Feasibility and effect of para-right bundle branch pacing in patients with atrial fibrillation and complete atrioventricular block

Background: Chronic right ventricular apex (RVA) pacing can induce negative clinical effects. The aim of the present study was to compare RVA pacing with para-right bundle branch (para-RBB) pacing in terms of electrocardiogram (ECG) and echocardiographic (ECHO) features. Methods: Forty-one consecutive persistent atrial fibrillation patients with an indication for permanent pacing treatment due to complete atrioventricular block were randomly assigned to receive a screw-in lead either in the RVA (n = 22) or at the para-RBB (n = 19). Para-RBB pacing leads were located according to the RBB potential recorded by electrophysiology catheter. ECG was recorded before and after implantation. All patients underwent the pacemaker pro­gramming at 1 day, 6 months, 12 months and 24 months after implantation. ECHO examina­tion was performed during follow-up at 6, 12 and 24 months after implantation to assess the heart function and synchronism. Results: There was no significant difference in pacing lead parameters between para-RBB pacing group and RVA pacing group. Compared with RVA pacing group, the para-RBB pacing group obtained a narrower QRS complex, more synchronic ventricular systole, and less nega­tive effect on heart function (p < 0.05). Conclusions: Para-RBB pacing has potential clinical benefits and may be a physiological pacing site.

Enhanced gross primary production and evapotranspiration in juniper-encroached grasslands.

Woody plant encroachment (WPE) into grasslands has been occurring globally and may be accelerated by climate change in the future. This land cover change is expected to alter the carbon and water cycles, but it remains uncertain how and to what extent the carbon and water cycles may change with WPE into grasslands under current climate. In this study, we examined the difference of vegetation indices (VIs), evapotranspiration (ET), gross primary production (GPP), and solar-induced chlorophyll fluorescence (SIF) during 2000-2010 between grasslands and juniper-encroached grasslands. We also quantitatively assessed the changes of GPP and ET for grasslands with different proportions of juniper encroachment (JWPE). Our results suggested that JWPE increased the GPP, ET, greenness-related VIs, and SIF of grasslands. Mean annual GPP and ET were, respectively, ~55% and ~45% higher when grasslands were completely converted into juniper forests under contemporary climate during 2000-2010. The enhancement of annual GPP and ET for grasslands with JWPE varied over years ranging from about +20% GPP (~+30% for ET) in the wettest year (2007) to about twice as much GPP (~+55% for ET) in the severe drought year (2006) relative to grasslands without encroachment. Additionally, the differences in GPP and ET showed significant seasonal dynamics. During the peak growing season (May-August), GPP and ET for grasslands with JWPE were ~30% and ~40% higher on average. This analysis provided insights into how and to what degree carbon and water cycles were impacted by JWPE, which is vital to understanding how JWPE and ecological succession will affect the regional and global carbon and water budgets in the future

Impervious surface change mapping with an uncertainty-based spatial-temporal consistency model: a case study in Wuhan city using Landsat time-series datasets from 1987 to 2016

Detailed information on the spatial-temporal change of impervious surfaces is important for quantifying the effects of rapid urbanization. Free access of the Landsat archive provides new opportunities for impervious surface mapping with fine spatial and temporal resolution. To improve the classification accuracy, a temporal consistency (TC) model may be applied on the original classification results of Landsat time-series datasets. However, existing TC models only use class labels, and ignore the uncertainty of classification during the process. In this study, an uncertainty-based spatial-temporal consistency (USTC) model was proposed to improve the accuracy of the long time series of impervious surface classifications. In contrast to existing TC methods, the proposed USTC model integrates classification uncertainty with the spatial-temporal context information to better describe the spatial-temporal consistency for the long time-series datasets. The proposed USTC model was used to obtain an annual map of impervious surfaces in Wuhan city with Landsat Thematic Mapper (TM), Enhanced Thematic Mapper (ETM+), and Operational Land Imager (OLI) images from 1987 to 2016. The impervious surfaces mapped by the proposed USTC model were compared with those produced by the support vector machine (SVM) classifier and the TC model. The accuracy comparison of these results indicated that the proposed USTC model had the best performance in terms of classification accuracy. The increase of overall accuracy was about 4.23% compared with the SVM classifier, and about 1.79% compared with the TC model, which indicates the effectiveness of the proposed USTC model in mapping impervious surfaces from long-term Landsat sensor imagery

Prism adaptation combined with eye movement training for unilateral spatial neglect after stroke: Study protocol for a single-blind prospective, randomized controlled trial

BackgroundUnilateral spatial neglect (USN) is a complex neurological syndrome that often reduces rehabilitation outcomes, prolongs patients' hospital stays, and decreases their quality of life. However, the current therapies for USN have varying efficacy. We will explore a new treatment option that combines prism adaptation (PA) with eye movement training (EMT) for the treatment of USN after stroke.MethodsWe will conduct a single-blind, prospective, randomized controlled trial to assess the efficacy of the combined intervention (PA & EMT) on USN in an inpatient rehabilitation setting. The study aims to recruit 88 patients with USN after an ischemic or hemorrhagic stroke. Participants will be randomly assigned to the following four groups: (1) PA group (n = 22), (2) EMT group (n = 22), (3) PA and EMT group (n = 22), and (4) control group (n = 22). All groups will receive 10 sessions of interventions over 2 weeks, 5 times per week. Blinded assessors will conduct a baseline assessment, a post-intervention assessment, and a follow-up assessment (2 weeks post-intervention). The primary outcome measure will use the Behavioral Inattention Test-Conventional Subset (BIT-C) and Catherine Bergego Scale (CBS) to assess the levels of USN. Secondary outcome measures will assess the patient's ability to perform activities of daily living using the Modified Barthel Index (MBI). Patients who completed all treatment and assessment sessions will be included in the final analysis.DiscussionThis study will explore the effects of 10 sessions of combined interventions (PA & EMT) on USN and functional capacity. This study has the potential to identify a new, evidence-based treatment option and provide new ideas for the treatment of USN.Ethics and disseminationThe study protocol has been approved by the Nanchong Central Hospital. Written informed consent will be obtained from all the participants. The results of this study will be disseminated to the public through scientific conferences and a peer-reviewed journal.Trial registrationChiCTR, ChiCTR2100049482. Registered on 2 August 2021, http://www.chictr.org.cn/showproj.aspx?proj=130823

Odor Characteristics and Formation Pathways of Low-Salted Large Yellow Croaker

In this study, our purpose was to investigate the effect of mild salting on the flavor of large yellow croaker. The volatile flavor compounds of raw (unsalted) and low-salted large yellow croaker were determined by solid phase microextraction (SPME) combined with gas chromatography-mass spectrometry (GC-MS) and evaluated by gas chromatography-olfactometry (GC-O) and odor activity values (OAV) analysis. The GC-MS analysis showed that the contents of hexanal, nonanal, heptanal, 1-octene-3-ol, anethole and hexanol in both samples were higher than those of other volatile compounds identified. GC-O and OAV analysis showed that the flavor of raw large yellow croaker was significantly affected by 1-octene-3-ol, octanal, nonanal, hexanal, heptanal, (E,Z)-2,6-nonadienal, trans-2-octenal and anethole (OAV > 1); the flavor of low-salted large yellow croaker was significantly affected by linalool, nonanal, hexanal, octanal, 1-octene-3-ol, anethole, (E,Z)-2,6-nonadienal and heptanal (OAV > 1). The changes in flavor after salting treatment was attributed to a significant increase in the OAV of linalool and anethole, and a significant decrease in the OAV of 1-octene-3-ol, hexanal, nonanal, trans-2-octenal, (E,Z)-2,6-nonadienal, heptanal and octanal. The changes of some flavor components might be related to reactions such as the oxidative degradation of unsaturated fatty acids, the biosynthesis of terpenoids, the isomerization of aromatic alcohols, the oxidation and reduction of aliphatic aldehyde and esterification

Case report: Giant atypical granular cell tumor of the median nerve

Granular cell tumors are extremely uncommon soft tissue neoplasms that mostly occur in the head and neck regions. Granular cell tumors are generally benign, asymptomatic, and rarely involve the median nerve. Due to the lack of awareness about granular cell tumors, they are easily misdiagnosed and mistreated in primary hospitals. Here, we report a giant atypical granular cell tumor located on the median nerve, approximately 12 cm in size, with unusual symptoms of median nerve damage. Magnetic resonance imaging revealed a fusiform mass that was hyperintense on T2-weighted images and iso-hypointense on T1-weighted images. The mass was subsequently biopsied and found to be a granular cell tumor. The tumor was resected, and a pathological examination was performed. Pathological examination revealed necrotic foci, abundant eosinophilic granules, pustular ovoid bodies, and multiple mitoses. Immunohistochemical staining revealed that the tumor cells were positive for S-100, CD68, SMA, SOX-10, Calretinin, and TFE3. The integrated diagnosis was an atypical granular cell tumor. To the best of our knowledge, this is the first report of an atypical granular cell tumor involving the median nerve. Furthermore, we comprehensively reviewed the existing literature to provide a concise summary of the diagnostic criteria, imaging findings, and pathological features of granular cell tumors. Given the high recurrence and metastasis rates of this disease, granular cell tumors of the median nerve should be considered when a patient presents with symptoms of median nerve impairment. The diagnosis of atypical granular cell tumors relies on pathological examination. In addition, extensive resection and long-term follow-up are necessary to improve prognosis

Genetic variation and forensic efficiency of 30 indels for three ethnic groups in Guangxi: relationships with other populations

Aim In this study, we used a series of diallelic genetic marker insertion/deletion polymorphism (indel) to investigate three populations of Yao, Kelao, and Zhuang groups in the Guangxi region of China and to evaluate their efficiency in forensic application. Result No deviations for all 30 loci were observed from the Hardy–Weinberg equilibrium after Bonferroni correction (p > 0.05/30 = 0.0017). The allele frequencies of the short allele (DIP-) for the above three populations were in the range of 0.0520–0.9480, 0.0950–0.8780, and 0.0850–0.915, respectively. The observed heterozygosity of the 30 loci for the three populations was in the ranges 0.0802–0.5802, 0.1908–0.6053, and 0.1400–0.5600, respectively. The cumulative power of exclusion and combined discrimination power for Yao, Kelao, and Zhuang groups were (0.9843 and 0.9999999999433), (0.9972 and 0.9999999999184), and (0.9845 and 0.9999999999608), respectively. The DA distance, principal component analysis, and cluster analysis indicated a clear regional distribution. In addition, Zhuang groups had close genetic relationships with the Yao and Kelao populations in the Guangxi region. Conclusion This study indicated that the 30 loci were qualified for personal identification; moreover, they could be used as complementary genetic markers for paternity testing in forensic cases for the studied populations

Simple non-invasive scoring systems and histological scores in predicting mortality in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis

[Background and Aim] There is debate among the hepatology community regarding the simple non-invasive scoring systems and histological scores (even it was developed for histological classification) in predicting clinical outcomes in patients with non-alcoholic fatty liver disease (NAFLD). This study aimed to determine whether the presence of simple non-invasive scoring systems and histological scores could predict all-cause mortality, liver-related mortality, and liver disease decompensation (liver failure, cirrhosis, hepatocellular carcinoma, or decompensated liver disease).[Methods] The pooled hazard ratio of prognostic factors and incidence rate per 1000 person-years in patients with NAFLD was calculated and further adjusted by two different models of handling the duplicated data.[Results] A total of 19 longitudinal studies were included. Most simple non-invasive scoring systems (Fibrosis-4 Score, BARD, and aspartate aminotransferase-to-platelet ratio index ) and histological scores (NAFLD activity score, Brunt, and "steatosis, activity, and fibrosis" ) failed in predicting mortality, and only the NAFLD fibrosis score > 0.676 showed prognostic ability to all-cause mortality (four studies, 7564 patients, 118 352 person-years followed up, pooled hazard ratio 1.44, 95% confidence interval [CI] 1.05–1.96). The incidence rate per 1000 person-years of all-cause mortality, liver-related mortality, cardiovascular-related mortality, and liver disease decompensation resulted in a pooled incidence rate per 1000 person-years of 22.65 (14 studies, 95% CI 9.62–53.31), 3.19 (7 studies, 95% CI 1.14–8.93), 6.02 (6 studies, 95% CI 4.69–7.74), and 11.46 (4 studies, 95% CI 5.33–24.63), respectively.[Conclusion] Non-alcoholic fatty liver disease fibrosis score showed promising prognostic value to all-cause mortality. Most present simple non-invasive scoring systems and histological scores failed to predict clinical outcomes.Peer reviewe

Plasma proteomics to identify drug targets for ischemic heart disease

Background Integrated analyses of plasma proteomic and genetic markers in prospective studies can clarify the causal relevance of proteins and discover novel targets for ischemic heart disease (IHD) and other diseases. Objectives The purpose of this study was to examine associations of proteomics and genetics data with IHD in population studies to discover novel preventive treatments. Methods We conducted a nested case-cohort study in the China Kadoorie Biobank (CKB) involving 1,971 incident IHD cases and 2,001 subcohort participants who were genotyped and free of prior cardiovascular disease. We measured 1,463 proteins in the stored baseline samples using the OLINK EXPLORE panel. Cox regression yielded adjusted HRs for IHD associated with individual proteins after accounting for multiple testing. Moreover, cis-protein quantitative loci (pQTLs) identified for proteins in genome-wide association studies of CKB and of UK Biobank were used as instrumental variables in separate 2-sample Mendelian randomization (MR) studies involving global CARDIOGRAM+C4D consortium (210,842 IHD cases and 1,378,170 controls). Results Overall 361 proteins were significantly associated at false discovery rate <0.05 with risk of IHD (349 positively, 12 inversely) in CKB, including N-terminal prohormone of brain natriuretic peptide and proprotein convertase subtilisin/kexin type 9. Of these 361 proteins, 212 had cis-pQTLs in CKB, and MR analyses of 198 variants in CARDIOGRAM+C4D identified 13 proteins that showed potentially causal associations with IHD. Independent MR analyses of 307 cis-pQTLs identified in Europeans replicated associations for 4 proteins (FURIN, proteinase-activated receptor-1, Asialoglycoprotein receptor-1, and matrix metalloproteinase-3). Further downstream analyses showed that FURIN, which is highly expressed in endothelial cells, is a potential novel target and matrix metalloproteinase-3 a potential repurposing target for IHD. Conclusions Integrated analyses of proteomic and genetic data in Chinese and European adults provided causal support for FURIN and multiple other proteins as potential novel drug targets for treatment of IHD