordingly, the dominant repression form of PagKNAT2/6b leads to increased xylem width per stem diameter through downregulation of PagXND1a. PagKNAT2/6b can inhibit cell differentiation and secondary wall deposition during wood formation in poplar by modulating the expression of NAC domain transcription factors. Direct activation of PagXND1a by PagKNAT2/6b is a key node in the negative regulatory network of xylem differentiation by KNOXs.

14.
Transbound Emerg Dis ; 67(1): 121-132, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31408582

RESUMO

Since its first emergence in 1998 in Malaysia, Nipah virus (NiV) has become a great threat to domestic animals and humans. Sporadic outbreaks associated with human-to-human transmission caused hundreds of human fatalities. Here, we collected all available NiV sequences and combined phylogenetics, molecular selection, structural biology and receptor analysis to study the emergence and adaptive evolution of NiV. NiV can be divided into two main lineages including the Bangladesh and Malaysia lineages. We formly confirmed a significant association with geography which is probably the result of long-term evolution of NiV in local bat population. The two NiV lineages differ in many amino acids; one change in the fusion protein might be involved in its activation via binding to the G protein. We also identified adaptive and positively selected sites in many viral proteins. In the receptor-binding G protein, we found that sites 384, 386 and especially 498 of G protein might modulate receptor-binding affinity and thus contribute to the host jump from bats to humans via the adaption to bind the human ephrin-B2 receptor. We also found that site 1645 in the connector domain of L was positive selected and involved in adaptive evolution; this site might add methyl groups to the cap structure present at the 5'-end of the RNA and thus modulate its activity. This study provides insight to assist the design of early detection methods for NiV to assess its epidemic potential in humans.

15.
IUBMB Life ; 72(2): 198-213, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31444954

RESUMO

Atherosclerotic plaque rupture is an important pathophysiologic mechanism of acute coronary syndrome. Emerging microRNAs (miRNAs) have been implicated in the atherosclerotic plaque formation and macrophage autophagy during the development of atherosclerosis (AS). Hence, this study was conducted to explore the role microRNA-135b (miR-135b) in macrophages and atherosclerotic plaque in mouse models of AS. The expression of miR-135b and erythropoietin receptor (EPOR) was altered in atherosclerotic mice to clarify their effect on inflammation, cell activities of aortic tissues, and macrophage autophagy. The obtained findings unraveled that miR-135b was upregulated and EPOR was downregulated in atherosclerotic mice. Upregulated miR-135b expression promoted cell apoptosis and inflammation, along with inhibited cell proliferation and decreased macrophage autophagy. Notably, miR-135 was validated to target EPOR and activate the PI3K/Akt signaling pathway. Moreover, miR-135b inhibition attenuated inflammation, atherosclerotic plaque development, and promoted macrophage autophagy. Besides, the effect of miR-135b inhibition was reversed in response to EPOR silencing. Taken conjointly, the study revealed that inhibition of miR-135b promoted macrophage autophagy and atherosclerotic plaque stabilization in atherosclerotic mice by inactivating the PI3K/Akt signaling pathway and upregulating EPOR.

16.
Artigo em Inglês | MEDLINE | ID: mdl-31797510

RESUMO

A series of stable heterometallic Fe2 M cluster-based MOFs (NNU-31-M, M=Co, Ni, Zn) photocatalysts are presented. They can achieve the overall conversion of CO2 and H2 O into HCOOH and O2 without the assistance of additional sacrificial agent and photosensitizer. The heterometallic cluster units and photosensitive ligands excited by visible light generate separated electrons and holes. Then, low-valent metal M accepts electrons to reduce CO2 , and high-valent Fe uses holes to oxidize H2 O. This is the first MOF photocatalyst system to finish artificial photosynthetic full reaction. It is noted that NNU-31-Zn exhibits the highest HCOOH yield of 26.3 µmol g-1 h-1 (selectivity of ca. 100 %). Furthermore, the DFT calculations based on crystal structures demonstrate the photocatalytic reaction mechanism. This work proposes a new strategy for how to design crystalline photocatalyst to realize artificial photosynthetic overall reaction.

17.
Polymers (Basel) ; 11(12)2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31835683

RESUMO

A new methodology for enhancing the solvent resistance of electrospun polyimide (PI) ultrafine fibrous mat (UFM) was investigated in the current work. For this purpose, a negative intrinsically photosensitive polyimide (PSPI) resin was prepared by the one-step high- temperature polycondensation procedure from 3,3',4,4'-benzophenonetetracarboxylic dianhydride (BTDA) and α,α-bis(4-amino-3,5-dimethylphenyl)phenylmethane (PTMDA). The PI varnish, by dissolving the derived PI (BTDA-PTMDA) resin in N,N-dimethylacetamide (DMAc) at a solid of 20 wt %, was used as the starting material for the standard electrospinning (ES) and ultraviolet-assisted ES (UVAES) fabrications, respectively. The 365 nm wavelength of the high-pressure mercury lamp ultraviolet (UV) irradiation induced the photocrosslinking reaction in the PSPI mat. Solubility tests indicated that the PI UFM fabricated by standard ES procedure showed poor DMAc resistance, while the one by UVAES (PI-UV) exhibited excellent resistance to DMAc.

18.
Zhen Ci Yan Jiu ; 44(11): 822-5, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31777232

RESUMO

OBJECTIVE: To observe the effect of electroacupunctur (EA) and moxibustion of left or right "Tian-shu" (ST25) on intragastric pressure (IGP) in normal rats. METHODS: Twenty male SD rats were equally and randomly divided into EA group and moxibustion group. EA (2 Hz/15 Hz, 2 mA) or moxibustion (46-48 ℃) was applied to unilate-ral ST25 for 2 min. The IGP was detected by using a pressure-transducer and an amplifier before and after EA or moxibustion. RESULTS: Compared with pre-intervention, the IGP was significantly decreased after EA or moxibustion stimulation of both left and right ST25 (P<0.05). The IGP levels during 0-30 s and 30-60 s of EA stimulation of both left and right ST25 were significantly lower than those of moxibustion (P<0.05). The IGP-lowering effect of EA on the left ST25 was evidently stronger than that of the right ST25 (P<0.05), but without significant difference between the bilateral sides in moxibustion-induced IGP reduction (P>0.05). CONCLUSION: Both EA and moxibustion of ST25 can lower IGP, and the effect of EA is significantly stronger than that of moxibustion in normal rats. In addition, the IGP-lowering effect of EA of the left ST25 is markedly stronger than that of the right ST25, suggesting a lateral advantage effect.


Assuntos
Eletroacupuntura , Moxibustão , Pontos de Acupuntura , Animais , Masculino , Ratos , Ratos Sprague-Dawley
19.
Can J Cardiol ; 35(11): 1523-1533, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31679622

RESUMO

BACKGROUND: The diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve (CT-FFR) in detecting ischemia in myocardial bridging (MB) has not been investigated to date. METHODS: This retrospective multicentre study included 104 patients with left anterior descending MBs. MB was classified as either superficial or deep, short, or long, whereas all MB vessels were further divided into <50%, 50% to 69%, and ≥70% groups, according to proximal lumen stenosis on invasive coronary angiography. Diagnostic performance and receiver operating characteristics (ROC) of CT-FFR to detect lesion-specific ischemia was assessed on a per-vessel level, using invasive FFR as reference standard. Intraclass correlation coefficient (ICC) and Bland-Altman plots were used for agreement measurement. RESULTS: Forty-eight MB vessels (46.2%) showed ischemia by invasive FFR (≤0.80). Sensitivity, specificity, and accuracy of CT-FFR to detect functional ischemia were 0.96 (0.85 to 0.99), 0.84 (0.71 to 0.92), and 0.89 (0.81 to 0.94), respectively, in all MB vessels. There were no differences in diagnostic performance between superficial and deep MB or between short and long MB (all P > 0.05). The accuracy of CT-FFR was 0.96 (0.85 to 0.99) in ≥70% stenosis, 0.82 (0.67 to 0.91) in 50% to 69% stenosis, and 0.89 (0.51 to 0.99) in <50% stenosis (P = 0.081). Bland-Altman analysis showed a slight mean difference between CT-FFR and invasive FFR of 0.014 (95% limit of agreement, -0.117 to 0.145). The ICC was 0.775 (95% confidence interval, 0.685-0.842, P < 0.001). CONCLUSIONS: CT-FFR demonstrated high diagnostic performance for identifying functional ischemia in vessels with MB and concomitant proximal atherosclerotic disease when compared with invasive FFR. However, the clinical use of CT-FFR in patients with MB needs further study for stronger and more robust results.

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