Threshold values of brachial cuff-measured arterial stiffness indices determined by comparisons with the brachial–ankle pulse wave velocity: a cross-sectional study in the Chinese population

BackgroundArterial Velocity-pulse Index (AVI) and Arterial Pressure-volume Index (API), measured by a brachial cuff, have been demonstrated to be indicative of arterial stiffness and correlated with the risk of cardiovascular events. However, the threshold values of AVI and API for screening increased arterial stiffness in the general population are yet to be established.MethodsThe study involved 860 subjects who underwent general physical examinations (M/F = 422/438, age 53.4 ± 12.7 years) and were considered to represent the general population in China. In addition to the measurements of AVI, API and brachial-ankle pulse wave velocity (baPWV), demographic information, arterial blood pressures, and data from blood and urine tests were collected. The threshold values of AVI and API were determined by receiver operating characteristic (ROC) analyses and covariate-adjusted ROC (AROC) analyses against baPWV, whose threshold for diagnosing high arterial stiffness was set at 18 m/s. Additional statistical analyses were performed to examine the correlations among AVI, API and baPWV and their correlations with other bio-indices.ResultsThe area under the curve (AUC) values in ROC analysis for the diagnosis with AVI/API were 0.745/0.819, 0.788/0.837, and 0.772/0.825 (95% CI) in males, females, and all subjects, respectively. Setting the threshold values of AVI and API to 21 and 27 resulted in optimal diagnosis performance in the total cohort, whereas the threshold values should be increased to 24 and 29, respectively, in order to improve the accuracy of diagnosis in the female group. The AROC analyses revealed that the threshold values of AVI and API increased markedly with age and pulse pressure (PP), respectively.ConclusionsWith appropriate threshold values, AVI and API can be used to perform preliminary screening for individuals with increased arterial stiffness in the general population. On the other hand, the results of the AROC analyses imply that using threshold values adjusted for confounding factors may facilitate the refinement of diagnosis. Given the fact that the study is a cross-sectional one carried out in a single center, future multi-center or follow-up studies are required to further confirm the findings or examine the value of the threshold values for predicting cardiovascular events

Inducing and Manipulating Heteroelectronic States in a Single MoS2 Thin Flake

By dual gating a few-layer MoS2 flake, we induce spatially separated electronic states showing superconductivity and Shubnikov–de Haas (SdH) oscillations. While the highly confined superconductivity forms at the K/K′ valleys of the topmost layer, the SdH oscillations are contributed by the electrons residing in the Q/Q′ valleys of the rest of the bottom layers, which is confirmed by the extracted Landau level degeneracy of 3, electron effective mass of 0.6me, and carrier density of 5×10^12  cm^−2. Mimicking conventional heterostructures, the interaction between the heteroelectronic states can be electrically manipulated, which enables “bipolarlike” superconducting transistor operation. The off-on-off switching pattern can be continuously accessed at low temperatures by a field effect depletion of carriers with a negative back gate bias and the proximity effect between the top superconducting layer and the bottom metallic layers that quenches the superconductivity at a positive back gate bias

Probing and Tuning the Spin Textures of the K and Q Valleys in Few-Layer MoS2

The strong spin-orbit coupling along with broken inversion symmetry in transition metal dichalcogenides (TMDs) results in spin polarized valleys, which are the origins of many interesting properties such as Ising superconductivity, circular dichroism, valley Hall effect, etc. Herein, it is shown that encapsulating few-layer MoS2 between hexagonal boron nitride (h-BN) and gating the electrical contacts by ionic liquid pronounce Shubnikov-de Haas (SdH) oscillations in magnetoresistance. Notably, the SdH oscillations remain unchanged in tilted magnetic fields, demonstrating that the spins of the Q/Q ' valleys are firmly locked to the out-of-plane direction; therefore, Zeeman energy is insensitive to the in-plane magnetic field. Ionic liquid gating induces superconductivity on the surface of unencapsulated MoS2. The spins of Cooper pairs are strongly pinned to the out-of-plane direction by the effective Zeeman field, hence are protected from being realigned by an in-plane magnetic field, namely, Ising protection. As a result, superconductivity persists in an in-plane magnetic field up to 14 T, in which T-c only decreases by approximate to 0.3 K from T-c0 as approximate to 7 K. By applying back gate, the strength of Ising protection can be effectively tuned, where an increase in 70% is observed when back gate changes from +90 to -90 V

Effect of rhubarb on gut microbiota-host co-metabolism in rats

Objective·To study the effect of rhubarb administration on the balance between intestinal flora and the body.Methods·Wistar rats were randomly divided into 4 groups (n=8), which were given extractions of rhubarb 0.1 g/kg (low dose group), 2.5 g/kg (medium dose group), 4.5 g/kg (high dose group) and normal saline (control group) by intragastric administration for 5 d, and the daily change of fecal water content of rats was observed. Gas chromatography/time of flight mass spectrometry (GC/TOFMS) approach was used to detect the metabolites in serum, colon tissue and fecal of rats on the 5th day of administration. Principal component analysis (PCA) and partial least squares discrimination analysis (PLS-DA) were used to analyze the differences of metabolites between different dose groups and the control group. The metabolites with statistical significance were obtained by t-test.Results·The water content of rat feces in the dose group gradually increased with the time and dose after rhubarb administration. Compared with the control group, 28, 18 and 20 differential metabolites were obtained in serum, colon tissue and fecal samples from different dose groups, which showed significant changes (P<0.05) on the 5th day. At the same time, the levels of 17 serum metabolites, 2 colon tissue metabolites, and 10 fecal metabolites altered significantly in a dose-dependent manner. Among these differential metabolites, some gut microbial-host co-metabolites, including neurotransmitters, indoles, and bile acids, were observed to alter significantly after rhubarb administration. The levels of fecal catechol and indole-3-acetic acid increased while the levels of fecal phenylalanine, 4-aminobutyric acid, L-DOPA, and indole-3-propionic acid decreased. Deoxycholic acid level was significantly elevated in colon tissue samples from the high-dose group. Compared with the control group, phenylalanine, tyrosine, and tryptophan levels in serum samples also increased in different dose groups. In addition, the levels of fumaric acid (one of organic acids related to energy metabolism), was down-regulated in fecal samples but up-regulated in colon tissue and serum samples. With the increase of dosage, the level of glutamic acid (one of amino acids) significantly increased in serum samples but gradually decreased in colon tissue samples. Except for 6-phosphogluconic acid, the levels of carbohydrates and lipid metabolites, including fructose, pyruvate, lactic acid, glucose-1-phosphate, D-glycero-1-phosphate docosenic acid, 13-docosenoic acid, 1-monostearoylglycerol, and cholesterol increased in the serum samples, while those of D-glycero-1-phosphate in colon tissue and lactic acid, glucose-1-phosphate, and linolenic acid in fecal samples decreased.Conclusion·Rhubarb affects brain-gut axis and bile acid metabolism through the gut microbial-host co-metabolism, and further affects the body's energy metabolism, amino acid metabolism, glycometabolism and lipid metabolism

Identification of an inflammatory response-related gene prognostic signature and immune microenvironment for cervical cancer

Background: Cervical cancer (CC) is the fourth most common cancer among women worldwide. As part of the brisk cross-talk between the host and the tumor, prognosis can be affected through inflammatory responses or the tumor microenvironment. However, further exploration of the inflammatory response-related genes that have prognostic value, microenvironment infiltration, and chemotherapeutic therapies in CC is needed.Methods: The clinical data and mRNA expression profiles of CC patients were downloaded from a public database for this study. In the TCGA cohort, a multigene prognostic signature was constructed by least absolute shrinkage and selection operator (LASSO) and Cox analyses. CC patients from the GEO cohort were used for validation. K‒M analysis was used to compare overall survival (OS) between the high- and low-risk groups. Univariate and multivariate Cox analyses were applied to determine the independent predictors of OS. The immune cell infiltration and immune-related functional score were calculated by single-sample gene set enrichment analysis (GSEA). Immunohistochemistry was utilized to validate the protein expression of prognostic genes in CC tissues.Results: A genetic signature model associated with the inflammatory response was built by LASSO Cox regression analysis. Patients in the high-risk group had a significantly lower OS rate. The predictive ability of the prognostic genes was evaluated by means of receiver operating characteristic (ROC) curve analysis. The risk score was confirmed to be an independent predictor of OS by univariate and multivariate Cox analyses. The immune status differed between the high-risk and low-risk groups, and the cancer-related pathways were enriched in the high-risk group according to functional analysis. The risk score was significantly related to tumor stage and immune infiltration type. The expression levels of five prognostic genes (LCK, GCH1, TNFRSF9, ITGA5, and SLC7A1) were positively related to sensitivity to antitumor drugs. Additionally, the expression of prognostic genes was significantly different between CC tissues and myoma patient cervix (non-tumorous) tissues in the separate sample cohort.Conclusion: A model consisting of 5 inflammation-related genes can be used to predict prognosis and influence immune status in CC patients. Furthermore, the inhibition or enhancement of these genes may become a novel alternative therapy

A novel immune-related risk-scoring system associated with the prognosis and response of cervical cancer patients treated with radiation therapy

Objective: The tumor microenvironment plays a critical role in the radiotherapy and immunotherapy response of cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC). Radioresistance is a key factor in treatment failure among patients who receive radical radiotherapy. Thus, new immune-related biomarkers associated with radiotherapy response in CESC are needed.Methods: In this study, the CIBERSORT and ESTIMATE methods were applied to determine the percentage of tumor-infiltrating cells and the number of immune components in 103 CESCs treated with radiotherapy from The Cancer Genome Atlas (TCGA) database. The main dysregulated genes were subjected to multivariate and univariate analyses. The prognostic value of this system was studied via receiver operating characteristic curve and survival analysis. For further confirmation, the biomarkers’ expression levels and predictive value were validated by immunohistochemistry (IHC) and qRT-PCR. The CIBERSORT algorithm was used to calculate the compositional patterns of 22 types of immune cells in cervical cancer patients treated with radiation therapy.Results: Data for 17 radioresistant and 86 radiosensitive tumors were obtained from the The Cancer Genome Atlas database. 53 immune-related DEGs were identified. GO and KEGG analyses revealed that the DEGs were enriched in protein kinase B signaling, growth factors in cytokines, the MAPK pathway and the PI3K-Akt pathway. Then, 14 key immune-related genes built a risk scoring model were deemed prognostic in CESC with radiotherapy. The area under the curve (AUC) of the model was 0.723, and the high-risk group presented worse outcomes than the low-risk group. In addition, the high-risk group tended to have persistent tumors (p = 0.001). The high expression of WT1 and SPOUYT4 were associated with relapse, the high expression of Angiotensinogen and MIEN1 were associated with nonrelapse. Analysis of the immune microenvironment indicated that M0 macrophages, M2 macrophages, activated mast cells and resting memory CD4+ T cells were positively correlated with the risk score (p &lt; 0.05).Conclusion: The novel immune-related risk scoring system has some advantages in predicting the prognosis and treatment response of cervical cancer patients treated with radiotherapy. Moreover, it might provide novel clues for providing targeted immune therapy to these patients

Cost-Effective Heating Control Approaches by Demand Response and Peak Demand Limiting in an Educational Office Building with District Heating

This study examined three different approaches to reduce the heating cost while maintaining indoor thermal comfort at acceptable levels in an educational office building, including decentralized (DDRC) and centralized demand response control (CDRR) and limiting peak demand. The results showed that although all these approaches did not affect the indoor air temperature significantly, the DDRC method could adjust the heating set point to between 20–24.5 °C. The DDRC approach reached heating cost savings of up to 5% while controlling space heating temperature without sacrificing the thermal comfort. The CDRC of space heating had limited potential in heating cost savings (1.5%), while the indoor air temperature was in the acceptable range. Both the DDRC and CDRC alternatives can keep the thermal comfort at good levels during the occupied time. Depending on the district heating provider, applying peak demand limiting of 35% can not only achieve 13.6% maximum total annual district heating cost saving but also maintain the thermal comfort level, while applying that of 43% can further save 16.9% of the cost, but with sacrificing a little thermal comfort. This study shows that demand response on heating energy only benefited from the decentralized control alternative, and the district heating-based peak demand limiting has significant potential for saving heating costs

Ventricular flow analysis and its association with exertional capacity in repaired tetralogy of Fallot: 4D flow cardiovascular magnetic resonance study

Background: Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) allows quantification of biventricular blood flow by flow components and kinetic energy (KE) analyses. However, it remains unclear whether 4D flow parameters can predict cardiopulmonary exercise testing (CPET) as a clinical outcome in repaired tetralogy of Fallot (rTOF). Current study aimed to (1) compare 4D flow CMR parameters in rTOF with age- and gender-matched healthy controls, (2) investigate associations of 4D flow parameters with functional and volumetric right ventricular (RV) remodelling markers, and CPET outcome. Methods: Sixty-three rTOF patients (14 paediatric, 49 adult; 30 ± 15 years; 29 M) and 63 age- and gender-matched healthy controls (14 paediatric, 49 adult; 31 ± 15 years) were prospectively recruited at four centers. All underwent cine and 4D flow CMR, and all adults performed standardized CPET same day or within one week of CMR. RV remodelling index was calculated as the ratio of RV to left ventricular (LV) end-diastolic volumes. Four flow components were analyzed: direct flow, retained inflow, delayed ejection flow and residual volume. Additionally, three phasic KE parameters normalized to end-diastolic volume (KEi EDV), were analyzed for both LV and RV: peak systolic, average systolic and peak E-wave. Results: In comparisons of rTOF vs. healthy controls, median LV retained inflow (18% vs. 16%, P = 0.005) and median peak E-wave KEi EDV (34.9 µJ/ml vs. 29.2 µJ/ml, P = 0.006) were higher in rTOF; median RV direct flow was lower in rTOF (25% vs. 35%, P < 0.001); median RV delayed ejection flow (21% vs. 17%, P < 0.001) and residual volume (39% vs. 31%, P < 0.001) were both greater in rTOF. RV KEi EDV parameters were all higher in rTOF than healthy controls (all P < 0.001). On multivariate analysis, RV direct flow was an independent predictor of RV function and CPET outcome. RV direct flow and RV peak E-wave KEi EDV were independent predictors of RV remodelling index. Conclusions: In this multi-scanner multicenter 4D flow CMR study, reduced RV direct flow was independently associated with RV dysfunction, remodelling and, to a lesser extent, exercise intolerance in rTOF patients. This supports its utility as an imaging parameter for monitoring disease progression and therapeutic response in rTOF. Clinical Trial Registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT03217240