Machine Learning for Early Prediction of Major Adverse Cardiovascular Events After First Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction: Retrospective Cohort Study.

BACKGROUND: The incidence of major adverse cardiovascular events (MACEs) remains high in patients with acute myocardial infarction (AMI) who undergo percutaneous coronary intervention (PCI), and early prediction models to guide their clinical management are lacking. OBJECTIVE: This study aimed to develop machine learning-based early prediction models for MACEs in patients with newly diagnosed AMI who underwent PCI. METHODS: A total of 1531 patients with AMI who underwent PCI from January 2018 to December 2019 were enrolled in this consecutive cohort. The data comprised demographic characteristics, clinical investigations, laboratory tests, and disease-related events. Four machine learning models-artificial neural network (ANN), k-nearest neighbors, support vector machine, and random forest-were developed and compared with the logistic regression model. Our primary outcome was the model performance that predicted the MACEs, which was determined by accuracy, area under the receiver operating characteristic curve, and F1-score. RESULTS: In total, 1362 patients were successfully followed up. With a median follow-up of 25.9 months, the incidence of MACEs was 18.5% (252/1362). The area under the receiver operating characteristic curve of the ANN, random forest, k-nearest neighbors, support vector machine, and logistic regression models were 80.49%, 72.67%, 79.80%, 77.20%, and 71.77%, respectively. The top 5 predictors in the ANN model were left ventricular ejection fraction, the number of implanted stents, age, diabetes, and the number of vessels with coronary artery disease. CONCLUSIONS: The ANN model showed good MACE prediction after PCI for patients with AMI. The use of machine learning-based prediction models may improve patient management and outcomes in clinical practice.

Rapid Diagnosis of Hemophagocytic Lymphohistiocytosis Triggered by Disseminated BCG Infection in Infants With Severe Combined Immunodeficiency: Case Report.

Hemophagocytic lymphohistiocytosis triggered by disseminated Bacillus Calmette-Guerin infection is rare. Targeted next-generation sequencing for tuberculosis can rapidly identify different strains of Mycobacterium tuberculosis complex as well as drug resistance genes. Herein we report 2 cases of hemophagocytic lymphohistiocytosis in whom targeted next-generation sequencing rapidly identified Bacillus Calmette-Guerin as the infectious trigger.

Pre- and post-pollination barriers between two exotic and five native Sagittaria species: Implications for species conservation.

Anthropogenic introduction of species has resulted in a breakdown of geographical barriers and hybridization in previously allopatric species. Thus, examining hybridization proneness of exotic species contributes to revealing its potential threat. Moreover, reproductive barriers may be strengthened or weakened due to long-term geographical isolation for these newly sympatric species. However, few studies have evaluated multiple barriers between alien and native species. In this study, we quantified the importance of four pre-pollination barriers (phenological, floral traits, pollen production, and floral constancy) and four post-pollination barriers (pollen-pistil incompatibility, seed set, seed viability, and seedling survival) between two introduced and five native Sagittaria species. Results showed that introduced S. platyphylla was cross-compatible with two native species, whereas introduced S. montevidensis was incapable of hybridizing with any native species. Different barriers were asymmetric within species pairs and multiple barriers acted in concert to maintain species boundaries. Post-pollination barriers contributed more to total reproductive isolation in native species, whereas pre-pollination barriers played a stronger role in total reproductive isolation for two introduced species. Seed set was the only barrier that was positively correlated with genetic distance. Our results provide a perspective to better understand reproductive barriers for secondary contact species. We highlight the importance of monitoring hybridization events before human introduction and the possible conservation strategies to remove invasive species with hybridization proneness.

Controlling basal plane sulfur vacancy in water splitting MoSx/NiF electrocatalysts through electric-field-assisted pulsed laser ablation.

Eco-friendly, efficient, and durable electrocatalysts from earth-abundant materials are crucial for water splitting through hydrogen and oxygen generation. However, available methods to fabricate electrocatalysts are either hazardous and time-consuming or require expensive equipment, hindering the large-scale, eco-friendly production of artificial fuels. Here, we present a rapid, single-step method for producing MoSx/NiF electrocatalysts with controlled sulfur-vacancies via electric-field-assisted pulsed laser ablation (EF-PLA) in liquid and in-situ deposition on nickel foam, enabling efficient water splitting. Electric-field parameters efficiently control S-vacancy active sites in electrocatalysts. Higher electric fields yield a MoSx/NiF electrocatalyst with a larger density of S-vacancy sites, suited for HER due to lower Gibbs free energy for H∗ adsorption, while lower electric fields produce an electrocatalyst with lower S-vacancy sites, better suited for OER, as shown by both experimental and theoretical results. The present work opens a horizon in designing high-efficiency catalysts, for a wide range of chemical reactions.

The influence of self-pollen deposition on female reproductive success in a self-incompatible plant, Akebia quinata.

Geitonogamy is inevitable in hermaphrodite and monecious. Even for self-incompatible species, the negative effects of self-pollen are unavoidable when geitonogamous or self-mating occurs. However, the influence of self-pollen on consecutive development of flowers (e.g., fruiting and seeding) was seldom evaluated. Here, the self-incompatible monecious species, Akebia quinata, was used to estimate the influence of self-pollen deposition. We evaluated the extent of pollen limitation and geitonogamous mating under natural conditions by count of stigmatic pollen load and pollen tracking experiment. Hand pollination with different amount and combinations of self vs. cross pollen grains was applied to detect the response of fruit and seed set. The results showed that geitonogamy and pollen limitation occurred under natural conditions in A. quinata. Carpel numbers, ratio of self- and cross-pollen, and the interactive effect of ratio of self- and cross-pollen and total mixed pollen numbers, and not total pollen grain number, determined the effect of self-pollen on female reproductive success. The effect of self-pollen depended on its intensity. In general, the transfer of self-pollen significantly affected young fruit set. However, a little self-pollen together with cross-pollen did not reduce young fruit production. Although self-incompatible plants have evolved physiological mechanisms that reduce self-fertilization, our results provide new insights into the effects of self-pollen and the adaptive significance of self-incompatible monecious species.

Compound heterozygous variations in IARS1 cause recurrent liver failure and growth retardation in a Chinese patient: a case report.

BACKGROUND: Aminoacyl-tRNA synthetases (ARSs) are enzymes responsible for attaching amino acids to tRNA, which enables protein synthesis. Mutations in isoleucyl-tRNA synthetase (IARS1) have recently been reported to be a genetic cause for growth retardation, intellectual disability, muscular hypotonia, and infantile hepatopathy (GRIDHH). CASE PRESENTATION: In this study, we reported an additional case of compound heterozygous missense variations c.701 T > C (p.L234P) and c.1555C > T (p.R519C) in IARS1, which were identified using medical exome sequencing; c.701 T > C (p.L234P) was a novel variant, and c.1555C > T (p.R519C) was found in GnomAD. Unlike other reported patients, this individual presented prominently with recurrent liver failure, which led to her death at an early age of 19 months. She also had significant growth retardation, muscular hypotonia, chubby and flabby face, recurrent loose stools, and abnormal brain computed tomography (CT), while zinc deficiency and hearing loss were not present. Studies in zebrafish embryo modeling recapitulated some of the key phenotypic traits in embryo development, neurodevelopment, liver development, and myogenesis, demonstrating that these variations caused a loss of gene function in IARS1. CONCLUSIONS: We have found a novel mutation point c.701 T > C (p.L234P) in IARS1. Compound heterozygous mutations of c.701 T > C (p.L234P) and c.1555C > T (p.R519C) in IARS1 are pathogenic, which can cause GRIDHH in child.

Effects of heterospecific pollen on stigma behavior in Campsis radicans: Causes and consequences.

PREMISE: Pollinator sharing of co-flowering plants may result in interspecific pollen receipt with a fitness cost. However, the underlying factors that determine the effects of heterospecific pollen (HP) are not fully understood. Moreover, the cost of stigma closure induced by HP may be more severe for plants with special touch-sensitive stigmas than for plants with non-touch-sensitive stigmas. Very few studies have assessed HP effects on stigma behavior. METHODS: We conducted hand-pollination experiments with 10 HP donors to estimate HP effects on stigma behavior and stigmatic pollen germination in Campsis radicans (Bignoniaceae) at low and high pollen loads. We assessed the role of phylogenetic distance between donor and recipient, pollen size, and pollen aperture number in mediating HP effects. Additionally, we observed pollen tube growth to determine the conspecific pollen-tube-growth advantage. RESULTS: Stigma behavior differed significantly with HP of different species. Pollen load increased, while pollen size decreased, the percentage of permanent closure and stigmatic germination of HP. Stigmatic HP germination increased with increasing aperture number. However, HP effects did not depend on phylogenetic distance. In addition, conspecific pollen had a pollen-tube-growth advantage over HP. CONCLUSIONS: Our results provide a good basis for understanding the stigma-pollen recognition process of plant taxa with touch-sensitive stigmas. We concluded that certain flowering traits drive the HP effects on the post-pollination period. To better understand the impact of pollinator sharing and interspecific pollen transfer on plant evolution, we highlight the importance of evaluating more factors that determine HP effects at the community level.

Identification of novel saltiness-enhancing peptides from yeast extract and their mechanism of action for transmembrane channel-like 4 (TMC4) protein through experimental and integrated computational modeling.

Excessive consumption of sodium salt is one of the important inducers of cardiovascular and cerebrovascular diseases. The reduction of physical labor and attention to health make research on low-sodium salt imminent. Ultrafiltration, gel filtration, preparative high-performance liquid chromatography, and liquid chromatography with tandem mass spectrometry were employed for further purification and identification of the salty enhancing peptides in yeast extracts. Moreover, human transmembrane channel-like 4 (TMC4) was constructed and evaluated by computer-based methods, and salt-enhancing peptides were identified based on its allosteric sites. PN, NSE, NE and SPE were further determined to be salty enhancing peptides through sensory evaluation, and their taste mechanism was investigated. The results presented here suggest that silicon screening focused on TMC4 allosteric sites and sensory evaluation experiments can greatly increase the discoverability and identifiability of salty enhancer peptides, and this strategy is the first to be applied to the development of salty enhancer peptides.

Fish oil-containing lipid emulsions prevention on parenteral nutrition-associated cholestasis in very low birth weight infants: a meta-analysis.

BACKGROUND: The effect of fish oil-containing lipid emulsions on preventing parenteral nutrition-associated cholestasis (PNAC) in very low birth weight (VLBW) infants is not known. Thus, we conducted a meta-analysis to identify any prevention effect. METHODS: PubMed, EMBASE, and CENTRAL were searched up to 26 January 2021 for studies related to the preventive effect of fish oil-containing lipid emulsions and fish oil-free lipid emulsions on cholestasis in VLBW infants. Revman 5.3 was used to synthesize the results. A fixed-effect model was used to summarize the data when the heterogeneity was non-significant (I2 < 50%), and a random-effects model was used when the heterogeneity was significant (I2 > 50%). RESULTS: Of 728 articles, 11 randomized controlled trials met the inclusion criteria. The meta-analysis indicated that fish oil-containing lipid emulsion reduced the occurrence of PNAC significantly with risk ratio (RR) = 0.53, 95% confidence interval (CI) 0.36-0.80, P = 0.002. The heterogeneity was non-significant with I2 = 23%. Subgroup analysis based on parenteral nutrition duration and median birth weight was performed. The synthesis results for patients with parenteral nutrition duration exceeding 14 days revealed I2 = 35% (P = 0.15) and pooled RR = 0.47, 95% CI 0.30-0.73, P = 0.0008; and for patients with duration less than 14 days revealed I2 = 0% (P = 0.72) and pooled RR = 1.14, 95% CI 0.39-3.35, P = 0.81. The synthesis for patients with birth weight more than 1000 g revealed I2 = 0% (P = 0.41) and pooled RR = 0.55, 95% CI 0.26-1.18, P = 0.12; and for patients with birth weight below 1000 g revealed I2 = 44% (P = 0.11) and pooled RR = 0.53, 95% CI 0.33-0.85, P = 0.009. CONCLUSIONS: The fish oil-containing lipid emulsion can reduce the occurrence of PNAC in VLBW infants based on the available original randomized controlled trial studies, especially for patients with parenteral nutrition duration exceeding 14 days and extremely low birth weight infants. Future studies should be performed before a definitive conclusion can be established.

Characterization of odor-active compounds in moso bamboo (Phyllostachys pubescens Mazel) leaf via gas chromatography-ion mobility spectrometry, one- and two-dimensional gas chromatography-olfactory-mass spectrometry, and electronic nose.

The leaf of moso bamboo (Phyllostachys pubescens Mazel) is rich in odorant compounds, which is important natural materials for the production of flavor. It also contains phenolic acids, amino acids and peptides, which is a potential source of natural bioactive compounds. The study of odor-active compounds in bamboo leaves can provide a basis for the discovery of natural flavor. The leaf, stem, and powder of moso bamboo were analyzed by gas chromatography-ion mobility spectrometry (GC-IMS). Main odor-active compounds in moso bamboo leaf were analyzed and characterized by (1) a gas chromatography olfactory mass spectrometry (GC-O-MS), (2) two-dimensional gas chromatography olfactory mass spectrometry (GC × GC-O-MS) and (3) electronic nose (E-nose). Based on aroma extract dilution analysis (AEDA), 13 key odor-active compounds with high flavor dilution (FD) factor (≥27), including 3-methyl-1-butanol, (E)-2-hexenal, ethyl hexanoate, (Z)-4-heptenenal, 6-methyl-5-hepten-2-one, octanal, ethyl (Z)-3-hexenoate, 1-hexanol, (Z)-3-hexen-1-ol, (E, E)-2,4-heptadienal, (Z)-2-hexen-1-ol, 1-octen-3-ol and benzaldehyde, were further analyzed. The compounds detected by the above four methods were (E)-2-hexenal, 6-methyl-5-hepten-2-one, octanal, (E, E)-2,4-heptadienal, 1-octen-3-ol and benzaldehyde, and all of which were the main and potential odorants of moso bamboo leaf.

Clinical features of sodium-taurocholate cotransporting polypeptide deficiency in pediatric patients: case series and literature review.

Sodium-taurocholate cotransporting polypeptide (NTCP) deficiency is a newly reported hereditary bile acid metabolic disease. Here we describe the clinical characteristics of 12 cases of pediatric NTCP deficiency, as well as review 60 previously reported cases in the literature in order to provide better guidance for pediatricians. The clinical records, laboratory and imaging data were collected of 12 cases who were treated at the pediatric infectious disease department of the West China Second University Hospital of Sichuan University, China, from December 2018 to July 2020. PubMed and Wanfang databases were searched and 11 studies including 60 pediatric NTCP deficiency patients from January 2015 to November 2020 were retrieved. In our center, there were 4 girls and 8 boys, with a median age at admission of 9.9 months (range, 2.2 to 70 months). Six patients (50%) had prolonged neonatal jaundice. All of the patients (12/12; 100%) had normal growth and development. The reason for the first visit was prolonged neonatal jaundice (4/12, 33.3%), non-liver related diseases (6/12, 50%) and routine checkup (2/12, 16.7%). Hypercholanemia was documented in 12/12 (100%), elevated aspartate aminotransferase (AST) in 6/12 (50%), and elevated alanine aminotransferase (ALT) in 1/12 (8.3%). All of the patients (12/12; 100%) had homozygous mutations of c.800C>T in SLC10A1. Sixty patients (22 girls and 38 boys) were included in the literature review; 36 (60%) had hyperbilirubinemia after 1 month. The reasons for testing for hypercholanemia were identified in 47/60 cases, and included prolonged neonatal jaundice and neonatal transient cholestasis in 26 (26/47, 55.3%); non-liver related diseases in 14 (14/47, 29.8%); routine medical examination in 3 (3/14, 6.4%); volunteer recruitment in 1 (1/14, 7.1%); dark urine in 1 (1/47, 2.1%). Hypercholanemia was confirmed in 60/60 (100%); 31 (51.7%) had elevated AST, and 10 (16.7%) had elevated ALT. Among 59 Chinese patients, 52 (88.1%) had homozygous mutations of c.800C>T in SLC10A1. The most common symptom of pediatric NTCP deficiency is jaundice. NTCP deficiency can also be detected during routine check-ups. The common biochemical features are hypercholanemia and elevated AST. Screening for c.800C>T mutation in SLC10A1 is useful for primary genetic screening in Chinese infants with persistent hypercholanemia after infectious, structural, and immunological factors are excluded.

Grow fast but don't die young: Maternal effects mediate life-history trade-offs of lizards under climate warming.

As postulated by life-history theory, not all life-history traits can be maximized simultaneously. In ectothermic animals, climate warming is predicted to increase growth rates, but at a cost to overall life span. Maternal effects are expected to mediate this life-history trade-off, but such effects have not yet been explicitly elucidated. To understand maternal effects on the life-history responses to climate warming in lizard offspring, we conducted a manipulative field experiment on a desert-dwelling viviparous lacertid lizard Eremias multiocellata, using open-top chambers in a factorial design (maternal warm climate and maternal present climate treatments × offspring warm climate and offspring present climate treatments). We found that the maternal warm climate treatment had little impact on the physiological and life-history traits of adult females (i.e. metabolic rate, reproductive output, growth and survival). However, the offspring warm climate treatment significantly affected offspring growth, and both maternal and offspring warm climate treatments interacted to affect offspring survival. Offspring from the warm climate treatment grew faster than those from the present climate treatment. However, the offspring warm climate treatment significantly decreased the survival rate of offspring from maternal present climate treatment, but not for those from the maternal warm climate treatment. Our study demonstrates that maternal effects mediate the trade-off between growth and survival of offspring lizards, allowing them to grow fast without a concurrent cost of low survival rate (short life span). These findings stress the importance of adaptive maternal effects in buffering the impact of climate warming on organisms, which may help us to accurately predict the vulnerability of populations and species to future warming climates.

Zinc supplementation in acute diarrhea.

OBJECTIVE: To determine the effect of zinc supplementation on the duration of acute diarrhea in children. METHODS: A search was conducted in PubMed, the Cochrane Library database, China Biology Medicine (CBM), CNKI, VIP, and Wanfang Data to find studies on zinc supplementation for children with acute diarrhea from the date of establishment of the respective databases to June 2013. Clinical trials were included, and reviews or other types of studies were excluded. Considering the inclusion criteria, articles were evaluated by two individual investigators. The Cochrane Handbook 5.0.2 was used to evaluate the methodological quality. RevMan 5.2 software was used for meta-analysis. Heterogeneity of the included studies was tested to select a proper effect model. Measurement data were expressed as standard mean difference (SMD), weighted mean difference (WMD), and 95 % confidence interval (CI). RESULTS: A total of 860 relevant articles were found, and 8 randomized control trials that met the inclusion criteria were included. Meta-analysis showed a significant difference in the duration of acute diarrhea between treatment and control groups, with a WMD of -14.47 (95 % CI: -25.06 to -3.89; P = 0.007). However, significant heterogeneity was found among the studies. Sensitivity analysis and subgroup analyses based on admission condition, sample size and age group were also performed, for which heterogeneity cannot be completely eliminated. CONCLUSIONS: Zinc supplementation can decrease the duration of acute diarrhea in children, but future studies should carry out a more thorough analysis in less heterogeneous subjects for a more definitive conclusion.

Aroma-active compounds in jinhua ham produced with different fermentation periods.

The aroma-active compounds in Jinhua ham processed and stored for 9, 12, 15 and 18 months were extracted by dynamic headspace sampling (DHS) and solvent-assisted flavor evaporation (SAFE) and analyzed by gas chromatography-olfactometry-mass spectrometry (GC-O-MS). In GC-O-MS, volatile compounds were identified based on their mass spectrum, linear retention index (LRI), odor properties, or reference compound comparisons. The results showed that a total number of 81 aroma-active compounds were identified by GC-O-MS. Among them, acids (such as acetic acid, butanoic acid and 3-methylbutanoic acid), saturated aldehydes (such as hexanal, heptanal, octanal and 3-methylbutanal), benzene derivatives (such as benzeneacetic acid), ester and lactone (such as γ-nonalactone and γ-decalactone) were identified as critical compounds in Jinhua ham aroma. The results also indicated that the type and content of the odorants increased significantly with the duration of the fermentation period.

[Relationship between white blood cell count, neutrophils ratio and erythrocyte sedimentation rate and short clinical outcomes among patients with acute ischemic stroke at hospital admission].

OBJECTIVE: To investigate the relationship between white blood cell count, neutrophils ratio and erythrocyte sedimentation rate and short outcomes among patients with acute ischemic stroke at admission to the hospital. METHODS: A total of 2675 acute ischemic stroke patients were included in this study. Data on demographic characteristics, life style, history of disease, white blood cell count (WBC), neutrophils ratio (NEUR), erythrocyte sedimentation rate (ESR) and clinical outcomes were collected for all the participants. Poor clinical outcome was defined as neurologic deficiency (NIHSS ≥ 5) at discharge or death during hospitalization. RESULTS: White blood cell count, neutrophils ratio and erythrocyte sedimentation rate were higher in patients with poor outcome than in those without clinical outcome. According to the quartile range, WBC, NEUR and ESR were divided into four levels at admission. After adjustment for multivariate, compared with WBC ≤ 5.6× 10(9)/L, the odds ratio (95% confidence intervals) of poor outcome with ≥ 8.7×10(9)/L was 1.883 (1.306 - 2.716). When compared with NEUR ≤ 0.56, the odds ratio (95% confidence intervals) of poor outcome with 0.57 - 0.64 and with ≥ 0.74 were 1.572 (1.002 - 2.466) and 2.577 (1.698 - 3.910), respectively. When compared with ESR ≤ 4 mm/h, the odds ratio (95% confidence intervals) of poor outcome with ≥ 17 mm/h was 2.426 (1.233 - 4.776). Elevated WBC count and NEUR at admission were significantly and positively associated with poor clinical outcomes among patients with acute ischemic stroke (trend test P < 0.05). Elevated ESR was not significantly or positively associated with poor clinical outcomes among patients with acute ischemic stroke (trend test P > 0.05). CONCLUSION: There appeared associations between WBC, NEUR, ESR and poor outcome among patients with acute ischemic stroke at admission to the hospital. Both elevated WBC count and NEUR showed significantly positive association with poor clinical outcomes among patients with acute ischemic stroke at admission.

[Environment spatial distribution of mercury pollution in Songhua River upstream gold mining areas].

Using Zeeman mercury spectrometer RA915+ monitoring the total gaseous mercury concentration were collected from gold mining area in Huadian, in the upper reaches of the Songhua River, during summer and autumn of 2008, where we simultaneously collected samples of air, water, sediment and soil. The research is focused on analyzing of the spatial and temporal distribution characteristics of atmospheric mercury pollution and the correlation with other environmental factors. The results show that: the concentration of atmospheric mercury in summer is higher than that in autumn and in the evening is higher than at noon, and it present a gradual decay with the distance to the gold mining area as the center point increasing. The distribution rule of mercury pollution of environmental factors in the gold mining area is: in sediment > in soil > in plant > in water, the characteristics of mercury pollution distribution in plant is: root > stem and leaf, and the content of mercury in plant in autumn is commonly higher than that in summer. This is thought due to the accumulation of pollutant element from soil during the growth of plant. The atmospheric mercury has a significant correlation with the root of plant, respectively 0.83 in summer and 0.97 in autumn.

Correlations of creatine and six related pyrimidine metabolites and diabetic nephropathy in Chinese type 2 diabetic patients.

OBJECTIVES: The assessment of the clinical significance of creatine, cytosine, cytidine, uridine, thymine, thymidine, and 2'-deoxyuridine concentrations in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) for the detection of the relationship between pyrimidine metabolites and disease. DESIGN AND METHODS: The study group consisted of 119 subjects, which were divided to three groups: control (n=31), type 2 diabetes without nephropathy (DM, n=23), and with nephropathy (DN, n=65). Levels of related metabolites were measured in plasma of all participants. RESULTS: There is a significant increase in levels of cytosine (P<0.001), cytidine (P<0.001), and thymidine (P=0.016) with DN compared to DM. The levels of uridine, thymine, 2'-deoxyuridine, and creatine did not change. CONCLUSIONS: The levels of cytosine, cytidine, and thymidine may be useful for monitoring the progression of DM and evaluating the treatment.