Reliable Predictor Research Articles

Assessing quality and reliability of online videos on tachycardia: a YouTube video-based study

BackgroundConsidering the adverse clinical consequences of pathologic tachycardia and the potential anxiety caused by physiological tachycardia in some heathy individuals, it is imperative to disseminate health information related to tachycardia for promotion in early diagnosis and appropriate management. YouTube has been increasingly used to access health care information. The aim of this study is to assess the quality and reliability of English YouTube videos focusing on tachycardia and further delve into strategies to enhance the quality of online health resources.MethodsWe conducted a search using the specific key words “tachycardia” in YouTube online library on December 2, 2023. The first 150 videos, ranked by “relevance”, were initially recorded. After exclusions, a total of 113 videos were included. All videos were extracted for characteristics and categorized based on different topics, sources or contents. Two independent raters assessed the videos using Journal of American Medical Association (JAMA) benchmark criteria, Modified DISCERN (mDISCERN) tool, Global Quality Scale (GQS) and Tachycardia-Specific Scale (TSS), followed by statistical analyses. All continuous data in the study were presented as median (interquartile range).ResultsThe videos had a median JAMA score of 2.00 (1.00), mDISCERN of 3.00 (1.00), GQS of 2.00 (1.00), and TSS of 6.00 (4.50). There were significant differences in JAMA (P < 0.001), mDISCERN (P = 0.004), GQS (P = 0.001) and TSS (P < 0.001) scores among different sources. mDISCERN (P = 0.002), GQS (P < 0.001) and TSS (P = 0.030) scores significantly differed among various contents. No significant differences were observed in any of the scores among video topics. Spearman correlation analysis revealed that VPI exhibited significant correlations with quality and reliability. Multiple linear regression analysis suggested that longer video duration, sources of academics and healthcare professionals were independent predictors of higher reliability and quality, while content of ECG-specific information was an independent predictor of lower quality.ConclusionsThe reliability and educational quality of current tachycardia-related videos on YouTube are low. Longer video duration, sources of academics and healthcare professionals were closely associated with higher video reliability and quality. Improving the quality of internet medical information and optimizing online patient education necessitates collaborative efforts.

An IGBT coupling structure with a smart service life reliability predictor using active learning

Abstract An effective approach is proposed to evaluate the service life reliability of a multi-physics coupling structure of an insulated gate bipolar transistor (IGBT) module. The node-based smoothed finite element method with stabilization terms is firstly employed to construct an electrical-thermal-mechanical (ETM) coupling structure of the IGBT module, based on which the multi-physics responses can be accurately calculated to predict the service life of the IGBT module. By using the high-quality sample data obtained through the ETM coupling model, a Monte Carlo based active learning Kriging metamodel (AK-MCS) is developed to assess the service life reliability of the IGBT module, which can greatly reduce the computational cost needed by the surrogate model construction and reliability analysis. Numerical results show that the proposed ETM coupling structure can produce high-quality sample data of the IGBT dynamics and the AK-MCS machine learning technique can accurately estimate the service life reliability of the IGBT module.

Reliability analysis of multiple repairable systems under imperfect repair and unobserved heterogeneity

AbstractImperfect repairs (IRs) are widely applicable in reliability engineering since most equipment is not completely replaced after failure. In this sense, it is necessary to develop methodologies that can describe failure processes and predict the reliability of systems under this type of repair. One of the challenges in this context is to establish reliability models for multiple repairable systems considering unobserved heterogeneity associated with systems failure times and their failure intensity after performing IRs. Thus, in this work, frailty models are proposed to identify unobserved heterogeneity in these failure processes. In this context, we consider the arithmetic reduction of age (ARA) and arithmetic reduction of intensity (ARI) classes of IR models, with constant repair efficiency and a power‐law process distribution to model failure times and a univariate Gamma distributed frailty by all systems failure times. Classical inferential methods are used to estimate the parameters and reliability predictors of systems under IRs. An extensive simulation study is carried out under different scenarios to investigate the suitability of the models and the asymptotic consistency and efficiency properties of the maximum likelihood estimators. Finally, we illustrate the practical relevance of the proposed models on two real data sets.

Factors Influencing Customer Satisfaction towards Internet Banking Service: Case Study of Vietnam

This study investigates the impact of service quality dimensions on customer satisfaction in the context of internet banking services in Vietnam. Using a quantitative approach, data were collected through a structured questionnaire from a sample of 934 customers of the ten largest banks in Vietnam. The five service quality dimensions examined in this study are Tangibility, Reliability, Assurance, Responsiveness, and Empathy. Correlation and multiple regression analyses were conducted to assess the relationships between these dimensions and customer satisfaction. The correlation analysis revealed that all five service quality dimensions had significant positive correlations with customer satisfaction, with Assurance having the strongest correlation, followed by Responsiveness, Empathy, Reliability, and Tangibility. The regression results indicated that all five dimensions were significant predictors of customer satisfaction, with Responsiveness, Reliability, and Assurance having the strongest relative impact. This study contributes to the understanding of service quality and customer satisfaction in the digital banking era, providing valuable insights for bank managers and policymakers to enhance service quality and customer satisfaction in the highly competitive Vietnamese banking market. The findings highlight the need for banks to prioritize Responsiveness, Reliability, and Assurance while also addressing Tangibility and Empathy to meet customer expectations and foster long-term customer loyalty.

Overexpression of CD44 as a predictor of metastatic potential in patients with colorectal cancer

Objective. To correlate CD44 expression with the clinicopathological characteristics of patients with colorectal carcinoma (CRC).&#x0D; Materials and methods. This study included 90 patients with CRC who underwent curative surgical resection. Standard histopathological techniques and immunohistochemistry analysis was used to investigate CD44 expression. Semi–quantitative scoring was used to categorize CD44 expression levels. Patients' clinicopathological characteristics were retrospectively examined.&#x0D; Results. Overexpression of CD44 was found in 46.7% of all patients with CRC. Patients with right colon cancer had the highest CD44 expression (54,6%). Overexpression of CD44 was present in 69.6% of patients with metastatic lesions in visceral organs. We found statistically significant differences between CD44 overexpression and the presence of visceral metastases (p = 0.015), different T categories (p = 0.011), N status (p = 0.006), and G differentiation (p = 0.011). Our results showed that the disease stage has the greatest effect on CD44 overexpression (p &lt;0.001).&#x0D; Conclusion. Overexpression of CD44 could be a reliable predictor of metastatic potential and poor prognosis in patients with CRC.

Predictive Value of Global Longitudinal Strain on the Recovery of Left Ventricular Function Following ST-Segment Elevation Myocardial Infarction

Background: Identifying reliable predictors for ventricular recovery at the outset is crucial for patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Objectives: This study aimed to evaluate the role of baseline global longitudinal strain (GLS) in predicting myocardial recovery following an acute infarction. Methods: We enrolled 60 consecutive patients diagnosed with STEMI and admitted to Al-Zahra Hospital for PCI from March 2022 to March 2023. Echocardiography was performed on all patients within 48 hours after revascularization to measure baseline parameters, including left ventricular ejection fraction (LVEF) and GLS. Follow-up echocardiography was conducted 6 months later to reassess LVEF. Results: At the 6-month follow-up, 38 (63.3%) patients showed a ≥ 5% improvement in LVEF, indicating ventricular recovery. The change in GLS was significantly different between the groups (recovered: -4.72 ± 2.00, not recovered: -2.41 ± 2.15, P &lt; 0.001). A baseline GLS ≤ -4.5 and &gt; -14.8 was predictive of either failure to recover or successful recovery of LVEF with 100% negative and positive predictive values, respectively. Baseline GLS values &gt; -9.2 were predictive of LV recovery with 50% sensitivity and 83.3% specificity (P = 0.0002, AUC (95% confidence interval) = 0.697 (0.594, 0.799)). The type of revascularization was linked to better prediction outcomes, with patients undergoing primary and rescue PCIs more likely to recover during the follow-up period compared to those receiving deferred PCI after 24 hours (P = 0.032). Conclusions: While certain baseline GLS value thresholds may serve as predictors of LVEF recovery in patients with STEMI undergoing primary PCI, further prospective studies with larger cohorts are needed to establish more precise cut-off values.

Prognostic Value of Pretreatment Fetal Hemoglobin Levels in Patients with Myelodysplastic Syndromes and Acute Myeloid Leukemia Treated with Azacitidine: A Single-center Retrospective Study.

Objective Azacitidine (AZA) has been the standard of care for elderly patients with high-risk myelodysplastic syndromes (MDS). However, reliable clinical predictors of outcome have yet to be identified. The prognostic value of fetal hemoglobin (HbF) levels has been reported for decitabine therapy. We evaluated pretreatment HbF levels in AZA monotherapy as a prognostic marker in MDS/acute myeloid leukemia (AML). Methods This study included chemotherapy-naïve patients who had received seven-day treatment schedules of AZA and whose HbF levels were measured at the onset of treatment between March 2011 and July 2020. Patients were grouped into HbF-normal (<1.0%) or HbF-elevated (≥1.0%) groups. Responses were classified according to the International Working Group 2006 criteria. Patients Twenty-nine patients were included and classified as having either MDS (n=21), chronic myelomonocytic leukemia (n=5), myelodysplastic/myeloproliferative neoplasm unclassifiable (n=1), or AML with <30% marrow blasts (n=2) based on the World Health Organization 2016 diagnostic criteria. According to the revised International Prognostic Scoring System classification, 20/29 patients were at intermediate, high, or very high risk. Pretreatment HbF levels were elevated in 13/29 patients. Results The median follow-up duration was 13.0 (range 1.5-93.5) months. The HbF-elevated group was associated with a significantly higher hematologic improvement rate (76.9% vs. 25%, p=0.009) and better overall survival (median, 21.0 vs. 13.0 months, p=0.048) than the HbF-normal group. Conclusion These results suggest that elevated pretreatment HbF levels can predict better outcomes in patients with MDS/AML treated with AZA.

Unlocking the potential of oncology biomarkers: advancements in clinical theranostics.

Cancer biomarkers have revolutionized the field of oncology by providing valuable insights into tumor changes and aiding in screening, diagnosis, prognosis, treatment prediction, and risk assessment. The emergence of "omic" technologies has enabled biomarkers to become reliable and accurate predictors of outcomes during cancer treatment. In this review, we highlight the clinical utility of biomarkers in cancer identification and motivate researchers to establish a personalized/precision approach in oncology. By extending a multidisciplinary technology-based approach, biomarkers offer an alternative to traditional techniques, fulfilling the goal of cancer therapeutics to find a needle in a haystack. We target different forms of cancer to establish a dynamic role of biomarkers in understanding the spectrum of malignancies and their biochemical and molecular characterization, emphasizing their prospective contribution to cancer screening. Biomarkers offer a promising avenue for the early detection of human cancers and the exploration of novel technologies to predict disease severity, facilitating maximum survival and minimum mortality rates. This review provides a comprehensive overview of the potential of biomarkers in oncology and highlights their prospects in advancing cancer diagnosis and treatment.

The clinical efficacy of preoperative flash visual evoked potential (VEP) for mature cataracts without a response to pattern VEP.

This study aims to assess the effectiveness of the preoperative flash visual evoked potential (VEP) test in predicting postoperative visual acuity for monocular mature cataract cases when compared to the contralateral normal eye. The study included 60 patients, each with a monocular mature cataract diagnosis, who underwent preoperative flash VEP testing showing no pattern VEP response. Subsequently, phacoemulsification was performed. The relationship between the flash VEP test latency values (P1, N2, P2) and amplitude value (N2-P2), and the degree of visual acuity recovery 3 months post-cataract surgery, was evaluated using the LogMAR scale. Furthermore, a linear regression analysis was conducted to explore the connection between preoperative flash VEP components and postoperative visual acuity. The average age of the patients was 65.4 ± 13.6 years, with a range of 43 to 87 years. The study included 36 males and 24 females. A significant disparity in visual acuity was observed between the preoperative and 3-month postoperative stages (p < 0.001). The preoperative flash VEP test for mature cataracts revealed significant delays in P1, N2, and P2 latency, as well as a reduction in N2-P2 amplitude potential when compared to the contralateral normal eye (p < 0.001). Notably, delayed P2 latency and reduced N2-P2 amplitude potential were particularly indicative of poor visual acuity prognosis after cataract surgery in the multiple regression analysis (p < 0.05). The N2-P2 amplitude potential was the important value that exhibited statistically significant results, with an area under the curve (AUC) of 80% sensitivity and 88% specificity, using a cutoff value of 6.07 μV. In cases of monocular mature cataract, a reduction in N2-P2 amplitude potential compared to the contralateral normal eye emerged as the most reliable predictor of postoperative visual prognosis following cataract surgery.

Immunological signatures and predictive biomarkers for first-generation somatostatin receptor ligand resistance in Acromegaly.

Predicting resistance to first-generation Somatostatin Receptor Ligands (fg-SRL) in Acromegaly patients remains an ongong challenge. Tumor-associated immune components participate in various pathological processes, including drug-resistance. We aimed to identify the immune components involved in resistance of fg-SRL, and to investigate biomarkers that can be targeted to treat those drug-resistant Acromegaly. We conducted a retrospective study involving 35 Acromegaly patients with somatotropinomas treated postoperatively with fg-SRL. Gathering clinicopathological data, SSTR2 expression, and immunological profiles, we utilized univariate, binary logistic regression, and ROC analyses to assess their predictive roles in fg-SRL resistance. Spearman correlation analysis further examined interactions among interested characteristics. 19 patients (54.29%) exhibited resistance to postoperative fg-SRL. GH level at diagnosis, preoperative tumor volume, T2WI-MRI intensity, granularity, PD-L1, SSTR2, and CD8 + T cell infiltration showed association with clinical outcomes of fg-SRL. Notably, T2WI-MRI hyperintensity, PD-L1-IRS > 7, CD8 + T cell infiltration < 14.8/HPF, and SSTR2-IRS < 5.4 emerged as reliable predictors for fg-SRL resistance. Correlation analysis highlighted a negative relationship between PD-L1 expression and CD8 + T cell infiltration, while showcasing a positive correlation with preoperative tumor volume of somatotropinomas. Additionally, 5 patients with fg-SRL resistance underwent re-operation were involved. Following fg-SRL treatment, significant increases in PD-L1 and SSTR5 expression were observed, while SSTR2 expression decreased in somatotropinoma. PD-L1 expression and CD8 + T cell infiltration, either independently or combined with SSTR2 expression and T2WI-MRI intensity, could form a predictive model guiding clinical decisions on fg-SRL employment. Furthermore, targeting PD-L1 through immunotherapy and embracing second-generations of SRL with higher affinity to SSTR5 represent promising strategies to tackle fg-SRL resistance in somatotropinomas.

TyG-GGT is a Reliable Non-Invasive Predictor of Advanced Liver Fibrosis in Overweight or Obese Individuals.

Liver fibrosis is a predisposing factor for liver cancer. This study will investigate the predictive role of the Triglyceride-glucose and Gamma-glutamyl transferase index (TyG-GGT) as a non-invasive indicator of advanced liver fibrosis in individuals with obesity or overweight. We enrolled patients who underwent metabolic and bariatric surgery as well as intraoperative liver biopsies at Zhejiang provincial people's hospital from August 2020 to March 2023. Clinical characteristics, comorbidities, laboratory data, and pathological variables of patients were collected and analysed. Then, we conducted logistics regression model to compare the performance of the TyG-GGT index with other 4 non-invasive models. A total of 65 patients were included in this study. 43(66.2%) of them were female, with the mean body mass index (BMI) of 39.0 ± 7.3kg/m2. Meanwhile, 24(36.9%) patients were diagnosed with diabetes. Advanced liver fibrosis were observed in 16.9% of patients, while liver cirrhosis was found in 4.6% of patients. The multivariable logistics regression showed that TyG-GGT was an independent risk factor of advanced liver fibrosis (OR = 6.989, P = 0.049). Additionally, compared to another 4 non-invasive liver fibrosis models (NFS = 0.66, FIB4 = 0.65, METS-IR = 0.68, APRI = 0.65), TyG-GGT exhibits the highest AUC value of 0.75. More than one-third of patients undergoing metabolic and bariatric surgery are afflicted with nonalcoholic steatohepatitis (NASH), and a significant proportion exhibit advanced fibrosis. TyG-GGT was a potentially reliable predictor for screening individuals with overweight or obesity at high risk of advanced liver fibrosis, thus providing clinical guidance for early intervention in this targeted group.

Evaluating mean platelet volume and platelet distribution width as predictors of early-onset pre-eclampsia: a prospective cohort study

BackgroundPlatelets are pivotal players in the pathophysiology of pre-eclampsia, with observed lower counts in affected individuals compared to normotensive counterparts. Despite advancements, the elusive cause of pre-eclampsia persists, motivating intense global efforts to identify reliable predictors. The currently recommended predictors of pre-eclampsia are not readily available in many resource-limited regions like Nigeria. This cohort study explores the potential of mean platelet volume (MPV) and platelet distribution width (PDW) as predictive markers of early-onset pre-eclampsia. Both platelet indices are components of the full blood count, a widely available routine test in pregnancy.MethodsIn this prospective cohort study, 648 healthy pregnant women attending antenatal care at Lagos State University Teaching Hospital and General Hospital Ifako-Ijaiye, Lagos, were recruited between 14-18weeks gestational age. Platelet count (PC), MPV and PDW were measured from their venous blood at recruitment. Participants were monitored until 34weeks of gestation, focusing on the occurrence of early-onset preeclampsia as the outcome of interest. Individuals with chronic medical conditions were excluded from the study. Data analysis involved t-test, Chi-Square and Mann–Whitney U tests, with statistical significance set at a confidence level of 95% and p < 0.05. Sensitivity, specificity, and predictive values were determined using receiver operating characteristics (ROC) curves.ResultsThe incidence of early-onset pre-eclampsia in the study was 5.9%. Women who later developed pre-eclampsia had higher median MPV and PDW at 14-18weeks (10.8 fl. and 24.8 fl.) compared to normotensive women (8.1 fl. and 13.3 fl.)(p < 0.001). The median PC was lower in pre-eclamptics (190 × 103/µl) compared to normotensives(264 × 103/µl)(p < 0.001). Using Youden’s test, cut-off values identified: PC < 211.5 × 103/µl, MPV > 9.4 fl., and PDW > 21.3 fl., predicted early-onset pre-eclampsia with 96.6% sensitivity and 65.6% specificity for PC; 79.3% sensitivity and 97.7% specificity for PDW; and 82.8% sensitivity and 96.1% specificity for MPV. Cut-offs of PC < 185 × 103/µl, MPV > 10.7 fl., and PDW > 28.3 fl., predicted severe early-onset pre-eclampsia with 100.0% sensitivity and 90.9% specificity for PC, 100.0% sensitivity and 99.4% specificity for MPV, and 100.0% sensitivity and 99.8% specificity for PDW, with corresponding area under the ROC curves of 0.983, 0.996, and 0.998, respectively.ConclusionThe evaluation of MPV and PDW between 14 and 18 weeks of gestation appears to be a reliable predictor of severe early-onset pre-eclampsia.

Early hospital discharge through prediction of post-thyroidectomy hypoparathyroidism

IntroductionHypoparathyroidism is the most common postsurgical complication of total thyroidectomy. Furthermore, it is the main cause of prolonged hospitalisation after this procedure. ObjectiveTo predict the probability of post-thyroidectomy hypocalcaemia according to the levels of intact parathyroid hormone (iPTH), as well as to determine the needs for treatment with exogenous calcium according to the levels of serum calcium (Ca). Materials and methodsRetrospective study was carried out on patients who underwent total thyroidectomy between January 2017 and January 2020 at Los Arcos del Mar Menor University Hospital (HULAMM). iPTH and Ca levels ​​were measured at 4, 24 and 48 h after the surgery. Follow-up was 6 months. ResultsNinety-four patients were operated on. Temporary and permanent postoperative hypoparathyroidism percentages were, respectively, 51.06% and 6.38%. iPTH level 24 h after the procedure was the most reliable predictor of post-thyroidectomy temporary hypoparathyroidism (Area Under the ROC Curve (AUC) = 0.933, p < .001). iPTH levels ​​≥29 pg/mL predicted normal parathyroid metabolism. ConclusionsThe combined values of iPTH and Ca levels 24 h after thyroidectomy seems to be a reliable, safe and efficient method to control the post-thyroidectomy hypoparathyroidism. Our protocol could reduce the hospital stay of patients at low risk of hypocalcaemia, allowing them to be discharged from the hospital on the first postoperative morning and identifying patients at high risk of hypocalcaemia early.

Fetal Anterior Abdominal Wall Thickness as an Indicator of Gestational Diabetes: A Sonographic Study

Objective: During pregnancy, sonographic measurements of subcutaneous adipose tissue may be a reliable diagnostic predictor of gestational diabetes mellitus (GDM) and fetal metabolism. A sonographic view of the fetal abdominal circumference can be used to measure the fetal anterior abdominal wall thickness (AAWT), which is straightforward and simple. Consequently, in this study, the aim was to evaluate whether the fetal AAWT value could be used as a diagnostic indicator of GDM, thus preventing the adverse neonatal and maternal outcomes thereof, including shoulder dystocia, neonatal hypoxia, and injury to the birth canal, secondary to fetal macrosomia. Materials and Methods: This prospective cross-sectional study was conducted at a hospital in Lahore, Pakistan, over a 9-month period. A total of 176 female participants in their third trimester of pregnancy were included in this study. The participants were assigned to two cohorts: a cohort of 88 participants diagnosed with GDM and a control cohort of 88 participants without GDM. An independent sample t test, analysis of variance, and chi-square test were used to compare the characteristics between the two cohorts of participants. A final analysis was performed to determine the strength of the correlations between the estimated fetal weight (EFW) and AAWT values. Results: The GDM and control cohorts had mean fetal AAWT values of 12.65 ± 1.276 and 6.389 ± 1.503, respectively. Thus, a statistically significant difference in the fetal AAWT values was observed between the GDM and control cohorts. Furthermore, a statistically significant positive correlation between the EFW and AAWT values was observed ( P = .01). Conclusion: This study highlighted that women with GDM have a considerably higher fetal AAWT values than those without GDM. In addition, the findings revealed that the AAWT value was correlated with the EFW value. Consequently, an increased fetal AAWT value can potentially be utilized as a predictive indicator for those pregnant women at risk of developing GDM, thus preventing adverse maternal and fetal outcomes.

Prognostic value of RNA methylation-related genes in gastric adenocarcinoma based on bioinformatics.

Gastric cancer (GC) is a malignant tumor that originates from the epithelium of the gastric mucosa and has a poor prognosis. Stomach adenocarcinoma (STAD) covers 95% of total gastric cancer. This study aimed to identify the prognostic value of RNA methylation-related genes in gastric cancer. In this study, The Cancer Genome Atlas (TCGA)-STAD and GSE84426 cohorts were downloaded from public databases. Patients were classified by consistent cluster analysis based on prognosis-related differentially expressed RNA methylation genes Prognostic genes were obtained by differential expression, univariate Cox and least absolute shrinkage and selection operator (LASSO) analyses. The prognostic model was established and validated in the training set, test set and validation set respectively. Independent prognostic analysis was implemented. Finally, the expression of prognostic genes was affirmed by reverse transcription quantitative PCR (RT-qPCR). In total, four prognostic genes (ACTA2, SAPCD2, PDK4 and APOD) related to RNA methylation were identified and enrolled into the risk signature. The STAD patients were divided into high- and low-risk groups based on the medium value of the risk score, and patients in the high-risk group had a poor prognosis. In addition, the RNA methylation-relevant risk signature was validated in the test and validation sets, and was authenticated as a reliable independent prognostic predictor. The nomogram was constructed based on the independent predictors to predict the 1/3/5-year survival probability of STAD patients. The gene set enrichment analysis (GSEA) result suggested that the poor prognosis in the high-risk subgroup may be related to immune-related pathways. Finally, the experimental results indicated that the expression trends of RNA methylation-relevant prognostic genes in gastric cancer cells were in agreement with the result of bioinformatics. Our study established a novel RNA methylation-related risk signature for STAD, which was of considerable significance for improving prognosis of STAD patients and offering theoretical support for clinical therapy.

Correlation Analysis of Pulmonary Vein Anatomy and Paroxysmal Atrial Fibrillation Recurrence after Cryoballoon Ablation

Background: Cryoballoon ablation (CBA) is a reliable therapy for paroxysmal atrial fibrillation (pAF). However, the relatively high recurrence rate poses a perplexing challenge for clinicians; thus, a more detailed understanding of the pulmonary vein anatomy and the left atrial (LA)-pulmonary vein (PV) conjunction mode is needed. This study aimed to explore the correlation between the PV anatomy and pAF recurrence in patients who underwent the index CBA. Methods: We included 274 consecutive pAF patients (men: 60%, mean age: 58.8 ± 11.5 years, median AF history: 25 (8, 63) months) with pAF who underwent their first cryoballoon ablation between October 2019 and March 2022. All data were collected from the patient’s medical records. Subsequent post-procedural long-term follow-up and statistical analysis were conducted. Results: Amongst the total patients, 220 (80%) remained AF-free. Multivariate analysis showed that the right inferior PV (RIPV) vertical angle (hazard ratio (HR): 1.097, 95% CI: 1.071–1.124, p &lt; 0.001) and PV variation (HR: 1.905, 95% CI: 1.079–3.362, p = 0.026) correlated with postoperative AF recurrence. The study investigated the effectiveness of the RIPV vertical angle, either alone or in combination with other recognized factors. Conclusions: In patients with pAF who underwent the index CBA, the RIPV vertical angle and PV variation served as reliable prognostic predictors. Specifically, the RIPV vertical angle, either alone or in combination with recognized factors, demonstrated effective predictive performance.

Mutual information between joint angles and toe height in healthy subjects

Understanding the relationship between the position of the foot and the lower limb joint angles during normal gait is critical for the identification of the mechanisms involved in pathological gait. In this article, we introduce a novel framework that characterizes this relationship using mutual information in healthy subjects. The nonlinear connection between these variables is quantified using mutual information, and the MINE algorithm is used for precise estimation. Several simulations over Gaussian bivariate random variables reveal that overfitting is a critical factor affecting mutual information estimations by MINE, and we propose a simple methodology to address this issue when using gait signals. Our findings indicate that the statistical dependency between joint angles and toe height is symmetrical between the limbs for healthy subjects. Additionally, our results show that the ipsilateral knee angle holds the most significant amount of information regarding the toe height. In simpler terms, this knee angle serves as the most reliable predictor for toe height, and vice versa. To further enhance our understanding, we have developed a mutual information reference profile that enables the comparison of how the relationship between these biomechanical variables evolves under pathological conditions. The findings have significant implications for gait analysis and may aid in the identification and understanding of gait abnormalities in various contexts, contributing to the advancement of biomechanical research and clinical applications.

Evolutionary rate covariation is a reliable predictor of co-functional interactions but not necessarily physical interactions

Co-functional proteins tend to have rates of evolution that covary over time. This correlation between evolutionary rates can be measured over the branches of a phylogenetic tree through methods such as evolutionary rate covariation (ERC), and then used to construct gene networks by the identification of proteins with functional interactions. The cause of this correlation has been hypothesized to result from both compensatory coevolution at physical interfaces and nonphysical forces such as shared changes in selective pressure. This study explores whether coevolution due to compensatory mutations has a measurable effect on the ERC signal. We examined the difference in ERC signal between physically interacting protein domains within complexes compared to domains of the same proteins that do not physically interact. We found no generalizable relationship between physical interaction and high ERC, although a few complexes ranked physical interactions higher than nonphysical interactions. Therefore, we conclude that coevolution due to physical interaction is weak, but present in the signal captured by ERC, and we hypothesize that the stronger signal instead comes from selective pressures on the protein as a whole and maintenance of the general function.

Association between different insulin resistance surrogates and all-cause mortality in patients with coronary heart disease and hypertension: NHANES longitudinal cohort study

BackgroundStudies on the relationship between insulin resistance (IR) surrogates and long-term all-cause mortality in patients with coronary heart disease (CHD) and hypertension are lacking. This study aimed to explore the relationship between different IR surrogates and all-cause mortality and identify valuable predictors of survival status in this population.MethodsThe data came from the National Health and Nutrition Examination Survey (NHANES 2001–2018) and National Death Index (NDI). Multivariate Cox regression and restricted cubic splines (RCS) were performed to evaluate the relationship between homeostatic model assessment of IR (HOMA-IR), triglyceride glucose index (TyG index), triglyceride glucose-body mass index (TyG-BMI index) and all-cause mortality. The recursive algorithm was conducted to calculate inflection points when segmenting effects were found. Then, segmented Kaplan–Meier analysis, LogRank tests, and multivariable Cox regression were carried out. Receiver operating characteristic (ROC) and calibration curves were drawn to evaluate the differentiation and accuracy of IR surrogates in predicting the all-cause mortality. Stratified analysis and interaction tests were conducted according to age, gender, diabetes, cancer, hypoglycemic and lipid-lowering drug use.Results1126 participants were included in the study. During the median follow-up of 76 months, 455 participants died. RCS showed that HOMA-IR had a segmented effect on all-cause mortality. 3.59 was a statistically significant inflection point. When the HOMA-IR was less than 3.59, it was negatively associated with all-cause mortality [HR = 0.87,95%CI (0.78, 0.97)]. Conversely, when the HOMA-IR was greater than 3.59, it was positively associated with all-cause mortality [HR = 1.03,95%CI (1.00, 1.05)]. ROC and calibration curves indicated that HOMA-IR was a reliable predictor of survival status (area under curve = 0,812). No interactions between HOMA-IR and stratified variables were found.ConclusionThe relationship between HOMA-IR and all-cause mortality was U-shaped in patients with CHD and hypertension. HOMA-IR was a reliable predictor of all-cause mortality in this population.

Carcinogenesis caused by transcription-coupled DNA damage through GANP and other components of the TREX-2 complex.

Perturbation of genes is important for somatic hypermutation to increase antibody affinity during B-cell immunity; however, it may also promote carcinogenesis. Previous studies have revealed that transcription is an important process that can induce DNA damage and genomic instability. Transciption-export-2 (TREX-2) complex, which regulates messenger RNA (mRNA) nuclear export, has been studied in the budding yeast Saccharomyces cerevisiae; however, recent studies have started investigating the molecular function of the mammalian TREX-2 complex. The central molecule in the TREX-2 complex, that is, germinal center-associated nuclear protein (GANP), is closely associated with antibody affinity maturation as well as cancer etiology. In this review, we focus on carcinogenesis, lymphomagenesis, and teratomagenesis caused by transcription-coupled DNA damage through GANP and other components of the TREX-2 complex. We review the basic machinery of mRNA nuclear export and transcription-coupled DNA damage. We then briefly describe the immunological relationship between GANP and the affinity maturation of antibodies. Finally, we illustrate that the aberrant expression of the components of the TREX-2 complex, especially GANP, is associated with the etiology of various solid tumors, lymphomas, and testicular teratoma. These components serve as reliable predictors of cancer prognosis and response to chemotherapy.