An important issue of burnout among pre-hospital emergency medical personnel in Chengdu: a cross-sectional study.

OBJECTIVE: This survey aims to comprehensively understand occupational burnout among pre-hospital emergency medical personnel and explore associated risk factors. METHODS: A cross-sectional online survey using a census method was conducted between 15 July, 2023, and ends on 14 August, 2023, in Chengdu, SiChuan province, China. The questionnaire included general demographic information, the Maslach Burnout Inventory-General Survey (MBI-GS) with 15 items, and the Fatigue Scale-14 (FS-14) with 14 items. Univariate analysis was conducted on all variables, followed by multivariate logistic regression models to examine the associations between occupational burnout and the risk factors. RESULTS: A total of 2,299 participants,99.57% completed the survey effectively The participants were from 166 medical institutions in Chengdu, comprising 1,420 nurses (61.50%) and 889 clinical doctors (38.50%). A total of 33.36% participants experienced burnout, predominantly mild (30.27%), followed by moderate (2.78%) and severe (0.3%). Physicians, higher fatigue scores, age, work experience appeared to be related to burnout. Logistic regression models revealed that individuals aged over 50 were less prone to experience burnout compared to medical staff aged 18-30 (OR: 0.269, 95% CI: 0.115-0.627, p = 0.002). Physicians were more prone to experience burnout compared to nursing staff (OR: 0.690, 95% CI: 0.531-0.898, p = 0.006). Those with 0-5 years of experience were more prone to experience burnout compared to those with 6-10 years or over 15 years of experience (OR: 0.734, 95% CI: 0.547-0.986, p = 0.040; OR: 0.559, 95% CI: 0.339-0.924, p = 0.023). Additionally, for each 1-point increase in the fatigue score, the likelihood of burnout in medical staff increased by 1.367 times (OR: 1.367, 95% CI: 1.323-1.412, p < 0.0001). CONCLUSION: Pre-hospital emergency medical personnel demonstrate a notable prevalence of mild job burnout. These results provide a groundwork for future focus on the various stages of job burnout within pre-hospital emergency staff, alerting hospital and departmental managers to promptly address the mental well-being of their personnel and intervene as needed.

Association Between Serum Uric Acid Levels and Neoatherosclerosis.

Neoatherosclerosis is a major cause of stent failure after percutaneous coronary intervention. Metabolism such as hyperuricemia is associated with in-stent restenosis (ISR). However, the association between serum uric acid (sUA) levels and in-stent neoatherosclerosis (ISNA) has never been validated.A total of 216 patients with 220 ISR lesions who had undergone optical coherence tomography (OCT) of culprit stents were included in this study. According to their sUA levels, eligible patients were divided into two groups [normal-sUA group: sUA < 7 mg/dL, n = 126, and high-sUA group: sUA ≥ 7 mg/dL, n = 90]. OCT findings were analyzed and compared between the normal- and high-sUA groups.The incidence of ISNA (63.0% versus 43.0%, P = 0.004) was significantly higher in the high-sUA group than in the normal-sUA group. Lipid plaques (66.3% versus 43.0%, P < 0.001) and thin-cap fibroatheroma (38.0% versus 18.0%, P = 0.001) were observed more frequently in the restenotic tissue structure in patients in the high-sUA group than in those in the normal-sUA group. Meanwhile, univariate (OR: 1.208, 95% CI: 1.037-1.407; P = 0.015) and multivariate (OR: 1.254, 95% CI: 1.048-1.501; P = 0.013) logistic regression analyses indicated that sUA levels were an independent risk factor for ISNA after adjusting for relevant risk factors.The high-sUA levels were an independent risk factor for the occurrence of neoatherosclerosis in patients with ISR via OCT.

Comparison of Neoatherosclerosis and Neovascularization of Restenosis after Drug-Eluting Stent Implantation: An Optical Coherence Tomography Study.

Background: Neoatherosclerosis (NA) is associated with stent failure. However, systematic studies on the manifestations of NA and neovascularization (NV) at different stages after drug-eluting stent (DES) implantation are lacking. Moreover, the relationship between NA and NV in in-stent restenosis (ISR) has not been reported. This study aimed to characterize NA and NV in patients with ISR at different post-DES stages and compare the association between NA and NV in ISR lesions. Methods: A total of 227 patients with 227 lesions who underwent follow-up optical coherence tomography before percutaneous coronary intervention for DES ISR were enrolled and divided into early (E-ISR: < 1 year), late (L-ISR: 1-5 years), and very-late (VL-ISR: > 5 years) ISR groups. Furthermore, ISR lesions were divided into NV and non-NV groups according to the presence of NV. Results: The prevalence of NA and NV was 52.9% and 41.0%, respectively. The prevalence of lipidic NA (E-ISR, 32.7%; L-ISR, 50.0%; VL-ISR, 58.5%) and intimal NV (E-ISR, 14.5%; L-ISR, 30.8%; VL-ISR, 38.3%) increased with time after stenting. NA was higher in ISR patients with NV lesions than in those without (p < 0.001). Patients with both ISR and NV had a higher incidence of macrophage infiltration, thin-cap fibroatheroma, intimal rupture, and thrombosis (p < 0.01). Conclusions: Progression of lipidic NA was associated with L-ISR and VL-ISR but may not be related to calcified NA. NA was more common in ISR lesions with NV; its formation may substantially promote NA progression and plaque instability.

[Expression of SDF-1/CXCR4 in acute infarct myocardium after implantation of bone marrow mesenchymal stem cells in rats].

OBJECTIVE: To explore the role of stromal cell derived factor-1 (SDF-1)/CXCR4 axis in acute infarct myocardium after an implantation of bone marrow mesenchymal stem cells (MSCs) in rats. METHODS: The animals were anesthetized by an intraperitoneal injection of pentobarbital sodium. Left anterior thoracotomy through 3/4 intercostals region was performed and then left anterior descending coronary arteries were ligated for modeling acute myocardial infarction. The MSCs were injected into the area of acute infarct myocardium after a 10-minute ligation of left anterior descending coronary artery. The different concentration and expression of SDF-1/CXCR4 in the area of acute myocardial infarction and left ventricular function were analyzed. RESULTS: At day 28 post-transplantation, the vascular density in MSCs implant group were significantly higher than that in control group (P<0.05). And left ventricular function in MSCs implant group improved significantly than that in control group too (P<0.05). At the same time, the expressions of SDF-1 and CXCR4 in topical injection sites of infarct myocardium were significantly higher than those in control group (P<0.05). In MSCs implant group, the level of SDF-1/CXCR4 peaked at Day 1 post-transplantation and then it declined. CONCLUSIONS: After the implantation of MSCs into acute infarct myocardium, there is vascular regeneration and the level of SDF-1/CXCR4 increases so that left ventricular function improves. And the mechanism may be due to an up-regulation of SDF-1/CXCR4 axis.

[Research Progress on Forensic Entomotoxicology].

Forensic entomotoxicology is a branch of forensic medicine, which applies entomology, toxicology and other related studies to solve the poisoning cases. It has an obvious advantage in the investigation on poisoning death. Based on the expounding definition and research of entomotoxicology, this paper reviews research progress and application value in some aspects of forensic medicine, such as the effects of drugs/toxins on the growth and development of sarcosaphagous insects and the qualitative and quantitative analysis of the drugs/toxins in the poisoned body tissue.

Association between periprocedural myocardial injury and neointimal characteristics in patients with in-stent restenosis: an optical coherence tomography study.

Background: The relationship between neointimal characteristics of in-stent restenosis (ISR) and periprocedural myocardial injury (PMI) remains unclear. Therefore, this study aimed to investigate the relationship between PMI and neointimal characteristics of ISR by using optical coherence tomography (OCT). Methods: This was a retrospective study. We enrolled 140 patients diagnosed with ISR with normal baseline high-sensitivity troponin T (hs-cTnT) levels who underwent OCT and subsequent revascularization by means of drug-coated balloon (DCB) or drug-eluting stent (DES) between October 2018 and October 2022 in the Affiliated Hospital of Zunyi Medical University. Based on the 4th universal definition of myocardial infarction, patients whose hs-cTnT were increased five times above the upper reference limit (URL) after percutaneous coronary interventions (PCI) were deemed to PMI. The patients were subdivided into PMI (n=53) and non-PMI (n=87) groups. In the univariable analysis, variables in the baselines, angiography characteristics and OCT findings were analyzed with binary logistic regression. A P value of <0.2 was included in the multivariable model. Multivariable logistic regression analysis was used to identify the independent predictors of PMI. Results: The prevalence of intra-intimal microvessels in patients with PMI was higher than in those without PMI (58.5% vs. 32.2%, P=0.003). The ratio of intra-stent plaque rupture (PR) was also higher in patients with PMI (60.4% vs. 40.2%, P=0.021). Multivariable logistic regression analysis showed that intra-intimal microvessels [odds ratio (OR): 3.193, 95% confidence interval (CI): 1.280-7.966; P=0.013] and intra-stent PR (OR: 2.124, 95% CI: 1.153-4.732; P=0.035) were independently associated with PMI. Conclusions: Intra-intimal microvessels and intra-stent PR were independently associated with PMI. Accurate identification and recognition of intra-intimal microvessels and intra-stent PR may be helpful in preventing PMI.

Morphological characteristics of in-stent restenosis with different degrees of area stenosis: an optical coherence tomography study.

The morphological characteristics of in-stent restenosis (ISR) in relation to varying degrees of area stenosis have not been comprehensively examined. This study aimed to explore the tissue characteristics of patients experiencing ISR with different degrees of area stenosis through the utilization of optical coherence tomography (OCT). In total, 230 patients with ISR who underwent OCT were divided into the following three groups: area stenosis (AS) < 70% (n = 26); 70-80% (n = 119) and AS ≥ 80% (n = 85). Among the 230 patients, the clinical presentation as stable angina was 61.5% in AS < 70%, followed by 47.2% in 70% < AS ≤ 80%, and 31.8% in AS ≥ 80% (P = 0.010). The OCT findings showed that heterogeneous neointima, ISNA, LRP, neointima rupture, TCFA-like pattern, macrophage infiltration, red and white thrombus was more common with AS increased. Ordinal logistic regression analysis showed that higher AS was associated with previous dyslipidemia (odds ratio [OR], 4.754; 95% confidence interval [CI], 1.419-15.927, P = 0.011), neointimal rupture (OR: 3.640; 95% CI, 1.169-11.325, P = 0.026), red thrombus (OR: 4.482; 95% CI, 1.269-15.816, P = 0.020) and white thrombus (OR: 5.259; 95% CI, 1.660-16.659, P = 0.005). Patients with higher degrees of area stenosis in the context of ISR exhibited a greater number of discernible morphological characteristics as identified through OCT analysis. Furthermore, previous dyslipidemia, neointimal rupture, white thrombus and red thrombus were highly associated with and the progression of ISR lesions.

[Effects of CGRP and CGRP receptor modified mesenchymal stem cells on proliferation and phenotypic transformation of vascular smooth muscle cells].

OBJECTIVE: To explore the effects and mechanism of secretory calcitonin gene-related peptide (CGRP) and CGRP receptor modified mesenchymal stem cells on proliferation and phenotypic transformation of vascular smooth muscle cell. METHODS: Firstly (Lenti-GFP-CGRP, referred to CGRP (+/+)) MSCs were transfected with high expression lentivirus vector of CGRP (MSCs(CGRP+/+)). Protein secretion in the above-mentioned MSCs(CGRP+/+) supernatant was detected with enzyme-linked immunosorbent assay (ELISA). And then MSCs(CGRP+/+) was co-cultured with VSMCs(RAMP1)(+/+) and VSMCs(RAMP1-/-) respectively. Experimental groups were as follows: MSCs +VSMCs MSCs(CGRP+/+) +VSMCs, MSCs(CGRP+/+) +VSMCs(RAMP1)(+/+) and MSCs(CGRP+/+) + VSMCs (RAMP1-/-). Flow cytometry was applied to detect the cycle variation of smooth muscle cells, thiazolyl blue tetrazolium bromide method for detecting the proliferation of smooth muscle cells and Western blot for examining the expression changes of spectrin α-SM-actin and synthetic protein OPN in each group respectively. RESULTS: After the transfection of CGRP(+/+), MSCs(CGRP+/+) secreted and expressed CGRP protein, the secretory volume of CGRP protein in MSCs(CGRP+/+) increased significantly compared with the control group (19.530 ± 0.498 vs 3.133 ± 0.160 and 3.120 ± 0.001, P < 0.05) . After a 72 h co-culturing with VSMCs, the proliferation of VSMCs in MSCs(CGRP+/+) +VSMCs(RAMP1)(+/+)group declined significantly (0.270 ± 0.263 vs 0.413 ± 0.070, P < 0.05) and the number of cells staying in G0 phase significantly increased (93.51% ± 0.38% vs 84.48% ± 0.31%, P < 0.05) , the expression of contractile phenotype protein α-SM-actin increased and intermediate phenotype OPN declined significantly as compared with MSCsCGRP(+/+) +VSMCs group { (α-SM-actin 102 946 ± 3847 vs 51 759 ± 635, P < 0.05), OPN (26 026 ± 2595 vs 44 201 ± 2811, P < 0.05) }; but compared with MSCs(CGRP+/+)+VSMCs(RAMP1)(+/+)group, the proliferation of VSMCs in MSCs(CGRP+/+) +VSMCs(RAMP1)-/-group significantly increased (0.601 ± 0.04 vs 0.270 ± 0.263, P < 0.05) while the number of cells staying in G0 phase significantly declined (78.57% ± 0.68% vs 93.51% ± 0.38%, P < 0.05) . The expression of contractile phenotype protein α-SM-actin declined while intermediate phenotype OPN increased significantly in MSCs(CGRP+/+)+VSMCs(RAMP1)-/-group {α-SM-actin (34 400 ± 2179 vs 102 946 ± 3847, P < 0.05), OPN (53 933 ± 1192 vs 26 026 ± 2595, P < 0.05)}. CONCLUSIONS: CGRP gene-modified MSCs may secrete target protein stably. And CGRP-modified MSCs inhibits VSMCs phenotypic transformation and cell proliferation. It is probably associated with enhanced CGRP effect due to an up-regulation of CGRP receptor.

An Overview of Systematic Reviews and Meta-Analyses of Clinical Studies of Acupuncture for Cancer Pain.

BACKGROUND: Systematic reviews (SRs) and meta-analyses (MAs) for the use of acupuncture for cancer pain have been increasing, but the evidence has not been systematically and comprehensively assessed. We aimed to perform an overview of the evidence quality of SRs/MAs of acupuncture for improving cancer pain. METHODS: 8 databases were systematically searched to identify SRs/MAs of acupuncture for improving cancer pain. The A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grades of Recommendations, Assessment, Development, and Evaluation (GRADE), respectively, were applied by 2 independent reviewers to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality. RESULTS: A total of 14 SRs/MAs were included in the present study. By AMSTAR-2, two reviews were rated as having high methodological quality, while 12 were given a critically low rating. All SRs/MAs in Phase 1, Domain 1, and Domain 4, according to ROBIS, were at low risk. Furthermore, 4 reviews in Domain 2, twelve reviews in Domain 3, and ten SRs/MAs in Phase 3, were rated as having low risk of bias. With reporting quality, some reporting flaws were identified in the topic of protocol and registration, additional analyses, and search strategy. According to GRADE, the level of evidence quality was "critically low" to "moderate," and risk of bias was the most common downgraded factor. CONCLUSION: Acupuncture may be beneficial in improving cancer pain. However, due to the identified limitations and inconsistent findings, we recommend further rigorous, and more standardized SRs/MAs to provide strong evidence for definitive conclusions.

Coal-gangue recognition via multi-branch convolutional neural network based on MFCC in noisy environment.

Traditional coal-gangue recognition methods usually do not consider the impact of equipment noise, which severely limits its adaptability and recognition accuracy. This paper mainly studies the more accurate recognition of coal-gangue in the noise site environment with the operation of shearer, conveyor, transfer machine and other device in the process of top coal caving. Mel Frequency Cepstrum Coefficients (MFCC) smoothing method was introduced to express the intrinsic feature of sound pressure more clearly in the coal-gangue recognition site. Then, a multi-branch convolution neural network (MBCNN) model with three branches was developed, and the smoothed MFCC feature was incorporated into this model to realize the recognition of falling coal and gangue in noisy environment. The sound pressure signal datasets under the operation of different device were constructed through a great deal of laboratory and site data acquisition. Comparative experiments were carried out on noiseless dataset, single noise dataset and simulated site dataset, and the results show that our method can provide higher correct recognition accuracy and better robustness. The proposed coal-gangue recognition approach based on MBCNN and MFCC smoothing can not only recognize the state of falling coal or gangue, but also recognize the operational state of site device.

Association of LDL-C level with neoatherosclerosis and plaque vulnerability in patients with late restenosis: an optical coherence tomography study.

Neoatherosclerosis (NA) is a significant contributor to late stent failure; however, predictors of late in-stent restenosis (ISR) with NA have not been systematically reported. This study aimed to identify predictors of NA incidence and plaque vulnerability in patients with late ISR and the role of low-density lipoprotein cholesterol (LDL-C) levels in this process. A total of 216 patients with 216 lesions who underwent optical coherence tomography (OCT) before interventional procedure for late drug-eluting stent ISR were enrolled and divided into NA and non-NA groups based on OCT findings. Results showed that higher LDL-C levels were associated with NA, thin-cap fibroatheroma (TCFA), intimal disruption, plaque erosion, and thrombosis. Multivariate regression analysis revealed that the LDL-C level was an independent risk factor for NA and TCFA. The LDL-C levels exhibited a significant predictive value for NA and TCFA, surpassing other factors such as stent age and other lipid types. In conclusion, a high LDL-C level is an independent predictor of NA incidence and plaque vulnerability in patients with late ISR.

[Effects of di'ao xinxuekang soft capsule on lipid peroxidation and the endothelial function in patients with coronary heart disease].

OBJECTIVE: To observe the effects of Di' ao Xinxuekang Soft Capsule (DK) on the plasma levels of superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), and endothelin (ET) in patients with coronary heart disease (CHD), and to study its underlying mechanisms. METHODS: Totally 100 patients with CHD confirmed by coronary angiography were randomly assigned to two groups, the control group (60 cases) and the DK treatment group (40 cases). Patients in the control group received conventional therapy, while those in the DK treatment group received DK additionally. The therapeutic course for all was 3 months. The plasma levels of SOD, MDA, ET, and NO were determined pre-treatment, 4, 8, and 12 weeks after treatment. RESULTS: Compared with before treatment, the serum levels of SOD and NO increased and the levels of MDA and ET decreased at each time point. Besides, better effects were obtained in the DK treatment group (P < 0.05). CONCLUSION: DK possibly played a role in inhibiting lipid peroxidation and improving the endothelial dysfunction.

[Effect of gene modified mesenchymal stem cells overexpression human receptor activity modified protein 1 on inflammation and cardiac repair in a rabbit model of myocardial infarction].

OBJECTIVE: To investigate the effect of mesenchymal stem cells (MSCs) overexpressing human receptor activity modified protein 1 (hRAMP1) by adenovirus vector on infarction related inflammation and cardiac repair in a rabbit model of myocardial infarction (MI). METHODS: Thirty rabbits underwent coronary artery ligation for 60 minutes followed by 24 hours reperfusion and divided into MSC(hRAMP1) group (intravenously injection of MSCs transfected with adenovirus vector encoding hRAMP1 gene enhanced green fluorescent protein, EGFP, n = 10), MSC(null) group (MSCs transfected with adenovirus vector encoding only EGFP without hRAMP1 gene, n = 10) and control group (equally volume of phosphate buffered saline, PBS, n = 10). The plasma level of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) were quantified by ELISA assay at before and 1, 3, 7, 28 days after induction of MI. The expression of nuclear factor-κB (NF-κB) and hRAMP1 in infracted myocardium were measured by Western blot at 1, 3, 7, 28 day following MI. The area of MI and collagen deposition and fibrosis were evaluated by TTC staining and Masson staining, respectively. RESULTS: Area of MI and collagen content were significantly reduced in MSC(hRAMP1) group compared those in MSC(null) and control group [(10.1 ± 2.9)% vs. (30.6 ± 2.7)% and (22.5 ± 3.2)%, P < 0.05]. Myocardial expression of NF-κB and plasma TNF-α[7 days after transplantation: (97.2 ± 6.7) pg/ml vs. (207.6 ± 12.7) pg/ml and (153.2 ± 9.9) pg/ml, P < 0.05] were also lower while plasma level of IL-10 [7 days after transplantation: (238.5 ± 17.5) pg/ml vs. (177.3 ± 19.8) pg/ml and (244.6 ± 27.3) pg/ml, P < 0.05] was significantly higher in MSC(hRAMP1) group than in MSC(null) and control group. CONCLUSION: MSCs overexpression hRAMP1 could further reduce area of MI possibly through inhibiting the myocardial expression of NF-κB and reducing the plasma TNF-α level and raising plasma IL-10 level.

COVID-19 crisis impact on the stability between parties in crowdfunding and crowdsourcing.

This research reviews challenges in building sustainable relationships between the parties involved in the crowdfunding and crowdsourcing projects, which are running in extreme situations, such as the COVID-19 pandemic. This study aims to solve problems that generate the crowdsourcing concerns and to find better alternatives to increase trust for crowdfunding among donors, as this impacts their strategic sustainability in the conditions of turbulence and COVID-induced financial crisis. It was found that factors influence donor decisions in different ways, yet the common tendency for donor activity is non-monotonicity. Future development in the field of sustainable relationships should focus on creating a donor classification system.

[Effect of mesenchymal stem cells on cardiac function and restenosis of injured artery after myocardial infarction].

OBJECTIVE: Although earlier studies have shown that the transplantation of mesenchymal stem cells (MSCs) might improve cardiac functions after myocardial infraction, its role on vascular restenosis after percutaneous coronary intervention (PCI) remains controversial. The aim of this study was to investigate the effects of MSCs on the restenosis of injured artery following balloon angioplasty in a rabbit model with both myocardial infarction reperfusion and atherosclerotic stenosis carotid artery by balloon injury. METHODS: After the animal model was established for myocardial infraction reperfusion and atherosclerotic stenosis carotid artery by balloon injury, the rabbits received an intravenous transplantation of MSCs. And an equal volume of phosphate buffered solution was administered for the control group. The animal vascular tissue and myocardium tissue were excised at different time points post-transplantation and used to detect the homing of MSCs and the expressions of platelet-endothelial cell adhesion molecule-1 (CD31) and proliferating cell nuclear antigen (PCNA) by immunohistochemical staining. Four weeks later, vascular restenosis was analyzed by angiography of bilateral carotid arteries and the vascular tissues were used for histological studies. RESULTS: At one week post-transplantation, the 4',6-diamidino-2-phenylindole (DAPI)-labeled MSCs could be detected in myocardial infarction and injured intima. And the intimal expression of CD31 was observed at 2 weeks in the MSCs transplantation group. Yet the expression of PCNA was significantly lower in the MSCs transplantation group than that in the control group (50.5% ± 3.6% vs 23.4% ± 2.8%, P < 0.05). At 4 week post-transplantation, the neointimal area of injured vessels and the vascular restenosis were significantly lower in the MSCs transplantation group than those in the control group (0.092 ± 0.009 vs 0.189 ± 0.007, P < 0.05; 41.7 ± 3.7 vs 61.3 ± 1.6, P < 0.05). Furthermore the MSCs transplantation group demonstrated improved cardiac functions, reduced myocardial infarct size (21.7% ± 2.2% vs 34.3% ± 1.8%, P < 0.05) and significantly increased capillary density around infarction foci (33.6% ± 2.1% vs 20.8% ± 2.6%, P < 0.05) versus the control group. CONCLUSION: The transplantation of MSCs plays significant roles in cardiac repairing in terms of improved cardiac functions, accelerated repair of injured vessels, suppression of neointimal hyperplasia and reduced restenosis of injured vessels.

Dual-peak long period fiber grating coated with graphene oxide for label-free and specific assays of H5N1 virus.

Avian influenza is an acute infectious disease caused by the avian influenza virus (AIV), which has caused enormous economic losses and posed considerable threats to public health. This study aimed to demonstrate an immunosensor based on dispersion turning point long-period fiber grating (DTP-LPFG) integrated with graphene oxide (GO) for the specific detection of a type of AIV H5N1 virus. LPFG was designed to work at DTP, whose dual-peak spacing was very high sensitive to a refractive index. Anti-H5N1 monoclonal antibodies were covalently bonded with the GO film on the fiber surface, thus constructing an immunosensor for the label-free and specific detection of the H5N1 virus. The proposed method was capable of the reliable detection of H5N1 virus with the limit of detection as low as ~1.05 ng/ml within the large range of 1 ng/mL to 25 µg/mL. More importantly, immunoassays of the whole H5N1 virus in clinical samples further confirmed that the GO-integrated DTP-LPFG immunosensor showed very high specificity to the H5N1 virus and demonstrated great potential for clinical use.

Clinical Feature-Based Machine Learning Model for 1-Year Mortality Risk Prediction of ST-Segment Elevation Myocardial Infarction in Patients with Hyperuricemia: A Retrospective Study.

Accurate risk assessment of high-risk patients is essential in clinical practice. However, there is no practical method to predict or monitor the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) complicated by hyperuricemia. We aimed to evaluate the performance of different machine learning models for the prediction of 1-year mortality in STEMI patients with hyperuricemia. We compared five machine learning models (logistic regression, k-nearest neighbor, CatBoost, random forest, and XGBoost) with the traditional global (GRACE) risk score for acute coronary event registrations. We registered patients aged >18 years diagnosed with STEMI and hyperuricemia at the Affiliated Hospital of Zunyi Medical University between January 2016 and January 2020. Overall, 656 patients were enrolled (average age, 62.5 ± 13.6 years; 83.6%, male). All patients underwent emergency percutaneous coronary intervention. We evaluated the performance of five machine learning classifiers and the GRACE risk model in predicting 1-year mortality. The area under the curve (AUC) of the six models, including the GRACE risk model, ranged from 0.75 to 0.88. Among all the models, CatBoost had the highest predictive accuracy (0.89), AUC (0.87), precision (0.84), and F1 value (0.44). After hybrid sampling technique optimization, CatBoost had the highest accuracy (0.96), AUC (0.99), precision (0.95), and F1 value (0.97). Machine learning algorithms, especially the CatBoost model, can accurately predict the mortality associated with STEMI complicated by hyperuricemia after a 1-year follow-up.

Development of a machine learning model to predict the risk of late cardiogenic shock in patients with ST-segment elevation myocardial infarction.

BACKGROUND: The in-hospital mortality of patients with ST-segment elevation myocardial infarction (STEMI) increases to more than 50% following a cardiogenic shock (CS) event. This study highlights the need to consider the risk of delayed calculation in developing in-hospital CS risk models. This report compared the performances of multiple machine learning models and established a late-CS risk nomogram for STEMI patients. METHODS: This study used logistic regression (LR) models, least absolute shrinkage and selection operator (LASSO), support vector regression (SVM), and tree-based ensemble machine learning models [light gradient boosting machine (LightGBM) and extreme gradient boosting (XGBoost)] to predict CS risk in STEMI patients. The models were developed based on 1,598 and 684 STEMI patients in the training and test datasets, respectively. The models were compared based on accuracy, the area under the curve (AUC), recall, precision, and Gini score, and the optimal model was used to develop a late CS risk nomogram. Discrimination, calibration, and the clinical usefulness of the predictive model were assessed using C-index, calibration plotd, and decision curve analyses. RESULTS: A total of 2282 STEMI patients recruited between January 1, 2016 and May 31, 2020, were included in the complete dataset. The linear models built using LASSO and LR showed the highest overall predictive power, with an average accuracy over 0.93 and an AUC above 0.82. With a C-index of 0.811 [95% confidence interval (CI): 0.769-0.853], the LASSO nomogram showed good differentiation and proper calibration. In internal validation tests, a high C-index value of 0.821 was achieved. Decision curve analysis (DCA) and clinical impact curve (CIC) examination showed that compared with the previous score-based models, the LASSO model showed superior clinical relevance. CONCLUSIONS: In this study, five machine learning methods were developed for in-hospital CS prediction. The LASSO model showed the best predictive performance. This nomogram could provide an accurate prognostic prediction for CS risk in patients with STEMI.

CircHIPK3 regulates cardiac fibroblast proliferation, migration and phenotypic switching through the miR-152-3p/TGF-ß2 axis under hypoxia.

BACKGROUND: The occurrence of pathological cardiac fibrosis is attributed to tissue hypoxia. Circular RNAs play significant regulatory roles in multiple cardiovascular diseases and are involved in the regulation of physiological and pathophysiological processes. CircHIPK3 has been identified as the one of the most crucial regulators in cardiac fibrosis. However, the mechanisms by which circHIPK3 regulates cardiac fibrosis under hypoxia remain unclear. Our study aimed to determine circHIPK3 expression in cardiac fibroblasts (CFs) and investigate the functions of circHIPK3 in hypoxia environment. METHODS: The expression level of circHIPK3 in CFs under hypoxia (1% O2) was analyzed by qRT-PCR. The role of circHIPK3 on the proliferation and migration of CFs were determined by EdU, cell wound scratch assay and cell cycle. The expression of proteins associated with phenotypic transformation in CFs in vitro was examined by immunofluorescence assay and western blot. Bioinformatics analysis, dual luciferase activity assay and RNA fluorescent in situ hybridization assay revealed that miR-152-3p was identified as a target of circHIPK3 and that TGF-ß2 was targeted by miR-152-3p. RESULTS: CircHIPK3 expression was significantly upregulated in CFs in a hypoxic environment. In vitro, overexpressing circHIPK3 obviously promoted CF proliferation, migration and phenotypic changes under hypoxia, but those processes were suppressed by circHIPK3 silencing. CircHIPK3 acted as an endogenous miR-152-3p sponge and miR-152-3p aggravated circHIPK3 silencing induced inhibition of CF proliferation, migration, phenotypic transformation and TGF-ß2 expression in vitro. In summary, circHIPK3 plays a pivotal role in the development of cardiac fibrosis by targeting the miR-152-3p/TGF-ß2 axis. CONCLUSIONS: These findings demonstrated that circHIPK3 acted as a miR-152-3p sponge to regulate CF proliferation, migration and phenotypic transformation through TGF-ß2, revealing that modulation of circHIPK3 expression may represent a potential target to promote the transition of hypoxia-induced CFs to myofibroblasts.

Cholesterol induces dedifferentiation of vascular smooth muscle cells by regulating monocyte chemotactic protein-1-induced protein 1.

OBJECTIVE: To discover the effect of cholesterol on dedifferentiation of VSMCs in vitro and the underlying mechanisms. METHODS: Vascular smooth muscle cells (VSMC) were employed to evaluate the role of cholesterol in regulating the dedifferentiation of VSMCs in vitro. Immunofluorescent staining, western blot, and RT-PCR were applied to uncover the inducing effect of cholesterol at a molecular level. RESULTS: We demonstrated that the cholesterol was capable of inducing the dedifferentiation of VSMCs. Mechanistic studies revealed that monocyte chemotactic protein-1-induced protein 1 (MCPIP1) composed the most influential factor in the regulation of VSMCs during the process of cholesterol induction. When MCPIP1 was overexpressed in VSMCs, the dedifferentiation, proliferation and migration of the cells was enhanced, and the expression of miR-145 was suppressed. In contrast, knocking down MCPIP1 by siRNA promoted the differentiation and prohibited the migration of VSMCs after cholesterol treatment. These results demonstrate that MCPIP1 plays an important role in regulating cholesterol-induced dedifferentiation of VSMCs in vitro.