1D-CADCapsNet: One dimensional deep capsule networks for coronary artery disease detection using ECG signals

PurposeCardiovascular disease (CVD) is a leading cause of death globally. Electrocardiogram (ECG), which records the electrical activity of the heart, has been used for the diagnosis of CVD. The automated and robust detection of CVD from ECG signals plays a significant role for early and accurate clinical diagnosis. The purpose of this study is to provide automated detection of coronary artery disease (CAD) from ECG signals using capsule networks (CapsNet).MethodsDeep learning-based approaches have become increasingly popular in computer aided diagnosis systems. Capsule networks are one of the new promising approaches in the field of deep learning. In this study, we used 1D version of CapsNet for the automated detection of coronary artery disease (CAD) on two second (95,300) and five second-long (38,120) ECG segments. These segments are obtained from 40 normal and 7 CAD subjects. In the experimental studies, 5-fold cross validation technique is employed to evaluate performance of the model.ResultsThe proposed model, which is named as 1D-CADCapsNet, yielded a promising 5-fold diagnosis accuracy of 99.44% and 98.62% for two- and five-second ECG signal groups, respectively. We have obtained the highest performance results using 2 s ECG segment than the state-of-art studies reported in the literature.Conclusions1D-CADCapsNet model automatically learns the pertinent representations from raw ECG data without using any hand-crafted technique and can be used as a fast and accurate diagnostic tool to help cardiologists.     

New fish assemblages from the Middle Permian from the Guadalupe Mountains,West Texas,USA

Late Wordian/Capitanian (Guadalupian, Middle Permian) fish assemblages are described from the “McKittrick Canyon Limestone”, Lamar Limestone and Reef Trail Members of the Bell Canyon Formation in the Patterson Hills and the PI section (Hegler/Pinery Members) along Highway 62/180 in the Guadalupe Mountains, West Texas. The assemblages contain chondrichthyan teeth of Stethacanthulus meccaensis, Texasodus varidentatus, Cooleyella cf. amazonensis, C. cf. peculiaris, and the new genus and species Lamarodus triangulus; and buccopharyngeal denticles of undetermined symmoriiform; chondrichthyan scales of eight morphotypes; fragment of an actinopterygian jaw, isolated teeth; the scales of Alilepis sp., Varialepis sp. and undetermined elonichthyid and haplolepid fishes. Using microtomography, the vascularization system has been observed for the first time for the teeth of Texasodus varidentatus and a new taxon Lamarodus triangulus. The distribution of chondrichthyan taxa was analyzed for the known fish assemblages of the Early, Middle, and Late Permian of the world. The end-Guadalupian crisis in the evolution of chondrichthyan fishes involved substantially more taxonomic change than the Permian–Triassic mass extinction.     

大鼠脑缺血/再灌注过程中血流量和脑组织含水量的变化趋势*

目的:研究大鼠脑缺血/再灌注过程中血流量及与脑组织水含量变化的趋势。方法:选取5只成年SD雄性大鼠(n=5),参照改良Zea-Longa线栓法制备大鼠大脑中动脉缺血/再灌注模型,2 h后拔出线栓。利用PeriCam PSI血流灌注成像系统实时监测大鼠在缺血前及缺血5 min、30 min、1 h、2 h、再灌注5 min、30 min、1 h、2 h、4 h、6 h及24 h的血流灌注量,记录在ROI(感兴趣区)测量的数值。再选取15只成年SD雄性大鼠,分为Control组、缺血2 h、再灌注30 min、4 h及24 h组(n=3)。正常组不做任何处理,实验组按上述线栓法制备MCAO模型。取新鲜脑组织用干湿重法测定其左、右半球的水含量。结果:栓塞时缺血侧血流量逐渐下降,缺血2 h下降最低(P＜0.05);再灌注早期血流量恢复较大(P＜0.05),30 min时显著下降(P＜0.05),4 h明显上升(P＜0.05),24 h再次上升(P＜0.05)但低于缺血前血流量(P＞0.05)。脑组织水含量测量,缺血2 h组和再灌注30 min组与正常组无明显差异(P＞0.05);再灌4 h组和再灌24 h组明显增高(P＜0.05),且再灌24 h组明显高于再灌4 h组(P＜0.05)。结论:大鼠脑缺血/再灌注过程中血流量和脑组织中水含量的变化存在一定的规律,且脑组织中水含量与再灌注过程中血流量的变化有一定关系。     

肺炎支原体感染对川崎病的影响及机制探讨

目的分析肺炎支原体感染对川崎病的影响及其机制,以期指导临床诊疗。方法回顾性分析2013年8月至2018年8月我科住院的496例川崎病患儿临床资料,其中合并肺炎支原体感染组193例,未合并肺炎支原体感染组303例。应用倾向评分匹配法1∶1校正2组的年龄、性别、是否为不完全型川崎病、是否使用糖皮质激素、丙种球蛋白使用时间、丙种球蛋白使用方法和阿司匹林初始剂量,比较2组患儿的总发热天数、冠状动脉直径、冠状动脉扩张发生率、冠状动脉瘤发生率和丙种球蛋白无反应发生率。结果川崎病合并肺炎支原体感染组男性患儿多,更易发生颈部淋巴结肿大,年龄、中性粒细胞百分比、血沉和低密度脂蛋白高于川崎病未合并肺炎支原体感染组,血钾、血钙、高密度脂蛋白和白蛋白低于川崎病未合并肺炎支原体感染组,差异有统计学意义(均P<0.05)。应用倾向评分匹配法1∶1配对后发现,川崎病合并肺炎支原体感染组患儿总发热时间更长[8(6~10)d vs 7(6~9)d,Z=-2.089,P<0.05),冠状动脉直径值更大[(2.81±0.81)mm vs(2.63±0.45)mm,t=2.532,P<0.05],冠状动脉瘤发生率更高(5.5% vs 1.1%,χ²=5.516,P<0.05)。结论肺炎支原体感染可能引起川崎病患儿脂质代谢及电解质的紊乱,其炎症反应更强,持续时间更长,对冠状动脉损伤更大。     

急性脑梗死并发肺部感染患者预后及危险因素分析

目的分析急性脑梗死并发肺部感染患者病原菌分布、病原菌耐药性、患者用药特征及其危险因素。方法选取2015年3月至2017年3月在我院急诊科进行住院治疗,且年龄60岁的急性脑梗死并发肺部感染患者60例为研究对象,对患者的一般资料及病原菌分布情况、耐药情况和患者用药情况进行分析。结果 60例患者中有30例出现肺部感染,感染率为50.00%。肺部感染患者中死亡4例。肺部感染患者痰液中共培养出28株病原菌,其中革兰阴性菌21株,革兰阳性菌5株,真菌2株。30例肺部感染患者共使用6种抗感染药物,其中哌拉西林/舒巴坦的使用频率最高,其次为依替米星及美罗培南。Logistic回归分析显示,病原菌分布、耐药情况和患者用药情况与患者的预后存在相关性。结论急性脑梗死并发肺部感染患者的病原菌分布、耐药情况及患者用药情况与患者的预后密切相关,应针对上述因素给予患者合理的治疗。     

Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study

Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ² or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P<0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value > 1, P<0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.     

Length-weight relationships of ornamental fish species from Amanã Lake,Amanã Reserve,Amazonas, Brazil

Length-weight relationships (LWRs) were estimated for 16 ornamental fish species from Amanã Lake and nine tributary streams, in Central Brazilian Amazonia. Sampling was carried out bimonthly for a year (2007–2008), using two sets of four gillnets (20 m × 2 m, 2,5; 3,5; 04; 4,5 cm stretch mesh size); trawls were performed with seine nets (35 m × 6 m, 3 mm stretch mesh size); native fish-traps (fyke-net like fish-traps woven from local lianas), and dip nets (0.5 m × 0.5 m stretch mesh size). Measurements were done for standard length (SL – 0.1 cm precision) and total weight (Wt – 0.01 g precision). This study provides information on the length–weight relationships for all sampled species and, in addition, provides new maximum standard lengths for six species.     

First partial cranium of Togocetus from Kpogamé (Togo) and the protocetid diversity in the Togolese phosphate basin

Earliest cetaceans (whales) originated from the early Eocene of Indo-Pakistan, but the group dispersed through most of the oceans of the planet by the late middle to late Eocene. This late Eocene global distribution indicates that important dispersal events took place during the middle Eocene (Lutetian), a globally undersampled time interval that is well documented in the Togolese phosphate series. We report here the first discovery of a partial cetacean cranium from middle Eocene deposits of Togo (West Africa). A 3D model of the cranium and teeth was reconstructed in order to reveal hidden anatomical features. The dental and cranial characteristics of the Togolese specimen recall those of protocetid taxa described in Africa, Asia, and North America, but also display significant differences. In particular, we show that the new specimen shares a number of morphological features with the Togolese taxon Togocetus. Such a hypothesis is further supported by a cladistic analysis including 45 taxa and 167 morphological characters, which recovers the new specimen close to Togocetus as the first offshoot of protocetids. Phylogenetic analysis including all the protocetids remains of Kpogamé confirms the singular diversity of the Togolese phosphate basin, and enables to examine potential connections with faunas from contemporaneous localities in Africa.     

Circulating antioxidant vitamins and copper in Azorean coronary artery disease patients under preventive medication – A case study

Background and aimOxidative stress and inflammation are conditions that are deeply involved in atherosclerosis and consequent coronary artery disease (CAD). Therefore, the aim of this study was to assess the relationship among circulating antioxidant vitamins (C, A, E), copper, and other pro- or antioxidant/inflammation markers in patients with and without CAD under preventive medication.Subjects and methods174 Azorean subjects symptomatic for CAD (age 56 ± 9y; 68 % men) submitted to coronary angiography were split into 2 groups: one formed by CAD patients (≥50 % stenosis in at least one major coronary vessel) and the other by non-CAD patients (<50 % stenosis). Both groups were age-, sex- and BMI-matched. Plasma levels of vitamins or copper were measured by HPLC and AAS, respectively.Results and conclusionsLower vitamin C levels were observed in CAD patients (mainly in women, who exhibited a high rate of diabetes mellitus) as compared to the non-CAD ones. Also, CAD patients (mainly men) exhibited significantly higher concentrations of plasma copper than their non-CAD counterparts (1.17 ± 0.3 mg/L vs. 1.09 ± 0.3 mg/L, p = 0.030). In bivariate analysis, plasma copper levels were positively associated with serum LDL-cholesterol (r=0.22; p = 0.004) and chiefly with C-reactive protein (r=0.40; p < 0.001). Furthermore, they were significantly lower in recurrent vs. non recurrent CAD patients (1.07±0.2 vs. 1.24±0.3 mg/L, p = 0.004). ROC analysis showed that plasma copper, whenever >1.06 mg/L, was an independent risk factor for CAD in primary prevention for men, which suggests that its levels can fluctuate with medical therapy (such as anti-inflammatory), thus indicating that copper is not a reliable marker for CAD. Moreover, plasma copper concentration was not associated with CAD severity. Yet, results do suggest that, even within its reference concentration range, it could be useful as an acute inflammation marker in CAD management.