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Despite the popularity of AI-oriented e-commerce live-streaming, the service failures that can result from real-time interaction and instant transactions have not been taken seriously. This study aims to assess the failure of AI-oriented live-streaming e-commerce services and help retailers identify various risks. Based on expectancy disconfirmation theory and a stressor–strain–outcome framework, this study identified a comprehensive framework including information, functional, system, interaction, and aesthetic failures. The structural equation modeling (SEM) method is used to further examine its effect on consumers’ discontinuance behavior. Further research reveals the mediating role of consumer disappointment and emotional exhaustion, as well as the moderating role of the live-streaming platform type. These results shed light on the negative influence of AI-oriented live-streaming e-commerce service failures and contribute to the literature on live-streaming commerce, service failure, and virtual streamers.

Abstract Background MicroRNA (miRNA) plays a critical function in the progression of acute coronary syndrome (ACS) and is associated with major adverse cardiovascular events (MACEs) after undergoing percutaneous coronary intervention (PCI). This research was designed to probe the diagnostic accuracy of miR-483-5p in patients with ACS and its predictive value of MACEs. Methods 118 patients with ACS (40 with unstable angina pectoris [UAP] and 78 with acute myocardial infarction [AMI]) and 75 healthy controls were enrolled. Serum miR-483-5p was detected in the subjects by reverse transcription-quantitative real-time PCR (RT-qPCR). ROC curve and logistic regression models were employed to estimate the diagnosis. Patients were monitored for 6 months after PCI to document the occurrence of MACEs. Kaplan-Meier survival was conducted to explore the predictive significance of miR-483-5p for the MACEs. Results Serum miR-483-5p levels were higher in ACS patients and associated with SYNTAX score and Gensini score. miR-483-5p was effective in identifying ACS patients from healthy individuals (AUC = 0.919) and AMI patients from ACS patients (AUC = 0.867), demonstrating a high diagnostic value, proven by logistic regression (OR = 9.664, 95%CI = 4.462–20.928, P

BackgroundThe Chinese government recently introduced a program to buy medical supplies in bulk to reduce the patient cost burden. For patients undergoing percutaneous coronary intervention (PCI), little is known about the effect on outcomes of this bulk-buy program.AimsThis study investigated whether the bulk-buy program to decrease the price of stents used in PCI affected clinical decision-making and outcomes.MethodsThis single-center study enrolled patients undergoing PCI from January 2020-December 2021. Prices decreased for stents on January 1, 2021, and balloons on March 1, 2021. Patients were grouped by surgical year as either before (2020) or after (2021) policy implementation. All clinical data were collected. To examine whether clinical decision-making for PCI was affected by the bulk-buy program, procedure appropriateness was analyzed using the 2017 appropriate use criteria (AUC). To assess outcomes, the rates of major adverse cardiac and cerebrovascular events (MACCE) and complications were compared between groups.ResultsStudy participants were 601 patients in 2020 (before bulk buying) and 699 patients in 2021 (after bulk buying). Results of analysis by AUC for procedure appropriateness were 74.5% appropriate, 21.6% may be appropriate, and 3.8% rarely appropriate in 2020, with no differences for patients who underwent PCI in 2021. Between-group comparisons showed MACCE rates of 0.5% in 2020 and 0.6% in 2021, whereas complication rates were 5.5% and 5.7%, respectively. No statistically significant differences were found between groups (p > 0.05).ConclusionThe bulk-buy program did not impact physician clinical decision-making or surgical outcomes for patients undergoing PCI.

Colletotrichum fructicola infects pear leaves, resulting in two major symptoms: tiny black spots (TS) followed by severe early defoliation and big necrotic lesions (BnL) without apparent damage depending on the pathotypes. How the same fungal species causes different symptoms remains unclear. To understand the molecular mechanism underlying the resulting diseases and the diverse symptoms, two C. fructicola pathogenetic strains (PAFQ31 and PAFQ32 responsible for TS and BnL symptoms, respectively) were inoculated on Pyrus pyrifolia leaves and subjected to transcriptome sequencing at the quiescent stage (QS) and necrotrophic stage (NS), respectively. In planta, the genes involved in the salicylic acid (SA) signaling pathway were upregulated at the NS caused by the infection of each strain. In contrast, the ethylene (ET), abscisic acid (ABA), and jasmonic acid (JA) signaling pathways were specifically related to the TS symptoms caused by the infection of strain PAFQ31, corresponding to the yellowish and early defoliation symptoms triggered by the strain infection. Correspondingly, SA was accumulated in similar levels in the leaves infected by each strain at NS, but JA was significantly higher in the PAFQ31-infected as measured using high-performance liquid chromatography. Weighted gene co-expression network analysis also reveals specific genes, pathways, phytohormones, and transcription factors (TFs) associated with the PAFQ31-associated early defoliation. Taken together, these data suggest that specific metabolic pathways were regulated in P. pyrifolia in response to the infection of two C. fructicola pathotypes resulting in the diverse symptoms: JA, ET, and ABA accumulated in the PAFQ31-infected leaves, which negatively affected the chlorophyll metabolism and photosynthesis pathways while positively affecting the expression of senescence-associated TFs and genes, resulted in leaf yellowing and defoliation; whereas SA inhibited JA-induced gene expression in the PAFQ32-infected leaves, which led to hypersensitive response-like reaction and BnL symptoms.

Abstract Background Chronic total occlusion revascularization remains a challenging problem because of its complexity. We present a case of a patient with chronic total occlusion who was successfully revascularized with the use of a new device called a real-time intravascular ultrasound double-lumen microcatheter. Case presentation A 58-year-old East Asians woman presented to our hospital with a complaint of recurrent chest pain of 5 months’ duration. Angiography revealed chronic total occlusion of the right coronary artery from the right coronary artery ostium to the ostia of the posterolateral and posterior descending branches. A guidewire was passed to the distal right coronary artery but went into the false lumens at the posterior descending and posterolateral ostia after use of the antegrade and retrograde approaches. Hence, we used the new device to pass through the subintimal right coronary artery space with reentry into the true lumen before the posterior descending and posterolateral ostia. A stent was successfully deployed at the posterior descending and posterolateral ostia, and the final result was excellent. Conclusions This device was useful for finding the entry point and for reentry into the true lumen of a chronic total occlusion. It may be a valuable tool for recanalization of complex chronic total occlusion lesions.

Diaporthe species are significant pathogens, saprobes, and endophytes, with comprehensive host association and geographic distribution. These fungi cause severe dieback, cankers, leaf spots, blights, and stem-end rot of fruits on different plant hosts. This study, explored the occurrence, diversity and pathogenicity of Diaporthe spp. associated with Actinidia chinensis and A. deliciosa in the main kiwifruit production areas of China. Diaporthe isolates (284) derived from 106 diseased leaf and branch samples were examined. Multi-locus phylogenetic analyses and morphology of 43 representative isolates revealed that seven Diaporthe species were obtained, including D. alangii, D. compactum, D. eres, D. hongkongensis, D. sojae, D. tectonae, and D. unshiuensis. Pathogenicity tests were performed on kiwifruit fruits, leaves and branches. Koch’s postulates confirmed all species were pathogenic. D. alangii and D. tectonae were the most aggressive species, followed by D. eres, D. sojae, D. hongkongensis, D. unshiuensis, and D. compactum. Host range evaluation showed that the seven Diaporthe species could also infect apricot, apple, peach, pear, and plum. This is the first report of D. alangii, D. compactum, D. sojae, D. tectonae, and D. unshiuensis infecting kiwifruit in China, increasing understanding of the Diaporthe complex causing diseases of kiwifruit plants, to assist effective disease management.