Radiomics analysis for prediction and classification of submucosal tumors based on gastrointestinal endoscopic ultrasonography.

Objectives: To identify and classify submucosal tumors by building and validating a radiomics model with gastrointestinal endoscopic ultrasonography (EUS) images. Methods: A total of 144 patients diagnosed with submucosal tumors through gastrointestinal EUS were collected between January 2019 and October 2020. There are 1952 radiomic features extracted from each patient's EUS images. The statistical test and the customized least absolute shrinkage and selection operator regression were used for feature selection. Subsequently, an extremely randomized trees algorithm was utilized to construct a robust radiomics classification model specifically tailored for gastrointestinal EUS images. The performance of the model was measured by evaluating the area under the receiver operating characteristic curve. Results: The radiomics model comprised 30 selected features that showed good discrimination performance in the validation cohorts. During validation, the area under the receiver operating characteristic curve was calculated as 0.9203 and the mean value after 10-fold cross-validation was 0.9260, indicating excellent stability and calibration. These results confirm the clinical utility of the model. Conclusions: Utilizing the dataset provided curated from gastrointestinal EUS examinations at our collaborating hospital, we have developed a well-performing radiomics model. It can be used for personalized and non-invasive prediction of the type of submucosal tumors, providing physicians with aid for early treatment and management of tumor progression.

Esophageal ulcer and multisystem inflammatory syndrome after COVID-19: A case report.

BACKGROUND: Multisystem inflammatory syndrome in adults (MIS-A) is a rare but severe disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 infection. It develops in adults with inflammation of different organs including the gastrointestinal tract, heart, kidneys, skin and hematopoietic system. CASE SUMMARY: We present a 58-year-old Chinese man diagnosed with MIS-A. His chief complaints were fever, generalized fatigue and anorexia, accompanied with rashes on his back. Further examination showed cardiac, renal and liver injury. He had melena and gastroscopy indicated esophageal ulcer and severe esophagitis. Repeated blood and sputum culture did not show growth of bacteria or fungi. Antibiotic treatment was stopped due to unsatisfactory performance. His condition improved after prednisone and other supportive treatment. CONCLUSION: Gastrointestinal involvement in MIS-A is not uncommon. Intestinal involvement predominates, and esophageal involvement is rarely reported. Esophageal ulcer with bleeding could also be a manifestation of MIS-A.

Multimodal imaging diagnosis and analysis of prognostic factors in patients with adult-onset Coats disease.

AIM: To describe the multimodal imaging features, treatment, and outcomes of patients diagnosed with adult-onset Coats disease. METHODS: This retrospective study included patients first diagnosed with Coats disease at ≥18 years of age between September 2017 and September 2021. Some patients received anti-vascular endothelial growth factor (VEGF) therapy (conbercept, 0.5 mg) as the initial treatment, which was combined with laser photocoagulation as needed. All the patients underwent best corrected visual acuity (BCVA) and intraocular pressure examinations, fundus color photography, spontaneous fluorescence tests, fundus fluorescein angiography, optical coherence tomography (OCT), OCT angiography, and other examinations. BCVA alterations and multimodal image findings in the affected eyes following treatment were compared and the prognostic factors were analyzed. RESULTS: The study included 15 patients who were aged 24-72 (57.33±12.61)y at presentation. Systemic hypertension was the most common associated systemic condition, occurring in 13 (86.7%) patients. Baseline BCVA ranged from 2.0 to 5.0 (4.0±1.1), which showed improvement following treatment (4.2±1.0). Multimodal imaging revealed retinal telangiectasis in 13 patients (86.7%), patchy hemorrhage in 5 patients (33.3%), and stage 2B disease (Shield's staging criteria) in 11 patients (73.3%). OCT revealed that the baseline central macular thickness (CMT) ranged from 129 to 964 µm (473.0±230.1 µm), with 13 patients (86.7%) exhibiting a baseline CMT exceeding 250 µm. Furthermore, 8 patients (53.3%) presented with an epiretinal membrane at baseline or during follow-up. Hyper-reflective scars were observed on OCT in five patients (33.3%) with poor visual prognosis. Vision deteriorated in one patient who did not receive treatment. Final vision was stable in three patients who received laser treatment, whereas improvement was observed in one of two patients who received anti-VEGF therapy alone. In addition, 8 of 9 patients (88.9%) who received laser treatment and conbercept exhibited stable or improved BCVA. CONCLUSION: Multimodal imaging can help diagnose adult-onset Coats disease. Anti-VEGF treatment combined with laser therapy can be an option for improving or maintaining BCVA and resolving macular edema. The final visual outcome depends on macular involvement and the disease stage.

25.71%-Efficiency FACsPbI3 Perovskite Solar Cells Enabled by A Thiourea-based Isomer.

Various isomers have been developed to regulate the morphology and reduce defects in state-of-the-art perovskite solar cells. To insight the structure-function-effect correlations for the isomerization of thiourea derivatives on the performance of the perovskite solar cells (PSCs), we developed two thiourea derivatives [(3,5-dichlorophenyl)amino]thiourea (AT) and N-(3,5-dichlorophenyl)hydrazinecarbothioamide (HB). Supported by experimental and calculated results, it was found that AT can bind with undercoordinated Pb2+ defect through synergistic interaction between N1 and C=S group with a defect formation energy of 1.818 eV, which is much higher than that from the synergistic interaction between two -NH- groups in HB and perovskite (1.015 eV). Moreover, the stronger interaction between AT and Pb2+ regulates the crystallization process of perovskite film to obtain a high-quality perovskite film with high crystallinity, large grain size, and low defect density. Consequently, the AT-treated FACsPbI3 device engenders an efficiency of 25.71% (certified as 24.66%), which is greatly higher than control (23.74%) and HB-treated FACsPbI3 devices (25.05%). The resultant device exhibits a remarkable stability for maintaining 91.0% and 95.2% of its initial efficiency after aging 2000 h in air condition or tracking at maximum power point for 1000 h, respectively.

High-resolution MR vessel wall imaging and cardiovascular health for evaluating the occurrence of ischemic stroke.

OBJECTIVES: To explore the value of high-resolution MR vessel wall imaging (HR-VWI) based plaque characteristics combined with cardiovascular health (CVH) metrics in the risk evaluation of ischemic stroke attributed to middle cerebral artery (MCA) atherosclerotic stenosis. METHODS: Retrospective analysis of 209 participants with middle cerebral atherosclerosis, 146 patients with high signal in the MCA area on DWI were included in the symptomatic group, and 63 patients were included in the asymptomatic group. The degree of stenosis, enhancement ratio, plaque burden, remodeling index, and intraplaque hemorrhage were measured and compared between groups. Seven CVH metrics and other clinical data were obtained. The association between these factors and ischemic stroke was investigated by univariate and multivariate analysis. RESULTS: The degree of stenosis [OR, 1.036 (95 % CI, 1.014-1.058); P = 0.001], plaque burden [OR, 0.958 (95 % CI, 0.928-0.989); P = 0.009], intraplaque hemorrhage [OR, 3.530 (95 % CI, 1.233-10.110); P = 0.019], physical activity [OR, 4.321 (95 % CI, 1.526-12.231); P = 0.006], and diet [OR, 8.986 (95 % CI, 2.747-29.401); P < 0.001] were the independent characteristics associated with the occurrence of ischemic stroke. ROC curve showed that the combination of plaque characteristics, diet, and physical activity achieved the highest AUC of 0.828 (95 % CI 0.770-0.877; P < 0.001), with sensitivity and specificity being 86.30 % and 66.67 %, respectively. CONCLUSION: Plaque characteristics combined with CVH metrics may identify high-risk populations for ischemic stroke and offer novel insights into risk evaluation and stratification.

A novel NIR-II fluorescent probe for hydrogen peroxide detection in drug-induced liver injury.

The synthesis of H2O2-activatable small molecules in the second near-infrared (NIR-II) window remains challenging. We present the NIR-II probe Z-1065 for real-time detection of H2O2. Z-1065 demonstrates high sensitivity and selectivity towards H2O2in vitro and effectively monitors H2O2 generation in drug-induced liver injury (DILI) mouse models.

[Ultrasonographic features of Castleman disease in the head and neck: a report of 7 cases].

PURPOSE: To summarize the ultrasonographic features of head and neck Castleman disease (CD), and to clarify its diagnostic key points. METHODS: Seven patients with head and neck CD confirmed by histopathology were collected from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The clinical features and ultrasound findings of the patients were evaluated. RESULTS: Of the 7 patients (1 male and 6 females), the mean age at diagnosis was 31.4 years (7-60 years). All the cases were hyaline vascular type. On ultrasound, 3 lesions (42.9%) were located in the parotid gland, 4 lesions(57.1%) in the neck. All the lesions presented as a solitary, well-defined and solid mass without calcification. The echogenicity was markedly hypoechoic in 1 case(14.3%) and hypoechoic in 6 cases (85.7%). Of the 7 CD cases, 4 cases (57.1%) were heterogeneous masses with linear echogenic septa. All lesions had mixed pattern in vascularity on color Doppler sonography. CONCLUSIONS: Most CDs in the head and neck represent as a markedly hypoechoic or hypoechoic lesion with mixed pattern in vascularity. The neoplasm may be characterized by the presence of linear echogenic septa within the mass.

Efficacy and safety of KRAS G12C inhibitor IBI351 monotherapy in patients with advanced non-small cell lung cancer: results from a phase 2 pivotal study.

INTRODUCTION: KRAS G12C mutation is a well-recognized and increasingly promising therapeutic target with significant unmet clinical needs in NSCLC patients. IBI351 is a potent covalent and irreversible inhibitor of KRAS G12C. Here, we present the efficacy and safety of IBI351 from an open-label, single-arm, phase 2 pivotal study. METHODS: Eligible NSCLC patients with KRAS G12C who failed standard therapy were enrolled. IBI351 was orally administered at a dose of 600 mg twice daily. Primary endpoint was confirmed objective response rate (ORR) assessed by independent radiological review committee (IRRC) as per RECIST v1.1. Other endpoints were safety, IRRC-confirmed disease control rate (DCR), duration of response (DoR), progression-free survival (PFS) and overall survival (OS). RESULTS: As of December 13, 2023, 116 pts were enrolled (ECOG PS 1: 91.4%; brain metastasis: 30.2%; prior treatments with both anti-PD-1/PD-L1 inhibitors and platinum-based chemotherapy: 84.5%). As per IRRC assessment, confirmed ORR was 49.1% (95% CI: 39.7-58.6), and DCR was 90.5% (95% CI: 83.7-95.2). The median DoR was not reached while disease progression or death events occurred in 22 (38.6%) pts, and the median PFS was 9.7 months (95% CI: 5.6-11.0). OS data was immature. Treatment-related adverse events (TRAEs) occurred in 107 (92.2%) pts while 48 (41.4%) pts had grade≥3 TRAEs. Common TRAEs were anemia (44.8%), alanine aminotransferase increased (28.4%), aspartate aminotransferase increased (27.6%), asthenia (26.7%) and protein urine present (25.0%). TRAEs leading to treatment discontinuation occurred in 9 (7.8%) pts. In biomarker evaluable pts (n=95), all pts had positive KRAS G12C in tissue while 72 pts were blood positive and 23 pts were blood negative for KRAS G12C. Pts with KRAS G12C in both blood and tissue had higher tumor burden at baseline (p <0.05) and worse PFS (p <0.05). Tumor mutation profiling identified TP53 (45.3%), STK11 (30.5%) and KEAP1 (21.1%) as the most common genes co-mutated with KRAS G12C. Among 13 genes with mutation frequency ≥5%, mutations of 6 genes (STK11, KEAP1, PIK3CG, POLE, SMAD4, and BRINP3) were significantly associated with worse PFS (p <0.05). Mutation in STK11 also showed significant association with higher tumor burden at baseline and lower response rate (p <0.05). CONCLUSIONS: IBI351 monotherapy demonstrated promising and sustained efficacy with manageable safety, supporting its potential as a new treatment option for KRAS G12C-mutant NSCLC.

Effects of undescribed iridoids in Patrinia punctiflora on insulin resistance in HepG2 cells.

Patrinia punctiflora is a medical and edible Chinese herb with high nutritional and medicinal value. The continuing study of its chemical constituents led to the isolation of six iridoids, which were previously unreported compounds, patriscabioins PU (1-6). Their structures were characterized and confirmed with NMR (1D & 2D), HRMS, IR and UV. Among them, compound 5 was screened to evaluate its insulin resistance activity on an IR-HepG-2 cell model. Compound 5 had no cytotoxicity compared with the control group and could promote glucose uptake in IR-HepG-2 cells. Through further mechanism studies, the undescribed compound 5 could increase the expression levels of PI-3 K, p-AKT, GLUT4 and p-GSK3ß proteins. Moreover, the expression of PEPCK and G6Pase proteins, which are key gluconeogenic enzymes, was also inhibited. Thus, compound 5 promotes the transfer of GLUT4 to the plasma membrane by activating the PI-3 K/AKT signaling pathway, at the same time, promotes glycogen synthesis and inhibits the onset of gluconeogenesis, which in turn ameliorates insulin resistance.

A photoelectrochemical sensor based on In2S3/AgInS2 in situ Z-type heterojunction with "photo-modulated interface charge" for sensitive detection of Programmed Death-Ligand 1.

The construction of heterostructure photoelectrodes can enhance the performance of photoelectrochemical (PEC) sensors. However, it is still a critical challenge to achieve efficient transfer of interface carriers. In this paper, we propose a strategy of "photo-modulated interface charge" to design a PEC sensor based on a hollow hexagonal tubular In2S3/AgInS2 in situ Z-type heterojunction for the susceptible detection of Programmed Death-ligand 1 (PD-L1). The hollow structured In2S3/AgInS2 is ingeniously synthesized employing indium-sourced MIL-68 as a sacrificial template and in situ cation exchange technique. This composite material has close contact interfaces due to in situ growth, which facilitates the spontaneous establishment of a robust and stable built-in electric field between the interfaces. Moreover, the inner cavity structure promotes multiple light refractions and scatterings, significantly enhancing light trapping capability. Under the influence of both light irradiation and electric field force, the migration direction of the interfacial charge is reversed, forming a Z-transfer path, which effectively delays the compounding of the electron-hole pairs (e-/h+) and further improves the sensitivity of the sensor. The minimum detection threshold of the PEC sensor is 26.58 fg/mL, and the feasibility of real samples is investigated, providing new insights for early diagnosis and prognostic treatment of diseases.

The acute effect of mindfulness-based regulation on neural indices of cue-induced craving in smokers.

Mindfulness has garnered attention for its potential in alleviating cigarette cravings; however, the neural mechanisms underlying its efficacy remain inadequately understood. This study (N=46, all men) aims to examine the impact of a mindfulness strategy on regulating cue-induced craving and associated brain activity. Twenty-three smokers, consuming over 10 cigarettes daily for at least 2 years， were compared to twenty-three non-smokers. During a regulation of craving task, participants were asked to practice mindfulness during smoking cue-exposure or passively view smoking cues while fMRI scans were completed. A 2 (condition: mindfulness-cigarette and look-cigarette) × 2 (phase: early, late of whole smoking cue-exposure period) repeated measures ANOVA showed a significant interaction of the craving scores between condition and phase, indicating that the mindfulness strategy dampened late-phase craving. Additionally, within the smoker group, the fMRI analyses revealed a significant main effect of mindfulness condition and its interaction with time in several brain networks involving reward, emotion, and interoception. Specifically, the bilateral insula, ventral striatum, and amygdala showed lower activation in the mindfulness condition, whereas the activation of right orbitofrontal cortex mirrored the strategy-time interaction effect of the craving change. This study illuminates the dynamic interplay between mindfulness, smoking cue-induced craving, and neural activity, offering insights into how mindfulness may effectively regulate cigarette cravings.

New Sweet-Tasting Gypenosides from "Jiaogulan" (Gynostemma pentaphyllum) and Their Interactions with the Homology Model of Sweet Taste Receptors.

Gynostemma pentaphyllum has been used as an herbal tea, vegetable, and dietary supplement for hundreds of years in East Asia. The sweet variety, grown in large areas in Fujian Province, China, is an essential source of "Jiaogulan" herbal tea. However, its sweet components are unknown. To investigate the sweet constituents of Fujian "Jiaogulan" and discover new natural high-potency sweeteners, phytochemical and sensory evaluations were combined to obtain 15 saponins, of which 11 (1-11) were sweet-tasting, including 2 new ones with sweetness intensities 20-200 times higher than that of sucrose, and four (12-15) were bitter-tasting. Their structures were elucidated using spectroscopic methods (NMR, MS, IR, UV), hydrolysis, and comparison with literature data. The contents of the 15 saponins were quantitatively analyzed using UPLC-MS/MS in multiple reaction monitoring mode. The contents of 1 and 2 sweet-tasting gypenosides were 9.913 ± 1.735 and 35.852 ± 1.739 mg/kg, respectively. The content of the sweetest compound (6) was 124.969 ± 0.961 mg/kg. Additionally, compound 4 was the most abundant sweet component (422.530 ± 3.702 mg/kg). Furthermore, molecular docking results suggested interactions of sweet saponins with sweet taste receptors. In general, this study revealed the material basis of the Fujian "Jiaogulan" taste.

Comprehensive compositional analysis of liquid organic product prepared by industrialized hydrothermal cracking of biomass waste and its potential application as fertilizer.

Hydrothermal cracking involves the conversion of organic waste into efficient fertilizer through hydrolysis at temperatures ranging from 180 to 220 °C and pressures of 1.5 to 2.45 MPa, which offers significant advantages in shortening the production cycle, enhancing efficiency, and decomposing antibiotics. As a result, it holds immense practical value for promoting organic fertilizer manufacturing processes globally. The products derived from hydrothermal cracking can be categorized into solid and liquid components. Extensive research has focused on the composition and use of solids, while studies on liquids have mainly examined basic characteristics. The study aimed to comprehensively analyze the components in liquid products prepared through hydrothermal cracking and evaluate their suitability as liquid fertilizers. Specifically, we employed rigorous analytical techniques to accurately identify and quantify medium and trace elements, organic acids, amino acids, and plant growth regulators. Furthermore, we carried out a planting experiment to assess the yield and soil changes following the application of liquid products in maize cultivation. The experimental data revealed that the liquid product contained abundant medium and trace elements, along with 6.22 g/L free amino acids and 9.22 g/L organic acids. It is noteworthy that this liquid product contained 1.22 × 105 pg/mL ABA, 6.26 × 103 pg/mL IAA, 1.07 × 102 pg/mL IBA, and 3.60 × 10-2 pg/mL GA3. The utilization of this liquid product has the potential to enhance the disease resistance of maize crops and promote the accumulation of nitrate nitrogen in the soil. By understanding the composition of liquid products via hydrothermal cracking, valuable insights can be gained into their potential benefits for agricultural and ecological applications.

Efficacy of atomic layer deposition of Al2O3 on composite LiNi0.8Mn0.1Co0.1O2 electrode for Li-ion batteries.

LiNi0.8Mn0.1Co0.1O2 (NMC811) is a popular cathode material for Li-ion batteries, yet degradation and side reactions at the cathode-electrolyte interface pose significant challenges to their long-term cycling stability. Coating LiNixMnyCo1-x-yO2 (NMC) with refractory materials has been widely used to improve the stability of the cathode-electrolyte interface, but mixed results have been reported for Al2O3 coatings of the Ni-rich NMC811 materials. To elucidate the role and effect of the Al2O3 coating, we have coated commercial-grade NMC811 electrodes with Al2O3 by the atomic layer deposition (ALD) technique. Through a systematic investigation of the long-term cycling stability at different upper cutoff voltages, the stability against ambient storage, the rate capability, and the charger transfer kinetics, our results show no significant differences between the Al2O3-coated and the bare (uncoated) electrodes. This highlights the contentious role of Al2O3 coating on Ni-rich NMC cathodes and calls into question the benefits of coating on commercial-grade electrodes.

Efficacy and Safety of Thermal Ablation for Solitary Low-Risk T2N0M0 Papillary Thyroid Carcinoma.

OBJECTIVE: To evaluate the efficacy and safety of thermal ablation in treating solitary low-risk T2N0M0 papillary thyroid cancer (PTC) and compare the outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA). MATERIALS AND METHODS: This retrospective, single center study involved 34 patients (age: 40.0 ± 13.9 years; 28 female) who had low-risk T2N0M0 PTC with a maximum diameter >2 cm and ≤4 cm and underwent MWA (n = 15) or RFA (n = 19) from November 2016 to April 2023. The primary outcomes were the cumulative rate of disease progression and delayed surgery rates. In contrast, the secondary outcomes included changes in tumor size, cumulative rate of complete tumor disappearance, and complication rates. RESULTS: The median follow-up period was 18.0 months (interquartile range [IQR]: 9.0-40.0 months). At 12 months, the median volume reduction rate of the ablation zone was 74.2% (IQR: 53.7%-86.0%). Disease progression was noted in two patients within 1 year, including one patient with local tumor progression post-RFA and one with a new tumor post-MWA, resulting in a constant cumulative disease progression rate of 8.8% (95% confidence interval [CI]: 0%-19.8%) throughout the remaining follow-up period. Both patients were subsequently treated with additional ablation and did not require surgery. The cumulative rates of complete tumor disappearance at 1, 3, and 5 years were 4.0% (95% CI: 0%-11.4%), 26.8% (95% CI: 2.7%-44.9%), and 51.2% (95% CI: 0%-79.1%), respectively. No significant differences were observed in the disease progression (P = 0.829) or complete tumor disappearance (P = 0.633) rates between the MWA and RFA groups. Complications occurred in 14.7% (5/34) of patients presenting with transient hoarseness. RFA had a higher but not statistically significant complication rate than MWA did (21.1% [4/19] vs. 6.7% [1/15]; P = 0.355). CONCLUSION: Both MWA and RFA demonstrated promising short-term outcomes in terms of efficacy and safety in treating solitary low-risk T2N0M0 PTC, with no significant differences.

Factors affecting patency time and semen quality in a single-armed microsurgical vasoepididymostomy.

ABSTRACT: Although microsurgical vasoepididymostomy (MVE) is an effective treatment for epididymal obstructive azoospermia, some patients may experience delayed patency or suboptimal semen parameters after patency. However, research into patency time, semen quality postpatency, and associated influencing factors remains limited. This study aimed to address these issues by evaluating 181 patients who underwent at least one-sided MVE employing asingle-armed longitudinal intussusception vasoepididymostomy technique, with a follow-up period of over 12 months for 150 patients. The overall patency rate was 75.3%, with 86.0% of patients achieving patency within 6 months following MVE. Unexpectedly, factors such as age, history of epididymitis, duration of surgery, side of anastomosis, sperm motility in epididymal fluid, and the site of anastomosis showed no correlation with patency time. Nonetheless, our univariate and multivariate linear regression analysis indicated that only the site of anastomosis was positively correlated with and could independently predict postoperative total motile sperm count. Therefore, the site of anastomosis might serve as a predictor for optimal postoperative semen quality following the MVE procedure.

Therapeutic Potential of Natural Resources Against Endometriosis: Current Advances and Future Perspectives.

Endometriosis (EMS) is defined as the appearance, growth, infiltration, and repeated bleeding of endometrioid tissue (glands and stroma) outside the uterus cavity, which can form nodules and masses. Endometriosis is a chronic inflammatory estrogen-dependent disease and occurs in women of reproductive age. This disorder may significantly affect the quality of life of patients. The pathogenic processes involved in the development and maintenance of endometriosis remain unclear. Current treatment options for endometriosis mainly include drug therapy and surgery. Drug therapy mainly ties to the use of non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal drugs. However, these drugs may produce adverse effects when used for long-term treatment of endometriosis, such as nausea, vomiting gastrointestinal reactions, abnormal liver and kidney function, gastric ulcers, and thrombosis. Although endometriosis lesions can be surgically removed, the disease has a high recurrence rate after surgical resection, with a recurrence rate of 21.5% within 2 years and 40% to 50% within 5 years. Thus, there is an urgent need to develop alternative or additional therapies for the treatment of endometriosis. In this review, we give a systematic summary of therapeutic multiple component prescriptions (including traditional Chinese medicine and so on), bioactive crude extracts of plants/herbs and purified compounds and their newly found mechanisms reported in literature in recent years against endometriosis.

Comparison of diagnostic algorithms in clinically suspected viral myocarditis: agreement between cardiac magnetic resonance, endomyocardial biopsy and troponin T.

AIMS: Myocardial inflammation is increasingly detected non-invasively by tissue mapping with cardiovascular magnetic resonance (CMR). Intraindividual agreement with endomyocardial biopsy (EMB) or marker of myocardial injury, high-sensitive troponin (hs-cTnT) in patients with clinically suspected viral myocarditis not understood. METHODS AND RESULTS: Prospective multicentre study of consecutive patients with clinically suspected myocarditis who underwent blood testing for hs-cTnT, CMR and EMB as a part of diagnostic work-up. EMB was considered positive based on immunohistological criteria in line with the ESC definitions. CMR diagnoses employed tissue mapping using sequence-specific cut-off for native T1 and T2 mapping; active inflammation was defined as T1≥2SD and T2≥2SD above the mean of normal range. Hs-cTnT of greater than 13.9ng/1 was considered significant. A total of 114 patients (age (mean±SD) 54±16, 65% males) were included, of which 79(69%) had positive EMB-criteria, 64(56%) CMR criteria, and a total of 58 (51%) positive troponin. Agreement between EMB and CMR diagnostic criteria was poor (CMR vs. ESC: AUCs: 0.51 (0.39-0.62)). The agreement between the significant hs-cTnT rise and CMR-based diagnosis of myocarditis was good (AUC: 0.84 (0.68-0.92); p<0.001), but poor for EMB (0.50 (0.40-0.61). Hs-cTnT was significantly associated with native T1 and T2, hs-CRP and NT-pro BNP (r=0.37, r=0.35, r=0.30, r=0.25 p<0.001), but not immunohistochemical criteria or viral presence. CONCLUSIONS: In clinically suspected viral myocarditis, all diagnostic approaches reflect the pathophysiological elements of myocardial inflammation, however the differing underlying drivers only partially overlap. The EMB and CMR diagnostic algorithms are neither interchangeable in terms of interpretation of myocardial inflammation nor in their relationship with myocardial injury.

Decoding of Salty/Saltiness-Enhancing Peptides Derived from Goose Hemoglobin and the Interaction Mechanism with TMC4 Receptor.

Amid the growing concern for health-oriented food choices, salt reduction has received widespread attention, particularly in the exploitation of salt alternatives. Peptides with a saltiness-enhancing effect may provide an alternative method for salt reduction. The objective of this study was to isolate and extract novel peptides with salt-reducing effects by fermenting goose blood using a Lactobacillus plantarum strain. Five potential target peptides were screened by a virtual database prediction and molecular docking. Sensory evaluation and E-tongue analysis showed that five peptides (NEALQRM, GDAVKNLD, HAYNLRVD, PEMHAAFDK, and AEEKQLITGL) were identified as target peptides. Particularly, the results of E-tongue showed that GDAVKNLD can increase the saltiness intensity (2.87 ± 0.02) in the complex system. The sensory evaluation results also indicated an increase in saltiness intensity (46.67 ± 4.67 mmol/L NaCl) after adding GDAVKNLD. The results of molecular dynamics simulation indicated that five peptides have good ability to bind tightly to TMC4 receptor, thereby stimulating it to exert an active effect. And these peptides interacted with the TMC4 receptor via hydrogen bonding, hydrophobic interactions, and electrostatic interactions. This research lays a theoretical foundation for discovering novel salty/saltiness-enhancing peptides and provides meaningful contributions to efforts in salt reduction.