The feasibility and safety of sharp recanalization for superior vena cava occlusion in hemodialysis patients: A retrospective cohort study

Introduction: Hemodialysis catheter‐related superior vena cava (SVC) occlusions can cause considerable morbidity for patients and be challenging to treat if refractory to conventional guide wire transversal. This pilot study assessed the feasibility and safety of sharp recanalization of SVC occlusion in hemodialysis patients.Methods: This study retrospectively enrolled hemodialysis patients treated in West China Hospital diagnosed with SVC occlusion who failed traditional guide wire transversal from January 2014 to November 2017. In brief, a guide wire from the femoral approach was advanced to the lower end of the obstructive lesion to act as a target, while the stiff end of hydrophilic wire was advanced though a jugular approach. Under fluoroscopic guidance in biplane imaging, the occlusive SVC lesion was penetrated with the stiff wire that was snared and pulled through. Graded dilation of the SVC and subsequent tunneled‐cuffed catheter implantation were performed. Demographic information and clinical outcomes were recorded and evaluated.Findings: Sixteen patients with a mean age of 62 ± 13 years (13 females and 3 males) who received SVC sharp recanalization were included in this study. The sharp recanalization procedure was successfully performed in 14 patients (87.5%). Two patients were complicated with SVC laceration and hemopericardium but remained asymptomatic and required no surgical repair. One patient suffered ventricular fibrillation during procedure. Despite the return of spontaneous circulation, the patient unfortunately died of gastrointestinal tract bleeding after 3 days in ICU. Follow‐up suggested the 6‐month catheter patency to be 92.85% and 12‐month catheter patency to be 58.33%. No long‐term procedure‐related complications were recorded.Discussion: Sharp recanalization might be a feasible strategy in managing SVC occlusion in hemodialysis patients. The potential life‐threatening complications (cardiac arrhythmia and SVC laceration) necessitate strict eligibility screening, skillful operation, and avoidance of over‐dilation of SVC.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153765/1/hdi12804.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153765/2/hdi12804_am.pd

A dynamic credit scoring model based on survival gradient boosting decision tree approach

Credit scoring, which is typically transformed into a classification problem, is a powerful tool to manage credit risk since it forecasts the probability of default (PD) of a loan application. However, there is a growing trend of integrating survival analysis into credit scoring to provide a dynamic prediction on PD over time and a clear explanation on censoring. A novel dynamic credit scoring model (i.e., SurvXGBoost) is proposed based on survival gradient boosting decision tree (GBDT) approach. Our proposal, which combines survival analysis and GBDT approach, is expected to enhance predictability relative to statistical survival models. The proposed method is compared with several common benchmark models on a real-world consumer loan dataset. The results of out-of-sample and out-of-time validation indicate that SurvXGBoost outperform the benchmarks in terms of predictability and misclassification cost. The incorporation of macroeconomic variables can further enhance performance of survival models. The proposed SurvXGBoost meanwhile maintains some interpretability since it provides information on feature importance. First published online 14 December 202

Bacterial endosymbiont Cardinium cSfur genome sequence provides insights for understanding the symbiotic relationship in Sogatella furcifera host

Background: Sogatella furcifera is a migratory pest that damages rice plants and causes severe economic losses. Due to its ability to annually migrate long distances, S.furcifera has emerged as a major pest of rice in several Asian countries. Symbiotic relationships of inherited bacteria with terrestrial arthropods have significant implications. The genus Cardinium is present in many types of arthropods, where it influences some host characteristics. We present a report of a newly # identified strain of the bacterial endosymbiont Cardinium cSfur in S. furcifera. Result: From the whole genome of S. furcifera previously sequenced by our laboratory, we assembled the whole genome sequence of Cardinium cSfur. The sequence comprised 1,103,593 bp with a GC content of 39.2%. The phylogenetic tree of the Bacteroides phylum to which Cardinium cSfur belongs suggests that Cardinium cSfur is closely related to the other strains (Cardinium cBtQ1 and cEper1) that are members of the Amoebophilaceae family. Genome comparison between the host-dependent endosymbiont including Cardinium cSfur and freeliving bacteria revealed that the endosymbiont has a smaller genome size and lower GC content, and has lost some genes related to metabolism because of its special environment, which is similar to the genome pattern observed in other insect symbionts. Cardinium cSfur has limited metabolic capability, which makes it less contributive to metabolic and biosynthetic processes in its host. From our findings, we inferred that, to compensate for its limited metabolic capability, Cardinium cSfur harbors a relatively high proportion of transport proteins, which might act as the hub between it and its host. With its acquisition of the whole operon related to biotin synthesis and glycolysis related genes through HGT event, Cardinium cSfur seems to be undergoing changes while establishing a symbiotic relationship with its host. Conclusion: A novel bacterial endosymbiont strain (Cardinium cSfur) has been discovered. A genomic analysis of the endosymbiont in S. furcifera suggests that its genome has undergone certain changes to facilitate its settlement in the host. The envisaged potential reproduction manipulative ability of the new endosymbiont strain in its S. furcifera host has vital implications in designing eco-friendly approaches to combat the insect pest

Analysis of clinical evidence on traditional Chinese medicine for the treatment of diabetic nephropathy: a comprehensive review with evidence mapping

ObjectiveThis study aims to map evidence from Randomized Controlled Trials (RCTs) and systematic reviews/Meta-analyses concerning the treatment of Diabetic Nephropathy (DN) with Traditional Chinese Medicine (TCM), understand the distribution of evidence in this field, and summarize the efficacy and existing problems of TCM in treating DN. The intention is to provide evidence-based data for TCM in preventing and treating DN and to offer a reference for defining future research directions.MethodsComprehensive searches of major databases were performed, spanning from January 2016 to May 2023, to include clinical RCTs and systematic reviews/Meta-analyses of TCM in treating DN. The analysis encompasses the publishing trend of clinical studies, the staging of research subjects, TCM syndrome differentiation, study scale, intervention plans, and outcome indicators. Methodological quality of systematic reviews was evaluated using the AMSTAR (Assessment of Multiple Systematic Reviews) checklist, and evidence distribution characteristics were analyzed using a combination of text and charts.ResultsA total of 1926 RCTs and 110 systematic reviews/Meta-analyses were included. The majority of studies focused on stage III DN, with Qi-Yin deficiency being the predominant syndrome type, and sample sizes most commonly ranging from 60 to 100. The TCM intervention durations were primarily between 12-24 weeks. Therapeutic measures mainly consisted of Chinese herbal decoctions and patented Chinese medicines, with a substantial focus on clinical efficacy rate, TCM symptomatology, and renal function indicators, while attention to quality of life, dosage of Western medicine, and disease progression was inadequate. Systematic reviews mostly scored between 5 and 8 on the AMSTAR scale, and evidence from 94 studies indicated potential positive effects.ConclusionDN represents a significant health challenge, particularly for the elderly, with TCM showing promise in symptom alleviation and renal protection. Yet, the field is marred by research inconsistencies and methodological shortcomings. Future investigations should prioritize the development of standardized outcome sets tailored to DN, carefully select evaluation indicators that reflect TCM’s unique intervention strategies, and aim to improve the robustness of clinical evidence. Emphasizing TCM’s foundational theories while incorporating advanced scientific technologies will be essential for innovating research methodologies and uncovering the mechanisms underlying TCM’s efficacy in DN management

SPOC learner's final grade prediction based on a novel sampling batch normalization embedded neural network method

Recent years have witnessed the rapid growth of Small Private Online Courses (SPOC) which is able to highly customized and personalized to adapt variable educational requests, in which machine learning techniques are explored to summarize and predict the learner's performance, mostly focus on the final grade. However, the problem is that the final grade of learners on SPOC is generally seriously imbalance which handicaps the training of prediction model. To solve this problem, a sampling batch normalization embedded deep neural network (SBNEDNN) method is developed in this paper. First, a combined indicator is defined to measure the distribution of the data, then a rule is established to guide the sampling process. Second, the batch normalization (BN) modified layers are embedded into full connected neural network to solve the data imbalanced problem. Experimental results with other three deep learning methods demonstrates the superiority of the proposed method.Comment: 11 pages, 5 figures, ICAIS 202

Internet addiction, loneliness, and academic burnout among Chinese college students: a mediation model

BackgroundThe dynamics of education and student life have changed since the COVID-19 pandemic. Our society, especially the education system, has become largely dependent on the Internet. This paradigm shifts largely took place in the last few decades. As such, there are various ways in which we cannot comprehend the impact that the Internet can have on student psychology, and how multiple other factors could influence that. Internet addiction and its relationship with academic burnout, along with the impact of loneliness, are all essential factors that must be discussed candidly in the post-COVID-19 era. Hence, the objective of this study was, therefore, to explore the relationship between Internet addiction, loneliness, and academic burnout among Chinese college students as well as the mediating role of loneliness.MethodsWe conducted a cross-sectional questionnaire survey at a Chinese university from October to November 2022. In total, 810 valid respondents were selected via random cluster sampling using the well-established Internet Addiction, Loneliness, and Academic Burnout Scale. The primary approach of mediation analysis and structural equation modeling testing examined the relationships among the three components.ResultsInternet addiction could be responsible for academic burnout among college students. Loneliness partially mediates the relationship between Internet addiction and academic burnout. In a mediated way, different types of loneliness contribute to different types of academic burnout.ConclusionPsychological interventions for loneliness, especially emotional loneliness prevention, are the critical aspects of the problem of Internet addiction accompanied with academic burnout. The causal relationship between Internet addiction and academic burnout, possibly of a two-way nature, needs to be further explored in the next future

Compound dietary fiber and high-grade protein diet improves glycemic control and ameliorates diabetes and its comorbidities through remodeling the gut microbiota in mice

Dietary intervention with a low glycemic index and full nutritional support is emerging as an effective strategy for diabetes management. Here, we found that the treatment of a novel compound dietary fiber and high-grade protein diet (CFP) improved glycemic control and insulin resistance in streptozotocin-induced diabetic mice, with a similar effect to liraglutide. In addition, CFP treatment ameliorated diabetes-related metabolic syndromes, such as hyperlipidemia, hepatic lipid accumulation and adipogenesis, systemic inflammation, and diabetes-related kidney damage. These results were greatly associated with enhanced gut barrier function and altered gut microbiota composition and function, especially those bacteria, microbial functions, and metabolites related to amino acid metabolism. Importantly, no adverse effect of CFP was found in our study, and CFP exerted a wider arrange of protection against diabetes than liraglutide. Thereby, fortification with balanced dietary fiber and high-grade protein, like CFP, might be an effective strategy for the management and treatment of diabetes

Gallic acid mitigates high-fat and high-carbohydrate diet-induced steatohepatitis by modulating the IRF6/PPARγ signaling pathway

Gallic acid (GA), a natural organic phenolic compound, is an abundant plant food bioactive substance present in many medicinal herbs. GA has anti-oxidative, anti-inflammatory and anticancer activities on multiple metabolic disorders. The present study was carried out to uncover the alleviating effects of GA on metabolic dysfunction-associated steatohepatitis (MASH) and the underlying mechanisms of its action. In this study, a mouse model of MASH induced by high-fat and high-carbohydrate diet was used to test the impact of GA on metabolic disorders. We found that GA administration attenuated obesity and fatty liver, relieved insulin resistance, and mitigated hepatic steatosis, inflammation and liver injury. Transcriptome sequencing (RNA-seq) of mouse liver tissues identified 154 differentially expressed genes (DEGs) among the NCD, HFHC, and GA groups. Bioinformatic analysis of these DEGs revealed significant enrichment in lipid metabolism function and the PPARγ signaling pathway, which were further validated. Overexpression of PPARγ significantly reduced the therapeutic effect of GA both in vitro and in vivo. Notably, the transcription factor interferon regulatory factor 6 (IRF6), a protective factor in metabolic stress, which was predicted as the upstream regulator, was significantly upregulated by GA. Furthermore, it was verified that GA’s anti-lipid deposition effect depends on the negative regulation of IRF6 on PPARγ using knocking-down strategy. Taken together, GA increases hepatic IRF6 expression, which mitigates lipid accumulation of hepatocytes and subsequent liver damage via inhibiting the PPARγ signaling pathway. These findings suggest a novel strategy for MASH management based on pharmacological intervention with GA