Publications by authors named "Chang Su"

560 Publications

Multi-Trajectories of Macronutrient Intake and Their Associations with Obesity among Chinese Adults from 1991 to 2018: A Prospective Study.

Nutrients 2021 Dec 21;14(1). Epub 2021 Dec 21.

Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing 100050, China.

Studies on macronutrient intake and obesity have been inconclusive. This study examined the associations between multi-trajectories of macronutrients and the risk of obesity in China. We used data from 7914 adults who participated in the China Health and Nutrition Survey at least three times from 1991 to 2018. We collected detailed dietary data by conducting three 24 h dietary recalls and weighing foods and condiments in household inventories. We identified multi-trajectories using group-based multi-trajectory models and examined their associations with the risk of obesity with multiple Cox regression models. We found four multi-trajectories in rural areas: balanced macronutrient intake (BM), moderate protein, increasing low fat, and decreasing high carbohydrate (MP&ILF&DHC); decreasing moderate protein, decreasing high fat, and increasing moderate carbohydrate (DMP&DHF&IMC); increasing moderate protein, increasing high fat, and decreasing low carbohydrate (IMP&IHF&DLC)-35.1%, 21.3%, 20.1%, and 23.5% of our rural participant population, respectively. Compared with the BM trajectory, the hazard ratios of obesity in the DMP&DHF&IMC and the IMP&IHF&DLC groups were 0.50 (95% confidence interval (CI): 0.27-0.95) and 0.48 (95% CI: 0.28-0.83), respectively, in rural participants. Relatively low carbohydrate and high fat intakes with complementary dynamic trends are associated with a lower risk of obesity in rural Chinese adults.
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http://dx.doi.org/10.3390/nu14010013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746800PMC
December 2021

Clinical Characteristics, Disease Course, and Outcomes of Patients With Acute Generalized Exanthematous Pustulosis in the US.

JAMA Dermatol 2022 Jan 5. Epub 2022 Jan 5.

Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.

Importance: Acute generalized exanthematous pustulosis (AGEP) is a rare, severe cutaneous adverse reaction associated with systemic complications. Currently available data are largely limited to small retrospective case series.

Objective: To describe the clinical characteristics, disease course, and outcomes of a heterogeneous group of patients with AGEP across the US.

Design, Setting, And Participants: A retrospective review of a case series of patients was conducted from January 1, 2000, through July 31, 2020. All 340 included cases throughout 10 academic health systems in the US were scored retrospectively using the EuroSCAR scoring system, and patients with a score corresponding to probable or definite AGEP and aged 18 years or older were included.

Main Outcomes And Measures: Patient demographic characteristics, clinical course, suspected causative agent, treatment, and short- and long-term outcomes.

Results: Most of the 340 included patients were women (214 [62.9%]), White (206 [60.6%]), and non-Hispanic (239 [70.3%]); mean (SD) age was 57.8 (17.4) years. A total of 154 of 310 patients (49.7%) had a temperature greater than or equal to 38.0 °C that lasted for a median of 2 (IQR, 1-4) days. Of 309 patients, 263 (85.1%) developed absolute neutrophilia and 161 patients (52.1%) developed either absolute or relative eosinophilia. Suspected causes of AGEP were medications (291 [85.6%]), intravenous contrast agents (7 [2.1%]), infection (3 [0.9%]), or unknown (39 [11.5%]). In 151 cases in which a single medication was identified, 63 (41.7%) were β-lactam antimicrobials, 51 (33.8%) were non-β-lactam antimicrobials, 9 (6.0%) were anticonvulsants, and 5 (3.3%) were calcium channel blockers. The median time from medication initiation to AGEP start date was 3 (IQR, 1-9) days. Twenty-five of 298 patients (8.4%) had an acute elevation of aspartate aminotransferase and alanine aminotransferase levels, with a peak at 6 (IQR, 3-9) days. Twenty-five of 319 patients (7.8%) experienced acute kidney insufficiency, with the median time to peak creatinine level being 4 (IQR, 2-5) days after the AGEP start date. Treatments included topical corticosteroids (277 [81.5%], either alone or in combination), systemic corticosteroids (109 [32.1%]), cyclosporine (10 [2.9%]), or supportive care only (36 [10.6%]). All-cause mortality within 30 days was 3.5% (n = 12), none of which was suspected to be due to AGEP.

Conclusions And Relevance: This retrospective case series evaluation of 340 patients, the largest known study cohort to date, suggests that AGEP onset is acute, is usually triggered by recent exposure to an antimicrobial, may be associated with liver or kidney complications in a minority of patients, and that discontinuation of the triggering treatment may lead to improvement or resolution.
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http://dx.doi.org/10.1001/jamadermatol.2021.5390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733866PMC
January 2022

Evaluation of Albumin Kinetics in Critically Ill Patients With Coronavirus Disease 2019 Compared to Those With Sepsis-Induced Acute Respiratory Distress Syndrome.

Crit Care Explor 2021 Dec 2;3(12):e0589. Epub 2021 Dec 2.

Department of Medicine, New York-Presbyterian Hospital-Weill Cornell Medical Center, Weill Cornell Medicine, New York, NY.

Objectives: This report aims to characterize the kinetics of serum albumin in critically ill patients with coronavirus disease 2019 compared with critically ill patients with sepsis-induced acute respiratory distress syndrome.

Design: Retrospective analysis.

Setting: We analyzed two critically ill cohorts, one with coronavirus disease 2019 and another with sepsis-induced acute respiratory distress syndrome, treated in the New York Presbyterian Hospital-Weill Cornell Medical Center.

Patients: Adult patients in the coronavirus disease 2019 cohort, diagnosed through reverse transcriptase-polymerase chain reaction assays performed on nasopharyngeal swabs, were admitted from March 3, 2020, to July 10, 2020. Adult patients in the sepsis-induced acute respiratory distress syndrome cohort, defined by Sepsis III criteria receipt of invasive mechanical ventilation and a Pao/Fio ratio less than 300 were admitted from December 12, 2006, to February 26, 2019.

Interventions: None.

Measurements And Main Results: We evaluated serial serum albumin levels within 30 days after ICU admission in each cohort. We then examined the albumin progression trajectories, aligned at ICU admission time to test the relationship at a similar point in disease progression, in survivors and nonsurvivors. Albumin trajectory in all critically ill coronavirus disease 2019 patients show two distinct phases: phase I (deterioration) showing rapid albumin loss and phase II (recovery) showing albumin stabilization or improvement. Meanwhile, albumin recovery predicted clinical improvement in critical coronavirus disease 2019. In addition, we found a deterioration and recovery trends in survivors in the sepsis-induced acute respiratory distress syndrome cohort but did not find such two-phase trend in nonsurvivors.

Conclusions: The changes in albumin associated with coronavirus disease 2019 associated respiratory failure are transient compared with sepsis-associated acute respiratory distress syndrome and highlight the potential for recovery following a protracted course of severe coronavirus disease 2019.
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http://dx.doi.org/10.1097/CCE.0000000000000589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718234PMC
December 2021

Time-resolved, Cardiac-gated Computed Tomography after Endovascular Ascending Aortic and Arch Repair.

Ann Thorac Surg 2021 Dec 28. Epub 2021 Dec 28.

Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA.

Purpose: Better time-resolved imaging of stent grafts in ascending aorta and arch accounting for cardiac motion is necessary to understand device-related complications and endoleaks. We describe a novel dynamic time-resolved computed tomography-angiography (d-CTA) and its combination with electrocardiography-gating (d-gated-CTA) to image stent grafts in ascending aorta and to better characterize endoleaks.

Description: d-CTA involves multiple scans acquired at different timepoints along contrast enhancement curve. d-gated-CTA involves concomitant electrocardiography-gating in a pre-defined cardiac phase minimizing motion induced artifacts.

Evaluation: We illustrate the utility of d-CTA and d-gated-CTA in two clinical scenarios. d-CTA demonstrated type 1A endoleak in a patient with aortic arch aneurysm treated by total arch debranching and thoracic stent graft. d-gated-CTA demonstrated type 1A endoleak in a patient with ascending aortic pseudo-aneurysm treated by aortic cuff placement.

Conclusions: Dynamic, cardiac-gated CTA enables time-resolved angiographic imaging of ascending aorta and arch without any cardiac motion related artifacts. Such advanced imaging techniques help with better characterization of endoleaks after stent-graft deployment in the ascending aorta and arch.
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http://dx.doi.org/10.1016/j.athoracsur.2021.11.054DOI Listing
December 2021

Amino Acids and Lipids Associated with Long-Term and Short-Term Red Meat Consumption in the Chinese Population: An Untargeted Metabolomics Study.

Nutrients 2021 Dec 20;13(12). Epub 2021 Dec 20.

Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

Red meat (RM) consumption is correlated with multiple health outcomes. This study aims to identify potential biomarkers of RM consumption in the Chinese population and evaluate their predictive ability. We selected 500 adults who participated in the 2015 China Health and Nutrition Survey and examined their overall metabolome differences by RM consumption by using elastic-net regression, then evaluate the predictivity of a combination of filtered metabolites; 1108 metabolites were detected. In the long-term RM consumption analysis 12,13-DiHOME, androstenediol (3α, 17α) monosulfate 2, and gamma-Glutamyl-2-aminobutyrate were positively associated, 2-naphthol sulfate and S-methylcysteine were negatively associated with long-term high RM consumption, the combination of metabolites prediction model evaluated by area under the receiver operating characteristic curve (AUC) was 70.4% (95% CI: 59.9-80.9%). In the short-term RM consumption analysis, asparagine, 4-hydroxyproline, and 3-hydroxyisobutyrate were positively associated, behenoyl sphingomyelin (d18:1/22:0) was negatively associated with short-term high RM consumption. Combination prediction model AUC was 75.6% (95% CI: 65.5-85.6%). We identified 10 and 11 serum metabolites that differed according to LT and ST RM consumption which mainly involved branch-chained amino acids, arginine and proline, urea cycle and polyunsaturated fatty acid metabolism. These metabolites may become a mediator of some chronic diseases among high RM consumers and provide new evidence for RM biomarkers.
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http://dx.doi.org/10.3390/nu13124567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709332PMC
December 2021

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging.

J Vis Exp 2021 Dec 9(178). Epub 2021 Dec 9.

Department of Cardiovascular Surgery, Houston Methodist Hospital.

In the United States, more than 80% of all abdominal aortic aneurysms are treated by endovascular aortic aneurysm repair (EVAR). The endovascular approach warrants good early results, but adequate follow-up imaging after EVAR is imperative to maintain long-term positive outcomes. Potential graft-related complications are graft migration, infection, fraction, and endoleaks, with the last one being the most common. The most frequently used imaging after EVAR is computed tomography angiography (CTA) and duplex ultrasound. Dynamic, time-resolved computed tomography angiography (d-CTA) is a reasonably new technique to characterize the endoleaks. Multiple scans are done sequentially around the endograft during acquisition that grants good visualization of the contrast passage and graft-related complications. This high diagnostic accuracy of d-CTA can be implemented into therapy via image fusion and reduce additional radiation and contrast material exposure. This protocol describes the technical aspects of this modality: patient selection, preliminary image review, d-CTA scan acquisition, image processing, qualitative and quantitative endoleak characterization. The steps of integrating dynamic CTA into intra-operative fluoroscopy using 2D-3D fusion-imaging to facilitate targeted embolization are also demonstrated. In conclusion, time-resolved, dynamic CTA is an ideal modality for endoleak characterization with additional quantitative analysis. It can reduce radiation and iodinated contrast material exposure during endoleak treatment by guiding interventions.
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http://dx.doi.org/10.3791/62958DOI Listing
December 2021

Four-Way Decomposition of Effect of Alcohol Consumption and Body Mass Index on Lipid Profile.

Int J Environ Res Public Health 2021 12 15;18(24). Epub 2021 Dec 15.

Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.

Both obesity and alcohol consumption are strongly associated with dyslipidemia; however, it remains unclear whether their joint effect on lipid profiles is through mediation, interaction, or a combination of the two. In total, 9849 subjects were selected from the 2009 panel of China Health and Nutrition Survey (CHNS). A four-way decomposition method was used to validate the pathways of drinking and body mass index (BMI) on lipids (total cholesterol, TC; triglyceride, TG; low-density lipoprotein cholesterol, LDL-C; high-density lipoprotein cholesterol, HDL-C; apolipoprotein A, APO-A; and apolipoprotein B, APO-B). According to four-way decomposition, the total effects of drinking on lipids were found to be statistically significant, except for LDL-C. The components due to reference interaction were 0.63, 0.48, 0.60, -0.39, -0.30, and 0.20 for TC, TG, LDL-C, HDL-C, APO-A and APO-B, respectively ( < 0.05 for all). The effect size of pure indirect effect and mediated interaction were 0.001~0.006 ( > 0.05 for all). Further, linear regression models were used to examine the effect of BMI on lipid profiles in drinkers and non-drinkers. The associations of BMI and lipids were higher in all drinkers than in non-drinkers (0.069 versus 0.048 for TC, 0.079 versus 0.059 for TG, 0.057 versus 0.037 for LDL-C, -0.045 versus -0.029 for HDL-C, -0.024 versus -0.011 for APO-A and 0.026 versus 0.019 for APO-B, interaction <0.05 for all). The joint effect of alcohol consumption and obesity on lipid profiles is through interaction rather than mediation. Alcohol consumption amplifies the harmful effect of BMI on lipid profiles. Greater attention should be paid to lipid health and cardiovascular risk in obese individuals regarding alcohol consumption. For obese individuals, we do not recommend alcohol consumption.
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http://dx.doi.org/10.3390/ijerph182413211DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8701985PMC
December 2021

Dynamic Contrast-Enhanced Ultrasonography with Sonazoid for Diagnosis of Microvascular Invasion in Hepatocellular Carcinoma.

Ultrasound Med Biol 2021 Dec 18. Epub 2021 Dec 18.

Department of Ultrasound, Hepatology, and Pathology, Harbin Medical University Cancer Hospital, Nangang District, Harbin, PR China. Electronic address:

The aim of the present study was to investigate the imaging features observed in pre-operative Sonazoid contrast-enhanced ultrasound (SZ-CEUS) and the correlations with the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. In this single-center retrospective study, 31 patients with surgically and histopathologically confirmed HCC lesions were included. Patients were classified according to the presence of MVI into the MVI-positive group (n = 15) and MVI-negative group (n = 16). The CEUS examinations were performed within 2 or 3 d before surgery. Features, including tumor necrosis and ultrasound contrast agent (UCA) distribution characteristics in the arterial phase (AP), tumor types (single nodular [SN] or non-single nodular [non-SN]) in the post-vascular phase (PVP), wash-in time, wash-in slope, time to peak (TTP) and peak intensity (PI), were assessed. Univariate analysis revealed statistically significant differences between the two groups with respect to tumor necrosis (p = 0.002), inhomogeneous distribution of contrast agent in the AP (p = 0.001) and non-SN type in the PVP (p < 0.001). There was no significant difference in the quantitative parameters. Multivariate analysis revealed that non-SN type in the PVP was a significant independent risk factor for MVI of HCC (odds ratio = 30.51, 95% confidence interval [CI]: 2.335-398.731, p = 0.009). The area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 0.873, 93.3%, 81.3%, 82.4% and 92.9%, respectively. Thus, SZ-CEUS can provide useful information for the diagnosis of MVI in HCC.
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http://dx.doi.org/10.1016/j.ultrasmedbio.2021.11.005DOI Listing
December 2021

Chemical compositions and bioactivities of essential oil from perilla leaf (Perillae Folium) obtained by ultrasonic-assisted hydro-distillation with natural deep eutectic solvents.

Food Chem 2022 May 13;375:131834. Epub 2021 Dec 13.

School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, China. Electronic address:

Natural deep eutectic solvents (NADESs) have received considerable attention for green extraction. In this study, ultrasonic-assisted natural deep eutectics were applied for hydrodistillation to extract essential oil from perilla leaves. Compared to hydrodistillation assisted with ultrasound, this novel method effectively raised the yield of perilla leaf EO from 0.21% to 0.69% (choline chloride: malic acid, molar ratio 2:1) and broadened the types of chemical compositions (71 in total), especially aliphatic and aromatic compounds. Stronger antimicrobial and antioxidant activity was confirmed, and phenolics were increased. Additionally, the pH of the final solution was detected. The leaf residues were dried, weighed and analyzed by scanning electron microscopy to show the influence of NADESs' strong extractability. This new extraction method may be applicable in edible natural product extraction and provide a reference for further exploration of NADESs.
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http://dx.doi.org/10.1016/j.foodchem.2021.131834DOI Listing
May 2022

Emerging Roles on Immunological Effect of Indoleamine 2,3-Dioxygenase in Liver Injuries.

Front Med (Lausanne) 2021 18;8:756435. Epub 2021 Nov 18.

New Drug Screening Center, Jiangsu Center for Pharmacodynamics Research and Evaluation, China Pharmaceutical University, Nanjing, China.

Indoleamine 2,3-dioxygenase (IDO) is one of the initial rate-limiting enzymes of the kynurenine pathway (KP), which causes immune suppression and induction of T cell anergy. It is associated with the imbalance of immune homeostasis in numerous diseases including cancer, chronic viral infection, allergy, and autoimmune diseases. Recently, IDO has extended its role to liver field. In this review, we summarize the dysregulation and potentials of IDO in the emerging field of liver injuries, as well as current challenges for IDO targets. In particular, we discuss unexpected conclusions against previous work published. IDO is induced by pro-inflammatory cytokines in liver dysfunction and exerts an immunosuppressive effect, whereas the improvement of liver injury may require consideration of multiple factors besides IDO.
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http://dx.doi.org/10.3389/fmed.2021.756435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636938PMC
November 2021

Emerging Roles on Immunological Effect of Indoleamine 2,3-Dioxygenase in Liver Injuries.

Front Med (Lausanne) 2021 18;8:756435. Epub 2021 Nov 18.

New Drug Screening Center, Jiangsu Center for Pharmacodynamics Research and Evaluation, China Pharmaceutical University, Nanjing, China.

Indoleamine 2,3-dioxygenase (IDO) is one of the initial rate-limiting enzymes of the kynurenine pathway (KP), which causes immune suppression and induction of T cell anergy. It is associated with the imbalance of immune homeostasis in numerous diseases including cancer, chronic viral infection, allergy, and autoimmune diseases. Recently, IDO has extended its role to liver field. In this review, we summarize the dysregulation and potentials of IDO in the emerging field of liver injuries, as well as current challenges for IDO targets. In particular, we discuss unexpected conclusions against previous work published. IDO is induced by pro-inflammatory cytokines in liver dysfunction and exerts an immunosuppressive effect, whereas the improvement of liver injury may require consideration of multiple factors besides IDO.
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http://dx.doi.org/10.3389/fmed.2021.756435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636938PMC
November 2021

Auricular acupressure for adverse events following immunization related to COVID-19 vaccine injection: study protocol for a multicenter, three-arm, blinded randomized controlled trial.

Trials 2021 Nov 27;22(1):857. Epub 2021 Nov 27.

Hospital of Chengdu university of Traditional Chinese Medicine, Chengdu university of Traditional Chinese Medicine, Chengdu, 610075, China.

Background: Some pain, fatigue, and gastrointestinal adverse events were observed in potential association with injection of COVID-19 vaccines, while there was no preventive intervention for it. We aim to investigate the efficacy of auricular acupressure (AA) therapy in preventing and relieving AEFI after injection of COVID-19 vaccine.

Methods: The study design is a randomized, multicentre, three-arm controlled, single-blind trial. Participants meeting the inclusion criteria will be advertised and enrolled and assigned in the medical institutions randomly for post-injection observation. No less than 360 participants will be randomized into one of three groups: auricular acupressure group, sham auricular acupressure group, and wait-list group. Interventions will be performed immediately and will happen 4 to 5 times per day for 5 days. The primary clinical outcomes will be quality and quantity evaluation among participants who reported any AEFI and who reported local pain at injection site. Secondary outcomes will concern headache, muscle and (or) joint pain, fatigue, nausea, vomiting, diarrhoea, and other potential events. All the outcomes will be assessed at baseline and 1, 3, 5, 7, and 14 days after the injection. Both intention-to-treat and per-protocol analyses will be performed, with significance level determined as 5%.

Discussion: Results of this trial will help to clarify the value of auricular acupressure therapy in preventing and relieving overall and certain adverse events following immunization after injection of COVID-19 vaccine.

Trial Registration: China Clinical Trial Registry (ChiCTR) ( ChiCTR2100043210 ). Registered on 8 February, 2021.
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http://dx.doi.org/10.1186/s13063-021-05837-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626745PMC
November 2021

Trajectories of energy intake distribution and subsequent risk of hyperglycemia among Chinese adults: findings from the China Health and Nutrition Survey (1997-2018).

Eur J Nutr 2021 Nov 27. Epub 2021 Nov 27.

Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, 100050, China.

Aims: Few studies have examined the secular trend of the energy intake distribution, and its effect on future risk of hyperglycemia. This study aims to describe trajectories of energy intake distribution over 12 years and relate them to subsequent risk of hyperglycemia over 9 years of follow-up.

Methods: Our study used ten waves of data from the CHNS survey, a population-based longitudinal survey in China, ongoing since 1989. We examined a cohort of adult participants who were free from diabetes but had at least three waves of dietary data from 1997 to 2009. We assessed energy intake using three consecutive 24 h recalls. We used these data to identify trajectory groups of energy intake distribution by multi-trajectory model based on energy intake proportions of breakfast, lunch, and dinner. We followed up participants for hyperglycemia, diabetes, and impaired fasting glucose for 9 years from 2009 to 2018. Outcomes were ascertained with fasting glucose, serum HbA1c, and self-report of diabetes and/or glucose-lowering medication. We estimated relative risk (RR) for hyperglycemia, diabetes, and impaired fasting glucose by identified trajectory groups using multilevel mixed-effects modified Poisson regression with robust (sandwich) estimation of variance. Gender difference was additionally examined.

Results: A total of 4417 participants were included. Four trajectory groups were identified, characterized and labeled by "Energy evenly distributed with steady trend group" (Group 1), "Dinner and lunch energy dominant with relatively steady trend group" (Group 2), "Dinner energy dominant with increasing trend and breakfast energy with declining trend group" (Group 3), and "breakfast and dinner energy dominant with increasing trend group" (Group 4). During 48,091 person-years, 1053 cases of incident hyperglycemia occurred, 537 cases of incident diabetes occurred, and 516 cases of impaired fasting glucose occurred. Compared with Group 1, Group 3 was associated with higher subsequent risk of incident hyperglycemia in 9 years of follow-up (RR = 1.28, 95% CI = 1.02, 1.61). No association was found for incident diabetes and impaired fasting glucose. Among males, Group 3 was associated with higher risk of incident hyperglycemia in 9 years of follow-up (RR = 1.44, 95% CI = 1.07, 1.94). No relationship was found in females.

Conclusions: Energy intake distribution characterized by over 40% of energy intake from dinner with a rising trend over years was associated with higher long-term risk of hyperglycemia in Chinese adults.
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http://dx.doi.org/10.1007/s00394-021-02745-3DOI Listing
November 2021

A combination of bioinformatics analysis and rational design strategies to enhance keratinase thermostability for efficient biodegradation of feathers.

Sci Total Environ 2021 Nov 20:151824. Epub 2021 Nov 20.

Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Pharmaceutical Sciences, Jiangnan University, Wuxi 214122, PR China. Electronic address:

Keratinase has shown great significance and application potentials in the biodegradation and recycle of keratin waste due to its unique and efficient hydrolysis ability. However, the inherent instability of the enzyme limits its practical utilization. Herein, we obtained a thermostability-enhanced keratinase based on a combination of bioinformatics analysis and rational design strategies for the efficient biodegradation of feathers. A systematical in silico analysis combined with filtering of virtual libraries derived a smart library for experimental validation. Synergistic mutations around the highly flexible loop, the calcium binding site and the non-consensus amino acids generated a dominant mutant which increased the optimal temperature of keratinase from 40 °C to 60 °C, and the half-life at 60 °C was increased from 17.3 min to 66.1 min. The mutant could achieve more than 66% biodegradation of 50 g/L feathers to high-valued keratin product with a major molecular weight of 36 kDa. Collectively, this work provided a promising keratinase variant with enhanced thermostability for efficient conversion of keratin wastes to valuable products. It also generated a general strategy to facilitate enzyme thermostability design which is more targeted and predictable.
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http://dx.doi.org/10.1016/j.scitotenv.2021.151824DOI Listing
November 2021

Associations Between Sleep Duration, Wake-Up Time, Bedtime, and Abdominal Obesity: Results From 9559 Chinese Children Aged 7-18 Years.

Front Endocrinol (Lausanne) 2021 14;12:735952. Epub 2021 Oct 14.

Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Objective: To investigate the associations of sleep duration, wake-up time, bedtime, and childhood abdominal obesity, and to test whether there is a weekday/weekend difference and the potential modifying role of sex.

Methods: This cross-sectional study was based on the Students' Constitution and Health Survey and included 9559 students (4840 boys and 4719 girls) aged 7-18 years (7227 aged 7-12 years, 2332 aged 13-18 years). They were divided into two groups (control group and group with abdominal obesity). The physical measurements included children and youth body height, body weight, and waist circumference (WC). A parent-report questionnaire was used to collect the information about parent characteristics as well as lifestyle and sleep patterns (sleep duration, bedtime, and wake-up time of weekdays and weekends) of children and youth.

Results: The prevalence of abdominal obesity was 30.57% and the percentages of sleep duration <9 hours/day, wake-up time before 07:00 am on weekdays and weekends, bedtime after 10:00 pm on weekends were significantly higher in the group with abdominal obesity. After adjusting for confounders, sleep duration <9 hours/day on weekends was inversely related to abdominal obesity in the overall subjects, regardless of their sex and age, while bedtime after 10:00 pm on weekends was inversely related to abdominal obesity only in the overall subjects, boys, and children aged 7-12 years. Logistic regression models in all subjects showed that shorter hours of weekends sleep duration were associated with greater risks of abdominal obesity, even after adjusting for all confounders, including wake-up time and bedtime. The adjusted odds ratios and 95% confidence intervals of abdominal obesity (with ≥10 hours/day as the reference group) for children with 9-10 hours/day, 8-9 hours/day, and <8 hours/day of weekend sleep duration were 1.23 (1.04-1.46), 1.59 (1.32-1.91) and 1.83 (1.42-2.36), respectively. Specifically, after stratification by sex and age, this phenomenon was only observed in boys and children aged 7-12 years.

Conclusions: Sleep duration and bedtime on weekends were independently associated with the risk of childhood abdominal obesity, particularly in boys and children aged 7-12 years.
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http://dx.doi.org/10.3389/fendo.2021.735952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552807PMC
October 2021

AI for COVID-19: Battling the pandemic with computational intelligence.

Intell Med 2021 Oct 21. Epub 2021 Oct 21.

Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York 10065, United States.

The new coronavirus disease 2019 (COVID-19) has become a global pandemic leading to over 180 million confirmed cases and nearly 4 million deaths until June, 2021, according to the World Health Organization. Since the initial reported from December 2019 in Wuhan, China, COVID-19 has demonstrated a high transmission rate (with a R0 > 2), a diverse set of clinical characteristics (e.g., high rate of hospital and intensive care unit admission rates, multi-organ dysfunction for critically ill patients due to hyperinflammation, thrombosis, etc.), and tremendous burden on health care systems around the world. To understand the serious and complex disease and develop effective control, treatment, and prevention strategies, researchers from different disciplines have been making significant efforts from different aspects including epidemiology and public health, biology and genomic medicine, as well as clinical care and patient management. In recent years, artificial intelligence (AI) has been introduced into the healthcare field to aid clinical decision-making for disease diagnosis and treatment such as detecting cancer based on medical images and has achieved superior performance in multiple data-rich application scenarios. In the COVID-19 pandemic, AI techniques have also been used as a powerful tool to overcome the complex disease. In this context, the goal of this study is to review existing studies on applications of AI techniques in combating the COVID-19 pandemic. Specifically, these efforts can be grouped into the fields of epidemiology, therapeutics, clinical research, social and behavioral studies and are summarized. Potential challenges, directions, and open questions are discussed accordingly, which may provide new insights into addressing COVID-19 pandemic and would be helpful for researchers to explore more related topics in the post-pandemic era.
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http://dx.doi.org/10.1016/j.imed.2021.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529224PMC
October 2021

Trajectories of Energy Intake Distribution and Risk of Dyslipidemia: Findings from the China Health and Nutrition Survey (1991-2018).

Nutrients 2021 Oct 1;13(10). Epub 2021 Oct 1.

Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing 100050, China.

Few studies have examined the secular trend of energy intake distribution. This study aims to describe trajectories of energy intake distribution and determine their association with dyslipidemia risk. Data of 2843 adult participants from the China Health and Nutrition Survey (CHNS) were analyzed. Trajectory groups of energy intake distribution were identified by multi-trajectory model over 27 years. Multilevel mixed-effects modified Poisson regression with robust estimation of variance was used to calculate risk ratio for incident dyslipidemia in a 9-year follow-up. Four trajectory groups were identified: "Energy evenly distributed group" (Group 1), "Lunch and dinner energy dominant group" (Group 2), "Dinner energy dominant group" (Group 3), "breakfast and dinner energy dominant group" (Group 4). Compared with Group 1, Group 3 was associated with higher risk of dyslipidemia (RR = 1.48, 95% CI = 1.26, 1.75), hypercholesterolemia (RR = 1.96, 95% CI = 1.37, 2.81) and high low-density lipoproteins cholesterols (LDL-C) (RR = 2.41, 95% CI = 1.82, 3.20). A U-shape was observed between cumulative average proportion of dinner energy and dyslipidemia risk ( for non-linear = 0.01), with stronger relationship at 40% and above. Energy intake distribution characterized by higher proportion of dinner energy, especially over 40% was associated with higher dyslipidemia risk in Chinese adults.
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http://dx.doi.org/10.3390/nu13103488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8538511PMC
October 2021

miR-488-5p promotes esophageal squamous cell carcinoma progression by suppressing the P53 pathway.

J Thorac Dis 2021 Sep;13(9):5534-5545

Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University, Shijiazhuang, China.

Background: miR-488-3p has been reported to play an important role in cancer progression and metastasis. The protein 53 (P53) gene serves as a mediator and biomarker of esophageal squamous cell carcinoma (ESCC). However, the molecular mechanism underlying miR-488-5p in the pathology of ESCC through the P53 pathway has not been examined.

Methods: The expression levels of miR-488-5p were determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cytological experiments were performed to evaluate the biological functions of miR-488-5p. A bioinformatics analysis was performed to determine the pathways and key miR-488-5p targets associated with ESCC. Correlations between miR-488-5p and P53 signaling pathways were validated by western blotting and the dual luciferase reporter gene system. Finally, the expression level of miR-488-5p was regulated and tumor formation experiments were performed in nude mice.

Results: The qRT-PCR analysis showed that MiR-488-5p expression was more upregulated in the KYSE-150 group than the HEEC group. In the KYSE-150 cells, the colony formation assay and flow cytometry analysis indicated that the miR-488-5p inhibitor inhibited cell viability and increased cell apoptosis; however, these effects were recovered by P53 knockdown (KD). In addition, cell invasion and cell migration were inhibited by the miR-488-5p inhibitor, but were also improved by P53 KD. Similarly, the miR-488-5p inhibitor induced the expression of P53 and P21 than normal control (NC) group in which miR-488-5p expression was normal, while P53 KD prevented the effects of the miR-488-5p inhibitor in KYSE-150 cells. Additionally, we found that tumor size was obviously smaller in miR-488-5p overexpression (OE)+ P53 OE mice than miR-488-5p OE mice. Hematoxylin and eosin and immunohistochemistry staining also revealed similar results.

Conclusions: Our results suggest that miR-488-5p promotes ESCC progression by suppressing the P53 pathway. These findings should provide novel ideas for ESCC therapies.
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http://dx.doi.org/10.21037/jtd-21-1448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482336PMC
September 2021

Prognostic Value of Computed Tomography-Derived Fractional Flow Reserve Comparison With Myocardial Perfusion Imaging.

JACC Cardiovasc Imaging 2021 Oct 7. Epub 2021 Oct 7.

Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA. Electronic address:

Objectives: The aim of this study was to compare the incremental prognostic value of coronary computed tomography (CT) angiography (CCTA)-derived machine learning fractional flow reserve CT (ML-FFRct) versus that of ischemia detected on single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI) on incident cardiovascular outcomes.

Background: SPECT MPI and ML-FFRct are noninvasive tools that can assess the hemodynamic significance of coronary atherosclerotic disease.

Methods: We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and SPECT MPI. ML-FFRct was computed using a ML prototype. The primary outcome was all-cause mortality and nonfatal myocardial infarction (D/MI), and the secondary outcome was D/MI and unplanned revascularization, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) occurring more than 90 days postimaging. Multiple nested multivariate cox regression was used to model a scenario wherein an initial anatomical assessment was followed by a functional assessment.

Results: A total of 471 patients (mean age: 64 ± 13 year; 53% males) were included. Comorbidities were prevalent (78% hypertension, 66% diabetes, 81% dyslipidemia). ML-FFRct was <0.8 in at least 1 proximal/midsegment was present in 41.6% of patients, and ischemia on MPI was present in 13.8%. After a median follow-up of 18 months, 7% of patients (n = 33) experienced D/MI. On multivariate Cox proportional analysis, the presence of ischemia on MPI but not ML-FFRct significantly predicted D/MI (HR: 2.3; 95% CI: 1.0-5.0; P = 0.047; or HR: 0.7; 95% CI: 0.3-1.4; P = 0.306 respectively) when added to CCTA obstructive stenosis. Furthermore, the model with SPECT ischemia had higher global chi-square result and significantly improved reclassification. Results were similar using the secondary outcome and on several sensitivity analyses.

Conclusions: In a high-risk patient cohort, SPECT MPI but not ML-FFRct adds independent and incremental prognostic information to CCTA-based anatomical assessment and clinical risk factors in predicting incident outcomes.
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http://dx.doi.org/10.1016/j.jcmg.2021.09.007DOI Listing
October 2021

Metabolome-wide association study of serum exogenous chemical residues in a cohort with 5 major chronic diseases.

Environ Int 2022 01 8;158:106919. Epub 2021 Oct 8.

CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; University of Chinese Academy of Sciences, Beijing 100049, China. Electronic address:

Background: Chronic diseases have become main killers affecting the health of human, and environmental pollution is a major health risk factor that cannot be ignored. It has been reported that exogenous chemical residues including pesticides, herbicides, fungicides, veterinary drugs and persistent organic pollutants are associated with chronic diseases. However, the evidence for their relationship is equivocal and the underlying mechanisms are unclear.

Objectives: We aim to investigate the linkages between serum exogenous chemical residues and 5 main chronic diseases including obesity, hyperuricemia, hypertension, diabetes and dyslipidemia, and further reveal the metabolic perturbations of chronic diseases related to exogenous chemical residue exposure, then gain potential mechanism insight at the metabolic level.

Methods: LC-MS-based targeted and nontargeted methods were respectively performed to quantify exogenous chemical residues and acquire metabolic profiling of 496 serum samples from chronic disease patients. Non-parametric test, correlation and regression analyses were carried out to investigate the association between exogenous chemical residues and chronic diseases. Metabolome-wide association study combined with the meeting-in-the-middle strategy and mediation analysis was performed to reveal and explain exposure-related metabolic disturbances and their risk to chronic diseases.

Results: In the association analysis of 106 serum exogenous chemical residues and 5 chronic diseases, positive associations of serum perfluoroalkyl substances (PFASs) with hyperuricemia were discovered while other associations were not significant. 240 exposure markers of PFASs and 84 disease markers of hyperuricemia were found, and 47 of them were overlapped and considered as putative effective markers. Serum uric acid, amino acids, cholesterol, carnitines, fatty acids, glycerides, glycerophospholipids, ceramides, and a part of sphingolipids were positively correlated with PFASs and associated with increased risk for hyperuricemia. Creatine, creatinine, glyceryl monooleate, phosphatidylcholine 36:6, phosphatidylethanolamine 40:6, cholesterol and sphingolipid 36:1;2O were significant markers which mediated the associations of the residues with hyperuricemia.

Conclusions: Our study demonstrated a significantly positive association between PFASs exposure and hyperuricemia. The most significant metabolic abnormality was lipid metabolism which not only was positively associated with PFASs, but also increased the risk of hyperuricemia.
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http://dx.doi.org/10.1016/j.envint.2021.106919DOI Listing
January 2022

A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study.

BMC Psychiatry 2021 10 4;21(1):485. Epub 2021 Oct 4.

National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.

Background: The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to detect mild cognitive impairment (MCI) in population-based epidemiologic studies. However, their comparison on which is best suited to assess cognition is scarce in samples from multiple regions of China.

Methods: We conducted a cross-sectional analysis of 4923 adults aged ≥55 years from the Community-based Cohort Study on Nervous System Diseases. Objective cognition was assessed by Chinese versions of MMSE and MoCA, and total score and subscores of cognitive domains were calculated for each. Education-specific cutoffs of total score were used to diagnose MCI. Demographic and health-related characteristics were collected by questionnaires. Correlation and agreement for MCI between MMSE and MoCA were analyzed; group differences in cognition were evaluated; and multiple logistic regression model was used to clarify risk factors for MCI.

Results: The overall MCI prevalence was 28.6% for MMSE and 36.2% for MoCA. MMSE had good correlation with MoCA (Spearman correlation coefficient = 0.8374, p < 0.0001) and moderate agreement for detecting MCI with Kappa value of 0.5973 (p < 0.0001). Ceiling effect for MCI was less frequent using MoCA versus MMSE according to the distribution of total score. Percentage of relative standard deviation, the measure of inter-individual variance, for MoCA (26.9%) was greater than for MMSE (19.0%) overall (p < 0.0001). Increasing age (MMSE: OR = 2.073 for ≥75 years; MoCA: OR = 1.869 for≥75 years), female (OR = 1.280 for MMSE; OR = 1.163 for MoCA), living in county town (OR = 1.386 and 1.862 for MMSE and MoCA, respectively) or village (OR = 2.579 and 2.721 for MMSE and MoCA, respectively), smoking (OR = 1.373 and 1.288 for MMSE and MoCA, respectively), hypertension (MMSE: OR = 1.278; MoCA: OR = 1.208) and depression (MMSE: OR = 1.465; MoCA: OR = 1.350) were independently associated with greater likelihood of MCI compared to corresponding reference group in both scales (all p < 0.05).

Conclusions: MoCA is a better measure of cognitive function due to lack of ceiling effect and with good detection of cognitive heterogeneity. MCI prevalence is higher using MoCA compared to MMSE. Both tools identify concordantly modifiable factors for MCI, which provide important evidence for establishing intervention measures.
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http://dx.doi.org/10.1186/s12888-021-03495-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489046PMC
October 2021

Whole Exome Sequencing Uncovered the Genetic Architecture of Growth Hormone Deficiency Patients.

Front Endocrinol (Lausanne) 2021 13;12:711991. Epub 2021 Sep 13.

Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Purpose: Congenital growth hormone deficiency (GHD) is a rare and etiologically heterogeneous disease. We aim to screen disease-causing mutations of GHD in a relatively sizable cohort and discover underlying mechanisms a candidate gene-based mutational burden analysis.

Methods: We retrospectively analyzed 109 short stature patients associated with hormone deficiency. All patients were classified into two groups: Group I (n=45) with definitive GHD and Group II (n=64) with possible GHD. We analyzed correlation consistency between clinical criteria and molecular findings by whole exome sequencing (WES) in two groups. The patients without a molecular diagnosis (n=90) were compared with 942 in-house controls for the mutational burden of rare mutations in 259 genes biologically related with the GH axis.

Results: In 19 patients with molecular diagnosis, we found 5 possible GHD patients received known molecular diagnosis associated with GHD ( [c.2329T>A, c.7131C>G], [c.731G>A], [c.1102delC], [c.187_207dup]). By mutational burden analysis of predicted deleterious variants in 90 patients without molecular diagnosis, we found that ( = 0.005), ( = 0.006), ( = 0.021) and ( = 0.040) represented top genes enriched in GHD patients.

Conclusion: Our study revealed the discrepancies between the laboratory testing and molecular diagnosis of GHD. These differences should be considered when for an accurate diagnosis of GHD. We also identified four candidate genes that might be associated with GHD.
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http://dx.doi.org/10.3389/fendo.2021.711991DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475633PMC
September 2021

Depression and Deliberate Self-Harm Among Rural Adolescents of Sichuan Province in Western China: A 2-Year Longitudinal Study.

Front Psychiatry 2021 13;12:605785. Epub 2021 Sep 13.

Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China.

To explore the change in the prevalence and association of depression and deliberate self-harm and their common and independent influencing factors among western Chinese rural adolescents. A total of 2,744 junior and senior high school students from two rural schools in Sichuan Province, China, participated in the baseline survey and were invited to participate in two follow-up surveys. The Center for Epidemiologic Studies-Depression Scale, a deliberate self-harm item, the Social Support Rating Scale, the Rosenberg Self-esteem Scale and the Connor-Davidson Resilience Scale were administered. A bivariate four-level logistic regression model was used for analysis. The prevalence of depression and deliberate self-harm were 39.6 and 21.2%, respectively. Regular physical exercise, a good relationship with parents, high resilience, and high self-esteem were common protective factors for both depression and deliberate self-harm. Feeling disliked by teachers was a common risk factor for both. Being female, having a mother who emigrated as a migrant worker before the student was 3 years old, feeling disliked by classmates and having a poor family economic status were associated only with an increased risk of depression. Participants with medium social support were less likely to report deliberate self-harm than those with low or high support. Depression and deliberate self-harm were clustered at the class level. The comorbidity of depression and deliberate self-harm in rural adolescents should be given ample attention. Interventions should consider the class clustering of depression and deliberate self-harm and their common and unique influencing factors.
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http://dx.doi.org/10.3389/fpsyt.2021.605785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473622PMC
September 2021

Acute paediatrics tele-support for caregivers in Singapore: an initial experience with a prototype Chatbot: UPAL.

Singapore Med J 2021 09 28. Epub 2021 Sep 28.

Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.

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http://dx.doi.org/10.11622/smedj.2021119DOI Listing
September 2021

Comprehensive subtyping of Parkinson's disease patients with similarity fusion: a case study with BioFIND data.

NPJ Parkinsons Dis 2021 Sep 17;7(1):83. Epub 2021 Sep 17.

Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, 10065, USA.

Parkinson's disease (PD) is a complex neurodegenerative disorder with diverse clinical manifestations. To better understand this disease, research has been done to categorize, or subtype, patients, using an array of criteria derived from clinical assessments and biospecimen analyses. In this study, using data from the BioFIND cohort, we aimed at identifying subtypes of moderate-to-advanced PD via comprehensively considering motor and non-motor manifestations. A total of 103 patients were included for analysis. Through the use of a patient-wise similarity matrix fusion technique and hierarchical agglomerative clustering analysis, three unique subtypes emerged from the clustering results. Subtype I, comprised of 60 patients (~58.3%), was characterized by mild symptoms, both motor and non-motor. Subtype II, comprised of 20 (~19.4%) patients, was characterized by an intermediate severity, with a high tremor score and mild non-motor symptoms. Subtype III, comprised of 23 (~22.3%) patients, was characterized by more severe motor and non-motor symptoms. These subtypes show statistically significant differences when looking at motor (on and off medication) clinical features and non-motor clinical features, while there was no clear difference in demographics, biomarker levels, and genetic risk scores.
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http://dx.doi.org/10.1038/s41531-021-00228-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448859PMC
September 2021

Mining genetic and transcriptomic data using machine learning approaches in Parkinson's disease.

NPJ Parkinsons Dis 2020 Sep 9;6(1):24. Epub 2020 Sep 9.

Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, NY, USA.

High-throughput techniques have generated abundant genetic and transcriptomic data of Parkinson's disease (PD) patients but data analysis approaches such as traditional statistical methods have not provided much in the way of insightful integrated analysis or interpretation of the data. As an advanced computational approach, machine learning, which enables people to identify complex patterns and insight from data, has consequently been harnessed to analyze and interpret large, highly complex genetic and transcriptomic data toward a better understanding of PD. In particular, machine learning models have been developed to integrate patient genotype data alone or combined with demographic, clinical, neuroimaging, and other information, for PD outcome study. They have also been used to identify biomarkers of PD based on transcriptomic data, e.g., gene expression profiles from microarrays. This study overviews the relevant literature on using machine learning models for genetic and transcriptomic data analysis in PD, points out remaining challenges, and suggests future directions accordingly. Undoubtedly, the use of machine learning is amplifying PD genetic and transcriptomic achievements for accelerating the study of PD. Existing studies have demonstrated the great potential of machine learning in discovering hidden patterns within genetic or transcriptomic information and thus revealing clues underpinning pathology and pathogenesis. Moving forward, by addressing the remaining challenges, machine learning may advance our ability to precisely diagnose, prognose, and treat PD.
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http://dx.doi.org/10.1038/s41531-020-00127-wDOI Listing
September 2020

Modifiable factors of 20-year blood pressure trajectories among normotensives and their associations with hypertension : a prospective study.

Br J Nutr 2021 Sep 2:1-11. Epub 2021 Sep 2.

National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.

Little is known about the impact of modifiable risk factors on blood pressure (BP) trajectories and their associations with hypertension (HTN). We aimed to identify BP trajectories in normotensive Chinese adults and explore their influencing factors and associations with HTN. We used data from 3436 adults with at least four BP measurements between 1989 and 2018 in the China Health and Nutrition Survey, an ongoing cohort study. We measured BP using mercury sphygmomanometers with appropriate cuff sizes in all surveys. We used group-based trajectory modelling to identify BP trajectories between 1989 and 2009 and multiple logistic and Cox regression models to analyse their influencing factors and associations with HTN in 2011-2018. We identified five systolic blood pressure (SBP) trajectories, 'Low-increasing (LI)', 'Low-stable (LS)', 'Moderate-increasing (MI)', 'High-stable (HS)' and 'Moderate-decreasing (MD)', and four diastolic blood pressure (DBP) trajectories classified as 'Low-increasing (LI)', 'Moderate-stable (MS)', 'Low-stable (LS)' and 'High-increasing (HI)'. People with higher physical activity (PA) levels and lower waist circumferences (WC) were less likely to be in the SBP LI, MI, HS and MD groups (P < 0·05). People with higher fruit and vegetable intakes, lower WCs and salt intakes and higher PA levels were less likely to be in the DBP LI, MS and HI groups (P < 0·05). Participants in the SBP HS group (hazard ratio (HR) 2·01) or the DBP LI, MS and HI groups (HR 1·38, 1·40, 1·71, respectively) had higher risks of HTN (P < 0·05). This study suggests that BP monitoring is necessary to prevent HTN in the Chinese population.
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http://dx.doi.org/10.1017/S0007114521003378DOI Listing
September 2021

Added prognostic value of plaque burden to computed tomography angiography and myocardial perfusion imaging.

Atherosclerosis 2021 10 19;334:9-16. Epub 2021 Aug 19.

Houston Methodist Debakey Heart & Vascular Center, Houston, TX, USA. Electronic address:

Background And Aims: Cardiac computed tomographic angiography (CCTA) - derived measures of coronary artery disease (CAD) burden have been shown to independently predict incident cardiovascular events. We aimed to compare the added prognostic value of plaque burden to CCTA anatomic assessment and single photon emission computed tomography (SPECT) physiologic assessment in a cohort with high prevalence of risk factors undergoing both tests.

Methods: Consecutive patients who underwent clinically indicated CCTA and SPECT myocardial imaging for suspected CAD were included. Stenosis severity and segment involvement score (SIS - number of segments with plaque irrespective of stenosis) were determined from CCTA, and presence of ischemia was determined from SPECT. Patients were followed for major adverse cardiovascular events (MACE, inclusive of all-cause death, non-fatal myocardial infarction, and percutaneous coronary intervention or coronary artery bypass grafting 90-days after imaging test.) RESULTS: A total of 956 patients were included (mean age 61.1 ± 14.2 years, 54% men, 89% hypertension, 81% diabetes, 84% dyslipidemia). Obstructive stenosis (left main ≥50%, all other coronary segments ≥70%) and ischemia were observed in a similar number of patients (14%). In multivariable Cox regression models, SIS significantly predicted outcomes and improved risk discrimination in models with CCTA obstructive stenosis (HR 1.15, p ≤ 0.001; Harrel's C 0.74, p = 0.008) and SPECT ischemia (HR 1.14, p < 0.001; Harrel's C 0.76, p = 0.019).

Conclusions: Our results suggest that in patients with suspected CAD and a high prevalence of risk-factors, plaque burden adds incremental prognostic value over established CCTA and SPECT measures to predict incident cardiovascular outcomes.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.08.032DOI Listing
October 2021

Trajectories of Dietary Patterns and Their Associations with Overweight/Obesity among Chinese Adults: China Health and Nutrition Survey 1991-2018.

Nutrients 2021 Aug 18;13(8). Epub 2021 Aug 18.

Department of Public Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

It is essential to understand the impact of different dietary pattern trajectories on health over time. Therefore, we aimed to explore the long-term trajectories of dietary patterns among Chinese adults and examine the prospective association between different trajectory groups and the risk of overweight/obesity. The sample was 9299 adults aged 18 years or older from the China Health and Nutrition Survey (CHNS) between 1991 and 2018. We used factor analysis to identify dietary patterns and group-based trajectory modeling to identify dietary pattern trajectories. Three trajectories of a southern pattern and a modern pattern and four trajectories of a meat pattern were identified. Participants who followed the highest initial score and a slight decrease trajectory (OR = 1.63; 95% CI: 1.04, 2.54) of the meat dietary pattern were positively associated with risk of overweight/obesity when compared with the lowest initial score trajectory. The southern dietary pattern and the modern dietary pattern trajectories of participants in Group 2 (OR = 0.64; 95% CI: 0.51, 0.81; OR = 0.76; 95% CI: 0.63, 0.91) and Group 3 (OR = 0.71; 95% CI: 0.54, 0.91; OR = 0.64; 95% CI: 0.44, 0.90) were associated with lower risk of overweight/obesity when compared with Group 1. We observed that dietary pattern trajectories have different associations with overweight/obesity among Chinese adults.
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http://dx.doi.org/10.3390/nu13082835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401187PMC
August 2021

Aggregation and deaggregation: The effect of high-pressure homogenization cycles on myofibrillar proteins aqueous solution.

Int J Biol Macromol 2021 Oct 21;189:567-576. Epub 2021 Aug 21.

College of Food Science, Southwest University, No. 2 Tiansheng Road, Beibei District, Chongqing 400715, China; Chongqing Engineering Research Center of Regional Food, No. 2 Tiansheng Road, Beibei District, Chongqing 400715, China. Electronic address:

Myofibrillar proteins (MPs) have not been fully used for a long time due to its poor solubility in low ionic strength solutions. The study explored the effect of high pressure homogenization (HPH) cycles under two pressures on the solubility of MPs. The MPs solubility increased with HPH cycles (p < 0.05), the results of turbidity, appearance, droplet size indicated that the increase of solubility was due to MPs depolymerization, excessive HPH cycles (25k psi for 11 cycles) would lead to protein re-aggregation but does not affect solubility (p>0.05). SDS-PAGE suggested that myosin formed soluble polymers with different molecular weights through disulfide bonds during HPH cycles, the polymer consisted of myosin subunits of different molecular weights. Endogenous fluorescence spectra, intermolecular chemical forces, isoelectric point analysis and free amino acids (FAAs) indicated that the dissolution of polymers in low ionic strength media was dominated by polar environment and intermolecular steric hindrance, but not to FAAs.
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http://dx.doi.org/10.1016/j.ijbiomac.2021.08.133DOI Listing
October 2021
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