Stage 2 Research Articles

A low-cost and open-hardware portable 3-electrode sleep monitoring device

To continue sleep research activities during the lockdown resulting from the COVID-19 pandemic, experiments that were previously conducted in laboratories were shifted to the homes of volunteers. Furthermore, for extensive data collection, it is necessary to use a large number of portable devices. Hence, to achieve these objectives, we developed a low-cost and open-source portable monitor (PM) device capable of acquiring electroencephalographic (EEG) signals using the popular ESP32 microcontroller. The device operates based on instrumentation amplifiers. It also has a connectivity microcontroller with Wi-Fi and Bluetooth that can be used to stream EEG signals. This portable single-channel 3-electrode EEG device allowed us to record short naps and score different sleep stages, such as wakefulness, non rapid eye movement sleep (NREM), stage 1 (S1), stage 2 (S2), stage 3 (S3) and stage 4 (S4). We validated the device by comparing the obtained signals to those generated by a research-grade counterpart. The results showed a high level of accurate similarity between both devices, demonstrating the feasibility of using this approach for extensive and low-cost data collection of EEG sleep recordings.

Comparing targeted memory reactivationduring slow wave sleep and sleep stage 2.

Sleep facilitates declarative memory consolidation, which is assumed to rely on the reactivation of newly encoded memories orchestrated by the temporal interplay of slow oscillations (SO), fast spindles and ripples. SO as well as the number of spindles coupled to SO are more frequent during slow wave sleep (SWS) compared to lighter sleep stage 2 (S2). But, it is unclear whether memory reactivation is more effective during SWS than during S2. To test this question, we applied Targeted Memory Reactivation (TMR) in a declarative memory design by presenting learning-associated sound cues during SWS vs. S2 in a counterbalanced within-subject design. Contrary to our hypothesis, memory performance was not significantly better when cues were presented during SWS. Event-related potential (ERP) amplitudes were significantly higher for cues presented during SWS than S2, and the density of SO and SO-spindle complexes was generally higher during SWS than during S2. Whereas SO density increased during and after the TMR period, SO-spindle complexes decreased. None of the parameters were associated with memory performance. These findings suggest that the efficacy of TMR does not depend on whether it is administered during SWS or S2, despite differential processing of memory cues in these sleep stages.

Clinical outcomes of cessation of nucleoside/nucleotide analogues in Chinese patients with HBeAg-negative chronic hepatitis B

Background and aimsCessation of nucleoside/nucleotide analogue (Nuc) therapy in patients with HBeAg-negative chronic hepatitis B (CHB) remains controversial. MethodsIn this prospective, single-center cohort study, we recruited 45 patients with HBeAg-negative CHB from The Fifth Medical Center of Chinese People's Liberation Army General Hospital in mainland China. Patients were classified into a Nuc cessation group (n = 27) and Nuc continuation group (n = 18) and followed-up for 36 months. Nuc were stopped after being inactive for at least 4 years (normal alanine aminotransferase (ALT), undetectable hepatitis B virus (HBV) DNA), with liver fibrosis ≤ Stage1 (S1) and inflammation ≤ Grade (G1). ResultsWithin 3 years of follow-up, 51.9% patients with Nuc cessation had virological relapse and 14.8% had ALT elevation, while all patients with Nuc continuation had undetectable HBV DNA and normal ALT. The rate of HBsAg loss after Nuc cessation was 22.2% compared with no seroconversion in patients with Nuc continuation. The hepatitis flare rate was 11.1% and there were no cases of hepatic decompensation after Nuc cessation. End of treatment (EOT) HBsAg, HBV RNA, and decline in HBV core-related antigen (HBcrAg) rate were predictive markers for HBsAg seroconversion at 6 months post-Nuc cessation. ConclusionThis study showed favorable HBsAg loss and low hepatitis flare rates after Nuc cessation. EOT HBsAg, HBV RNA, and decline in HBcrAg rate were predictive markers for HBsAg seroconversion at 6 months post-Nuc cessation.

Unveiling the impact of harvest time on Dioscorea opposita Thunb. cv. Tiegun maturity by NMR-based metabolomics and LC-MS/MS analysis.

Dioscorea opposita Thunb. cv. Tiegun maturity (DM) is an important factor influencing its quality. However, there are few studies on the impact of harvest time on its maturation. In the present study, a NMR-based metabolomics approach was applied to investigate the dynamic metabolic changes of D. opposita Thunb. cv. Tiegun at six different harvest stages: stage 1 (S1), stage 2 (S2), Stage 3 (S3), stage 4 (S4), stage 5 (S5) and stage 6 (S6). Principal component analysis showed distinct segregation of samples obtained from S1, S2 and S3 compared to those derived from S4, S5 and S6. Interestingly, these samples from the two periods were obtained before and after frost, indicating that frost descent might be important for DM. Eight differential metabolites responsible for good separation of different groups were identified by the principal component analysis loading plot and partial least squares-discriminant analysis. In addition, quantitative analysis of these metabolites using liquid chromatography-tandem mass spectrometry determined the effects of harvest time on these metabolite contents, two of which, sucrose and allantoin, were considered as potential biomarkers to determine DM. The present study demonstrated that NMR-based metabolomics approach could serve as a powerful tool to identify differential metabolites during harvesting processes, also offering a fresh insight into understanding the DM and the potential mechanism of quality formation. © 2024 Society of Chemical Industry.

Comprehensive analysis of quality and bioactive compounds in umbu-cajá fruit during different ripening stages

Umbu-cajá (Spondias tuberosa x S. mombin) is a tropical fruit with potential health benefits due to its bioactive compounds. The objective of this study was to identify the optimal harvest point for enhanced nutritional value and consumer appeal of umbu-cajá. Umbu-cajá fruit was collected at five ripening stages (S1 to S5). Immature fruit (S1) had a higher pulp yield but a lower seed yield, suggesting an inverse relationship between these fruit components. Stage 3 (S3) was identified as the optimal harvest time, as it maintained stable pulp and seed mass, corresponding to the ideal physiological maturity point for human consumption. The respiration rate increased significantly at stages S4 and S5, indicating that Spondias sp. could be classified as a climacteric fruit. Color analysis revealed increased yellowness during ripening, which is indicative of the development of desirable attributes such as sweetness and soft texture in hipened fruits. Compositional analysis demonstrated that moisture content decreased while ash and solids content increased during ripening, reflecting appropriate maturity for human consumption. The ratio of soluble solids to acidity increased, suggesting enhanced sweetness as the fruits ripened. The levels of antioxidants, except for anthocyanins, decreased during ripening, with the latter increasing up to stage S3, thereby providing the fruit with its vibrant colors. The compositional changes underscore the importance of considering both nutritional and sensory attributes in determining the optimal harvest time. Moreover, the increased antioxidant content at early ripening stages signifies the fruit's potential as a valuable source of health-promoting compounds. This study contributes to optimizing the quality of umbu-cajá and offers valuable information for sustainable production and improved consumption of these fruits. By identifying the ideal harvest time and evaluating the changes in bioactive compounds and quality attributes during ripening, this research aids in promoting healthier dietary choices and supporting the fruit industry. The findings have implications for producers, retailers, and consumers, providing a scientific basis for enhancing the nutritional value and flavor profile of umbu-cajá at the optimal stage of ripening.

Peer Feedback: Model for the Assessment and Development of Metacognitive Competences in Nursing Students in Clinical Training

Peer feedback serves as a pedagogical methodology that actively engages students throughout their academic journey. Developing metacognitive competences of students in a clinical training context motivates student’s engagement and active participation in the learning and assessment processes as added value for academic success. It is particularly effective in fostering competences that are crucial for future professional practice. This study introduces the design and development of a peer feedback model tailored for the assessment and development of metacognitive competences among nursing students undergoing clinical training, named PEERFEED-EClínico 1.0. The research employs a constructivist case study approach using a multi-method design comprising two stages: Stage 1 (S1) involves development and modeling, conducted through the first and second cycles of participatory action research (PAR); Stage 2 (S2) focuses on validity and feasibility, employing a quasi-experimental study (before and after) to validate the model’s requirements, receptivity, and potential compliance among teachers and students. Data were collected from 2018 to 2021 and involved 163 nursing students and 24 teachers/supervisors enrolled in curricular units related to clinical training during the 3rd and 4th years of their undergraduate nursing degrees. The findings highlight the PEERFEED-EClínico 1.0 model, which features four levels of implementation. The model emphasizes self-knowledge, self-reflection, and self-regulation along with communication, interpersonal relationships, and teamwork, all of which are deemed essential for students’ future professional practice. The peer feedback model promotes a centered student approach, allows the alignment of pedagogical methodologies with international frameworks of quality assurance in higher education, and contributes significantly to nursing education and science knowledge.

The Effect of Blade Distances on the Performance of Double-Stage Gravitational Water Vortex Turbine

A gravitational water vortex turbine is a turbine that generates electricity by rotating its runner under vortex flow through basins. The present experimental study investigated the effect of blade distance through a double-stage vortex turbine. The study used rotational speeds, torque, and efficiency to describe the vortex turbine performance under different applied discharges and blade distances. Each blade has a different profile, such as Savonius and a curved blade profile. Each blade independently generates its performance because they constructed under different hollow and solid shafts. The results illustrated that an increased distance between blades produces the best performance with a higher flow rate. A discharge of 9.5×10-3m3/s and a distance of 150 mm has a total mechanical power of 28,51 W with an efficiency of 28.92%. The longest distance between the stage 1 (S1) and stage 2 (S2) turbine causes the smaller air core diameter. It has given an advantage in their performances on rotational speeds, mechanical power, torque, and efficiency generated by the Gravitational Water Vortex Turbine (GWVT).

Staged abdominal wall reconstruction in the setting of complex gastrointestinal reconstruction.

Literature on one- versus two-staged abdominal wall reconstruction (AWR) with complex gastrointestinal reconstruction (GIR) is limited to single-arm case series with a focus on patients who complete all planned stages. Herein, we describe our experience with both one- and two-staged approaches to AWR/GIR, with attention to those who did not complete both intended stages. A retrospective review of prospectively collected data was conducted to identify patients who underwent a one- or two-stage approach to GIR/AWR from 2013 to 2020. The one-stage approach included GIR and definitive sublay mesh herniorrhaphy. The two-stage approach included Stage 1 (S1)-GIR and non-definitive herniorrhaphy and Stage 2 (S2)-definitive sublay mesh herniorrhaphy. Fifty-four patients underwent GIR/AWR: 20 (37.0%) underwent a planned 1-stage operation while 34 (63.0%) underwent S1 of a planned 2-stage approach. Patients assigned to the 2-stage approach were more likely to be smokers, have a history of mesh infection, have an enterocutaneous fistula, and a contaminated wound class (p<0.05). Of the 34 patients who underwent S1, 12 (35.3%) completed S2 during the mean follow-up period of 44 months while 22 (64.7%) did not complete S2. Of these, 10 (45.5%) developed hernia recurrence but did not undergo S2 secondary to elective nonoperative management (40%), pending preoperative optimization (30%), additional complex GIR (10%), hernia-related incarceration requiring emergent surgery (10%), or unrelated death (10%). No differences in outcome including SSI, SSO, readmission, and recurrence were noted between the 12 patients who completed the two-stage approach and the 20 patients who completed a one-stage approach, despite increased risk factors for complications in the 2-stage group (p>0.05). Planned two-stage operations for GIR/AWR may distribute operative complexity and post-operative morbidity into separate surgical interventions. However, many patients may never undergo the intended definitive S2 herniorrhaphy. Future evaluation of 1- versus 2-stage GIR/AWR is needed to clarify indications for each approach. This work must also consider the frequent deviations from intended clinical course demonstrated in this study.

In Vivo Electron Paramagnetic Resonance Molecular Profiling of Tumor Microenvironment upon Tumor Progression to Malignancy in an Animal Model of Breast Cancer.

Hypoxia and acidosis are recognized tumor microenvironment (TME) biomarkers of cancer progression. Alterations in cancer redox status and metabolism are also associated with elevated levels of intracellular glutathione (GSH) and interstitial inorganic phosphate (Pi). This study aims to evaluate the capability of these biomarkers to discriminate between stages and inform on a switch to malignancy. These studies were performed using MMTV-PyMT( +) female transgenic mice that spontaneously develop breast cancer and emulate human tumor staging. In vivo assessment of oxygen concentration (pO2), extracellular acidity (pHe), Pi, and GSH was performed using L-band electron paramagnetic resonance spectroscopy and multifunctional trityl and GSH-sensitive nitroxide probes. Profiling of the TME showed significant deviation of measured biomarkers upon tumor progression from pre-malignancy (pre-S4) to the malignant stage (S4). For the combined marker, HOP: (pHe × pO2)/Pi, a value > 186 indicated that the tumors were pre-malignant in 85% of the mammary glands analyzed, and when < 186, they were malignant 42% of the time. For GSH, a value < 3mM indicated that the tumors were pre-malignant 74% of the time, and when > 3mM, they were malignant 80% of the time. The only marker that markedly deviated as early as stage 1 (S1) from its value in pre-S1 was elevated Pi, followed by a decrease of pHe and pO2 and increase in GSH at later stages. Molecular TME profiling informs on alteration of tumor redox and metabolism during tumor staging. Early elevation of interstitial Pi at S1 may reflect tumor metabolic alterations that demand elevated phosphorus supply in accordance with the high rate growth hypothesis. These metabolic changes are supported by the following decrease of pHe due to a high tumor reliance on glycolysis and increase of intracellular GSH, a major intracellular redox buffer. The appreciable decrease in TME pO2 was observed only at malignant S4, apparently as a consequence of tumor mass growth and corresponding decrease in perfusion efficacy and increase in oxygen consumption as the tumor cells proliferate.

Understanding the dynamics of evaporation from stony soils via laboratory experiments and numerical modeling

Stones and rock fragments are typically found within soil profiles across various landscapes. However, knowledge on, and understanding of, their impact on hydraulic functions and processes are still lacking. Specifically, the presence of stones within the soil profile may increase water storage and availability to vegetation and reduce plant mortality in drylands. However, physically-based testing of stones effect on soil water budget components is overlooked. Experiments under laboratory conditions from soil columns, with two volume content t levels and two sizes of stones, were carried out in this research. Our results reveal that stoniness reduces the duration of stage-1 evaporation (S1) and consequently the overall cumulative evaporation, proportionally to their volumetric content and to the initial soil water content. The effect of stone size on evaporation was minor during S1 but was more pronounced during stage-2 (S2) — when the evaporation front migrates downward — with smaller stones reducing evaporation more than the larger ones. A recent evaporation model, assuming that transient evaporation is a succession of steady state solutions, was applied to explain the 2-phases evaporation process in a stony profile. The model results indicate that apart from changing the effective porosity of the soil profile by replacing a soil volume by stones, stoniness affects mainly the hydraulic conductivity function but practically not the water retention curve. Stoniness induced an increase in the tortuosity-related parameters compared with those of the stone-free soil. This observation was strengthened by the fact that both measured and modelled data reveal that stoniness has not affected the downward movement of the water table level during drying. Although we tested two stone sizes only and further experiments are required for a broader understanding, we suggest that the outcoming insights may improve estimates of water budget components in stony soil profiles and their response to global climatic changes.

Polyimide/Carboxylated Multi-walled Carbon Nanotube Hybrid Aerogel Fibers for Fabric Sensors: Implications for Information Acquisition and Joule Heating in Harsh Environments

Polymeric hybrid sensors have garnered great interest in health monitoring, human–computer interaction, and soft robotics for their lightweight, flexibility, and feasible fabrication process. However, polymeric hybrid sensors suitable for harsh environments remain a considerable challenge, limiting further application. Herein, polyimide (PI)/carboxylated multi-walled carbon nanotube (c-MWCNT) hybrid aerogel fibers with a micro-porous structure were fabricated via wet-spinning and chemical thermal imidization. The fabricated PI/c-MWCNT hybrid aerogel fibers’ conductivity and the change of current in response to the bending degree were tested, in which the relative current change achieved 4.78% with a bending degree of 150°. The fibers possessed a density of 0.41 ± 0.06 g/cm3, a conductivity of 17.8 ± 2.9 μS/m, and a tensile strength of 13.0 ± 1.1 MPa. In addition, they exhibited excellent heat/cold durability, whose decomposition temperature, cold resistance, and service life were 367 °C, −196 °C, and 300 cycles, respectively. Furthermore, the fabric sensor woven with PI/c-MWCNT hybrid aerogel fibers demonstrated two sensitivity stages of stage 1 (S1) = 6.04 and stage 2 (S2) = 0.55 under various pressures. Besides, it could be heated to 62 °C at a voltage of 30 V in 90 s with a changing resistance. The above properties demonstrate that the as-prepared fabric sensor exhibited great application potential for information acquisition and joule heating in harsh environments.

Transcriptomics analysis of mangosteen ripening revealed active regulation of ethylene, anthocyanin and xanthone biosynthetic genes

Mangosteen (Garcinia mangostana Linn.) is known as the ‘Queen of Fruits’ due to its sweet and unique taste. The fruit also contains beneficial compounds such as anthocyanins and xanthones which have pharmacological properties including anticancer, and anti-inflammatory activities. Mangosteen has unique ripening behavior whereby the fruit undergoes full ripening (up to Stage 6 (S6), dark purple) only when harvested at the middle ripening stage (Stage 2 (S2), appearance of pink spots) onwards. This is unlike most other climacteric fruits which can ripen completely when harvested at the initial green stage (Stage 0, S0). However, information governing the ripening regulation of mangosteen is limited particularly at the molecular level. Hence, transcriptomics analyses on mangosteen pericarp was performed at different ripening stages; S0 (initial stage), S2 (middle stage), and S6 (final stage), revealing 250,680 unique transcripts, of which 6233 were differentially expressed transcripts (DETs). Furthermore, the benchmarking universal single-copy orthologs (BUSCO) analysis affirmed that the assembled transcriptome contains 93.8 % of gene representation in the Viridiplantae kingdom. Functional annotation indicated a high match with the species from the Malpighiales order, with most of the DETs participating in the metabolism process. Additionally, transcriptomics analysis indicated the fruit undergoes transitioning at the early ripening (S0 vs S2) by conserving carbon skeleton instead of energy production before ethylene surge later (S2 vs S6). Transcripts relating to the anthocyanin and xanthone biosynthesis were upregulated during ripening particularly at an early stage, consistent with ripening as an oxidative process with high requirements of antioxidants. This study contributes to the findings of novel transcripts important for the regulation of ripening which could lead to better commercial utilization and preservation of mangosteen in the future.

Integration of high-throughput phenotyping, GWAS, and predictive models reveals the genetic architecture of plant height in maize

Plant height (PH) is an essential trait in maize (Zea mays) that is tightly associated with planting density, biomass, lodging resistance, and grain yield in the field. Dissecting the dynamics of maize plant architecture will be beneficial for ideotype-based maize breeding and prediction, as the genetic basis controlling PH in maize remains largely unknown. In this study, we developed an automated high-throughput phenotyping platform (HTP) to systematically and noninvasively quantify 77 image-based traits (i-traits) and 20 field traits (f-traits) for 228 maize inbred lines across all developmental stages. Time-resolved i-traits with novel digital phenotypes and complex correlations with agronomic traits were characterized to reveal the dynamics of maize growth. An i-trait-based genome-wide association study identified 4945 trait-associated SNPs, 2603 genetic loci, and 1974 corresponding candidate genes. We found that rapid growth of maize plants occurs mainly at two developmental stages, stage 2 (S2) to S3 and S5 to S6, accounting for the final PH indicators. By integrating the PH-association network with the transcriptome profiles of specific internodes, we revealed 13 hub genes that may play vital roles during rapid growth. The candidate genes and novel i-traits identified at multiple growth stages may be used as potential indicators for final PH in maize. One candidate gene, ZmVATE, was functionally validated and shown to regulate PH-related traits in maize using genetic mutation. Furthermore, machine learning was used to build predictive models for final PH based on i-traits, and their performance was assessed across developmental stages. Moderate, strong, and very strong correlations between predictions and experimental datasets were achieved from the early S4 (tenth-leaf) stage. Colletively, our study provides a valuable tool for dissecting the spatiotemporal formation of specific internodes and the genetic architecture of PH, as well as resources and predictive models that are useful for molecular design breeding and predicting maize varieties with ideal plant architectures.

Expression Analysis of Brassinolide-Metabolism-Related Genes at Different Growth Stages of Pak Choi

Pak choi needs to be exposed to low temperature (vernalized) before flowering will initiate. Early bolting caused by low temperature often occurs in spring and leads to significant economic losses. Therefore, it is of great practical significance to study the flowering process of pak choi. Brassinolide (BR) plays a certain role in the flowering process of pak choi. In order to better understand the role of BR in the flowering process of pak choi, the BR content in the shoot apices of pak choi at different growth stages was determined by enzyme-linked immunosorbent assay (ELISA). The results showed that the BR content increased after low-temperature treatment. With the progress of vegetative growth, the BR content decreased and reached the lowest at 10 days after transplanting (V10), then the content increased and reached a small peak at the critical period of floral bud differentiation (S0). After initiation of floral bud differentiation, the content decreased at floral bud differentiation stage 1 (S1), and then gradually increased and reached a peak at floral bud differentiation stage 3 (S3). In order to clarify the molecular mechanism of BR content changes, we analyzed the expressions of key enzymes coding genes in the BR metabolic pathway, and found that six major synthase-encoding genes (Bra008760, Bra030023, Bra036097, Bra027405, Bra011678, and Bra025409) were upregulated at the critical period of floral bud differentiation, leading to the increase in BR content, which were consistent with changes in the BR content. By analyzing the functions of differentially expressed genes (DEGs) between the vegetative growth stage (V10) and the critical period of floral bud differentiation (S0), 21 DEGs were found to be related to BR metabolism. These findings can provide a reference for elucidating the molecular mechanism of BR regulating the flowering process of pak choi.

Data Gap in Sacral Neuromodulation Documentation: Call to Improve Documentation Protocols

PurposeWe quantified patient record documentation of sacral neuromodulation (SNM) threshold testing and programming parameters at our institution to identify opportunities to improve therapy outcomes and future SNM technologies.MethodsA retrospective review was conducted using 127 records from 40 SNM patients. Records were screened for SNM documentation including qualitative and quantitative data. The qualitative covered indirect references to threshold testing and the quantitative included efficacy descriptions and device programming used by the patient. Findings were categorized by visit type: percutaneous nerve evaluation (PNE), stage 1 (S1), permanent lead implantation, stage 2 (S2) permanent impulse generator implantation, device-related follow-up, or surgical removal.ResultsDocumentation of threshold testing was more complete during initial implant visits (PNE and S1), less complete for S2 visits, and infrequent for follow-up clinical visits. Surgical motor thresholds were most often referred to using only qualitative comments such as “good response” (88%, 100% for PNE, S1) and less commonly included quantitative values (68%, 84%), locations of response (84%, 83%) or specific contacts used for testing (0%). S2 motor thresholds were less well documented with qualitative, quantitative, and anatomical location outcomes at 70%, 48%, and 36% respectively. Surgical notes did not include specific stimulation parameters or contacts used for tests. Postoperative sensory tests were often only qualitative (80%, 67% for PNE, S1) with quantitative values documented much less frequently (39%, 9%) and typically lacked sensory locations or electrode-specific results. For follow-up visits, <10% included quantitative sensory test outcomes. Few records (<7%) included device program settings recommended for therapy delivery and none included therapy-use logs.ConclusionsWhile evidence suggests contact and parameter-specific programming can improve SNM therapy outcomes, there is a major gap in the documentation of this data. More detailed testing and documentation could improve therapeutic options for parameter titration and provide design inputs for future technologies.

Subcutaneous Treprostinil Improves Surgical Candidacy for Next Stage Palliation in Single Ventricle Patients With High-Risk Hemodynamics

Single ventricle (SV) patients with pulmonary vascular disease (SV-PVD) are considered poor surgical candidates for Glenn or Fontan palliation. Given limited options for Stage 1 (S1) and Stage 2 (S2) SV patients with SV-PVD, we report on the use of subcutaneous treprostinil (TRE) to treat SV-PVD in this population. This single-center, retrospective cohort study examined SV patients who were not candidates for subsequent surgical palliation due to SV-PVD and were treated with TRE. The primary outcome was ability to progress to the next surgical stage; secondary outcomes included changes in hemodynamics after TRE initiation. Between 3/2014 and 8/2021, 17 SV patients received TRE for SV-PVD: 11 after S1 and 6 after S2 (median PVR 4.1 [IQR 3.2-4.8] WU*m2 and 5.0 [IQR 1.5-6.1] WU*m2, respectively). Nine of 11 (82%) S1 progressed to S2, and 2 (18%) underwent heart transplant (HTx). Three of 6 (50%) S2 progressed to Fontan, 1 underwent HTx and 2 are awaiting Fontan on TRE. TRE significantly decreased PVR in S1 patients with median post-treatment PVR of 2.0 (IQR 1.5-2.6) WU*m2. TRE can allow for further surgical palliation in select pre-Fontan patients with SV-PVD, obviating the need for HTx. Improvement in PVR was significant in S1 patients and persisted beyond discontinuation of therapy for most patients.

The Prognostic Role of Polysomnography Parameters in Heart Failure Patients with Previous Decompensation.

Background: Sleep-disordered breathing (SDB) is a widespread comorbidity in patients with chronic heart failure (HF) and may have a deleterious effect on the pathogenesis of HF. We aimed to evaluate the prognostic role of polysomnography parameters in HF patients with previous decompensation. Methods: 123 patients were included in the prospective cohort study. In addition to the standard examination, all patients underwent polysomnography (PSG). Results: The Kaplan–Meier analysis showed the incidence of the combined endpoint differs between LVEF categories ≤25.5% vs. >25.5% (χ2 = 9.6, log rank p = 0.002), NTpro-BNP > 680 vs. ≤680 pg/mL (χ2 = 12.7, log rank p = 0.001), VO2peak categories <16 vs. ≥16 mL/min/kg (χ2 = 14.2, log rank p = 0.001), VE/VCO2 slope ≥38.5 vs. <38.5 (χ2 = 14.5, log rank p = 0.001), wake after sleep onset >40 min vs. ≤40 min (χ2 = 9.7, log rank p = 0.03), and sleep stage 2 (S2) <44% vs. ≥44% (χ2 = 12.4, log rank p = 0.001). Conclusion: Among the PSG parameters, WASO > 40 min and S2 < 44% were associated with a combined endpoint in patients with previous decompensation of HF. Moreover, higher NT-proBNP and VE/VCO2 slope, lower LVEF, and VO2peak were also independent factors of a poor prognosis.

Gene regulation network analyses of pistil development in papaya

BackgroundThe pistil is an essential part of flowers that functions in the differentiation of the sexes and reproduction in plants. The stigma on the pistil can accept pollen to allow fertilization and seed development. Papaya (Carica papaya L.) is a dioecious plant, where female flowers exhibit normal pistil, while the male flowers exhibit aborted pistil at a late stage of pistil development.ResultsThe developmental stages of papaya pistil were analyzed after first dividing it into slices representing the primordium stage 1 (S1), the pre-meiotic stages S2, post-meiotic stage S3, and the mitotic stage S4. The SS scoring algorithm analysis of genes preferentially expressed at different stages revealed differentially expressed genes between male and female flowers. A transcription factor regulatory network for each stage based on the genes that are differentially expressed between male and female flowers was constructed. Some transcription factors related to pistil development were revealed based on the analysis of regulatory networks such as CpAGL11, CpHEC2, and CpSUPL. Based on the specific expression of genes, constructed a gene regulatory subnetwork with CpAGL11-CpSUPL-CpHEC2 functioning as the core. Analysis of the functionally enriched terms in this network reveals several differentially expressed genes related to auxin/ brassinosteroid signal transduction in the plant hormone signal transduction pathway. At the same time, significant differences in the expression of auxin and brassinosteroid synthesis-related genes between male and female flowers at different developmental stages were detected.ConclusionsThe pistil abortion of papaya might be caused by the lack of expression or decreased expression of some transcription factors and hormone-related genes, affecting hormone signal transduction or hormone biosynthesis. Analysis of aborted and normally developing pistil in papaya provided new insights into the molecular mechanism of pistil development and sex differentiation in dioecious papaya.

Characterization and profiling analysis of bovine oviduct and uterine extracellular vesicles and their miRNA cargo through the estrous cycle.

Extracellular vesicles (EVs) found in various biological fluids and particularly in reproductive fluids, have gained considerable attention for their possible role in cell- to- cell communication. Among, the different bioactive molecules cargos of EVs, MicroRNAs (miRNAs) are emerging as promising diagnostic biomarkers with high clinical potential. Aiming to understand the roles of EVs in bovine reproductive tract, we intended to characterize and profile the EVs of oviduct and uterine fluids (OF-EVs, UF-EVs) and their miRNA across the estrous cycle. Nanoparticle tracking analysis and transmission electron microscopy confirmed the existence of small EV population in OF and UF at all stages, (size between 30 and 200nm; concentration: 3.4×1010 EVs/ml and 6.0×1010 EVs/ml for OF and UF, respectively, regardless of stage). The identification of EV markers (CD9, HSP70, and ALIX proteins) was confirmed by western blot. The miRNA analysis revealed the abundance of 310 and 351 miRNAs in OF-EVs and UF-EVs, respectively. Nine miRNAs were differentially abundant in OF-EVs between stages of the cycle, eight of them displayed a progressive increase from S1 to S4 (p<.05). In UF-EVs, a total of 14 miRNAs were differentially abundant between stages. Greater differences were observed between stage 1 (S1) and stage 3 (S3), with 11 miRNAs enriched in S3 compared to S1. Functional enrichment analysis revealed the involvement of these miRNAs in relevant pathways such as cell signaling, intercellular junctions, and reproductive functions that may be implicated in oviduct and uterus modulation across the cycle, but also in their preparation for embryo/conceptus presence and development.

Thoracic Aortic Calcification and Pre-Clinical Hypertension by New 2017 ACC/AHA Hypertension Guidelines.

The recently revised 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension (HTN) guidelines employ a lower blood pressure threshold to define HTN, aiming for earlier prevention of HTN-related cardiovascular diseases (CVD). Thoracic aortic calcification (TAC), a new surrogate marker of aging and aortic medial layer degeneration, and different stages of HTN, according to the 2017 ACC/AHA HTN guidelines, remain unknown. We classified 3022 consecutive asymptomatic individuals enrolled into four HTN categories using the revised 2017 ACC/AHA guidelines: normal blood pressure (NBP), elevated blood pressure (EBP), and stage 1 (S1) and stage 2 (S2) HTN. The coronary artery calcification score and TAC metrics (total Agaston TAC score, total plaque volume (mm3), and mean density (Hounsfield units, HU)) were measured using multi-detector computed tomography. Compared to NBP, a graded and significant increase in the TAC metrics was observed starting from EBP and S1 and S2 HTN, using the new 2017 ACC/AHA guidelines (NBP as reference; all trends: p < 0.001). These differences remained consistent after being fully adjusted. Older age (>50 years), S1 and S2 HTN, prevalent diabetes, and chronic kidney disease (<60 mL/min/1.73 m2) are all independently contributing factors to higher TAC risk using multivariate stepwise logistic regressions (all p ≤ 0.001). The optimal cutoff values of systolic blood pressure, diastolic blood pressure, and pulse pressure were 121, 74, and 45 mmHg, respectively, for the presence of TAC after excluding subjects with known CVD and ongoing HTN medication treatment. Our data showed that the presence of TAC starts at a stage of elevated blood pressure not categorized as HTN from the updated 2017 ACC/AHA hypertension guidelines.