Association between mild thyroid dysfunction and clinical outcome in acute coronary syndrome undergoing percutaneous coronary intervention

Background: Thyroid hormones profoundly influence the cardiovascular system, but the effects of mild thyroid dysfunction on the clinical outcome of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are not well defined. This study aimed to determine the effect of mild thyroid dysfunction on 12-month prognosis in ACS patients undergoing PCI. Methods: In this prospective cohort study with a 12-month follow-up, 1560 individuals were divided into four groups based on thyroid hormone levels upon admission: euthyroidism (used as a reference group), subclinical hypothyroidism, subclinical hyperthyroidism, and low triiodothyronine syndrome (low T3 syndrome). The outcomes measured were all-cause mortality, cardiac mortality, nonfatal rein­farction, and unplanned repeat revascularization. Results: In this study, the prevalence of mild thyroid dysfunction was 10.8%. Multivariate analysis showed that low T3 syndrome, but not subclinical hypothyroidism or subclinical hyperthyroidism, was associated with a higher rate of all-cause (HR 2.553, 95% CI 1.093–5.964, p = 0.030) and cardiac mortality (HR 2.594, 95% CI 1.026–6.559, p = 0.034), compared with the euthyroidism group. Conclusions: Mild thyroid dysfunction was frequent in patients with ACS undergoing PCI. Low T3 syndrome was the predominant feature and was associated with 12-month adverse outcomes in these patients

Decreased Glomerular Filtration Rate Is Associated with Mortality and Cardiovascular Events in Patients with Hypertension: A Prospective Study

BACKGROUND: Few studies reported the associations between decreased glomerular filtration rate (GFR) and mortality, coronary heart disease (CHD), and stroke in hypertensive patients. We aim to assess the associations between GFR and mortality, CHD, and stroke in hypertensive patients and to evaluate whether low GFR can improve the prediction of these outcomes in addition to conventional cardiovascular risk factors. METHODS AND FINDINGS: This is an observational prospective study and 3,711 eligible hypertensive patients aged ≥5 years from rural areas of China were used for the present analysis. The associations between eGFR and outcomes, followed by a median of 4.9 years, were evaluated using Cox proportional hazards models adjusting for other potential confounders. Low eGFR was independently associated with risk of all-cause mortality, cardiovascular mortality, and incident stroke [multivariable adjusted hazard ratios (95% confidence intervals) for eGFR <60 ml/min/1.73 m(2) relative to eGFR ≥90 ml/min/1.73 m(2) were 1.824 (1.047-3.365), 2.371 (1.109-5.068), and 2.493 (1.193-5.212), respectively]. We found no independent association between eGFR and the risk of CHD. For 4-year all-cause and cardiovascular mortality, integrated discrimination improvement (IDI) was positive when eGFR were added to traditional risk factors (1.51%, P = 0.016, and 1.99%, P = 0.017, respectively). For stroke and CHD events, net reclassification improvements (NRI) were 5.9% (P = 0.012) and 1.8% (P = 0.083) for eGFR, respectively. CONCLUSIONS: We have established an inversely independent association between eGFR and all-cause mortality, cardiovascular mortality, and stroke in hypertensive patients in rural areas of China. Further, addition of eGFR significantly improved the prediction of 4-year mortality and stroke over and above that of conventional risk factors. We recommend that eGFR be incorporated into prognostic assessment for patients with hypertension in rural areas of China. LIMITATIONS: We did not have sufficient information on atrial fibrillation to control for the potential covariate. These associations should be further confirmed in future

Associations of trajectories in body roundness index with incident cardiovascular disease: a prospective cohort study in rural China

AimsThe body roundness index (BRI) has good predictive ability for both body fat and visceral adipose tissue. Longitudinal BRI trajectories can reveal the potential dynamic patterns of change over time. This prospective study assessed potential associations between BRI trajectories and incident cardiovascular disease (CVD) in rural regions of Northeast China.MethodsIn total, 13,209 participants (mean age: 49.0 ± 10.3 years, 6,856 [51.9%] male) were enrolled with three repeated times of BRI measurements at baseline (2004–2006), 2008, and 2010, and followed up until 2017 in this prospective study. Using latent mixture model, the BRI trajectories were determined based on the data from baseline, 2008 and 2010. Composite CVD events (myocardial infarction, stroke, and CVD death combined) was the primary endpoint. Cox proportional-hazards models were used to analyze the longitudinal associations between BRI trajectories and incident CVD.ResultsThree distinct BRI trajectories were identified: high-stable (n = 538), moderate-stable (n = 1,542), and low-stable (n = 11,129). In total, 1,382 CVD events were recorded during follow-up. After adjustment for confounders, the moderate-stable and high-stable BRI groups had a higher CVD risk than did the low-stable BRI group, and the HR (95%CI) were 1.346 (1.154, 1.571) and 1.751 (1.398, 2.194), respectively. Similar associations were observed between the trajectories of BRI and the risk of stroke and CVD death. The high-stable group was also significantly and independently associated with CVD, myocardial infarction, stroke, and CVD death in participants aged &lt;50 years.ConclusionBRI trajectory was positively associated with incident CVD, providing a novel possibility for the primary prevention of CVD in rural regions of China

Providing modeling tools on extreme events of climate change to Puget Sound managers

As climate change becomes a reality for the management of Puget Sound, water resource and fisheries managers should consider incorporating predictions and outcomes of future climate drivers into their long-range plans and daily operations. Modeling tools that focus on climate impacts and predictions show that extreme events are more often responsible for large impacts than the long-term press of climate change. Working with water resource and fisheries managers in the Dungeness and Skagit watersheds, this project uses outputs of existing climate and estuarine models to define thresholds and metrics associated with extreme climate-driven events that are of importance to the resource managers. Managers from the Dungeness and Skagit basins were brought together to assist with defining information needs for sustainable fish habitat and human water uses. The resource managers participating in the project include municipal waste water treatment operators and planners, fisheries managers, agricultural practitioners and conservation district staff, flood control specialists, and others. The information needs identified by the planners, based on the climate model outputs, include better predictions for low stream flows, stream temperature, extent of salinity intrusion into tidal rivers, and timing of extreme events that fall outside the historical norm. The project is developing a decision-support system to meet these needs. The metrics used to drive the decision-support system are derived from model outputs, driven by resource management needs. The information needs, metrics derived from existing models, and the draft decision-support system will be presented. The research team also seeks to use the project to define improved communication pathways between the scientific community and local managers

Dendrobium candidum quality detection in both food and medicine agricultural product: Policy, status, and prospective

Dendrobium candidum (DC) is an agricultural product for both food and medicine. It has a variety of beneficial effects on the human body with antioxidant, anti-inflammatory, antitumor, enhancing immune function, and other pharmacological activities. Due to less natural distribution, harsh growth conditions, slow growth, low reproduction rate, and excessive logging, wild DC has been seriously damaged and listed as an endangered herbal medicine variety in China. At present, the quality of DC was uneven in the market, so it is very necessary to detect its quality. This article summarized the methods of DC quality detection with traditional and rapid nondestructive, and it also expounded the correlation between DC quality factor and endophytes, which provides a theoretical basis for a variety of rapid detection methods in macromolecules. At last, this article put forward a variety of rapid nondestructive detection methods based on the emission spectrum. In view of the complexity of molecular structure, the quality correlation established by spectral analysis was greatly affected by varieties and environment. We discussed the possibility of DC quality detection based on the molecular dynamic calculation and simulation mechanism. Also, a multimodal fusion method was proposed to detect the quality. The literature review suggests that it is very necessary to understand the structure performance relationship, kinetic properties, and reaction characteristics of chemical substances at the molecular level by means of molecular chemical calculation and simulation, to detect a certain substance more accurately. At the same time, several modes are combined to form complementarity, eliminate ambiguity, and uncertainty and fuse the information of multiple modes to obtain more accurate judgment results

Polymicrobial and Monomicrobial Infections after Spinal Surgery: A Retrospective Study to Determine which Infection is more Severe

Study DesignA retrospective clinical review.PurposeTo investigate the difference in clinical manifestations and severity between polymicrobial and monomicrobial infections after spinal surgery.Overview of LiteratureSurgical site infections (SSIs) after spinal surgery are a major diagnostic and therapeutic challenge for spinal surgeons. Polymicrobial infections after spinal surgery seem to result in poorer outcomes than monomicrobial infections because of complementary resistance to antibiotics. However, comparison of the clinical manifestations and severity between polymicrobial and monomicrobial infections are limited.MethodsSixty-seven patients with SSIs after spinal surgery were studied: 20 patients with polymicrobial infections and 47 with monomicrobial infections. Pathogenic bacteria identified were counted and classified. Age, sex, and body mass index were compared between the two groups to identify homogeneity. The groups were compared for clinical manifestations by surgical site, postoperative time to infection, infection site, incisional drainage, incisional swelling, incisional pain, neurological signs, temperature, white blood cell count, and the percentage of neutrophils. Finally, the groups were compared for severity by hospital stay, number of rehospitalizations, number of debridements, duration of antibiotics administration, number of antibiotics administered, and implant removal.ResultsPolymicrobial infections comprised 29.9% of SSIs after spinal surgery, and most polymicrobial infections (70.0%) were caused by two species of bacteria only. There was no difference between the groups in terms of clinical manifestations and severity. In total, 96 bacterial strains were isolated from the spinal wounds: 60 strains were gram-positive and 36 were gram-negative pathogenic bacteria. Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Enterobacter cloacae were cultured in order of the frequency of appearance.ConclusionsMost polymicrobial infections were caused by two bacterial species after spinal surgery. There was no difference in clinical manifestations or severity between polymicrobial and monomicrobial infections

Assessing harmful algal bloom risk in Puget Sound: a coupled modeling-data analysis approach

The increased frequency, duration and geographic extent of toxic Alexandrium blooms in Puget Sound presents new challenges of how to best allocate resources available for toxin monitoring of shellfish in order to protect human health. Monitoring plans are typically based on shellfish toxicity patterns from the recent past; however, the increasing trend in Alexandrium blooms means that managers are chasing a moving target. With projected future changes in global and regional climate, the risk of toxic Alexandrium blooms is expected to increase. Through funding from NOAA’s Coastal and Ocean Climate Applications Program, we are developing a harmful algal bloom (HAB) risk index that will provide another source of information to the Washington State Department of Health (WDOH) and local health jurisdictions for allocating paralytic shellfish poisoning (PSP) monitoring resources in the Sound. The HAB risk index is being developed from existing modeling capabilities and six years of year-round PSP toxin data in mussels collected by the WDOH. Climate/meteorological data produced by the University of Washington Climate Impacts Group, was used to drive the Puget Sound hydrologic and coastal hydrodynamic models developed by Pacific Northwest National Laboratory. Temperature and salinity output from the modeling framework provided input to an Alexandrium growth rate model developed by the Puget Sound Alexandrium Harmful Algal Bloom (PS-AHAB) program. Output from these models was calculated for spatially-explicit WDOH biotoxin closure zones. Statistical correlations between model outputs were examined for trends related to initiation of biotoxin zone closures and changes in shellfish PSP toxin levels. These relationships are being used to develop a risk index that can inform decisions about resource allocation for PSP monitoring in the future at the county, regional, and state level. Changes in risk factors based on a future climate scenario are also being examined. Results of the modeled data and development of the risk index will be presented at the conference

Prevalence of ideal cardiovascular health and its relationship with relative handgrip strength in rural northeast China

ObjectivesWe aimed to investigate ideal cardiovascular health (CVH), its relationship with handgrip strength, and its components in rural China.MethodsWe conducted a cross-sectional study of 3,203 rural Chinese individuals aged ≥35 years in Liaoning Province, China. Of these, 2,088 participants completed the follow-up survey. Handgrip strength was estimated using a handheld dynamometer and was normalized to body mass. Ideal CVH was assessed using seven health indicators (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose). Binary logistic regression analyses were performed to assess the correlation between handgrip strength and ideal CVH.ResultsWomen had a higher rate of ideal cardiovascular health (CVH) than men (15.7% vs. 6.8%, P &lt; 0.001). Higher handgrip strength correlated with a higher proportion of ideal CVH (P for trend &lt;0.001). After adjusting for confounding factors, the odds ratios (95% confidence interval) of ideal CVH across increasing handgrip strength tripartite were 1.00 (reference), 2.368 (1.773, 3.164), and 3.642 (2.605, 5.093) in the cross-sectional study and 1.00 (reference), 2.088 (1.074, 4.060), and 3.804 (1.829, 7.913) in the follow-up study (all P &lt; 0.05).ConclusionIn rural China, the ideal CVH rate was low, and positively correlated with handgrip strength. Grip strength can be a rough predictor of ideal CVH and can be used to provide guidelines for improving CVH in rural China

CMTM6 shapes antitumor T cell response through modulating protein expression of CD58 and PD-L1

The dysregulated expression of immune checkpoint molecules enables cancer cells to evade immune destruction. While blockade of inhibitory immune checkpoints like PD-L1 forms the basis of current cancer immunotherapies, a deficiency in costimulatory signals can render these therapies futile. CD58, a costimulatory ligand, plays a crucial role in antitumor immune responses, but the mechanisms controlling its expression remain unclear. Using two systematic approaches, we reveal that CMTM6 positively regulates CD58 expression. Notably, CMTM6 interacts with both CD58 and PD-L1, maintaining the expression of these two immune checkpoint ligands with opposing functions. Functionally, the presence of CMTM6 and CD58 on tumor cells significantly affects T cell-tumor interactions and response to PD-L1-PD-1 blockade. Collectively, these findings provide fundamental insights into CD58 regulation, uncover a shared regulator of stimulatory and inhibitory immune checkpoints, and highlight the importance of tumor-intrinsic CMTM6 and CD58 expression in antitumor immune responses