A review of the signaling pathways of aerobic and anaerobic exercise on atherosclerosis.

Atherosclerosis (AS), a chronic inflammatory vascular disease with lipid metabolism abnormalities, is one of the major pathological bases of coronary heart disease. As people's lifestyles and diets change, the incidence of AS increases yearly. Physical activity and exercise training have recently been identified as effective strategies for lowering cardiovascular disease (CVD) risk. However, the best exercise mode to ameliorate the risk factors related to AS is not clear. The effect of exercise on AS is affected by the type of exercise, intensity, and duration. In particular, aerobic and anaerobic exercise are the two most widely discussed types of exercise. During exercise, the cardiovascular system undergoes physiological changes via various signaling pathways. The review aims to summarize signaling pathways related to AS in two different exercise types and provide new ideas for the prevention and treatment of AS in clinical practice.

Investigating the impact of SARS-CoV-2 infection on basic semen parameters and in vitro fertilization/intracytoplasmic sperm injection outcomes: a retrospective cohort study.

BACKGROUND: This study aimed to evaluate the influences of SARS-CoV-2 infection on semen parameters and investigate the impact of the infection on in vitro fertilization (IVF) outcomes. METHODS: This retrospective study enrolled couples undergoing IVF cycles between May 2020 and February 2021 at Tongji Hospital, Wuhan. Baseline characteristics were matched using propensity score matching. Participants were categorized into an unexposed group (SARS-COV-2 negative) and exposed group (SARS-COV-2 positive) based on a history of SARS-CoV-2 infection, and the populations were 148 and 50 after matching, respectively. IVF data were compared between the matched cohorts. Moreover, semen parameters were compared before and after infection among the infected males. The main measures were semen parameters and IVF outcomes, including laboratory and clinical outcomes. RESULTS: Generally, the concentration and motility of sperm did not significantly differ before and after infection. Infected males seemed to have fewer sperm with normal morphology, while all values were above the limits. Notably, the blastocyst formation rate and available blastocyst rate in the exposed group were lower than those in the control group, despite similar mature oocytes rates, normal fertilization rates, cleavage rates, and high-quality embryo rates. Moreover, no significant differences were exhibited between the matched cohorts regarding the implantation rate, biochemical pregnancy rate, clinical pregnancy rate, or early miscarriage rate. CONCLUSIONS: The results of this retrospective cohort study suggested that the semen quality and the chance of pregnancy in terms of IVF outcomes were comparable between the males with a history of SARS-CoV-2 infection and controls, although a decreased blastocyst formation rate and available blastocyst rate was observed in the exposed group, which needs to be reinforced by a multicenter long-term investigation with a larger sample size.

The price of political polarization: Evidence from municipal issuers during the coronavirus pandemic.

This study estimates the financial costs imposed by political polarization among citizens on U.S. local governments during the COVID-19 pandemic. We measure local political polarization by using citizens' voting results in the presidential elections. We find local political polarization leads to higher offering yield of the bonds issued by the U.S. municipalities. The impact on borrowing costs is exaggerated by the number of pandemic cases in the local area, suggesting political polarization hinders the making and enforcement of government measures for the pandemic. This study highlights the mechanisms through which financial markets and local political ideology jointly affect social welfare.

What influenced the lesion patterns and hemodynamic characteristics in patients with internal carotid artery stenosis? A retrospective study.

OBJECTIVES: This study aimed to explore the dynamic changes of lesion patterns and hemodynamic characteristics in patients with internal carotid artery stenosis (ICAS). PATIENTS AND METHODS: Patients who had suffered an acute ischemic stroke in the distribution of ipsilateral ICAS were included. Computed tomography (CT) and transcranial doppler ultrasound (TCD) were conducted to evaluate the degree of ICAS and the hemodynamic characteristics of the intracranial and extracranial arteries. RESULT: A total of 424 patients were included in the study. With the aggravation of ICAS, blood velocity in ipsilateral ICA was increased, while blood flow in the ipsilateral middle cerebral artery (MCA) was decreased. In the same degree of ICAS, patients with opened communicating arteries showed relatively higher blood perfusion in MCA compared with those without communicating arteries. In the average stage of ICAS, small lesions (D=0-1.5cm), middle lesions (1.5cm3.0cm) commonly existed. The number of small and large lesions significantly increased when the blood flow of ipsilateral MCA decreased. In the same degree of stenosis, the number of small lesions and large lesions, and the total area of all lesions, evidently increased with the decrease of ipsilateral MCA blood velocity. CONCLUSION: Hypoperfusion is an independent risk factor for ischemic lesions in patients with ICAS. Whether or not the communicating arteries are open influences the blood flow of the intracranial arteries. TCD was a convenient and rapid tool to assess intracranial perfusion and vascular compensatory status.

[Effects of mild hypothemia on hemodynamics of systemic and renal of dog with septic shock].

OBJECTIVES: To explore the effects of mild hypothemia on hemodynamics of systemic and renal of dog with septic shock. METHODS: 40 healthy dogs were randomly and evenly divided into the normal temperature non-infected group (NTNS), normal temperature infected group (NTS), hypothermia non-infected group (MHNS) and hypothermia infected group (MHS). NTS and MHS were pumped through the femoral vein of Escherichia coli (E.coli 1 × 109 cfu/ml) by 0.5 ml·kg⁻¹·h⁻¹, producting septic shock model with high-power cycle. Combining with blood pump devices and low temperature thermostat bath, the MHNS and MHS implemented extracorporeal blood cooling method to maintain the blood in temperature (33 ± 1) °C. 0, 24, 48, 72 h point, tested specimens from femoral vein for renal function. In the 0-72 h. Pulse indicates the continuous cardiac output monitor (PiCCO) monitored systemic hemodynamics on each time point. In the 0-72 h, color Doppler ultrasound (CDFI) measured renal hemodynamic on each time point. RESULTS: There was an increase of SBP (P<0.05), SVR [(2 415 ± 651) dyn·s·cm⁻5 vs (1 613 ± 223) dyn·s·cm⁻5, P=0.01] and RI (P=0.04) in the MHS group comparing with the NTS group from 24 to 72 h. CO [(3.58 ± 0.44) L/min vs (4.18 ± 0.60) L/min, P=0.04], HR and PSV was decreased in the MHS group. BUN [(8.6 ± 1.6) mmol/L vs (21.2 ± 4.8) mmol/L, P<0.01] and Scr [(167.6 ± 31.2) µmol/L vs (383.8 ± 35.2) µmol/L, P<0.01] was decreased in MHS group comparing with the NTS group. There was a positively correlation between CO and PSV in the canine model of septic shock (P<0.01); and CO was negatively correlated with RI (P<0.01). CONCLUSIONS: In this canine model of septic shock, hypothermia can stable systemic and renal hemodynamics, and improve kidney function.

Energy and oxygen metabolism disorder during septic acute kidney injury.

BACKGROUND/AIMS: Acute kidney injury (AKI) during septic shock, which is one of the most common clinical syndromes in the intensive care unit (ICU), has a high mortality rate and poor prognosis, partly because of a poor understanding of the pathogenesis of renal dysfunction during septic shock. Although ischemic injury of the kidney has been reported to result from adenosine triphosphate (ATP) depletion, increasing evidence has demonstrated that AKI occurs in the absence of renal hypoperfusion and even occurs during normal or increased renal blood flow (RBF); nevertheless, whether energy metabolism disorder is involved in septic AKI and whether it changes according to renal hemodynamics have not been established. Moreover, tubular cell apoptosis, which is closely related to ATP depletion, rather than necrosis, has been shown to be the major form of cell injury during AKI. METHODS: We used canine endotoxin shock models to investigate the hemodynamics, renal energy metabolism, renal oxygen metabolism, and pathological changes during septic AKI and to explore the underlying mechanisms of septic AKI. RESULTS: The present results revealed that the nicotinamide adenine dinucleotide (NAD+) pool and the ATP/adenosine diphosphate (ADP) ratio were significantly decreased during the early phase of septic AKI, which is accompanied by a decreased renal oxygen extraction ratio (O2ER%) and decreased renal oxygen consumption (VO2). Furthermore, significant apoptosis was observed following renal dysfunction. RBF and renal oxygen delivery were not significantly altered. CONCLUSION: These results suggest that imbalanced energy metabolism, rather than tubular cell apoptosis, may be the initiator of renal dysfunction during septic shock.

Some cross-talks between immune cells and epilepsy should not be forgotten.

Recent studies have reported that immune cells were not always found in brain specimens from epileptic patients, then should we stop investigating the relationship between these cells and epilepsy? The answer is no! In addition to immunocyte infiltration in brain parenchyma, a flurry of papers have demonstrated that there were significant alterations in peripheral blood cells (PBCs) immediately after seizure onset, especially changes in some specific transporters of neurotransmitters expressed on the membrane of immunocyte. These transporters may regulate neuronal excitability in mature neurons. Besides, many researchers did find activated leukocytes adhered to the endothelium of blood brain barrier or infiltrated into the brain parenchyma in several types of epilepsy both in human and animal studies; moreover, it is worth noting that different immune cells play different roles in epilepsy development, which was indicated by in vitro and in vivo evidence. This review is going to summarize available evidence supporting changes in PBCs after seizures, and will also focus on some specific effects of immune cells on epilepsy development.

[Changes of renal hemodynamics in dogs with endotoxemic shock].

OBJECTIVE: To explore the changes of renal hemodynamic in dogs with endotoxemic shock (ES) and their potential roles in acute kidney injury (AKI). METHODS: Canine endotoxic shock model was induced by an infusion of lipopolysaccharide of Escherichia coli through pulmonary artery catheter (PAC). Systemic hemodynamics and left renal blood flow (RBF) was monitored by PAC, pulse index continuous cardiac output (PiCCO) and ultrasonic blood flow meter. Blood and urine specimens were harvested timely for blood gas analysis, renal function tests and biochemical detection. RESULTS: Hemodynamics: CO and RBF fluctuated widely but without any significance (P > 0.05). The values of mean arterial pressure (MAP), systemic vascular resistance (SVR), renal vascular resistance (RVR) and 2-hour urine volume significantly decreased (all P < 0.05) while extravascular lung water (EVLW) increased markedly (P < 0.05). Renal function: There was a drop in CCr, urine osmotic pressure and an elevation in SCr and NAG. RBF was correlated positively with CO (R(2) = 0.630, P = 0.001) .However, it had no correlation with MAP (R(2) = 0.009, P = 0.758) . CCr was correlated positively with MAP (R(2) = 0.415, P = 0.003) . However, it had no correlation with RBF or CO (P > 0.05 ). The auto-regulation curve of GFR had a shift to the right. CONCLUSION: RBF is positively correlated with cardiac output in endotoxin shock. Renal pressure perfusion may decrease obviously without any noticeable change of renal flow perfusion. The shift of renal auto-regulation under pressure perfusion occurs at the early stage of septic shock.

The cost-effectiveness of including liquid biopsy into molecular profiling strategies for newly diagnosed advanced non-squamous non-small cell lung cancer in an Asian population.

OBJECTIVES: Liquid biopsy is complementary to tissue biopsy for lung cancer profiling, yet evidence of the cost-effectiveness is limited. This could retard implementation and reimbursement in clinical practice. The aim of this study is to estimate the cost-effectiveness of profiling strategies that include liquid biopsy and to identify the optimal profiling approach for newly diagnosed advanced non-squamous non-small cell lung cancer (NSCLC) in an Asian population using Singapore as an example. MATERIALS AND METHODS: A decision tree and partitioned-survival model was developed from the Singapore healthcare system's perspective to evaluate the cost-effectiveness of five molecular profiling strategies: either tissue or plasma next-generation sequencing (NGS) alone, a concurrent, and two sequential approaches. Model inputs were informed by local data or published literature. Sensitivity analyses and scenario analyses were undertaken to understand the robustness of the conclusions for decision making. The optimal strategy at different willingness-to-pay (WTP) thresholds was presented by cost-effectiveness acceptability frontier and the expected loss curve. RESULTS: The sequential tissue-plasma NGS approach revealed an additional 0.0981 quality adjusted life years (QALYs) for an extra cost of S$3,074 over a 20-year time horizon compared to tissue NGS alone, resulting in an incremental cost-effectiveness ratio (ICER) of S$31,318/QALY and an incremental net monetary benefit of S$1,343 per patient. The findings were sensitive to the costs of pembrolizumab and osimertinib and the probabilities of re-biopsy after tissue NGS. Sequential plasma-tissue NGS and plasma NGS alone were more costly and less effective than alternatives. CONCLUSION: The sequential tissue-plasma NGS approach generated the highest net monetary benefit and was the optimal testing strategy when WTP was S$45,000/QALY. It retained superiority but understandably with a higher ICER when expensive, non-first line treatments were included. Overall, its routine clinical practice should be proactively considered for newly diagnosed advanced non-squamous NSCLC in an Asian population.

Exopolysaccharides of lactic acid bacteria: Structure, biological activity, structure-activity relationship, and application in the food industry: A review.

Over the past few decades, researchers have discovered that probiotics play an important role in our daily lives. With the further deepening of research, more and more evidence show that bacterial metabolites have an important role in food and human health, which opens up a new direction for the research of lactic acid bacteria (LAB) in the food and pharmaceutical industry. Many LAB have been widely studied because of the ability of exopolysaccharides (EPS). Lactic acid bacteria exopolysaccharides (LAB EPS) not only have great potential in the treatment of human diseases but also can become natural ingredients in the food industry to provide special qualitative structure and flavor. This paper has organized and summarized the biosynthesis, strain selection, production process parameters, structure, and biological activity of LAB EPS, filling in the monotony and incompleteness of previous articles' descriptions of LAB EPS. Therefore, this paper focuses on the general biosynthetic pathway, structural characterization, structure-activity relationship, biological activity of LAB EPS, and their application in the food industry, which will help to deepen people's understanding of LAB EPS and develop new active drugs from LAB EPS. Although the research results are relatively affluent, the low yield, complex structure, and few clinical trials of EPS are still the reasons that hinder its development. Therefore, future knowledge expansion should focus on the regulation of structure, physicochemical properties, function, higher production of EPS, and clinical trial applications, which can further increase the commercial significance and value of EPS. Furthermore, better understanding the structure-function relationship of EPS in food remains a challenge to date.

Effect of exopolysaccharides yield and addition concentration of Lactobacillus helveticus on the processing characteristics of fermented milk and its mechanism.

Exopolysaccharides (EPS) yield and added concentration of lactic acid bacteria can greatly affect the processing characteristics of fermented milk. In order to investigate the effects and mechanisms of EPS yield and added concentration on fermented milk, researchers extracted EPS from 50 strains of Lactobacillus helvedicus (L. helvedicus) and selected the two strains with the largest difference in EPS yield (L. helvedicus LH18 and L. helvetigus LH33) for subsequent experiments. The physicochemical properties of EPS-LH18 and EPS-LH33 were analyzed. The gel characteristics and protein conformation of fermented milk were studied by means of texture analyzer, rheometer, scanning electron microscopy, nuclear magnetic resonance machine, fluorescence spectrophotometer and circular dichroism. The results indicate that the monosaccharide compositions of EPS-LH18 and EPS-LH33 are the same and have good thermal stability. The texture and rheological properties of L. helveticus LH18 fermented milk are significantly superior to other fermented milk. The reason is that L. helveticus LH18 EPS has the highest yield, which leads to a denser gel structure, lower surface hydrophobicity and free sulfhydryl content of its fermented milk. According to circular dichroism analysis, ß- sheet and random coil are the internal factors leading to the difference in fermented milk gel. In addition, the fermented milk improved even more favorably as the concentration of the two EPS additions increased. As described above, L. helveticus LH18 has the potential to be an excellent yogurt starter, and both of the above EPS can be used as probiotic stabilizer alternatives for fermented dairy products.

Robust Sensory Information Reconstruction and Classification With Augmented Spikes.

Sensory information recognition is primarily processed through the ventral and dorsal visual pathways in the primate brain visual system, which exhibits layered feature representations bearing a strong resemblance to convolutional neural networks (CNNs), encompassing reconstruction and classification. However, existing studies often treat these pathways as distinct entities, focusing individually on pattern reconstruction or classification tasks, overlooking a key feature of biological neurons, the fundamental units for neural computation of visual sensory information. Addressing these limitations, we introduce a unified framework for sensory information recognition with augmented spikes. By integrating pattern reconstruction and classification within a single framework, our approach not only accurately reconstructs multimodal sensory information but also provides precise classification through definitive labeling. Experimental evaluations conducted on various datasets including video scenes, static images, dynamic auditory scenes, and functional magnetic resonance imaging (fMRI) brain activities demonstrate that our framework delivers state-of-the-art pattern reconstruction quality and classification accuracy. The proposed framework enhances the biological realism of multimodal pattern recognition models, offering insights into how the primate brain visual system effectively accomplishes the reconstruction and classification tasks through the integration of ventral and dorsal pathways.

Milk fat globule membrane regulates the physicochemical properties and surface composition of infant formula powders by improving the stability of the emulsion.

The milk fat globules in infant formula (IF) are encapsulated by a component known as milk fat globule membrane (MFGM). However, it is currently unclear whether the improved emulsion stability of MFGM can have a profound effect on the finished IF. Therefore, this study investigated the effects of MFGM on the particle size, stability, rheology, and microstructure of emulsions prepared by dairy ingredients via wet mixing. Further, IF were processed using such emulsions, the physicochemical properties, surface composition of the powders were examined. The results showed that MFGM reduced the particle size of the emulsion, increased the viscosity, and improved the microstructure of the MFGM. Furthermore, MFGM reduced the moisture content of the powder, increased the glass transition temperature, and reduced the presence of surface fat. In conclusion, the addition of MFGM enhance the finished powder stability by improving the emulsion stability prepared during IF manufacturing.

Association of blood pressure and outcomes differs upon cerebral perfusion post-thrombectomy in patients with acute ischemic stroke.

BACKGROUND: The relationship between post-endovascular thrombectomy (EVT) blood pressure (BP) and outcomes in patients with acute ischemic stroke (AIS) remains contentious. We aimed to explore whether this association differs with different cerebral perfusion statuses post-EVT. METHODS: In a multicenter observational study of patients with AIS with large vessel occlusion who underwent EVT, we enrolled those who accepted CT perfusion (CTP) imaging within 24 hours post-EVT. We recorded post-EVT systolic (SBP) and diastolic BP. Patients were stratified into favorable perfusion and unfavorable perfusion groups based on the hypoperfusion intensity ratio (HIR) on CTP. The primary outcome was good functional outcome (90-day modified Rankin Scale score of ≤3). Secondary outcomes included early neurological deterioration, infarct size growth, and symptomatic intracranial hemorrhage. RESULTS: Of the 415 patients studied (mean age 62 years, 75% male), 233 (56%) achieved good functional outcomes. Logistic regression showed that post-EVT HIR and 24-hour mean SBP were significantly associated with functional outcomes. Among the 326 (79%) patients with favorable perfusion, SBP <140 mmHg was associated with a higher percentage of good functional outcomes compared with SBP ≥140 mmHg (68% vs 52%; aOR 1.70 (95% CI 1.00 to 2.89), P=0.04). However, no significant difference was observed between SBP and functional outcomes in the unfavorable perfusion group. There was also no discernible difference between SBP and secondary outcomes across the different perfusion groups. CONCLUSIONS: In patients with favorable perfusion post-EVT, SBP <140 mmHg was associated with good functional outcomes, which underscores the need for further investigations with larger sample sizes or a more individualized BP management strategy. CLINICAL TRIAL REGISTRATION: ChiCTR1900022154.

LYSTO: The Lymphocyte Assessment Hackathon and Benchmark Dataset.

We introduce LYSTO, the Lymphocyte Assessment Hackathon, which was held in conjunction with the MICCAI 2019 Conference in Shenzhen (China). The competition required participants to automatically assess the number of lymphocytes, in particular T-cells, in images of colon, breast, and prostate cancer stained with CD3 and CD8 immunohistochemistry. Differently from other challenges setup in medical image analysis, LYSTO participants were solely given a few hours to address this problem. In this paper, we describe the goal and the multi-phase organization of the hackathon; we describe the proposed methods and the on-site results. Additionally, we present post-competition results where we show how the presented methods perform on an independent set of lung cancer slides, which was not part of the initial competition, as well as a comparison on lymphocyte assessment between presented methods and a panel of pathologists. We show that some of the participants were capable to achieve pathologist-level performance at lymphocyte assessment. After the hackathon, LYSTO was left as a lightweight plug-and-play benchmark dataset on grand-challenge website, together with an automatic evaluation platform.

An update on the role of TRIM/NLRP3 signaling pathway in atherosclerosis.

Atherosclerosis (AS) is a chronic inflammatory disease of large and medium arteries that includes lipid metabolism disorder and recruitment of immune cells to the artery wall. An increasing number of studies have confirmed that inflammasome over-activation is associated with the onset and progression of atherosclerosis. The NLRP3 inflammasome, in particular, has been proven to increase the incidence rate of cardiovascular diseases (CVD) by promoting pro-inflammatory cytokine release and reducing plaque stability. The strict control of inflammasome and prevention of excessive inflammatory reactions have been the research focus of inflammatory diseases. Tripartite motif (TRIM) is a protein family with a conservative structure and rapid evolution. Several studies have demonstrated the TRIM family's regulatory role in mediating inflammation. This review aims to clarify the relationship between TRIMs and NLRP3 inflammasome and provide insights for future research and treatment discovery.

Elucidating gut microbiota and metabolite patterns shaped by goat milk-based infant formula feeding in mice colonized by healthy infant feces.

The gut microbiota plays an evolutionarily conserved role in host metabolism, which is influenced by diet. Here, we investigated differences in shaping the gut microbiota and regulating metabolism in cow milk-based infant formula, goat milk-based infant formula, and mix milk-based infant formula compared with pasteurized human milk. 16S rRNA results showed that goat milk-based infant formula selectively increased the relative abundance of Blautia, Roseburia, Alistites and Muribaculum in the gut compared to other infant formulas. Metabolomics identification indicated that goat milk-based infant formula mainly emphasized bile acid biosynthesis, arachidonic acid metabolism and steroid biosynthesis metabolic pathways. Metabolites associated with these metabolic pathways were positively associated with increased microorganisms in goat milk-based infant formula, particularly Alistipes. Furthermore, we found a deficiency of Akkermansia abundance in three infant formula-fed compared to pasteurizedhuman milk-fed. This study presents new insights into the improvement and application of goat milk-based infant formulas in terms of intestinal microecology.

Study on the Characteristics of Early Cytokine Storm Response to Cardiac Surgery.

Cardiac surgery can provoke an acute cytokine storm that may contribute to the development of postoperative multiple organ dysfunction syndrome. We prospectively observed patients undergoing cardiac surgery and divided them into two groups: the severe group and the mild group. Healthy individuals were enrolled acting as the control group for comparison. Plasma samples and clinical data were recorded at the initiation of cardiac-pulmonary bypass (CPB) and 3, 6, 12, 24, and 48 h after initiation of CPB. Cytokine levels were detected using the Luminex® technique. Thirty-nine adults were enrolled in this study (14 in the severe group, 15 in the mild group, and 10 in the control group). Cytokine concentrations were significantly higher in the severe group. Principal component analysis was used to establish a cytokine storm intensity curve, which represented the overall trend of 10 cytokines. The peak concentrations of interleukin (IL)-6, IL-10, and IL-16 were 425.1, 198.5, and 623.0 pg/mL, which were more than 1,200, 1,800, and 240 times the normal level, respectively. The maximum cytokine storm intensity predated the maximum Vasoactive-Inotropic Score (VIS) and Sequential Organ Failure Assessment (SOFA) score in the severe group. Cytokine storm response to cardiac surgery occurred early and was associated with disease severity. Interventions to cytokine storm should be initiated early as guided by cytokine storm biomarkers such as IL-6, IL-10, and IL-16 in severe patients undergoing cardiac surgery. Clinical Trial Registration: ChiCTR1900021351.

Economic Evaluations of Imaging Biomarker-Driven Companion Diagnostics for Cancer: A Systematic Review.

INTRODUCTION: There is a boom in imaging biomarker-driven companion and complementary diagnostics (CDx) for cancer, which brings opportunity for personalized medicine. Whether adoption of these technologies is likely to be cost-effective is a relevant question, and studies on this topic are emerging. Despite the growing number of economic evaluations, no review of the methods used, quality of reporting, and potential risk of bias has been done. We report a systematic review to identify, summarize, and critique the cost-effectiveness evidence for the use of biomarker-driven and imaging-based CDx to inform cancer treatments. METHODS: The Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Systematic literature searches until 30 December 2022 were performed in PubMed, Web of Science, Medline, Embase, and Scopus for economic evaluations of imaging biomarker-based CDx for cancer. The inclusion and exclusion of studies were determined by pre-specified eligibility criteria informed by the 'Patient, Intervention, Comparison, Outcome' (PICO) framework. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the quality of reporting, and the Bias in Economic Evaluation (ECOBIAS) was used to examine the potential risk of bias of included studies. RESULTS: A total of 12 papers were included, with eight model-based and four trial-based studies. Implementing biomarker-driven, imaging-based CDx was reported to be cost-effective, cost saving, or dominant (cost saving and more effective) in ten papers. Inconsistent methods were found in the studies, and the quality of reporting was lacking against the CHEERS reporting guideline. Several potential sources of 'risk of bias' were identified. These should be acknowledged and carefully considered by researchers planning future health economic evaluations. CONCLUSION: Despite favorable results towards the implementation of imaging biomarker-based CDx for cancer, there is room for improvement regarding the quantity and quality of economic evaluations, and that is expected as the awareness of current study limitations increases and more clinical data become available in the future.

Optimal systolic and diastolic blood pressure threshold that associated with lower risk of white matter hyperintensity progression.

Background: The optimal control thresholds for systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with white matter hyperintensity (WMH) are still unclear. Method: A longitudinal retrospective study of patients with brain magnetic resonance imaging (MRI) scans with intervals of more than 3 years was conducted. Blood pressure records during hospitalization and from outpatient visits between baseline and the last MRI scan were collected. The outcome was the change in total WMH from baseline to the final visit. Results: Among the 965 patients with MRI scans, 457 patients with detailed longitudinal blood pressure records were ultimately included and classified into the WMH absent group (n = 121), mild WMH group (n = 126), and moderate to severe WMH group (n = 210). Both baseline and longitudinal mean SBP, DBP, and SBP SD were significantly associated with WMH severity (p < 0.05). An average SBP of 130-140 mmHg [vs. <130 mmHg, aOR, 1.80, (95% CI, 1.05-3.07), p = 0.03] was associated with a higher risk of WMH progression. DBP ≥ 90 mmHg [vs. <80 mmHg, OR, 1.81, (95% CI, 0.88-3.74), p = 0.02, aOR, 1.54, (95% CI, 0.66-3.53), p = 0.32] was associated with a higher risk of WMH progression, but was not after adjusted for other covariates. Longitudinal BP variability was not significantly associated with WMH progression. Conclusion: Both SBP and DBP had a stronger relationship with the severity of WMH. A target mean SBP of <130 mmHg and mean DBP of <80 mmHg was associated with a lower risk of WMH progression.