Three-dimensional printing-guided percutaneous transcatheter closure of secundum atrial septal defect with rim deficiency: First-in-human series

Background: This study aimed to prospectively evaluate the use of 3-dimensional printing (3DP) for the percutaneous transcatheter closure of a secundum atrial septal defect (ASD) with rim deficiency less than 5 mm.Methods: Patients with ASD were scanned using multi-slice computed tomography to acquire raw data for virtual 3DP reconstruction models. Different ASD occluders were tried on the 3DP models to select the optimal size for intraoperative use. The patients were followed up 1 month postoperatively, and 3DP models were again manufactured to observe the operative effects.Results: From January to April 2016, 6 patients (5 females and 1 male) were recruited. Their average age was 29.5 ± 17.6 years, and the mean ASD size was 13.4 ± 1.3 mm. ASD occlusion succeeded in 5 of 6 cases. There were 1, 2, and 3 cases with 0-mm distance from the defect rim to the aorta, inferior vena cava, and superior vena cava, respectively. ASD occluder sizes were consistent between preoperative simulation and intraoperative placement in 4 cases. One case had occluder size change from 30 mm to 34 mm.Conclusions: A 3DP model presents ASD in a more visible way and allows more direct preoperativesimulation to choose the most appropriate size of occluder, as compared with conventional imaging techniques. This technique is likely to extend the current indications for ASD with an insufficient rim

Agricultural land use regulates the fate of soil phosphorus fractions following the reclamation of wetlands

Over half of the Earth's wetlands have been reclaimed for agriculture, leading to significant soil P destabilization and leaching risks. To evaluate the effects of agricultural land use on soil P stability, we used sequential P extraction to investigate the long-term effects of wetland cultivation for rice and soybean on soil P fractions, including labile and moderately labile inorganic/organic P (LPi, LPo, MPi, and MPo), and stable P in Northeast China. The results showed that soybean cultivation decreased the total P by 35.9 %, whereas rice cultivation did not influence the total P content (p &lt; 0.05). Both the soybean and rice cultivations significantly increased LPi (p &lt; 0.05). Soybean cultivation significantly decreased the LPo and MPo compared to rice cultivation, and the latter increased MPi by 309.28 % compared with the reference wetlands (p &lt; 0.05). Redundancy analysis indicated that pH, poorly crystalline Fe (Feca), crystalline Fe (Fec), and total organic carbon (TOC) explained similar variations in P fractions during soybean and rice cultivation (54.9 % and 49.7 %, respectively). Similarly, during soybean or rice cultivation, pH negatively influenced LPo and MPo, while Feca positively influenced MPi and LPi. Furthermore, TOC showed a positive role in LPo, and MPo, but a negative effect on LPi and MPi during rice cultivation. Hence, we concluded that the cultivation of soybean or rice create contrasting modifications to wetland soil P fractionation by altering TOC, Feca, Fec, and pH. Our study indicates that agricultural land use can regulate the fate of wetland soil P fractionation, with potential benefits to both i) P risk management in cultivated wetlands and ii) potential approaches for future wetland restoration.</p

Relationship Between Morning Hypertension and T-Peak to T-End Interval in Patients with Suspected Coronary Heart Disease

Objective: To investigate the relationship between morning hypertension (MH) and T-peak to T-end interval (Tp-e interval) in patients with suspected coronary heart disease. Methods: Patients with typical symptoms of coronary heart disease were examined by ambulatory blood monitoring, electrocardiogram, echocardiography, and coronary angiography, and were assigned to two groups on the basis of blood pressure: an MH group and a morning normotension (MN) group. The following data were collected and compared: basic characteristic, Tp-e interval, corrected QT (QTc) interval, echocardiography parameters, and Gensini score of the two groups. Results: Three hundred fifty-eight patients, with a mean age of 64 years (54.1% men), were divided into the MH group ( n =170) and the MN group ( n =188). Tp-e interval (84.52±14.77 ms vs. 65.19±19.03 ms, P<0.001), QTc interval (416.21±29.59 ms vs. 401.70±36.10 ms, P<0.001), left ventricular mass index (121.42±10.97 g/m 2 vs. 105.63±17.10 g/m 2, P<0.001), and Gensini score (72.12±32.90 vs. 39.47±29.32, P<0.001) were significantly increased in the MH group compared with the MN group. Morning systolic blood pressure ( r =0.678, P<0.001), morning diastolic blood pressure ( r =0.404, P<0.001), Gensini score ( r =0.513, P<0.001), and left ventricular mass index ( r =0.646, P<0.001) were correlated with Tp-e interval. Conclusion: Tp-e interval is correlated with morning systolic blood pressure and diastolic blood pressure in patients with coronary heart disease. More research on how the Tp-e interval changes after control of MH is necessary

Identification of a peripheral blood long non-coding RNA (Upperhand) as a potential diagnostic marker of coronary artery disease

Background: Long non-coding RNAs (lncRNAs) have been confirmed to be involved in the pathologi­cal processes of multiple diseases. However, the characteristic expression of lncRNAs in peripheral blood of coronary artery disease (CAD) patients and whether some of these lncRNAs can be used as diagnostic biomarkers for CAD requires further investigation. Methods: Six healthy and CAD individuals were selected for microarray analysis, and 5 differentially expressed lncRNAs were selected and confirmed in the second cohort consisting of 30 control individu­als and 30 CAD patients with different SYNTAX scores. Upperhand were verified in the third cohort consisting of 115 controls and 137 CAD patients. Results: Thirty one lncRNAs were differentially expressed between the two groups, among whom, 25 were upregulated in the CAD group and 6 were downregulated. Four of the selected five lncRNAs were significantly upregulated in the CAD group, and Upperhand had the largest area under the curve (AUC). The diagnostic value of Upperhand was tested further, and it remained having a high diagnostic value. Conclusions: The expression level of Upperhand in peripheral blood of CAD patients is significantly higher than in control individuals, and is correlated with severity of CAD. Upperhand is a potential diagnostic biomarker of CAD, and when combined with TCONS_00029157, diagnostic value slightly increased

Chemical stability of carbon pool in peatlands dominated by different plant types in Jilin province (China) and its potential influencing factors

IntroductionThe peat carbon pool stores 30% of the total global soil carbon accounting for 3–4% of the global land surface. The stability of the peatland carbon pool is a key factor affecting global carbon cycling that is seriously disturbed by climate change and regional human activities. However, the impact of these factors on carbon pool stability remains poorly understood.MethodsBased on the physicochemical properties and carbon compounds of 973 peat samples from Jilin Province (China), which are widely distributed in different altitude regions of the Changbai Mountains, we investigated the stability of the carbon pool in different dominant plants and degradation types of peatlands and assessed the effects of regional environmental factors on the peatland carbon pool.Results and DiscussionOur results showed that the carbohydrate content of peat soils in different peatland types ranged from 33.2 ± 6.9% to 40.5 ± 4.8%, and the aromatic content ranged from 19.8 ± 1.2% to 22.7 ± 2.3%. Bulk density is the most important physicochemical factor, and annual average temperature is the most important environmental factor that influences carbon stability. The effects of selected environmental factors on the peatland carbon pool covered by different plants were different, and the carbon stability in shrub peatlands is more sensitive to climate characteristics than in peatlands dominated by the other two plant types. Peatland degradation decreases the carbon stability in herb and herb/shrub peatlands and increases the carbon stability in shrub peatlands, leading the peatland carbon pool to be more easily influenced by regional human activities than natural peatlands

Evaluation of association tests for rare variants using simulated data sets in the Genetic Analysis Workshop 17 data

We evaluate four association tests for rare variants—the combined multivariate and collapsing (CMC) method, two weighted-sum methods, and a variable threshold method—by applying them to the simulated data sets of unrelated individuals in the Genetic Analysis Workshop 17 (GAW17) data. The family-wise error rate (FWER) and average power are used as criteria for evaluation. Our results show that when all nonsynonymous SNPs (rare variants and common variants) in a gene are jointly analyzed, the CMC method fails to control the FWER; when only rare variants (single-nucleotide polymorphisms with minor allele frequency less than 0.05) are analyzed, all four methods can control FWER well. All four methods have comparable power, which is low for the analysis of the GAW17 data sets. Three of the methods (not including the CMC method) involve estimation of p-values using permutation procedures that either can be computationally intensive or generate inflated FWERs. We adapt a fast permutation procedure into these three methods. The results show that using the fast permutation procedure can produce FWERs and average powers close to the values obtained from the standard permutation procedure on the GAW17 data sets. The standard permutation procedure is computationally intensive

Experimental quantum adversarial learning with programmable superconducting qubits

Quantum computing promises to enhance machine learning and artificial intelligence. Different quantum algorithms have been proposed to improve a wide spectrum of machine learning tasks. Yet, recent theoretical works show that, similar to traditional classifiers based on deep classical neural networks, quantum classifiers would suffer from the vulnerability problem: adding tiny carefully-crafted perturbations to the legitimate original data samples would facilitate incorrect predictions at a notably high confidence level. This will pose serious problems for future quantum machine learning applications in safety and security-critical scenarios. Here, we report the first experimental demonstration of quantum adversarial learning with programmable superconducting qubits. We train quantum classifiers, which are built upon variational quantum circuits consisting of ten transmon qubits featuring average lifetimes of 150 $\mu$s, and average fidelities of simultaneous single- and two-qubit gates above 99.94% and 99.4% respectively, with both real-life images (e.g., medical magnetic resonance imaging scans) and quantum data. We demonstrate that these well-trained classifiers (with testing accuracy up to 99%) can be practically deceived by small adversarial perturbations, whereas an adversarial training process would significantly enhance their robustness to such perturbations. Our results reveal experimentally a crucial vulnerability aspect of quantum learning systems under adversarial scenarios and demonstrate an effective defense strategy against adversarial attacks, which provide a valuable guide for quantum artificial intelligence applications with both near-term and future quantum devices.Comment: 26 pages, 17 figures, 8 algorithm

Folic acid therapy reduces the first stroke risk associated with hypercholesterolemia among hypertensive patients

Background and Purpose - We sought to determine whether folic acid supplementation can independently reduce the risk of first stroke associated with elevated total cholesterol levels in a subanalysis using data from the CSPPT (China Stroke Primary Prevention Trial), a double-blind, randomized controlled trial. Methods - A total of 20 702 hypertensive adults without a history of major cardiovascular disease were randomly assigned to a double-blind daily treatment of an enalapril 10-mg and a folic acid 0.8-mg tablet or an enalapril 10-mg tablet alone. The primary outcome was first stroke. Results - The median treatment duration was 4.5 years. For participants not receiving folic acid treatment (enalapril-only group), high total cholesterol (≥ 200 mg/dL) was an independent predictor of first stroke when compared with low total cholesterol (\u3c200 mg/dL; 4.0% versus 2.6%; hazard ratio, 1.52; 95% confidence interval, 1.18-1.97; P=0.001). Folic acid supplementation significantly reduced the risk of first s roke among participants with high total cholesterol (4.0% in the enalapril-only group versus 2.7% in the enalapril-folic acid group; hazard ratio, 0.69; 95% confidence interval, 0.56-0.84 P\u3c0.001; number needed to treat, 78; 95% confidence interval, 52-158), independent of baseline folate levels and other important covariates. By contrast, among participants with low total cholesterol, the risk of stroke was 2.6% in the enalapril-only group versus 2.5% in the enalapril-folic acid group (hazard ratio, 1.00; 95% confidence interval, 0.75-1.30; P=0.982). The effect was greater among participants with elevated total cholesterol (P for interaction=0.024). Conclusions - Elevated total cholesterol levels may modify the benefits of folic acid therapy on first stroke. Folic acid supplementation reduced the risk of first stroke associated with elevated total cholesterol by 31% among hypertensive adults without a history of major cardiovascular diseases

Deconvolution of single-cell multi-omics layers reveals regulatory heterogeneity

Heterogeneity in gene expression and epigenetic states exists across individual cells. Here, the authors develop scCAT-seq, a technique for simultaneously performing ATAC-seq and RNA-seq within the same single cell