Search

Introduction: The DESyne novolimus‐eluting coronary stent (NES) is a new‐generation drug‐eluting stent (DES) that is widely used, but clinical data are rarely reported for this stent. We compared the safety and effectiveness of the DESyne NES and the Orsiro bioresorbable polymer sirolimus‐eluting stent (SES) in patients undergoing percutaneous coronary intervention (PCI). Methods: This was a retrospective, single‐center, observational study. Between July 2017 and December 2022, patients who presented with chronic or acute coronary syndrome undergoing PCI with DESyne NES or Orsiro SES were consecutively enrolled in the present study. The primary endpoint, major adverse cardiovascular event (MACE), was a composite of cardiovascular death, target‐vessel myocardial infarction, or clinically driven target‐lesion revascularization. Results: A total of 776 patients (age 68.8 ± 12.2; 75.9% male) undergoing PCI were included. Overall, 231 patients with 313 lesions received NES and 545 patients with 846 lesions received SES. During a follow‐up duration of 784 ± 522 days, the primary endpoint occurred in 10 patients (4.3%) in the NES group and in 36 patients (6.6%) in the SES group. After multivariate adjustment, the risk of MACE did not significantly differ between groups (NES vs. SES, hazard ratio 0.74, 95% CI, 0.35–1.55, p = 0.425). The event rate of individual components of the primary endpoint was comparable between the two groups. Conclusions: Favorable and similar clinical outcomes were observed in patients undergoing PCI with either NES or SES in a medium‐term follow‐up duration. Future studies with adequately powered clinical endpoints are required for further evaluation. [ABSTRACT FROM AUTHOR]

BackgroundBAHD acyltransferases, named after the first four biochemically characterized enzymes of the group, are plant-specific enzymes that catalyze the transfer of coenzyme A-activated donors onto various acceptor molecules. They are responsible for the synthesis in plants of a myriad of secondary metabolites, some of which are beneficial for humans either as therapeutics or as specialty chemicals such as flavors and fragrances. The production of pharmaceutical, nutraceutical and commodity chemicals using engineered microbes is an alternative, green route to energy-intensive chemical syntheses that consume petroleum-based precursors. However, identification of appropriate enzymes and validation of their functional expression in heterologous hosts is a prerequisite for the design and implementation of metabolic pathways in microbes for the synthesis of such target chemicals.ResultsFor the synthesis of valuable metabolites in the yeast Saccharomyces cerevisiae, we selected BAHD acyltransferases based on their preferred donor and acceptor substrates. In particular, BAHDs that use hydroxycinnamoyl-CoAs and/or benzoyl-CoA as donors were targeted because a large number of molecules beneficial to humans belong to this family of hydroxycinnamate and benzoate conjugates. The selected BAHD coding sequences were synthesized and cloned individually on a vector containing the Arabidopsis gene At4CL5, which encodes a promiscuous 4-coumarate:CoA ligase active on hydroxycinnamates and benzoates. The various S. cerevisiae strains obtained for co-expression of At4CL5 with the different BAHDs effectively produced a wide array of valuable hydroxycinnamate and benzoate conjugates upon addition of adequate combinations of donors and acceptor molecules. In particular, we report here for the first time the production in yeast of rosmarinic acid and its derivatives, quinate hydroxycinnamate esters such as chlorogenic acid, and glycerol hydroxycinnamate esters. Similarly, we achieved for the first time the microbial production of polyamine hydroxycinnamate amides; monolignol, malate and fatty alcohol hydroxycinnamate esters; tropane alkaloids; and benzoate/caffeate alcohol esters. In some instances, the additional expression of Flavobacterium johnsoniae tyrosine ammonia-lyase (FjTAL) allowed the synthesis of p-coumarate conjugates and eliminated the need to supplement the culture media with 4-hydroxycinnamate.ConclusionWe demonstrate in this study the effectiveness of expressing members of the plant BAHD acyltransferase family in yeast for the synthesis of numerous valuable hydroxycinnamate and benzoate conjugates.

Background: Ruling out obstructive coronary artery disease (CAD) using coronary computed tomography angiography (CCTA) is time‐consuming and challenging. This study developed a deep learning (DL) model to assist in detecting obstructive CAD on CCTA to streamline workflows. Methods: In total, 2929 DICOM files and 7945 labels were extracted from curved planar reformatted CCTA images. A modified Inception V3 model was adopted. To validate the artificial intelligence (AI) model, two cardiologists labelled and adjudicated the classification of coronary stenosis on CCTA. The model was trained to differentiate the coronary artery into binary stenosis classifications <50% and ≥50% stenosis. Using the quantitative coronary angiography (QCA) consensus results as a reference standard, the performance of the AI model and CCTA radiology readers was compared by calculating Cohen's kappa coefficients at patient and vessel levels. The net reclassification index was used to evaluate the net benefit of the DL model. Results: The diagnostic accuracy of the AI model was 92.3% and 88.4% at the patient and vessel levels, respectively. Compared with CCTA radiology readers, the AI model had a better agreement for binary stenosis classification at both patient and vessel levels (Cohen kappa coefficient:.79 vs..39 and.77 vs..40, p <.0001). The AI model also exhibited significantly improved model discrimination and reclassification (Net reclassification index =.350; Z = 4.194; p <.001). Conclusions: The developed AI model identified obstructive CAD, and the model results correlated well with QCA results. Incorporating the model into the reporting system of CCTA may improve workflows. [ABSTRACT FROM AUTHOR]

Insulin resistance (IR) is associated with cardiovascular disease in non-diabetic patients. The triglyceride-glucose (TyG) index, incorporating serum glucose and insulin concentrations, is a surrogate insulin resistance marker. We investigated its association with obstructive coronary artery disease (CAD) and sex differences therein. Patients with stable angina pectoris requiring invasive coronary angiography between January 2010 and December 2018 were enrolled. They were divided into two groups according to TyG index. Two interventional cardiologists diagnosed obstructive CAD by angiography review. Demographic characteristics and clinical outcomes were compared between groups. Relative to lower index, patients with higher (≥ 8.60) TyG index had higher BMIs and more prevalent hypertension, diabetes, and elevated lipid profiles [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), fasting plasma glucose (FPG)]. Higher TyG index increased women's obstructive CAD risk after multivariate adjustment (adjusted odds ratio (aOR) 2.15, 95% confidence interval (95% CI) 1.08–4.26, p = 0.02) in non-diabetic populations compared with men. No sex difference was found for diabetic patients. Higher TyG index significantly increased the obstructive CAD risk, overall and for non-diabetic women. Larger-scale studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

This study applies social support theory to the question of whether four types of husband behavior (taking the wife's side, problem solving, ignoring conflict, and taking the mother's side) moderate the association between conflict with the mother-in-law and a Taiwanese woman's marital satisfaction. Data were collected from 125 married Taiwanese women. The results of hierarchical regression analyses indicate a significant negative main effect of conflict with the mother-in-law on the wife's marital satisfaction. This main effect is moderated by two types of husband behavior. When wives reported that their husbands frequently took their side or used problem-solving strategies to the conflict, conflict is not significantly related to the wives' marital satisfaction. The conflict and the two types of husband behavior accounted for 32% to 38% of the variance in wives' marital satisfaction. (Contains 2 tables and 1 figure.)

We investigate the solvability of a general class of mixed Hessian type equations on compact Kähler manifolds. Based on an observation in Guan and Zhang [Pure Appl. Math. Q. 17 (2021), pp. 865–907], the mixed Hessian equations can be rewritten as elliptic and concave equations which satisfy the general framework in Székelyhidi [J. Differential Geom. 109 (2018), pp. 337–378] and Phong and Tô [Ann. Sci. Éc. Norm. Supér. (4) 54 (2021), pp. 793–829] except one condition. We notice that the absence of this condition can be overcome by using the particular structure of the mixed Hessian equations. As an application, the solvability of the deformed Hermitian Yang-Mills equations in dimension three was also studied. [ABSTRACT FROM AUTHOR]

: Galectin-1 is a glycan-binding protein with broad anti-inflammatory properties. Left ventricular diastolic dysfunction (DD) is associated with heart failure and mortality. The pathophysiology of DD is complex and our study aimed to investigate the associations between serum galectin-1 level, DD, and heart failure with preserved ejection fraction (HFpEF). : Patients with symptoms of angina pectoris were enrolled. Serum galectin-1 levels and echocardiography were assessed. The study endpoint was a composite of all-cause mortality or new-onset HFpEF. : In total, 258 patients were enrolled (63% male; mean age 68±12 years) and grouped into tertiles based on galectin-1 levels. Patients in the highest galectin-1 group had increased left ventricular mass indexes, left atrial diameters, and prevalence of DD compared to those in the lower tertiles (all p <0.05). Moreover, elevated galectin-1 levels were significantly associated with the composite endpoint (p =0.039). After adjusting for confounding factors, high galectin-1 levels remained significantly associated with DD (odds ratio 2.44, p =0.005). The Kaplan-Meier analysis revealed patients in the highest galectin-1 group had lowest cumulative survival of composite endpoint (log rank p =0.043). : Elevated serum galectin-1 levels were associated with DD and the composite endpoint of all-cause mortality and incident HFpEF. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Obesity is associated with metabolic syndrome which increases further risk of coronary artery disease and adverse cardiovascular events. Impact of body mass index (BMI) on long‐term outcome in patients with coronary chronic total occlusion (CTO) is less clear. Method and results: From January 2005 to November 2020, a total of 1301 patients with coronary angiographic confirmed CTO were enrolled in our study. Patients were divided into two groups: low BMI group: 18–24.99 kg/m2 and high BMI group ≥25 kg/m2. Clinical outcomes were 3‐year all‐cause mortality, 3‐year cardiovascular mortality and 3‐year non‐fatal myocardial infarct. During the 3‐year follow‐up period, all‐cause mortality was significantly higher in patients with low BMI group compared to those in high BMI groups (14% vs. 6%, p =.0001). Kaplan–Meier analysis showed patients with high BMI groups had significant better survival compared with those in low BMI group (p =.0001). In multivariate analysis, higher BMI was independently associated with decreased risk of 3‐year all‐cause mortality (Hazard ratio [HR]: 0.534; 95% confidence interval [CI]: 0.349–0.819, p =.004) after controlling for age, renal function, prior history of stroke, coronary artery bypass graft, co‐morbidities with peripheral arterial disease, heart failure and revascularization status for CTO. In propensity‐matched multivariate analysis, high BMI remained a significant predictor of 3‐year all‐cause mortality (HR, 0.525; 95% CI, 0.346–0.795, p =.002). Conclusion: Higher BMI was associated with better long‐term outcome in patients with coronary CTO. [ABSTRACT FROM AUTHOR]

Informational and noninformational advertising content. We investigate the relationship between both advertising content and quantity and several stages of consumers' decision making, namely, unaided and aided awareness, consideration, and purchase. Understanding how the amount and content of advertisements affect consumers' decision making is crucial for companies to effectively and efficiently use their advertising budgets. Spanning a time period from 2010 to 2016, we combine a unique data set on TV advertising content and quantities with individual-level data containing information on purchases, consideration and awareness sets, demographic variables, and perceived prices. Our results reveal that advertising quantity significantly increases consumer (unaided and aided) awareness but has no effect on conditional consideration and conditional purchase. However, when investigating the relationship between different types of advertising content and purchase stages, we find a more nuanced set of results: advertising only containing noninformational content increases unaided awareness, whereas advertising only containing informational content increases aided awareness. Advertising with both informational and noninformational content affects shoppers' but not nonshoppers' awareness and the awareness of other groups of involved consumers. [ABSTRACT FROM AUTHOR]

Background: Trimethylamine N-oxide (TMAO) is a microbiota-derived metabolite, which is linked to vascular inflammation and atherosclerosis in cardiovascular (CV) diseases. But its effect in infectious diseases remains unclear. We conducted a single-center prospective study to investigate association of TMAO with in-hospital mortality in septic patients admitted to an intensive care unit (ICU). Methods: Totally 95 septic, mechanically ventilated patients were enrolled. Blood samples were obtained within 24 h after ICU admission, and plasma TMAO concentrations were determined. Septic patients were grouped into tertiles according to TMAO concentration. The primary outcome was in-hospital death, which further classified as CV and non-CV death. Besides, we also compared the TMAO concentrations of septic patients with 129 non-septic patients who were admitted for elective coronary angiography (CAG). Results: Septic patients had significantly lower plasma TMAO levels than did subjects admitted for CAG (1.0 vs. 3.0 μmol/L, p < 0.001). Septic patients in the lowest TMAO tertile (< 0.4 μmol/L) had poorer nutrition status and were given longer antibiotic courses before ICU admission. Circulating TMAO levels correlated positively with daily energy intake, the albumin and prealbumin concentration. Compared with those in the highest TMAO tertile, septic patients in the lowest TMAO tertile were at greater risk of non-CV death (hazard ratio 2.51, 95% confidence interval 1.21–5.24, p = 0.014). However, TMAO concentration was no longer an independent predictor for non-CV death after adjustment for disease severity and nutritional status. Conclusion: Plasma TMAO concentration was inversely associated with non-CV death among extremely ill septic patients, which could be characterized as TMAO paradox. For septic patients, the impact of malnutrition reflected by circulating TMAO levels was greater than its pro-inflammatory nature. [ABSTRACT FROM AUTHOR]

Background: Galectin-1 (Gal-1), a member of the β-galactoside binding protein family, is associated with inflammation and chronic kidney disease. However, the effect of Gal-1 on mortality and acute kidney injury (AKI) in critically-ill patients remain unclear. Methods: From May 2018 to March 2020, 350 patients admitted to the medical intensive care unit (ICU) of Taipei Veterans General Hospital, a tertiary medical center, were enrolled in this study. Forty-one patients receiving long-term renal replacement therapy were excluded. Serum Gal-1 levels were determined within 24 h of ICU admission. The patients were divided into tertiles according to their serum Gal-1 levels (low, serum Gal-1 < 39 ng/ml; median, 39–70 ng/ml; high, ≥71 ng/ml). All patients were followed for 90 days or until death. Results: Mortality in the ICU and at 90 days was greater among patients with elevated serum Gal-1 levels. In analyses adjusted for the body mass index, malignancy, sepsis, Sequential Organ Failure Assessment (SOFA) score, and serum lactate level, the serum Gal-1 level remained an independent predictor of 90-day mortality [median vs. low: adjusted hazard ratio (aHR) 2.11, 95% confidence interval (CI) 1.24–3.60, p = 0.006; high vs. low: aHR 3.21, 95% CI 1.90–5.42, p < 0.001]. Higher serum Gal-1 levels were also associated with a higher incidence of AKI within 48 h after ICU admission, independent of the SOFA score and renal function (median vs. low: aHR 2.77, 95% CI 1.21–6.34, p = 0.016; high vs. low: aHR 2.88, 95% CI 1.20–6.88, p = 0.017). The results were consistent among different subgroups with high and low Gal-1 levels. Conclusion: Serum Gal-1 elevation at the time of ICU admission were associated with an increased risk of mortality at 90 days, and an increased incidence of AKI within 48 h after ICU admission. [ABSTRACT FROM AUTHOR]

Elevated glycemic gap, as the differences between measured glucose and hemoglobin A1c (HbA1c)-derived average glucose (ADAG) levels, is a marker of stress-induced hyperglycemia and is a predictor of mortality in critically ill patients. Whether low glycemic gaps are associated with outcomes in critically ill patients remains unclear. We investigated the association of different glycemic gaps on mortality in critically ill patients. Totally 935 patients admitted to intensive care units (ICUs) were enrolled retrospectively after the exclusion of patients with absolute hypoglycemia, extreme hyperglycemia, and incomplete glycemic records. Patients were divided into 3 groups according to their glycemic gaps (<-29.7, −29.7–40, ≧40 mg/dL) at the time of ICU admission. The patients were followed for 1 year or until death. Patients with low glycemic gap (glycemic gap < -29.7 mg/dL), which implied relative hypoglycemia, had lower serum glucose levels, higher HbA1c levels, and greater disease severity. Compared with medium group (glycemic gap −29.7–40 mg/dL), both the low and the high glycemic gap (glycemic gap ≧40 mg/dL) groups had significantly greater 30-day (log-rank p = 0.0464) and 1-year mortality (log-rank p = 0.0016). However, only the low glycemic gap group was independently associated with greater in-hospital mortality after adjusting for comorbidities (adjusted OR 1.78, 95% CI 1.00–3.16, p = 0.048). This study revealed the presence of a U-shaped relationship between the glycemic gap and mortality in critically ill patients. Low glycemic gaps suggested relative hypoglycemia at the time of ICU admission, and were associated independently with greater in-hospital mortality. [ABSTRACT FROM AUTHOR]