Multimodal data integration for enhanced longitudinal prediction for cardiac and cerebrovascular events following initial diagnosis of obstructive sleep apnea syndrome.

Background: Obstructive sleep apnea syndrome (OSAS), a prevalent condition, often coexists with intricate metabolic issues and is frequently associated with negative cardiovascular outcomes. We developed a longitudinal prediction model integrating multimodal data for cardiovascular risk stratification of patients with an initial diagnosis of OSAS. Methods: We reviewed the data of patients with new-onset OSAS who underwent diagnostic polysomnography between 2018-19. Patients were treated using standard treatment regimens according to clinical practice guidelines. Results: Over a median follow-up of 32 months, 98/729 participants (13.4%) experienced our composite outcome. At a ratio of 7:3, cases were randomly divided into development (n = 510) and validation (n = 219) cohorts. A prediction nomogram was created using six clinical factors - sex, age, diabetes mellitus, history of coronary artery disease, triglyceride-glucose index, and apnea-hypopnea index. The prediction nomogram showed excellent discriminatory power, based on Harrell's C-index values of 0.826 (95% confidence interval (CI) = 0.779-0.873) for the development cohort and 0.877 (95% CI = 0.824-0.93) for the validation cohort. Moreover, comparing the predicted and observed major adverse cardiac and cerebrovascular events in both development and validation cohorts indicated that the prediction nomogram was well-calibrated. Decision curve analysis demonstrated the good clinical applicability of the prediction nomogram. Conclusions: Our findings demonstrated the construction of an innovative visualisation tool that utilises various types of data to predict poor outcomes in Chinese patients diagnosed with OSAS, providing accurate and personalised therapy. Registration: Chinese Clinical Trial Registry ChiCTR2300075727.

A sequential light-harvesting system with thermosensitive colorimetric emission in both aqueous solution and hydrogel.

Inspired by natural photosynthetic systems that feature both sequential energy transfer and temperature response, we herein report an artificial thermosensitive sequential light-harvesting system (LHS) based on an amphiphilic molecule TPEO. It self-assembles into fluorescent nanoparticles in water and shows tunable LCST behavior. By loading ESY as the first acceptor and NiR as the second acceptor into the nanoparticles, an artificial LHS with two-step FRET was successfully constructed. Interestingly, the system exhibits thermosensitive colorimetric fluorescence in both aqueous solution and hydrogel by taking advantage of a combination of LCST and sequential FRET.

Association between weekend catch-up sleep and depression of the United States population from 2017 to 2018: A cross-sectional study.

Insufficient sleep on weekdays has become a societal norm, and studies have shown that sleep deprivation increases the risk of depression. Although individuals often resort to weekend catch-up sleep (CUS) as a compensatory measure, the present evidence supporting its efficacy in mitigating the risk of depression is limited. This article attempts to explore the relationship between CUS and depression. In this study, a total of 5510 participants were included, characterized into two groups: nondepressed (n = 5051) and depressed (n = 459), with data extracted from the National Health and Nutrition Examination Survey (NHANES). Compared with people without CUS, those practicing CUS exhibited a significantly lower risk of depression (OR = 0.81, P = 0.048). In subgroup analysis, this reduction effect was only observed in males (OR = 0.70, 95 % CI 0.05 to 0.99, P = 0.04), middle-aged (>40, ≤60) (OR: 0.57, 95 % CI: 0.40 to 0.81, P = 0.002), married or living with parents (OR: 0.61, 95 % CI: 0.44 to 0.86, P = 0.004), groups with three or more family members (OR: 0.69, 95 % CI: 0.52 to 0.93, P = 0.01), and individuals without alcohol intake (OR: 0.24,95 % CI: 0.09 to 0.67, P = 0.006). Therefore, in the realm of depression treatment, doctors may consider advising patients to get adequate sleep on weekends as part of their overall treatment plan. At the same time, individuals can also choose weekend sleep as a proactive strategy for regulating their psychological status.

Engineering Sulfur-Containing Polymeric Fire-Retardant Coatings for Fire-Safe Rigid Polyurethane Foam.

With the advantages of lightweight and low thermal conductivity properties, polymeric foams are widely employed as thermal insulation materials for energy-saving buildings but suffer from inherent flammability. Flame-retardant coatings hold great promise for improving the fire safety of these foams without deteriorating the mechanical-physical properties of the foam. In this work, four kinds of sulfur-based flame-retardant copolymers are synthesized via a facile radical copolymerization. The sulfur-containing monomers serve as flame-retardant agents including vinyl sulfonic acid sodium (SPS), ethylene sulfonic acid sodium (VS), and sodium p-styrene sulfonate (VSS). Additionally, 2-hydroxyethyl acrylate (HEA) and 4-hydroxybutyl acrylate are employed to enable a strong interface adhesion with polymeric foams through interfacial H-bonding. By using as-synthesized waterborne flame-retardant polymeric coating with a thickness of 600 µm, the coated polyurethane foam (PUF) can achieve a desired V-0 rating during the vertical burning test with a high limiting oxygen index (LOI) of >31.5 vol%. By comparing these sulfur-containing polymeric fire-retardant coatings, poly(VS-co-HEA) coated PUF demonstrates the best interface adhesion capability and flame-retardant performance, with the lowest peak heat release rate of 166 kW m-2 and the highest LOI of 36.4 vol%. This work provides new avenues for the design and performance optimization of advanced fire-retardant polymeric coatings.

Myocardial extracellular volume derived from contrast-enhanced chest computed tomography in longitudinal evaluation of cardiac toxicity in patients treated with immune checkpoint inhibitors.

Background: The immune-related adverse effects after immune checkpoint inhibitors (ICIs) treatment have always been a hot topic. Although the incidence of myocarditis is not high among the related adverse effects, the mortality rate is extremely high once it occurs. In the past, the risk of cancer therapy-related cardiac dysfunction (CTRCD) after drug treatment was evaluated based on imaging examinations, but this evaluation still had certain limitations. Currently, the extracellular volume (ECV) score measurement calculated using cardiac magnetic resonance T1 mapping has become a reliable method for evaluating myocardial toxicity and computed tomography (CT) examination may become an alternative. This study aimed to longitudinally evaluate the cardiac toxicity of patients treated with ICIs using myocardial ECV derived from contrast-enhanced chest CT. Methods: A total of 500 patients with III-IV lung cancer and esophageal cancer treated with ICIs were evaluated. Participants underwent baseline examination and at least 1 follow-up examination after treatment. Contrast-enhanced chest CT-ECV, left ventricular ejection fraction (LVEF), and measurement of cardiac troponin T (cTnT) were conducted before the first treatment, 3-6 months after the first treatment, and about 12 months after the first treatment, respectively. The ECV value of the middle part of the left ventricular septum was evaluated on CT venography and plain scan, the LVEF value was evaluated by color Doppler ultrasound, and the quantity of cTnT was detected by chemiluminescence. Cancer therapy-related cardiac dysfunction was recorded. Results: The mean baseline LVEF value was 68.51%±4.81% (N0=500), and those of LVEF1, LVEF2, and LVEF3 were 68.77%±4.30%, 68.16%±3.59%, and 66.23%±4.20%, respectively (N1=500, N2=467, and N3=361, respectively). There was no significant difference between LVEF1, LVEF2, and LVEF0 (P1=0.095, P2=0.062), whereas LVEF3 was significantly lower than LVEF0 (P<0.001). The average baseline cTnT0 value was 7.42±3.95 (N0=500). The values of cTnT1, cTnT2, and cTnT3 were 10.05±11.40, 12.24±13.59, and 14.54±14.49, respectively (N1=500, N2=467, N3=361). The values of cTnT1, cTnT2, and cTnT3 were significantly higher than cTnT0 (P1<0.001, P2<0.001, P3<0.001). The average ECV0 was 47.14%±7.48% (N0=500). ECV1, ECV2, and ECV3 were 50.85%±6.79%, 53.44%±6.96% and 52.64%±7.58% respectively (N1=500, N2=467 and N3=361). ECV1, ECV2, and ECV3 were significantly higher than ECV0 (P1<0.001, P2<0.001, P3<0.001). CTRCD occurred in 49 patients. There were significant differences between the CTRCD (+) group and the CTRCD (-) group in cTnT1, cTnT2, and cTnT3 (P1<0.001, P2<0.001, and P3<0.001, respectively) and in ECV1, ECV2, and ECV3 (P1=0.039, P2=0.041, and P3=0.013, respectively). Conclusions: CT-ECV began to increase at the early stage after the treatment of ICIs. CT-ECV is a potential biomarker for dynamically monitoring the cardiac toxicity of tumor patients after receiving ICIs. ECV may be used to speculate the CTRCD caused by the treatment of ICIs.

Safety and efficacy of day anterior cervical discectomy and fusion procedure for degenerative cervical spondylosis: a retrospective analysis.

OBJECTIVE: Our study aimed to develop a day anterior cervical discectomy and fusion (ACDF) procedure to treat degenerative cervical spondylosis (DCS). The goal was to analyze its clinical implications, safety, and early effects to provide a better surgical option for eligible DCS patients. METHODS: A retrospective analysis was performed to identify DCS patients who underwent day ACDF from September 2022 to August 2023. The operative time, intraoperative blood loss, postoperative drainage, preoperative and postoperative visual analog scale (VAS) scores, neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, JOA recovery rate (RR), incidence of dysphagia-related symptoms, 30-day hospital readmission rate, and incidence of other complications were recorded to evaluate early clinical outcomes. Radiography was performed to assess the location of the implants, neurological decompression, and cervical physiological curvature. RESULTS: All 33 patients (23 women and 10 men) underwent successful surgery and experienced significant symptomatic and neurological improvements. Among them, 26 patients underwent one-segment ACDF, 5 underwent two-segment ACDF, and 2 underwent three-segment ACDF. The average operative time was 71.1 ± 20.2 min, intraoperative blood loss was 19.1 ± 6.2 mL, and postoperative drainage was 9.6 ± 5.8 mL. The preoperative VAS and NDI scores improved postoperatively (7.1 ± 1.2 vs. 3.1 ± 1.3 and 66.7% ± 4.8% vs. 24.1% ± 2.5%, respectively), with a significant difference (P < 0.01). Moreover, the preoperative JOA scores improved significantly postoperatively (7.7 ± 1.3 vs. 14.2 ± 1.4; P < 0.01) with an RR of 93.9% in good or excellent. Postoperative dysphagia-related symptoms occurred in one patient (3.0%). During the follow-up period, no patient was readmitted within 30 days after discharge; however, an incisional hematoma was reported in one patient on the 6th day after discharge, which was cured by pressure dressing. The postoperative radiographs revealed perfect implant positions and sufficient nerve decompression in all patients. Furthermore, the preoperative cervical physiological curvature improved significantly after the operation (14.5° ± 4.0° vs. 26.3° ± 5.4°; P < 0.01). CONCLUSIONS: Day ACDF has good safety and early clinical efficacy, and it could be an appropriate choice for eligible DCS patients.

Case Report: A case of third-degree atrioventricular block associated with primary cardiac lymphoma.

Background: Primary cardiac lymphoma is an extremely rare malignant lymphoma, with clinical manifestations related to its location. We reported the diagnosis and treatment of primary cardiac lymphoma in a patient presented with atrioventricular block. Case presentation: A 64 year-old man was admitted to our hospital because of symptoms of a tired heart and shortness of breath. The initial electrocardiogram revealed a third-degree atrioventricular block. Computed tomography scan showed an irregularly shaped right heart, irregular clusters, and relatively weakly enhanced areas in the right auricle, atrium, and ventricle. The local boundary between the lesion, pericardium, and left atrium was unclear, and the ventricular septum was irregular and thickened. Multiple irregular gray neoplasms with less smooth surfaces were observed, with a maximum diameter of approximately 7 cm. Pathological findings confirmed a non-germinal center B cell subtype of diffuse large B-cell lymphoma. After surgical resection of the tumor and implantation of a permanent pacemaker, the symptoms of the patient were significantly improved, allowing subsequent chemotherapy. Conclusion: Surgical resection and placement of a permanent pacemaker were effective treatments for a patient with primary cardiac lymphoma presented with atrioventricular block.

Multifunctional bimetallic MOF with oxygen vacancy synthesized by microplasma for rapid total antioxidant capacity assessment in agricultural products.

The assessment of total antioxidant capacity (TAC) is crucial for evaluating overall antioxidant potential, predicting the risk of chronic diseases, guiding dietary and nutritional interventions, and studying the effectiveness of antioxidants. However, achieving rapid TAC assessment with high sensitivity and stability remains a challenge. In this study, Ce/Fe-MOF with abundant oxygen vacancies was synthesized using microplasma for TAC determination. The microplasma synthesis method was rapid (30 min) and cost-effective. The presence of oxygen vacancies and the collaboration between iron and cerium in Ce/Fe-MOF not only enhanced the catalyst's efficiency but also conferred multiple enzyme-like properties: peroxidase-like, oxidase-like, and superoxide dismutase mimetic activities. Consequently, a simple colorimetric assay was established for TAC determination in vegetables and fruits, featuring a short analysis time of 15 min, a good linear range of 5-60 µM, a low detection limit of 1.3 µM and a good recovery of 91 %-107 %. This method holds promise for rapid TAC assessment in agricultural products.

Large-Scale, Mechanically Robust, Solvent-Resistant, and Antioxidant MXene-Based Composites for Reliable Long-Term Infrared Stealth.

MXene-based thermal camouflage materials have gained increasing attention due to their low emissivity, however, the poor anti-oxidation restricts their potential applications under complex environments. Various modification methods and strategies, e.g., the addition of antioxidant molecules and fillers have been developed to overcome this, but the realization of long-term, reliable thermal camouflage using MXene network (coating) with excellent comprehensive performance remains a great challenge. Here, a MXene-based hybrid network comodified with hyaluronic acid (HA) and hyperbranched polysiloxane (HSi) molecules is designed and fabricated. Notably, the presence of appreciated HA molecules restricts the oxidation of MXene sheets without altering infrared stealth performance, superior to other water-soluble polymers; while the HSi molecules can act as efficient cross-linking agents to generate strong interactions between MXene sheets and HA molecules. The optimized MXene/HA/HSi composites exhibit excellent mechanical flexibility (folded into crane structure), good water/solvent resistance, and long-term stable thermal camouflage capability (with low infrared emissivity of ≈0.29). The long-term thermal camouflage reliability (≈8 months) under various outdoor weathers and the scalable coating capability of the MXene-coated textile enable them to disguise the IR signal of various targets in complex environments, indicating the great promise of achieved material for thermal camouflage, IR stealth, and counter surveillance.

Engineered EVs with pathogen proteins: promising vaccine alternatives to LNP-mRNA vaccines.

Extracellular vesicles (EVs) are tiny, lipid membrane-bound structures that are released by most cells. They play a vital role in facilitating intercellular communication by delivering bioactive cargoes to recipient cells and triggering cellular as well as biological responses. EVs have enormous potential for therapeutic applications as native or engineered exosomes. Native EVs are naturally released by cells without undergoing any modifications to either the exosomes or the cells that secrete them. In contrast, engineered EVs have been deliberately modified post-secretion or through genetic engineering of the secreting cells to alter their composition. Here we propose that engineered EVs displaying pathogen proteins could serve as promising alternatives to lipid nanoparticle (LNP)-mRNA vaccines. By leveraging their unique characteristics, these engineered EVs have the potential to overcome certain limitations associated with LNP-mRNA vaccines.

Multimodal Prognostic Model for Predicting Chronic Coronary Artery Disease in Patients Without Obstructive Sleep Apnea Syndrome.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS), with metabolic disorders as a central feature, is closely correlated with coronary artery disease (CAD). Our goal was to develop a prediction nomogram that integrated multimodal data that could accurately predict the prognosis of patients with chronic coronary disease (CCD). METHODS: We evaluated 393 patients with CCD with a low-to-intermediate pretest probability of OSAS based on polysomnography. A nomogram was constructed by means of least absolute shrinkage and selection operator (LASSO) and multiple Cox regression analyses to identify independent risk factors for major adverse cardiovascular events (MACEs). RESULTS: Two hundred seventy-seven patients were randomly assigned to the training set, and 116 to the verification set. The constructed nomogram consisted of seven clinical variables: age, previous CAD, current alcohol consumption, neck circumference, apnea-hypopnea index (AHI), and triglyceride-glucose index (TyG). The nomogram showed good discriminatory power, as evidenced by Harrell's C-index values of 0.79 (95% confidence interval [CI] 0.731-0.849) in the training set and 0.78 (95% CI 0.678-0.882) in the verification set. Moreover, a high correlation was observed between the predicted and actual incidence of MACEs in both the training and verification sets. Decision curve analysis demonstrated excellent clinical utility of the nomogram based on net benefit and threshold probabilities. CONCLUSIONS: We developed an integrated visualized prognostic nomogram that utilizes multi-modal data, including clinical characteristics, AHI, and TyG index, to predict MACEs in patients with CCD. This approach demonstrated excellent performance, highlighting the potential of combining different data sources to enhance prediction accuracy.

Hydrosilylation Adducts to Produce Wide-Temperature Flexible Polysiloxane Aerogel under Ambient Temperature and Pressure Drying.

Despite incorporation of organic groups into silica-based aerogels to enhance their mechanical flexibility, the wide temperature reliability of the modified silicone aerogel is inevitably degraded. Therefore, facile synthesis of soft silicone aerogels with wide-temperature stability remains challenging. Herein, novel silicone aerogels containing a high content of Si are reported by using polydimethylvinylsiloxane (PDMVS), a hydrosilylation adduct with water-repellent groups, as a "flexible chain segment" embedded within the aerogel network. The poly(2-dimethoxymethylsilyl)ethylmethylvinylsiloxane (PDEMSEMVS) aerogel is fabricated through a cost-effective ambient temperature/pressure drying process. The optimized aerogel exhibits exceptional performance, such as ultra-low density (50 mg cm-3), wide-temperature mechanical flexibility, and super-hydrophobicity, in comparison to the previous polysiloxane aerogels. A significant reduction in the density of these aerogels is achieved while maintaining a high crosslinking density by synthesizing gel networks with well-defined macromolecules through hydrolytic polycondensation crosslinking of PDEMSEMVS. Notably, the pore/nanoparticle size of aerogels can be fine-tuned by optimizing the gel solvent type. The as-prepared silicone aerogels demonstrate selective absorption, efficient oil-water separation, and excellent thermal insulation properties, showing promising applications in oil/water separation and thermal protection.

ANO6 is a reliable prognostic biomarker and correlates to macrophage polarization in breast cancer.

To investigate the value of Anoctamin 6 (ANO6) in breast cancer (BC) by analyzing its expression, prognostic impact, biological function, and its association with immune characteristics. We initially performed the expression and survival analyses, followed by adopting restricted cubic spline to analyze the nonlinear relationship between ANO6 and overall survival (OS). Stratified and interaction analyses were conducted to further evaluate its prognostic value in BC. Next, we performed enrichment analyses to explore the possible pathways regulated by ANO6. Finally, the correlations between ANO6 and immune characteristics were analyzed to reveal its role in immunotherapy. Lower ANO6 expression was observed in BC than that in the normal breast group, but its overexpression independently predicted poor OS among BC patients (P < .05). Restricted cubic spline analysis revealed a linear relationship between ANO6 and OS (P-Nonlinear > 0.05). Interestingly, menopause status was an interactive factor in the correlation between ANO6 and OS (P for interaction = 0.016). Additionally, ANO6 was involved in stroma-associated pathways, and its elevation was significantly linked to high stroma scores and macrophage polarization (P < .05). Moreover, ANO6 was notably correlated with immune checkpoint expression levels, and scores of tumor mutation burden and microsatellite instability (all P < .05). ANO6 was an independent prognostic factor for BC, and might be a potential target for the BC treatment. Besides, ANO6 might affect BC progression via the regulation of stroma-related pathways and macrophage polarization.

Effects of 0.4 T, 3.0 T and 9.4 T static magnetic fields on development, behaviour and immune response in zebrafish (Danio rerio).

Magnetic Resonance Imaging (MRI) is widely applied in medical diagnosis due to its excellent non-invasiveness. With the increasing intensity of static magnetic field (SMF), the safety assessment of MRI has been ongoing. In this study, zebrafish larvae were exposed to SMFs of 0.4, 3.0, and 9.4 T for 2 h (h), and we found that there was no significant difference in the number of spontaneous tail swings, heart rate, and body length of zebrafish larvae in the treatment groups. The expression of development-related genes shha, pygo1, mylz3 and runx2b in the three SMF groups was almost not significantly different from the control group. Behavior tests unveiled a notable reduction in both the average speed and duration of high-speed movements in zebrafish larvae across all three SMF groups. In addition, the 0.4 and 3.0 T SMFs increased the migration of neutrophils in caudal fin injury, and the expression of pro-inflammatory cytokines was also increased. To explore the mechanism of SMFs on zebrafish immune function, this study utilized aanat2-/- mutant fish to demonstrate the effect of melatonin (MT) involvement in SMFs on zebrafish immune function. This study provides experimental data for understanding the effects of SMFs on organisms, and also provides a new insight for exploring the relationship between magnetic fields and immune function.

A Simple Approach to Determine Single-Receiver Differential Code Bias Using Precise Point Positioning.

In this study, a precise single-receiver differential code bias (DCB) estimation method using the precise point positioning (PPP) model is presented. The first step is to extract the high-precision ionospheric observations, including DCBs, based on the PPP model. Then, the satellite DCBs are corrected using International GNSS Service (IGS) products. Lastly, the algorithm for the minimization of the standard deviation of vertical total electron content (VTECmstd) is employed to determine the value of receiver DCB. To check the method, GNSS data from more than 200 IGS stations around the globe on four days with various geomagnetic and solar activity circumstances are processed. The receiver DCBs are compared to those obtained using previous carried-to-code level (CCL) models. The experimental results show that, compared to the CCL model, the values of VTECmstd for most stations are significantly reduced, the mean number of stations with negative ionospheric measurements is reduced by 40% after correcting the receiver DCBs, and the mean error of estimated receiver DCBs is reduced by approximately 0.6 ns using the PPP model. These results suggest that this method can provide more high-precision receiver DCB estimation.

Thermoelectrics and thermocells for fire warning applications.

Historically, fire disasters have killed numerous human lives, and caused tremendous property loss. Fire warning systems play a vital role in predicting fire risks, and are strongly desired to effectively prevent the disaster occurrence and significantly reduce the loss. Among the developed fire warning systems, thermoelectrics (TEs) and thermocells (TECs)-based fire warning materials are extremely important and indispensable in future research, owing to their unique capability of direct conversion between heat and electricity. Here, we present this review of the recent progress of TEs and TECs in fire warning field. Firstly, a brief introduction of existing fire warning systems is provided, including the mechanisms and features of various types. Then, the mechanisms of electronic TE (eTE), ionic TE (iTE) and TEC are elucidated. Next, the basic principles for the material preparation and device fabrication are discussed in their dimension sequence. Subsequently, some important advances or examples of TE fire warnings are highlighted in details. Finally, the challenges and prospects are outlooked.

Tomato-fruit-derived extracellular vesicles inhibit Fusobacterium nucleatum via lipid-mediated mechanism.

Nano-sized extracellular vesicles (EV) are essential for cell communication. Studies on EV from natural sources including edible plants are gaining momentum due to the biological implications. In this study, EV from tomato fruit were isolated by ultracentrifugation and their physical and morphological features along with their biocargo profiles were analyzed. We found that tomato EV promote the growth of probiotic Lactobacillus species, while inhibiting growth of the opportunistic intestinal pathogens Clostridioides difficile and Fusobacterium nucleatum. Tomato EV reversed microbiota dysbiosis caused by F. nucleatum in a simulator of the gut microbiota fermentation model. Phospholipid analysis of tomato EV revealed that the anti-bacterial effect of tomato-EV was driven by the presence of specific lipids in the EV, as demonstrated by lipid depletion and reconstitution experiments. The findings suggest the potential of tomato-derived EV for treating gut microbiota dysbiosis and preventing intestinal bacterial infections.

A simple and reliable instance selection for fast training support vector machine: Valid Border Recognition.

Support vector machines (SVMs) are powerful statistical learning tools, but their application to large datasets can cause time-consuming training complexity. To address this issue, various instance selection (IS) approaches have been proposed, which choose a small fraction of critical instances and screen out others before training. However, existing methods have not been able to balance accuracy and efficiency well. Some methods miss critical instances, while others use complicated selection schemes that require even more execution time than training with all original instances, thus violating the initial intention of IS. In this work, we present a newly developed IS method called Valid Border Recognition (VBR). VBR selects the closest heterogeneous neighbors as valid border instances and incorporates this process into the creation of a reduced Gaussian kernel matrix, thus minimizing the execution time. To improve reliability, we propose a strengthened version of VBR (SVBR). Based on VBR, SVBR gradually adds farther heterogeneous neighbors as complements until the Lagrange multipliers of already selected instances become stable. In numerical experiments, the effectiveness of our proposed methods is verified on benchmark and synthetic datasets in terms of accuracy, execution time and inference time.

Multimodal data-driven prognostic model for predicting new-onset ST-elevation myocardial infarction following emergency percutaneous coronary intervention.

OBJECTIVES: We developed a nomogram model derived from inflammatory indices, clinical data, and imaging data to predict in-hospital major adverse cardiac and cerebrovascular events (MACCEs) following emergency percutaneous coronary intervention (PCI) in patients with new-onset ST-elevation myocardial infarction (STEMI). METHODS: Patients with new-onset STEMI admitted between June 2020 and November 2022 were retrospectively reviewed. Data pertaining to coronary angiograms, clinical data, biochemical indices, and in-hospital clinical outcomes were derived from electronic medical records. Lasso regression model was employed to screen risk factors and construct a prediction model. RESULTS: Overall, 547 patients with new-onset STEMI who underwent PCI were included and assigned to the training cohort (n = 384) and independent verification cohort (n = 163). Six clinical features (age, diabetes mellitus, current smoking, hyperuricemia, neutrophil-to-lymphocyte ratio, and Gensini score) were selected by LASSO regression to construct a nomogram to predict the risk of in-hospital MACCEs. The area-under-the-curve (AUC) values for in-hospital MACCEs risk in the training and independent verification cohorts were 0.921 (95% CI 0.881-0.961) and 0.898 (95% CI 0.821-0.976), respectively. It was adequately calibrated in both training cohort and independent verification cohorts, and predictions were correlated with actual outcomes. Decision curve analysis demonstrated that the nomogram was capable of predicting in-hospital MACCEs with good clinical benefit. CONCLUSIONS: Our prediction nomogram based on multi-modal data (inflammatory indices, clinical and imaging data) reliably predicted in-hospital MACCEs in new-onset STEMI patients with emergency PCI. This prediction nomogram can enable individualized treatment strategies.