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Background Levels of inflammatory markers are elevated in patients with psychological disorders. However, anti-psychological drugs have an effect on proinflammatory cytokine production and disturb their relationship. Limited evidence focuses on the inflammatory marker profile of psychological status before treatment. This study aimed to investigate the inflammatory biomarker profiles of psychological treatment-naive individuals. Methods We included 790 psychological treatment-naive individuals from a longitudinal cohort study of Midlife in the United States (MIDUS). Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) subscales, the Social Anxiety Scale (STAI), and Liebowitz Social Anxiety Scale (LSAS), the Perceived Stress Scale (PSS), respectively. Results Spearman correlation analysis showed that a higher CESD total score was correlated with higher CRP (p=0.009), IL-6 (p=0.007), fibrinogen (p=0.036), E-selectin (p=0.018), ICAM-1 (p=0.013), and IL-8 (p=0.05) levels. Multivariate linear regression analysis showed that the CESD total score was positively associated with the levels of IL-6 (p=0.024) after adjustments. Moreover, the perceived stress score (PSS) was negatively associated with the levels of IL-8 (p=0.025). However, these associations were not significant after multiple testing (p=0.088, 0.091, respectively). Limitations The casual relationship cannot be drawn due to the cross-sectional design Conclusion Overall, our results suggested IL-6 and IL-8 might play a important role in the pathogenesis of psychological disorder. Larger and longitude studies are needed to confirm our results.

Jingfeng Wang,1,2,&ast; Jian Liu,3,&ast; Longfei Gao,3 Guangqiao Li,1,2 Yilin Sun,3 Bo Shi1,2 1School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China; 2Anhui Key Laboratory of Computational Medicine and Intelligent Health, Bengbu Medical College, Bengbu, Anhui, 233030, People’s Republic of China; 3Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu, Anhui, 233004, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bo ShiSchool of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, People’s Republic of ChinaTel +86-18955203003Email shibo@bbmc.edu.cnPurpose: Heart rate variability (HRV) has been reported as a useful biomarker for prognostic factors in a variety of cancers. The purpose of this study was to explore the predictive value of preoperative HRV for lymph node metastasis (LNM) in patients with cervical cancer (CC).Patients and Methods: A total of 77 patients with CC were included, including 18 LNM and 59 non-LNM patients. A five-minute resting electrocardiogram (ECG) was collected before surgery for the analysis of HRV time domain, frequency domain and Poincaré plot parameters (ie, SDNN, RMSSD, LF, HF, LF/HF, SD1, SD2 and SD2/SD1). Student’s t-tests and logistic regression were performed to determine the relationship between HRV and LNM.Results: The LNM group had significantly lower SDNN, LF, and SD2 than the non-LNM group (all p < 0.05; all Cohen’s d > 0.5). Binary logistic regression analysis indicated that SDNN, LF and SD2 were still significantly associated with LNM. Specifically, for each 1 ms decrease in SDNN and SD2 and each 1 logarithmic unit decrease in ln (LF), the odds of LNM increased by 12%, 9%, and 86%, respectively (all p < 0.05).Conclusion: These findings suggest an association between HRV and CC LNM, and HRV could be a potential noninvasive biomarker for the prediction of LNM in CC patients.Keywords: cervical cancer, heart rate variability, lymph node metastasis, autonomic nervous system

Aims The purpose of our study was to evaluate the feasibility and efficacy of cardiac resynchronization therapy (CRT) via left bundle branch pacing (LBBP-CRT) compared with optimized biventricular pacing (BVP) with adaptive algorithm (BVP-aCRT) in heart failure with reduced left ventricular ejection fraction ≤35% (HFrEF) and left bundle branch block (LBBB). Methods and results One hundred patients with HFrEF and LBBB undergoing CRT were prospectively enrolled in a non-randomized fashion and divided into two groups (LBBP-CRT, n = 49; BVP-aCRT, n = 51) in four centres. Implant characteristics and echocardiographic parameters were accessed at baseline and during 6-month and 1-year follow-up. The success rate for LBBP-CRT and BVP-aCRT was 98.00% and 91.07%. Fused LBBP had the greatest reduced QRS duration compared to BVP-aCRT (126.54 ± 11.67 vs. 102.61 ± 9.66 ms, P Conclusions The feasibility and efficacy of LBBP-CRT demonstrated better electromechanical resynchronization and higher clinical and echocardiographic response, especially higher super-response than BVP-aCRT in HFrEF with LBBB.

Gusset rotation would cause adverse influence on the buckling-restrained brace (BRB) end zone and even lead to premature buckling of the BRB end zone. However, limited studies to date referred to the gusset rotation response. To evaluate the cyclic behavior and gusset rotation response, five 1/2-scaled buckling-restrained braced frame (BRBF) subassemblages with various gusset connections, i.e., pinned gusset connection, bolted gusset connection, welded gusset connection, pinned-welded gusset connection, and pinned-bolted gusset connection, were conducted under horizontal cyclic loading. The effects of gusset connection type on the failure modes, horizontal initial stiffness, energy dissipation and rotation response of specimens were analyzed in detail. It showed that all specimens performed plump and stable hysteresis behavior. The upper gusset rotation of the specimen with pinned gusset connection was larger than that of bolted gusset connection, followed by welded connection. Meanwhile, the finite element (FE) models were established and validated by test results. Furthermore, the standard FE model of a full-scale one-story one-bay steel moment BRBF with a single diagonal BRB was developed and then extended to a large number of models to investigate the contribution of various parameters on the upper gusset rotation. Finally, the gusset rotational formulae for predicting its response, as the steel moment BRBF reached to either 2.0% or 3.0% drift, were proposed on the basis of the results of the extensive parametric analysis. It could be used to determine the rotation of the BRB end zone, and the flexural moment acting on the BRB end zone and corresponding practical design procedure can be finally derived to avoid the potential premature failure of the BRB end zone.

Background Leadless pacemaker has been acknowledged as a promising pacing strategy to prevent pocket and lead-related complications. Although rare, cardiac perforation remains a major safety concern for implantation of Micra transcatheter pacing system (TPS). Case presentation A 83-year-old female with low body mass index (18.9 kg m−2) on dual anti-platelet therapy, was indicated for Micra TPS implantation due to sinus arrest and paroxysmal atrial flutter. The patient developed mild pericardial effusion during the procedure since the delivery catheter was accidentally placed into the coronary sinus for several times. Cardiac perforation with moderate pericardial effusion and pericardial tamponade was detected 2 h post-procedure. The patient was treated with immediately pericardiocentesis and recovered without further invasive therapy. Conclusion Pericardial effusion caused by accidently placing a delivery catheter into the coronary sinus is rare but should be carefully considered in Micra TPS implantation, especially for those with periprocedural anti-platelet therapy.

This study aimed to uncover underlying mechanisms and promising intervention targets of heart failure (HF)-related stroke. HF-related dataset GSE42955 and stroke-related dataset GSE58294 were obtained from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was conducted to identify key modules and hub genes. Gene Ontology (GO) and pathway enrichment analyses were performed on genes in the key modules. Genes in HF- and stroke-related key modules were intersected to obtain common genes for HF-related stroke, which were further intersected with hub genes of stroke-related key modules to obtain key genes in HF-related stroke. Key genes were functionally annotated through GO in the Reactome and Cytoscape databases. Finally, key genes were validated in these two datasets and other datasets. HF- and stroke-related datasets each identified two key modules. Functional enrichment analysis indicated that protein ubiquitination, Wnt signaling, and exosomes were involved in both HF- and stroke-related key modules. Additionally, ten hub genes were identified in stroke-related key modules and 155 genes were identified as common genes in HF-related stroke. OTU deubiquitinase with linear linkage specificity (OTULIN) and nuclear factor interleukin 3-regulated (NFIL3) were determined to be the key genes in HF-related stroke. Through functional annotation, OTULIN was involved in protein ubiquitination and Wnt signaling, and NFIL3 was involved in DNA binding and transcription. Importantly, OTULIN and NFIL3 were also validated to be differentially expressed in all HF and stroke groups. Protein ubiquitination, Wnt signaling, and exosomes were involved in HF-related stroke. OTULIN and NFIL3 may play a key role in HF-related stroke through regulating these processes, and thus serve as promising intervention targets.

The preparation of large-area uniform continuous MoSe2 films is a challenge, which greatly limits its large-scale application. It is of great importance to control the preparation conditions to obtain a single-phase structure and excellent semiconductive properties. Herein, we report the preparation of thin MoSe2 films from Mo films using electron beam evaporation. The effects of the evaporation temperature, growth temperature, and growth time on the phase structure and stoichiometric ratio of thin MoSe2 films were investigated. It was concluded that the optimal preparation conditions of MoSe2 are a Se source temperature of 400℃, growth temperature of 600℃, and selenization time of 3 h. It was confirmed that thin MoSe2 films with a 2H phase prepared from a thin Mo film exhibit excellent semiconductor properties in a transistor device.

U-shaped steel–concrete composite girder has higher flexural resistance, more excellent fire resistance and better sound insulation due to the infilled concrete in U-shaped steel girder, compared with traditional composite beams. The existing researches indicated that U-shaped composite beams with shear connectors of headed studs and steel angles all exhibited good flexural performance. However, limited studies were conducted on shear resistance of angle-shaped connectors in U-shaped composite beams and then it is difficult to choose the more suitable shear connector for U-shaped composite beams. Therefore, push-out tests of different configuration of shear connectors were performed to determine their effectiveness in developing composite action in term of strength and load-slip behavior. In the tests, several options of shear connectors were examined including steel angle welded to webs, steel angles welded to flanges, headed studs, steel angle welded to webs working together with headed studs, and two separated steel plates welded to webs. The experimental results showed angle connectors welded to the webs of U-shaped girder possess higher shear resistance, larger slip capacity among all shear connectors. Combining with avoiding the congestion between shear connectors and longitudinal reinforcements, steel angles welded to the webs are recommended as shear connectors for U-shaped composite beams. At last, analytical formulas were proposed to describe the load-slip curves of different shear connectors and the design parameters obtained by regression analysis agreed well with the test results.

Purpose Airports are booming in China, to enlarge their capacities and stimulate economic development. Large-span spatial steel structures are commonly used in the terminal buildings of airport projects. Their advantages include prefabrication, strength, usability, adaptability and aesthetic quality. To manage large-span spatial steel structure projects, building information modeling (BIM) is recommended. Although there are plenty of studies on BIM application in steel structure projects, it is still rare to apply BIM to optimize the schedule and cost of steel structures, especially for airport projects. Design/methodology/approach This paper aims to develop a framework in which BIM and a time-cost optimization model are integrated to optimize construction costs and the duration of large-span spatial steel structure projects. A real case study was conducted to verify the feasibility of the BIM-based time-cost optimization model in an airport terminal building, which was built with a large-span spatial steel structure. Findings The results preliminarily support the reliability of the proposed BIM-based time-cost optimization model. The BIM-based time-cost optimization model will benefit construction planning for professionals and enrich relevant research on the application of BIM in large-span spatial steel structure projects. Originality/value The steel structure is difficult to control budgets and progress. This paper is expected to be adopted for optimizing the time and cost plans for projects involving steel structures in airport terminal buildings.

Concrete-encased concrete-filled steel tube (CECFST) columns and partially encased composite (PEC) beams are both steel-concrete composite members which have outstanding advantages and have been applicated in some engineering constructions. This paper makes an attempt to employ blind bolting technique to assemble CECFST columns to PEC beams. For the purpose of exploring the mechanical performance of this type of assembled joints, firstly, a nonlinear finite element (FE) model was established and validated, where complicated contact interaction was taken into consideration. Plenty of parametric analysis were adopted to find out the effect of ten parameters on strength and initial stiffness of the assembled joint. Numerical analysis showed that mechanic behavior is notably affected by axial load ratio, width and thickness of end-plate, bolt pretension force, bolt diameter, and steel ratio of CECFST column. Full-range analysis was then carried out to observe stress and strain developments and failure modes. Load transfer mechanism in CECFST column was also studied. Design methods to estimate the flexural capacity and initial stiffness of the connections were proposed in accordance with the component models. In comparison, it could be concluded that the calculation results fit well with the analytical results, which confirms that the design formulas could provide a favorable basis in practical design.

Due to the rapidly increasing urbanisation in China, the energy consumption of buildings and infrastructures has increased; this has resulted in environmental problems such as excessive carbon emissions. Increasing the strength of steel rebars enables manufacturers to use less steel and save more energy. The micro-alloyed 635 MPa hot-rolled ribbed high strength rebars (HRHSR) offer the advantages of high strength, good ductility, and low costs, compared to ordinary rebars. Bond anchorage is one of the key problems that limits the promotion and application of 635 MPa HRHSRs in practice. In this study, the bond properties of 635 MPa HRHSRs embedded in concrete subjected to monotonic loads were investigated. A total of 120 specimens, which consisted of 60 simple-anchored and 60 hooked-anchored specimens, were subjected to direct pull-out tests to evaluate the effects of anchorage length, hoop ratio, concrete cover, rebar diameter, concrete strength, and anchorage types on the anchorage feature. Meanwhile, the mechanical properties and failure modes of 635 MPa HRHSRs were also analysed. The results demonstrated that the concrete compressive strength, cover size, anchorage length, and stirrups ratio had a positive influence on the ultimate bond strength, whereas the bar size had a negative influence on the ultimate bond strength. Furthermore, four typical failure modes were analysed, including rebar yielding, concrete splitting, concrete crushing, and rebar rupturing, which occurred during the pull-out tests. Thereafter, a modified equation for calculating the ultimate bond strength of 635 MPa HRHSRs in concrete was derived based on the mechanical model and further verified using the test data. This study is expected to be beneficial in promoting the widespread application of 635 MPa HRHSRs and enabling resource savings in the future.

Objective: The head-up tilt test (HUTT) is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope (VVS). The present study aims to verify the hypothesis that ambulatory blood pressure (BP) monitoring (ABPM) and the simplistic tilt test may be potential alternatives to the HUTT. Methods: The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS. BP), heart rate (HR), and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence, pattern, and stage of syncope during the HUTT. Results: Mixed response was the commonest pattern, and syncope occurred frequently with infusion of isoproterenol at a rate of 3 μg/min. During the simplistic tilt test, the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group, while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group. The higher the BP/HR ratio in the tilted position, the higher the isoproterenol dosage needed to induce a positive response. During ABPM, BP/HR ratios were significantly higher in the cardioinhibitory group than in the vasodepressor group. The higher the ABPM-derived BP, the higher the dosage of isoproterenol needed to induce syncope. There were significant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group, while significant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group. The mixed pattern shared correlative features of the other two patterns. Conclusion: ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.

High-mobility group box 1 (HMGB1) is increased in the myocardium under pressure overload (PO) and is involved in PO-induced cardiac remodeling. The mechanisms of the upregulation of cardiac HMGB1 expression have not been fully elucidated. In the present study, a mouse transverse aortic constriction (TAC) model was used, and an angiotensin II (Ang II) type 1 (AT1) receptor inhibitor (losartan) or Ang II type 2 (AT2) receptor inhibitor (PD123319) was administrated to mice for 14 days. Cardiac myocytes were cultured and treated with Ang II for 5 minutes to 48 hours conditionally with the blockage of the AT1 or AT2 receptor. TAC-induced cardiac hypertrophy was observed at 14 days after the operation, which was partially reversed by losartan, but not by PD123319. Similarly, the upregulated HMGB1 expression levels observed in both the serum and myocardium induced by TAC were reduced by losartan. Elevated cardiac HMGB1 protein levels, but not mRNA or serum levels, were significantly decreased by PD123319. Furthermore, HMGB1 expression levels in culture media and cardiac myocytes were increased following Ang II treatment in vitro, positively associated with the duration of treatment. Similarly, Ang II-induced upregulation of HMGB1 in vitro was inhibited by both losartan and PD123319. These results suggest that upregulation of HMGB1 in serum and myocardium under PO, which are partially derived from cardiac myocytes, may be induced by Ang II via the AT1 and AT2 receptors. Additionally, amelioration of PO-induced cardiac hypertrophy following losartan treatment may be associated with the reduction of HMGB1 expression through the AT1 receptor.

Zinc is considered protective against atherosclerosis; however, the association between dietary zinc intake and cardiovascular disease remains debated. We investigated whether dietary zinc intake was associated with coronary artery calcium (CAC) progression in the Multi-Ethnic Study of Atherosclerosis (MESA). This analysis included 5186 participants aged 61.9 ± 10.2 years (48.8% men; 41.3% white, 25.0% black, 21.6% Hispanic, and 12.1% Chinese American) from the MESA. Dietary zinc intake was assessed by a self-administered, 120-item food frequency questionnaire at baseline (2000–2002). Baseline and follow-up CAC were measured by computed tomography. CAC progression was defined as CAC > 0 at follow-up for participants with CAC = 0 at baseline; and an annualized change of 10 or percent change of ≥ 10% for those with 0 0.05). In this multiethnic population free of clinically apparent cardiovascular disease, higher dietary zinc intake from non-red meat sources was independently associated with a lower risk of CAC progression. The MESA trial was registered at clinicaltrials.gov as NCT00005487.

Cold-formed steel (CFS) shear walls filled with lightweight polymer material (LPM) is an efficient structural system which can provide high lateral stiffness and strength to resist lateral loads. Despite the significant advantages, the nonlinear behavior of the CFS shear wall filled with LPM is not fully understood. In this study, a total of seven full-scale CFS shear walls filled with LPM were tested under cyclic loads. The test parameters included different LPM types, X-shaped bracing configurations, sheathing types and wall openings. The failure modes hysteresis curves, envelope curves, feature values, ductility ratio, stiffness and energy dissipation of CFS shear wall with and without filling LPM were systematically compared. The experimental data reveled that this type of shear wall showed higher load carrying and energy dissipation capacities than CFS framing wall without LPM. To assist with the design of CFS shear walls filled with LPM, a modified strut-and-tie model was proposed. The modified strut-and-tie model was validated using the experimental data. The result demonstrates that the proposed model can be utilized to accurately estimate the load carrying capacity of CFS shear walls filled with LPM. The presented experimental and analytical results can be used by engineers to design CFS shear walls filled with LPM for earthquake engineering applications.

Coronary artery calcification (CAC) progression is a strong predictor of cardiovascular disease (CVD) morbidity and mortality. However, the association between whole milk and CAC progression remains unknown. Recent studies highlighted beneficial effects of short chain fatty acids (SCFA) from whole milk on CVD. In this study, we attempted to investigate the relationship between whole milk consumption and CAC progression, and the potential effect of SCFA in it. We analyzed a population-based cohort with 5273 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) who completed a dietary questionnaire at baseline. CAC was measured at baseline and subsequent follow-up examinations by multi-detector computed tomography (MDCT) scans with Agatston scores. CAC progression was defined as increased CAC scores in the follow-up from the baseline exam. Participants consuming whole milk exhibited lower baseline CAC and CAC progression than those who never/rarely consumed whole milk (P

The present study is aimed at investigating whether Qiliqiangxin (QL) could regulate myocardial energy metabolism in heart failure rats after acute myocardial infarction (AMI) and further exploring the underlying mechanisms. AMI was established by ligating the left anterior descending coronary artery in adult male SD rats. AMI rats with ejection fraction EF<50% at two weeks after the operation were chosen as heart failure rats for the main study. Rats were randomized into the sham, MI, MI+QL, and MI+QL+2-MeOE2 groups. The results showed that compared with the MI group, QL significantly improved cardiac function, reduced serum NT-proBNP level, and alleviated myocardial fibrosis. QL also increased myocardial capillary density by upregulated protein expressions of vascular endothelial growth factor (VEGF) and CD31 by regulating the HIF-1α/VEGF pathway. Moreover, QL promoted ATP production, glucose uptake, and glycolysis by upregulating HIF-1α and a series of glycolysis-relevant enzymes in a HIF-1α-dependent manner. QL also improved myocardial glucose oxidation enzyme expression and free fatty acid uptake by a HIF-1α-independent pathway. Our results indicate that QL treatment improves cardiac function through regulating glucose uptake, FFA uptake, and key enzymes of energy metabolism via HIF-1α-dependent and independent mechanisms.

Background and aims Fatty liver diseases are highly prevalent in patients with coronary artery disease (CAD) and might progress to irreversible liver fibrosis. Whether baseline liver fibrosis (LF) scores are associated with long-term mortality among patients with CAD requires investigation. Methods The analysis was conducted based on a prospective cohort study among 3263 patients with CAD in China. Cox models were used to assess the association of baseline levels of LF scores, including non-alcoholic fatty liver disease fibrosis score (NFS), fibrosis 4 score (FIB-4), aspartate aminotransferase to platelet ratio index (APRI), gamma-glutamyltransferase to platelet ratio (GPR), and Forns score, with the risk of all-cause and cardiovascular mortality among CAD patients. Results During a median follow-up period of 7.56 (inter-quartile range: 6.86–8.31) years, 538 deaths were identified, 319 of those were due to cardiovascular diseases. Compared with patients with lowest score levels, multivariable-adjusted HRs (95% CI) for those with highest levels of NFS, FIB-4, APRI, GPR and Forns score were 2.89 (2.14–3.91), 2.84 (2.14–3.76), 1.77 (1.33–2.36), 1.47 (1.19–1.83) and 3.10 (1.88–5.11) for all-cause mortality, 3.02 (2.05–4.45), 3.34 (2.29–4.86), 1.99 (1.40–2.83), 1.80 (1.36–2.39) and 2.43 (1.28–4.61) for cardiovascular mortality, respectively. These associations were consistent when we excluded those who died within the first year of follow-up or stratified patients by different sex, age, BMI, diabetes status, metabolic syndrome status, CAD type and hsCRP level. Conclusions Higher LF scores are associated with increased risks of all-cause and cardiovascular mortality among CAD patients. LF scores might play a potential role in CAD prognosis prediction.

Background Cardiac resynchronization therapy (CRT)-defibrillator (CRT-D) has been more widely implanted than CRT-pacemaker (CRT-P) in patients of heart failure with reduced ejection fraction and prolonged QRS duration. However, the superiority of CRT-D over CRT-P in improving prognosis has not been well established. Methods Consecutive patients who underwent CRT implantation between 2005 and 2016 were retrospectively recruited and followed up to December 2017. Baseline characteristics were collected and all-cause mortality was compared between CRT-D and CRT-P recipients. Propensity score matched analysis was further performed to validate the results. Results A total of 345 patients (219 CRT-D, 126 CRT-P) were included. During a median follow-up of 36 months, there were 81 deaths (37.0%) in the CRT-D group compared to 56 deaths (44.4%) in the CRT-P group. There was no significant difference in the risk of mortality between CRT-D and CRT-P groups [hazard ratio (HR) 0.99, 95% CI 0.70–1.40, p = 0.95]. Propensity score matching yielded 111 cases per group, and there was no significant difference in the risk of mortality between CRT-D and CRT-P groups (HR 0.87, 95%CI 0.57–1.34, p = 0.53). No significant difference between CRT-D and CRT-P in reducing mortality was observed in any pre-specified subgroups, although the difference between CRT-D and CRT-P was more pronounced in patients with left bundle branch block (p = 0.01 for interaction). Conclusions CRT-D did not reduce all-cause mortality compared with CRT-P in this retrospective propensity score matched study. A comprehensive score system incorporating multiple factors is needed for risk stratification and guidance on device selection.

Concrete encased CFST (CECFST) column is a composite member consisted of outer encased concrete and inner CFST. Currently, a cast-in-place connection between a CECFST column and a reinforcement concrete beam is generally employed in engineering practice due to the outer encased concrete hinders the application of assembled connection, and the steel beam is usually connected to the CECFST column by on-site welding. In this paper, a novel on-site assembled connection between a CECFST column and a steel beam was proposed. In considering various material models and complex contacts, a FE model for this type of joint was established and verified. Further, parametric analyses of the assembled connections to concrete encased CFST columns were conducted to analyze the structural behavior. More importantly, an extended component model was developed to cover the feature of CECFST column focusing on the initial stiffness and moment resistance of the assembled connection. The load transfer mechanism for bolt in tension and beam flange in compression were considered in the modelling for evaluating the stiffness and strength of column wall in tension and in compression, respectively. The numerical results from the parametric analyses coincided well with the predicted results. The numerical and analytical results declared that this novel assembled connection between the CECFST column and steel beam performed favorable structural behavior and could be employed in assembled structures with CECFST columns.

Blood inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), and the platelet-to-lymphocyte ratio (PLR), play a significant role in determining the prognosis of patients with cervical cancer (CC). Currently, no methods are available to predict these indexes pre-operatively. Cardiac autonomic function is determined based on the heart rate variability (HRV), which is also associated with a progressive inflammatory response and cancer. Thus, the main aim of this study was to evaluate the feasibility of using pre-operative HRV parameters in CC patients to predict post-operative blood inflammation biomarkers as a means of determining prognosis. Between 2020 and 2021, 56 patients who were diagnosed with CC and then underwent hysterectomy surgery at the Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical College were enrolled in this study. Five-minute electrocardiogram data were collected 1 day before the operation for analysis of HRV parameters, including frequency domain parameters (LF, HF, and LF/HF) and Poincaré plot parameters (SD1, SD2, and SD2/SD1). Venous blood was collected 2 days post-operatively and inflammatory biomarkers were evaluated, with the NLR, LMR, and PLR determined. Pre-operative SD2 was significantly associated with post-operative PLR, with each 1-unit increase in SD2 decreasing the PLR value by 2.4 ± 0.9 (P < 0.05). Besides, LF/HF was significantly correlated with NLR, with each 1-unit increase in LF/HF increasing the NLR value by 1.1 ± 0.5 (P < 0.05). This association was independent of patient age and body mass index. These results suggest that the pre-operative autonomic nervous system plays a role in the regulation of post-operative cancer inflammation and that pre-operative HRV parameters can potentially predict post-operative inflammation and facilitate clinical treatment decisions.

Background: Females with novel coronavirus disease 2019 (COVID-19) state-ordered home isolation were associated with higher anxiety and reduced sleep quality than males. Sex differences in psychobehavioral changes during the COVID-19 stay-at home orders among healthcare workers remained unclear. The purpose of this study was to explore the sex differences in psychological burden and health behaviors among these persons.Methods: This was a cross-sectional study using online data available in the open Interuniversity Consortium for Political and Social Research (OPENICPSR). Healthcare workers including females and males who transitioned to working from home during the COVID-19 stay-at-home orders were included. Sex differences were compared using the chi-square test and Student's t-test. We performed logistic and linear regression analyses to determine the association of females with psychological burden and health behaviors.Results: A total of 537 respondents (425 females and 112 males) were enrolled in our study. Sex differences in age (42.1 ± 12.3 years vs. 46.6 ± 15.7 years, t = −2.821, p = 0.005), occupation (χ2 = 41.037, p < 0.001), mood change (n = 297, 69.9% vs. n = 61, 54.5%, χ2 = 9.482, p = 0.002), bedtime schedule (χ2 = 6.254, p = 0.044) and news consumption (n = 344, 80.9% vs. n = 76, 67.9%, χ2 = 8.905, p = 0.003) were statistically significant. Logistic regression showed that females was negatively associated with better mood status (OR = 0.586, 95% CI 0.153–2.247, p = 0.436). In addition, linear regression showed that females were not correlated with total sleep time after adjusting for sio-demographics, mental health outcomes and health behaviors (B = 0.038, 95% CI −0.313–0.388, p = 0.833).Conclusion: No sex differences in psychological burden and health behaviors of healthcare workers were found during the COVID-19 stay-at-home orders. The COVID-19 state-ordered home isolation may be a potential way to reduce disproportionate effects of COVID-19 pandemic on females and help to minimize sex differences in psychological burden and health behaviors among healthcare workers.

Cardiac autonomic modulation, assessed by heart rate variability (HRV), is associated with tumor pathogenesis and development as well as invasion and metastasis. This study aimed to examine this association in breast cancer (BC) patients. A total of 133 patients (average age 49.2years) with BC or benign breast tumors were divided into three groups: benign group, early-stage group, and advanced-stage group. About 5-min resting ECG was collected for the analysis of linear and nonlinear HRV parameters. Multiple logistic regression models were performed to test the independent contribution of HRV to breast tumor stage. The advanced-stage group had significantly reduced HRV compared to the benign and early-stage groups. In particular, for each 1-SD increase in SD2, SD of normal-to-normal intervals, very-low frequency, total power, and low frequency, the odds of having advanced staging decreased by 69.3, 64.3, 58.3, 53.3, and 65.9%, respectively. These associations were independent of age, body mass index, mean heart rate (HR), and respiratory rate (RR). These findings suggest an association between HRV and breast tumor stage, and HRV parameters may help construct an effective early diagnostic and clinical prognostic model.

In recent years, steel or composite beam-column connections adopting blind fasteners have drawn increasing praise due to the rapid development of assembled steel structures. However, limited researches have paid attention to the experimental and analytical behavior of concrete filled double-skin steel tube (CFDST) column blind bolted joints. For investigating the structural performance and seismic behavior of this type of connection, cyclic tests on blind bolted joints to square CFDST columns were carried out to explore the effects of column hollow ratio and end plate type. Finite element analytical modelling of the semi-rigid joint was performed considering complex contact interactions and material models. Good agreement between the test and analytical results was observed in terms of the failure modes and the hysteretic behavior. Substantial parametric analyses were conducted on typical CFDST column connections to observe the influence of parameters including strength of steel tube, column hollow ratio and bolt pretension force. Furthermore, certain constructional measures commonly employed in engineering practice were also discussed. It was concluded that the CFDST column blind bolted to the steel beam joint has favorable seismic behavior and is feasible for application in high-intensity earthquake regions.

This study aimed to compare the renal impairments in post-myocardial infarction (MI) rats with normal renal biochemical parameters at baseline with versus without cardiac dysfunction and explore the potential mechanisms involved in these differences. Sprague–Dawley rats with permanent ligation of coronary artery were used as MI models. Renal function, histological and molecular changes were compared between the reduced ejection fraction (EF) (EF

INTRODUCTION Several automatic algorithms have developed to optimize the timing cycle setting in cardiac resynchronization therapy (CRT). The present study aims to investigate whether the novel device-based SyncAV algorithm could elicit better synchrony and acute hemodynamic response. METHODS AND RESULTS Thirty five patients undergoing CRT implantation were prospectively studied. The device was programmed to three biventricular (BiV) pacing modes sequentially after the procedure: QuickOpt algorithm (mode I), SyncAV algorithm with default 50 ms offset (mode II), and SyncAV algorithm with optimized offset minimizing QRS duration (QRSd) (mode III). After each setting, electrocardiographic and echocardiographic data were collected. As a result, QRSd was reduced from 172.8 ± 17.9 ms during intrinsic conduction to 153.1 ± 15.9 ms in mode I, further narrowed to 140.5 ± 16.7 ms in mode II, and reached shortest (134.8 ± 16.1 ms) in mode III (P .05). Mode I presented significantly higher aortic velocity time integral than intrinsic conduction (21.0 ± 6.4 cm vs 18.4 ± 5.5 cm; P

INTRODUCTION Left bundle branch area pacing (LBBAP) has recently been reported to be a new physiological pacing strategy with clinical feasibility and safety. The present study aims to investigate depolarization-repolarization measures including QT interval, QT dispersion (QTD), and Tpeak-end interval (Tp Te ) in this novel LBBAP strategy. METHODS AND RESULTS A total of 131 pacing-indicated patients were prospectively enrolled and randomized to the LBBAP group (n = 66) and right ventricular septum pacing (RVSP) group (n = 65). LBBAP was successfully achieved in 61 subjects with stable lead performance and comparable complications (ie, pocket hematoma, lead perforation, and dislodgement) compared with RVSP. Of the 61 patients with successful LBBAP, the mean LV peak activation time was 67.89 ± 6.80 ms, with the LBB potential mapped in 46 cases (75.4%). Electrocardiogram (ECG) indices were compared between these two groups before and after implantation. As a result, LBBAP yielded a narrower paced QRS duration (121.49 ± 9.87 ms vs 145.62 ± 8.89 ms; P

Diastolic dysfunction is common in various cardiovascular diseases, which could be affected by adiponectin (APN). Nevertheless, the effects of APN on diastolic dysfunction in pressure overload model induced by transverse aorta constriction (TAC) remain to be further elucidated. Here, we demonstrated that treatment of APN attenuated diastolic dysfunction and cardiac hypertrophy in TAC mice. Notably, APN also improved active relaxation of adult cardiomyocytes, increased N2BA/N2B ratios of titin isoform, and reduced collagen type I to type III ratio and lysyl oxidase (Lox) expressions in the myocardial tissue. Moreover, APN supplementation suppressed TAC-induced oxidative stress. In vitro, inhibition of AMPK by compound C (Cpc) abrogated the effect of APN on modulation of titin isoform shift and the anti-hypertrophic effect of APN on cardiomyocytes induced by AngII. In summary, our findings indicate that APN could attenuate diastolic dysfunction in TAC mice, which are at least partially mediated by AMPK pathway. Electronic supplementary material The online version of this article (10.1007/s12265-019-09913-1) contains supplementary material, which is available to authorized users.

The blind bolting technique, recognized as a novel solution to connect a beam to a closed section column for unavailable installation from one side, has been gradually employed in concrete filled steel tube (CFST) column to steel beam connections recently. However, unexpected failure modes including bulge of the thin-walled steel tube and anchorage failure of the blind bolt in the core concrete still existed for this type of connection, which resulted in a limited ductility and inferior strength of the connection. Therefore, a novel blind bolted joint was proposed by replacing the CFST column with the concrete-filled double skin steel tubular (CFDST) column to overcome the above problems. A series of interior joint specimens to square CFDST columns were carried out to investigate their seismic behavior. Compared with the CFST column joints, typical failure modes of the CFDST column joints were characterized. Seismic response was also analyzed in terms of the hysteretic performance, strength and stiffness degradation and energy dissipation capacity to explore the effects of the column hollow ratio and end plate type. The experimental results denoted the CFDST column to steel beam joint with blind bolts performed excellent seismic performance. Based on the equivalent method, two simplified analytical models were discussed to evaluate the initial stiffness of this type of joint. The experimental and analytical results were beneficial for the application of semi-rigid connections to CFDST columns in engineering practice.

An experimental program was carried out to investigate the seismic performance and analytical modelling of blind bolted flush or extended end plate connections to circular concrete filled double skin steel tubular (CFDST) columns. A series of cruciform assemblage specimens composed of circular CFDST columns and H-shaped steel beams were tested under lateral cyclic loads. The test parameters were determined as the curved end plate type and column hollow ratio. Typical failure modes for the connections to CFDST columns were analyzed by comparing with blind bolted connections to CFST columns, which indicated CFDST column blind bolted to steel beam connections significantly restricted the outward deformation of column wall. Moreover, the seismic performance of blind bolted connections between circular CFDST columns and steel beams was also estimated in terms of the moment (M) -rotation (θr) relationship curves, ductility and energy dissipation capacities. Besides, the failure mechanism was studied through the analysis of strain responses. Analytical models were calibrated to estimate the initial stiffness and moment resistance of the blind bolted connections, which focused on the stiffness coefficients of curved flush and extended end plates in bending and the influence of circular CFDST column. The analytical models were verified against the experimental results. The experimental and analytical results indicated that the blind bolted flush or extended end plate connections to circular CFDST columns had superior seismic behavior and properly could meet the design demands in high-intensity seismic regions.

Fatigue failure is usually modelled by estimating fatigue lifetime with corresponding S-N curve and fatigue damage accumulation law such as Miner's law. This approach can neither track the stress redistribution induced by fatigue damage nor explain the mechanism of fatigue damage evolution properly. In this paper, a constitutive model for concrete fatigue is developed within the framework of continuum damage mechanics, where fatigue damage can capture the gradual degradation of mechanical performance in concrete. The conventional phenomenologically modelled fatigue damage evolution is built with an explanation on its physical mechanism. Then, in order to increase computational efficiency instead of taking cycle-by-cycle approach to track fatigue damage evolution in FEM simulation, an accelerating numerical scheme based on two temporal scales homogenization is employed to make computational cost acceptable. The simulation results are compared with fatigue experimental results to validate the proposed constitutive model and accelerating numerical scheme.

This paper reported an innovative semi-rigid composite frame comprised of concrete-filled steel tubular (CFST) columns and H-shaped steel beams assembled using flush or extended end plates with blind fasteners. Two specimens of two-story single-bay end plate moment-resisting square or circular CFST frames were investigated by a series of pseudo-dynamic tests. To analyze dynamic response of this type of structure under the earthquake action, time history response and story drift were investigated. The influence of the column section type and the end plate type on seismic performance of semi-rigid moment-resisting CFST frames under different earthquake loading levels were also discussed according to hysteretic behavior, rigidity degradation and energy dissipation capacity. The experimental and analytical results indicated that at the same section width and steel ratio of the column, the rigidity of end plate moment-resisting square CFST frame was greater than that of circular CFST frame, while the story drift of square CFST frame was smaller than that of circular CFST frame. The type of end plate moment-resisting CFST frames with blind fasteners, which can provide good seismic behavior and energy dissipation ability, can be well used in a seismic region.

This paper reports a series of experimental and analytical assessments on the flexural behaviour of cold-formed thin-walled lipped-channel section truss (CTLST) beams with profiled steel sheeting-concrete (PSSC) slabs or autoclaved lightweight concrete (ALC) slabs. Three test parameters were studied, including the floor type, the U-shaped shear connector, and the connection type among CTLST members. Besides, testing phenomena, failure modes, load versus deflection curves, and strain response for these CTLST composite beams were also analyzed. The experimental data showed that flexural strength of CTLST composite beam was significantly increased by adopting reliable connection type; bond performance of the interface between the profiled steel sheeting (PSS) and concrete slab was improved by erecting U-shaped shear connectors. These CTLST composite beams were in accordance with specification recommendations of deflection limits. In addition, three-dimensional finite element (FE) modelling of CTLST composite beams were developed and verified by test data. Effect of material and geometrical parameters on the flexural feature of the CTLST beams with PSSC slabs was explored. Finally, a simplified method, which was verified by the tested and simulated results, was proposed to predict the mid-span deflection of the CTLST composite beam using reliable connection type under serviceability loads.

In order to satisfy the requirements of seismic capacity of cold-formed thin-walled steel structure in low- and multi-rise buildings, an innovative cold-formed thin-walled steel tube truss (CFSTT) shear wall sheathed with both-side oriented strand board (OSB) was proposed in this paper. Five full-scale specimens of CFSTT shear walls which composed of square cold-formed thin-walled steel tubes, tracks, galvanized V-shaped connectors and OSB panels were tested under low-cyclic loading. The seismic performance of CFSTT shear wall was evaluated in terms of hysteretic behavior, envelop curves, ductility and energy dissipation, etc. Then, a practical nonlinear simplified analysis method of CFSTT shear walls under low-cyclic reversed lateral loading was proposed based on the principle of equivalent tie rod model. The double- and four-limb lattice studs were also simplified as single steel tubes. Besides, a pivot modeling approach was suggested to stimulate the sheathing-to-frame connection. Subsequently, the finite element models of CFSTT shear walls were established based on this simplified method and verified by the experimental data. Numerical and experimental results indicated that CFSTT shear walls exhibited excellent seismic performance, and the accuracy of the simplified of lattice stud was verified. Furthermore, the simplified method proposed in this paper will highly facilitate conducting the nonlinear analysis for shear walls.

The mechanism of cardiac resynchronization therapy (CRT) remains unclear. In this study, mitochondria calcium uniporter (MCU), dynamin‐related protein‐1 (DNM1L/Drp1) and their relationship with autophagy in heart failure (HF) and CRT are investigated. Thirteen male beagle's dogs were divided into three groups (sham, HF, CRT). Animals received left bundle branch (LBB) ablation followed by either 8‐week rapid atrial pacing or 4‐week rapid atrial pacing and 4‐week biventricular pacing. Cardiac function was evaluated by echocardiography. Differentially expressed genes (DEGs) were detected by microarray analysis. General morphological changes, mitochondrial ultrastructure, autophagosomes and mitophagosomes were investigated. The cardiomyocyte stretching was adopted to imitate the mechanical effect of CRT. Cells were divided into three groups (control, angiotensin‐II and angiotensin‐II + stretching). MCU, DNM1L/Drp1 and autophagy markers were detected by western blots or immunofluorescence. In the present study, CRT could correct cardiac dysfunction, decrease cardiomyocyte's size, alleviate cardiac fibrosis, promote the formation of autophagosome and mitigate mitochondrial injury. CRT significantly influenced gene expression profile, especially down‐regulating MCU and up‐regulating DNM1L/Drp1. Cell stretching reversed the angiotensin‐II induced changes of MCU and DNM1L/Drp1 and partly restored autophagy. CRT's mechanical effects down‐regulated MCU, up‐regulated DNM1L/Drp1 and subsequently enhanced autophagy. Besides, the mechanical stretching prevented the angiotensin‐II‐induced cellular enlargement.

To explore the axial compression property and failure mechanism of concrete-filled steel tubular (CFST) columns partially wrapped by carbon-fibre-reinforced polymer (FRP), a series of tests using carbon-FRP-strengthened circular CFST stubs and slender columns imposed with axial loads were conducted. The effects of various parameters including steel yield stress, number of carbon-FRP layer, slenderness ratio of the composite column, and spacing of carbon-FRP strip on the axial load bearing capacities of the tested specimens were studied. Moreover, the axial compression behaviour of the circular CFST columns with carbon-FRP composites was evaluated in terms of axial compression force (N)–longitudinal shortening displacement (δ) curves, axial stiffness, strain response, strength enhancement indexes, and ductility indexes. Subsequently, a nonlinear finite element (FE) analysis modelling concerning the surface contact action of carbon-FRP-strengthened circular CFST columns was established and validated experimentally. The experimental and analytical results indicate that strengthening the circular CFST stub columns using carbon-FRP wraps could improve their axial load bearing capacities and prevent outward local bulges for the thin-walled steel tubes. Only a slight effect was observed when laterally confined carbon-FRP strips were used for the type of slender composite columns. Finally, several simplified empirical formulas for predicting the axial load bearing capacity of the circular CFST column partially wrapped by carbon-FRP are proposed.

Background: Antibiotic resistance genes (ARGs) have become an important public health problem. In this study, we used metagenomic sequencing to analyze the composition of ARGs in certain original habitats of northeast China, comprising three different rivers and riverbank soils of the Heilongjiang River, Tumen River, and Yalu River. Results: Twenty types of ARG were detected in every water sample. The major ARGs were multidrug resistance genes, at approximately 0.5 copies/16s rRNA, accounting for 57.5% of the total ARG abundance. The abundance of multidrug, bacitracin, beta-lactam, macrolide‑lincosamide‑streptogramin, sulfonamide, fosmidomycin, and polymyxin resistance genes covered 96.9% of the total ARG abundance. No significant ecological boundary of ARG diversity was observed. The compositions of the resistance genes in the three rivers were very similar to each other, and 92.1% of ARG subtypes were shared by all water samples. Except for vancomycin resistance genes, almost all ARGs in riverbank soils were detected in the river water. About 31.05% ARGs were carried by Pseudomonas. Opportunistic pathogenic bacteria carrying resistance genes were mainly related to diarrhea and respiratory infections. Multidrug and beta-lactam resistance genes correlated positively with mobile genetic elements (MGEs), indicating a potential risk of diffusion.Conclusions: The composition of ARGs in three different rivers was similar, indicating that climate played an important role in ARG occurrence. ARG subtypes in river water were almost completely the same as those in riverbank soil. ARGs had no significant geographical distribution characteristics. Many ARGs were carried by human pathogenic bacteria related to human diarrhea and respiratory infections, such as Pseudomonas aeruginosa and Aeromonas caviae. In general, our results provide a valuable dataset of river water ARG distribution in northeast China. The related ecological geography distribution characteristics should be further explored.

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA/GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t = –11.53, p

Introduction: Left ventricular reverse remodeling (LVRR) is associated with decreased cardiovascular mortality and improved cardiac survival and also crucial for therapeutic options. However, there is a lack of an early prediction model of LVRR in first-diagnosed dilated cardiomyopathy.Methods: This single-center study included 104 patients with idiopathic DCM. We defined LVRR as an absolute increase in left ventricular ejection fraction (LVEF) from >10% to a final value >35% and a decrease in left ventricular end-diastolic diameter (LVDd) >10%. Analysis features included demographic characteristics, comorbidities, physical sign, biochemistry data, echocardiography, electrocardiogram, Holter monitoring, and medication. Logistic regression, random forests, and extreme gradient boosting (XGBoost) were, respectively, implemented in a 10-fold cross-validated model to discriminate LVRR and non-LVRR, with receiver operating characteristic (ROC) curves and calibration plot for performance evaluation.Results: LVRR occurred in 47 (45.2%) patients after optimal medical treatment. Cystatin C, right ventricular end-diastolic dimension, high-density lipoprotein cholesterol (HDL-C), left atrial dimension, left ventricular posterior wall dimension, systolic blood pressure, severe mitral regurgitation, eGFR, and NYHA classification were included in XGBoost, which reached higher AU-ROC compared with logistic regression (AU-ROC, 0.8205 vs. 0.5909, p = 0.0119). Ablation analysis revealed that cystatin C, right ventricular end-diastolic dimension, and HDL-C made the largest contributions to the model.Conclusion: Tree-based models like XGBoost were able to early differentiate LVRR and non-LVRR in patients with first-diagnosed DCM before drug therapy, facilitating disease management and invasive therapy selection. A multicenter prospective study is necessary for further validation.Clinical Trial Registration:http://www.chictr.org.cn/usercenter.aspx (ChiCTR2000034128).

Digital, Background Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk. Objectives In a post hoc analysis of the ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, the authors evaluated the benefit of adding the proprotein subtilisin/kexin type 9 inhibitor alirocumab to optimized statin treatment in patients with LDL-C levels near 70 mg/dL. Effects were evaluated according to concurrent lipoprotein(a) levels. Methods ODYSSEY Outcomes compared alirocumab with placebo in 18,924 patients with recent acute coronary syndromes receiving optimized statin treatment. In 4,351 patients (23.0%), screening or randomization LDL-C was 13.7 mg/dL or ≤13.7 mg/dL; corresponding adjusted treatment hazard ratios were 0.82 (95% CI: 0.72-0.92) and 0.89 (95% CI: 0.75-1.06), with Pinteraction = 0.43. Conclusions In patients with recent acute coronary syndromes and LDL-C near 70 mg/dL on optimized statin therapy, proprotein subtilisin/kexin type 9 inhibition provides incremental clinical benefit only when lipoprotein(a) concentration is at least mildly elevated. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402), Ciencias Médicas y de la Salud

Objective: Vascular calcification (VC) is an important predictor of cardiovascular morbidity and mortality in patients with chronic renal failure (CRF). It is well-known that obesity and metabolic syndrome (OB/MS) predicts poor prognosis of CRF patients. However, the influence of OB/MS on VC in CRF patients isn't clear. IL-18 mediates OB/MS-related inflammation, but whether IL-18 is involved in OB/MS -mediated VC in CRF patients hasn't been studied. In this study, it was explored that whether OB/MS caused by high-fat diet (HFD) can affect the level of serum IL-18 and aggravate the degree of VC in CRF rats. Furthermore, it was studied that whether IL-18 induces rat vascular smooth muscle cells (VSMCs) calcification by activating the MAPK pathways.Approach: The rats were randomly assigned to the sham-operated, CRF and CRF + HFD groups. CRF was induced by 5/6 nephrectomy. Serum IL-18 levels and aortic calcification indicators were compared in each group. Primary rat VSMCs calcification were induced by β-glycerophosphate and exposed to IL-18. VSMCs were also treated with MAPK inhibitors.Results: The weight, serum levels of hsCRP, TG and LDL-C in CRF + HFD group were significantly higher than those in sham-operated and CRF groups (p < 0.05). Compared with the sham-operated group, the calcium content and the expression of BMP-2 of aorta in CRF and CRF + HFD groups were significantly increased (p < 0.05). Moreover, the calcium content and the expression of BMP-2 of aorta in CRF + HFD group was significantly higher than those in CRF group (p < 0.05). And the serum IL-18 level was positively correlated with aortic calcium content. It was also found that p38 inhibitor SB203580 can suppress the VSMCs calcification and osteoblast phenotype differentiation induced by IL-18. But the JNK inhibitor SP600125 can't suppress the VSMCs calcification and osteoblast phenotype differentiation induced by IL-18.Conclusions: These findings suggest that obesity-related inflammation induced by high-fat diet could exacerbate VC in CRF rats. Furthermore, serum IL-18 level had a positive correlation with the degree of VC. It is also found that IL-18 promoted osteogenic differentiation and calcification of rat VSMCs via p38 pathway activation.

BACKGROUND: The assessment of interatrial septum (IAS) requires a standardized, systematic approach, including two-dimensional transthoracic echocardiography (2D TTE), 2D transesophageal echocardiography (2D TEE), and three-dimensional (3D) TEE. Although 2D TEE has been widely used for the preoperative assessment of atrial septal defect (ASD), its ability to provide reliable information is often limited due to the structural characteristics of IAS. The introduction of 3D TEE provides a unique “en face” view of IAS, which allows the visualization and accurate measurements of diameters, area, and rims of ASD. Hence, appropriate ASD imaging information is particularly important in successful transcatheter closure. METHODS: In this retrospective study, 2D TTE/TEE, and 3D TEE were performed before ASD closure, with 2D minimal and maximal diameters, areas, and residual rims being recorded. Adequate 3D TEE imaging data sets were collected and then analyzed. ASD related parameters were compared using different echocardiography. Patients who underwent ASD closure completed a clinical follow-up. RESULTS: The mean defect maximal diameter and aperture area by 3D TEE was significantly larger than that of the corresponding 2D TEE (P

BACKGROUND: This study investigated whether combinations of high-density lipoprotein (HDL) subfractions and inflammatory markers would add value to coronary artery disease (CAD) prediction. METHODS: Non-CAD subjects (n=245) were stratified into low/moderate/high-Framingham risk (L/M/H-FR) groups and 180 CAD patients were enrolled. Levels of HDL-C, HDL(2), HDL(3), monocyte chemoattractant protein-1 (MCP-1), and high-sensitivity C-reactive protein (hsCRP) were measured. Multivariable logistic models for CAD were estimated with a single parameter or all parameters together after adjustment for conventional risk factors (CRFs), and Z statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to compare discrimination among different models. RESULTS: The results show that HDL-C, HDL(2,) and HDL(3) gradually decreased, while MCP-1 and hsCRP gradually increased from L/M/H-FR to the CAD group. When applying a single factor in the CRFs-adjusted models, HDL-C (OR 0.011, 95% CI, 0.002–0.071, P

Background It remains unclear whether triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, is prospectively associated with incident peripheral arterial disease (PAD). Methods We included 12,320 Atherosclerosis Risk in Communities Study participants (aged 54.3 ± 5.7 years) free of a history of PAD at baseline (visit 1: 1987–1989). The TyG index was determined using ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2), and measured at 5 visits between 1987 and 2013. Incident PAD was defined as the first hospitalization with PAD diagnosis or a new onset of measured ABI Results Over a median follow-up of 23 years, 1300 participants developed PAD. After adjustment for traditional PAD risk factors, each 1-SD (0.58) increase in TyG index was associated with an 11.9% higher risk of incident PAD [hazard ratio, 1.119 (95% CI, 1.049–1.195)]. Results were similar when individuals were categorized by TyG index quartiles [hazard ratio, 1.239 (95% CI, 1.028–1.492); comparing extreme quartiles]. Four distinct trajectories of stable TyG indexes at various levels along the follow-up duration were identified [low (22.2%), moderate (43.2%), high (27.5%), and very high (7.1%) trajectory groups]. Compared with those with a TyG index trajectory at a low level, those participants with TyG index trajectories at high and very high levels had an even greater risk of future incident PAD [odds ratio (95%CI): 1.404 (1.132–1.740) and 1.742 (1.294–2.344), respectively] after multivariate adjustments for traditional PAD risk factors. Conclusions Higher TyG index is independently associated with an increased risk of incident PAD. Long-term trajectories of TyG index help identify individuals at a higher risk of PAD who deserve specific preventive and therapeutic approaches. Trial registration: Clinical trial registration number: The ARIC trial was registered at clinicaltrials.gov as NCT00005131.

Emerging evidence suggests that the reduction of ethanolamine plasmalogen (PlsEtn) is associated with in Alzheimer's disease and metabolic diseases. However, the mechanistic bases for PlsEtn on the these diseases are not well understood. Plasmalogens are primarily synthesized in the liver and enriched in brain. To this end, the present study sought to investigate the potential role of PlsEtn on steatohepatitis and memory impairments and its underlying mechanism. Here we show that peroxisome dysfunction and impairment of PlsEtn synthesis pathway occurs in both of hippocampus and liver, resulting in the decrease of PlsEtn level in APP/PS1 mice and HFD-fed mice. shGNPAT induced PlsEtn deficiency in hepatocytes induces p75NTR enhancement leading to decreased lipolysis activity, thereby exacerbating steatosis. Moreover, in the brain, PlsEtn administration appears to not only improve steatosis but also prevent Alzheimer's disease through restoration of TrkA/p75NTR balance. Together, our findings reveal a molecular mechanistic insight into the preventive role of plasmalogen modulation against steatosis and memory impairments via p75NTR inhibition., Graphical abstract The potential of plasmalogen modulation as a therapeutic strategy in lipid accumulation and memory impairments was demonstrated, and p75NTR was identified to play a pivotal role on the effect of PlsEtn in lipid accumulation and cognitive impairment.Image 1, Highlights • Peroxisome dysfunction and impairment of plasmalogen synthesis pathway resulted in the decrease of plasmalogen level. • Plasmalogen deficiency in hepatocytes induces p75NTR enhancement leading to decreased lipolysis activity. • Ethanolamine plasmalogen administration improves memory impairments by restoration of TrkA/p75NTR balance. • Ethanolamine plasmalogen administration attenuates neurodegeneration and neuronal death, and mitigates oxidative stress.

Background: Whether heart rate (HR) fluctuation after admission has an impact on the outcomes of critically ill myocardial infarction (MI) patients in intensive care unit remains unknown.Methods: A total of 2,031 MI patients were enrolled from the Medical Information Mart for Intensive Care (MIMIC-III) database. HR fluctuation was calculated as the maximum HR minus the minimum HR in the initial 24 h after admission. Participants were divided into 3 groups, namely, low HR fluctuation [Results: Each 10-bpm increase in HR fluctuation was associated with a higher risk of 30-day mortality and 1-year mortality, with adjusted hazard ratios of 1.122 (95% CI, 1.083–1.162) and 1.107 (95% CI, 1.074–1.140), respectively. Compared with the low HR fluctuation group, the high HR fluctuation group suffered a significantly higher risk of mortality after adjustment, with hazard ratios of 2.156 (95% CI, 1.483–3.134) for 30-day mortality and 1.796 (95% CI, 1.354–2.381) for 1-year mortality. A typical J-type curve was observed in restricted cubic splines for the association between HR fluctuation and 30-day or 1-year mortality of MI patients, with the lowest risk on the HR fluctuation of 30 bpm. Sensitivity analyses emphasized the robustness of our results.Conclusions: This retrospective cohort study revealed an independent positive association between HR fluctuation and 30-day and 1-year mortality in critically ill MI patients, which warrants further investigation.

BackgroundGiven the traditional acceptance of higher central venous pressure (CVP) levels, clinicians ignore the incidence of acute kidney injury (AKI). The objective of this study was to assess whether elevated CVP is associated with increased AKI in critically ill patients with multiple comorbidities.MethodsThis was a retrospective observational cohort study using data collected from the Medical Information Mart for Intensive Care (MIMIC)-III open-source clinical database (version 1.4). Critically ill adult patients with CVP and serum creatinine measurement records were included. Linear and multivariable logistic regression were performed to determine the association between elevated CVP and AKI.ResultsA total of 11,135 patients were enrolled in our study. Critically ill patients in higher quartiles of mean CVP presented greater KDIGO AKI severity stages at 2 and 7 days. Linear regression showed that the CVP quartile was positively correlated with the incidence of AKI within 2 (R2 = 0.991,P = 0.004) and 7 days (R2 = 0.990,P = 0.005). Furthermore, patients in the highest quartile of mean CVP exhibited an increased risk of AKI at 7 days than those in the lowest quartile of mean CVP with an odds ratio of 2.80 (95% confidence interval: 2.32–3.37) after adjusting for demographics, treatments and comorbidities. The adjusted odds of AKI were 1.10 (95% confidence interval: 1.08–1.12) per 1 mmHg increase in mean CVP.ConclusionsElevated CVP is associated with an increased risk of AKI in critically ill patients with multiple comorbidities. The optimal CVP should be personalized and maintained at a low level to avoid AKI in critical care settings.

The concrete-filled steel tube (CFT) composite frames using blind bolts and buckling-restrained braces (BRBs) have been studied with the development of building industrialization and energy dissipation technology. However, there has been no research so far on the probabilistic seismic fragility analysis for the blind-bolted end-plate CFT composite frames with BRBs (BRB-BECFT). Therefore, a total of 6-, 9-, 12- and 20-story BRB-BECFT prototype structures were designed based on the performance-based plastic design method. The results obtained from nonlinear static and dynamic analyses indicated that the four structures achieved predefined performance objectives in terms of story drift, joint rotation, and BRB ductility demand. Subsequently, fragility curves including non-collapse and collapse states were established to evaluate the behavior of the structure for a given intensity measure using the incremental dynamic analysis approach. Meanwhile, the geometric mean of spectral acceleration over a period range (Sa,avg) was selected as the intensity measure to assess the structural collapse capacity. Results showed that the adoption of Sa,avg can result in 32–42% lower data dispersion for the determination of collapse point, and simplification of the process of calculation of the collapse margin ratio of a structure. Furthermore, based on the combination of Sa,avg, residual story drift and BRB core plate strain, a framework of probabilistic seismic damage analysis of structures for combined damage evaluation at three levels of the system, subsystem, and component was summarized and conducted by the 6- and 12-story case study. This is practically useful to assess structural damage state after an earthquake because it could present more information on the probability distribution of various damage scenarios.

Background: Little is known regarding the impact of socioeconomic factors on the use of evidence-based therapies and outcomes in patients with heart failure with reduced ejection fraction across Asia. Methods: We investigated the association of both patient-level (household income, education levels) and country-level (regional income level by World Bank classification, income disparity by Gini index) socioeconomic indicators on use of guideline-directed therapy and clinical outcomes (composite of 1-year mortality or HF hospitalization, quality of life) in the prospective multinational ASIAN-HF study (Asian Sudden Cardiac Death in Heart Failure). Results: Among 4540 patients (mean age: 60±13 years, 23% women) with heart failure with reduced ejection fraction, 39% lived in low-income regions; 34% in regions with high-income disparity (Gini ≥42.8%); 64.4% had low monthly household income (P interaction Conclusions: These findings highlight the importance of socioeconomic determinants among patients with heart failure in Asia and suggest that attention should be paid to address disparities in access to care among the poor and less educated, including those from wealthy regions. Registration: URL: https://clinicaltrials.gov ; Unique Identifier: NCT01633398.