Machine learning-based diagnosis and prognosis of IgAN: A systematic review and meta-analysis.

Purpose: Plenty of studies have explored the diagnosis and prognosis of IgA nephropathy (IgAN) based on machine learning (ML), but the accuracy lacks the support of evidence-based medical evidence. We aim at this problem to guide the precision treatment of IgAN. Methods: Embase, Pubmed, Cochrane Library, and Web of Science were searched systematically until February 24th, 2024, for publications on ML-based diagnosis and prognosis of IgAN. Subgroup analysis or meta-regression was conducted according to modeling method, follow-up time, endpoint definition, and variable type. Further, the rank sum test was applied to compare the discrimination ability of prognosis. Results: A total of 47 studies involving 51,935 patients were eligible. Among the 38 diagnostic models, the pooled C-index was 0.902 (95 % CI: 0.878-0.926) in 27 diagnostic models. Of the 162 prognostic models, the C-index for model discrimination of 144 prognostic models was 0.838 (95 % CI: 0.827-0.850) in training. The overall discrimination ability of prognosis was as follows: COX regression > new ML models (e.g. ANN, DT, RF, SVM, XGBoost) > traditional ML models (logistic regression) > Naïve Bayesian network (P < 0.05). External validation of IIgAN-RPT in 19 models showed a pooled C-index of 0.801 (95 % CI: 0.784-0.817). Conclusions: New ML models have shown application values that are as good as traditional ML models, both in diagnosis and prognosis. In addition, future models are desired to use a more sensitive prognostic endpoint (albuminuria), improve predictive ability in moderate progression risk, and ultimately translate into clinically applicable intelligent tools.

Joint SIC and power allocation for a multi-user paired UWOC-NOMA system in a turbulence environment.

This paper proposes a staircase joint optimization scheme (SJOS) with alternating diagonal interference cancellation and power allocation in an underwater wireless optical communication system based on nonorthogonal multiple access (UWOC-NOMA) with the multi-user paired. The scheme employs the directional iteration to alternatively optimize the subproblems of the interference cancellation and the power allocation. Furthermore, a one-way sorting algorithm based on the alternating diagonal interference cancellation and power allocation subalgorithm based on the conjugate gradient method are presented to solve the two subproblems, respectively. Simulation results show that the algorithm effectively reduces the average outage probability of the system with fast convergence, even with an increase in the number of paired users.

Constraints on the maintenance of wild Taxus cuspidata populations based on regression conservation.

To clarify the key factors constraining the maintenance of wild Taxus cuspidata populations and to develop conservation strategies and technical links for current populations, we investigated the renewal status and distribution patterns of wild T. cuspidata populations in the main distribution areas of China. We analyzed the effects of stand factors and human disturbance on population renewal and maintenance. The results showed that the overall regeneration of wild T. cuspidata populations was poor. The basal diameter and height class structure of renewed individuals showed an unhealthy state. 19% of the area was well regenerated. There were three types of regeneration, including poor regeneration with few adult trees, poor regeneration with many adult trees, and good regeneration with few adult trees. The communities in which T. cuspidata was found could be classified into Abies nephrolepis + Tilia amurensis forest, spinney forest, and Picea jezoensis var. microsperma + A. nephrolepis forest. The renewal number of A. nephrolepis + T. amurensis forest was significantly higher than that of spinney forest. Increased stand density and moderate human disturbance contributed to the regeneration of T. cuspidata. The regenerating T. cuspidata seedlings increased significantly when stand density increased from low to medium. The number of regenerating populations in moderately disturbed habitats was significantly higher than those in lightly disturbed habitats. Human disturbance and habitat were currently critical constraints to maintaining and regenerating wild T. cuspidata populations. The conservation of T. cuspidata should consider current status of population regeneration in each habitat patch to develop corresponding in situ conservation and regression conservation measures and focus on the influence of critical factors such as disturbances and habitat conditions.

24-h Urinary Calcium Excretion and Renal Outcomes in Hospitalized Patients with and without Chronic Kidney Disease.

This study investigated the impact of 24-h urinary calcium excretion (UCaE) on renal function decline in hospitalized patients with and without chronic kidney disease (CKD). This study enrolled 3815 CKD patients in stages 1-4 and 1133 non-CKD patients admitted to the First Center of the Chinese PLA General Hospital between January 2014 and July 2022. The primary outcome for CKD patients was a composite of CKD progression, defined as a 40% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease. Annual eGFR change was the secondary outcome. For non-CKD patients, the primary outcome was an eGFR decline of ≥20% or CKD incidence, while annual eGFR change was the secondary outcome. The association between UCaE and kidney function decline was assessed using Cox proportional hazards and generalized linear models. Primary outcomes were observed in 813 CKD patients and 109 non-CKD patients over a median follow-up of 3.0 and 4.1 years, respectively. For CKD patients, every 1-mmol/d increase in UCaE was associated with a 15% decreased risk of CKD progression. The hazard ratio (HR) was 0.85, with a 95% confidence interval (CI) of 0.77-0.93. For non-CKD patients, the risk of renal function decline decreased by 11%. The multivariate models indicated that there was an annual decrease in eGFR in both CKD and non-CKD patients, with a reduction of 0.122 mL/min/1.73 m2/year (p < 0.001) and 0.046 mL/min/1.73 m2/year (p = 0.004), respectively, for every 1-mmol/d increase in UCaE. CKD experiences a decrease in 24-h UCaE as early as stage 1, with a significant decline in stage 4. CKD and non-CKD patients with lower UCaE levels are at an increased risk of renal decline, regardless of other variables.

Evaluating Efficacy and Safety of Tacrolimus Treatment in Membranous Nephropathy: Results of a Retrospective Study of 182 Patients.

Purpose: Tacrolimus is recommended by KDIGO Clinical Practice Guidelines as an initial therapy for the treatment of membranous nephropathy (MN). However, little is known about the factors that influence response and recurrence of the disease after tacrolimus therapy, and there are limited data regarding the duration of tacrolimus treatment. Here, we present a real-world retrospective cohort study of 182 MN patients treated with tacrolimus, aiming to assess the efficacy and safety of tacrolimus in the treatment of MN. Patients and Methods: The clinical data of 182 patients with MN treated with tacrolimus and followed up for at least one year were analyzed retrospectively for the efficacy and safety of tacrolimus. Results: The mean follow-up period was 27.3 (19.3-41.6) months. A total of 154 patients (84.6%) achieved complete or partial remission, and 28 patients (15.4%) did not. Multivariate Cox regression analysis showed that male and higher baseline BMI were independently associated with lower, while higher serum albumin was associated with higher probability of remission. Among the responders, 56 patients (36.4%) relapsed. After adjustments for age and sex, Cox regression analysis revealed that the longer period of full-dose tacrolimus was administered, the lower the incidence of relapse. However, high levels of serum creatinine and proteinuria at the onset of tacrolimus discontinuation were risk factors for relapse. During the treatment of tacrolimus, a decline in renal function (≥50% increase in serum creatinine after the onset of tacrolimus treatment) was the most common adverse reaction, observed in 20 (11.0%) patients, followed by elevated blood glucose and infection, but the latter two occurred mostly during treatment with tacrolimus plus corticosteroids. Conclusion: Tacrolimus is effective in the treatment of MN, but the relapse rate is high. Clinical studies with larger sample sizes are needed to further explore the use of tacrolimus in the treatment of membranous nephropathy.

Modeling and performance analysis of oblique underwater optical communication links considering turbulence effects based on seawater depth layering.

Underwater wireless optical communication (UWOC) has been introduced to support emerging high-speed and low latency underwater communication applications. Most of the current studies on UWOC assume that the water temperature and salinity are constant, which can be justified only for horizontal links. In fact, as the temperature and salinity of seawater change with increasing depth, the seawater at different depths is bound to exhibit different optical properties. This implies that for the same link length, the communication system with the transmitter and receiver at different depths, will exhibit different performances. This paper first proposes an oblique optical link model considering turbulence effects, which is based on the layering of temperature and salinity with depth in realistic ocean water. Subsequently, the performance of the optical communication system with vertical and oblique links is analysed by adopting the oceanic power spectrum and seawater data from different ocean areas measured by the global ocean observation buoy, Argo. Our simulation shows that the performance of the underwater optical communication system is worse when the optical transmitter is located at the mixed layer than at the thermocline. When the transmitter is at the thermocline, the communication quality of the system will be worse at environments that temperature and salinity vary more slowly. When the tilt angle of the optical link in the vertical direction is less than 10°, the oblique link can be treated as a vertical link with the same link length.

Adaptive Fuzzy Asymptotic Tracking for Nonlinear Systems With Nonstrict-Feedback Structure.

In this article, the tracking control problems of the nonlinear nonstrict-feedback systems are considered. By combining the backstepping technique and bound estimation method, a novel nonlinear adaptive asymptotical control law is proposed, which offsets the effect of the unknown virtual control parameters and the uncertain nonlinearities. Correspondingly, an improved Lyapunov function by introducing the lower bounds of control parameters has been devised in this article. Compared with the existing adaptive tracking control schemes, the controller designed in this article can guarantee that the tracking control error converges to zero asymptotically and all the signals which contain the state variables and the adaptive laws are bounded. Moreover, the asymptotic stability of the system is realized for the first time. Finally, simulation examples are applied to test and prove the availability of the presented methods and the performance of the controlled system.

Structural characterisation of a full-length mitochondrial outer membrane TOM40 preprotein translocase: implications for its interaction with presequence peptides.

Tom40, the central component of the preprotein translocase of the mitochondrial outer membrane (TOM complex), forms the import pore that facilitates the translocation of preproteins across the outer membrane. Though the function of Tom40 has been intensively studied, the details of the interactions between presequence peptides and Tom40 remain unclear. In this study, we expressed rat Tom40 in Escherichia coli and purified it from inclusion bodies before investigating the refolded protein by fluorescence spectroscopy and circular dichroism (CD) spectroscopy. The far-UV CD spectra of the refolded Tom40 in various concentrations of urea revealed that the refolded protein has a well-defined structure consisting mainly of ß-sheet. Moreover, the specific binding of presequence peptides to Tom40, which was demonstrated by fluorescence quenching, showed that the refolded purified protein is functional and that the interaction between Tom40 and presequence peptides is mainly electrostatic in nature.

Detection of genetically modified tomato using PCR coupled with muParaflo microfluidics microarrays.

Genetically modified (GM) tomatoes have been approved for commercialization in many countries since the first GM tomato FLAVR SAVR was permitted for planting in 1994. To meet the requirement of the GM tomatoes labeling policy, in this study we firstly set up the conventional PCR and multiplex PCR detection system for screening the universal elements transformed into tomato, such as cauliflower mosaic virus 35s (CaMV 35s) promoter, nopaline synthase (nos) terminator of Agrobacterium tumefaciens, neomycinphosphotransferase (nptII) gene, and the specifically inserted heterologous DNA sequence between CaMV 35s promoter and anti-sense ethylene-forming enzyme (anti-EFE) gene in GM tomato "Huafan No. 1." Tomato lat52, mcpi, fru and apx genes were used as endogenous reference genes. Besides these, a muParaflo microfluidic microarray was also developed to screen the exogenous or endogenous genes of GM tomatoes. A total of 957 probes were designed, which can be classified into two categories according to their purpose: the first for screening GM plants from un-transgenic plants based on the common elements such as promoter, reporter and terminator genes, and the second for specific gene confirmation based on target sequences such as anti-EFE or aminocyclopropane cyclase synthase (acc) gene. To ensure the reliability of this method, different kinds of positive and negative controls (such as the probes complementary to cp gene of CaMV) were included in microarray detection system. Four tomato species were identified by means of these methods, and the results indicated that microarray is a high-throughput and more efficient screening method, which could complement PCR-based screening procedures by providing direct conclusive evidence and also may be useful to resolve masking of unknown events by known events.

[Chemotherapy resistance induced by interleukin-6 in ovarian cancer cells and its signal transduction pathways].

OBJECTIVE: To study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. METHODS: Ovarian cancer cell lines A2780 (IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines (overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6 (by transfecting with plasmid encoding for sense IL-6) in A2780 cells or deleting of endogenous IL-6 expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. RESULTS: We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6.25 and 7.31; endogenous, 7.13-8.34 and 7.61-10.70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs (the resistance multiple to cisplatin and paclitaxel was 0.15 and 0.10, 0.10 and 0.08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [mitogen-activated protein kinase-extracellular signal-regulated kinase (MEK) inhibitor] and wortmannin [phosphatidylinositol 3-kinase (PI3K) inhibitor] significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase (ERK) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration. CONCLUSIONS: These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes (MDR1 and GST-π) and apoptosis-inhibiting genes (bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PI3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

[Review and reflection on study of four properties of traditional Chinese medicine].

To summarize the biological effects of four natures of traditional Chinese medicine (TCM) in the recent 40 years, including cold, hot, warm and cool, which have the effect on central nervous system, endocrine system on the activity of sympathetic nerves, basal metabolic rate, the function of organs and tissues and secretion of cytokine out of body. And to review the new concepts and new hypotheses in recent 10 years which proposed on the four natures of traditional Chinese medicine. Based on the above summary we pointed out that the previous studies on biological effects have shortage in the following aspects: The studies had little connection with the TCM theory; The research highly concentrated on the biological effects of the cold and heat natures of drug; There is almost no research on the biological effects of the neutral nature; The research on the biological effects of the natures of traditional Chinese medicine had no combination with effects of drugs. And pointed out that studies on four natures of traditional Chinese medicine will be a multi-level, multi-disciplinary, multi-factor, multi-targe research, connecting Chinese medicine theory. The research will be a combination of the macro research and the micro research, the qualitative research and the quantitative research and the experimental research and the clinical research.