Neurohumoral,cardiac and inflammatory markers in the evaluation of heart failure severity and progression

Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.

交互联合上的国际进步和评估在都市化和 eco 环境之间完成

Global urbanization is exerting severe stress and having far-reaching impacts on the eco-environment, and yet there exists a complex non-linear coupling relationship between the two. Research on the interactive coupling effect between urbanization and the eco-environment will be a popular area of study and frontier in international earth system science and sustainability science in the next 10 years, while also being a high-priority research topic of particular interest to international organizations. This paper systematically collates and summarizes the international progress made in research on interactive coupling theory, coupling relationships, coupling mechanisms, coupling laws, coupling thresholds, coupling models and coupling optimization decision support systems. The research shows that urbanization and eco-environment interactive coupling theories include the Kuznets curve theory, telecoupling theory, planetary boundaries theory, footprint family theory and urban metabolism theory; most research on interactive coupling relationships is concerned with single- element coupling relationships, such as those between urbanization and water, land, atmosphere, climate change, ecosystems and biodiversity; the majority of research on interactive coupling mechanisms and laws focuses on five research paradigms, including coupled human and nature systems, complex social-ecological systems, urban ecosystems, social-economic-natural complex ecosystems, and urbanization development and eco-environment constraint ring; the majority of interactive coupling simulations use STIRPAT models, coupling degree models, multi-agent system models and big data urban computer models; and research has been carried out on urbanization and eco-environment coupling thresholds, coercing risk and optimal decision support systems. An objective evaluation of progress in international research on interactive coupling between urbanization and the eco-environment suggests that there are six main research focal points and six areas lacking research： a lot of research exists on macroscopic coupling effects, with little research on urban agglomeration and scale coupling effects; considerable research exists on sin-gle-dimension coupling effects, with little on multiple-dimension coupling effects; a great deal exists on ＂one-to-one＂ dual- element coupling effects, with little on ＂many-to-many＂ multiple-element coupling effects; a lot exists on positive feedback coupling effects, and little on negative feedback coupling effects; a great deal exists on empirical coupling effects, and little on theoretical coupling effects; a great deal exists on the use of simple quantitative methods, and little on using integrated simulation methods. Future studies should focus on coupling effects between urbanization in urban agglomerations and the eco-environment, spatial scale coupling effects, multi-dimensional coupling effects, telecoupling effects, ＂one-to-many＂ and ＂many-to-many＂ element coupling effects, and positive and negative feedback coupling effects. There is also a need to strengthen the development and application of dynamic models for multi-element,-scale,-scenario,-module and-agent integrated spatiotemporal coupling systems and further improve theoretical innovations in coupling effect research and integrate and form complete and diverse coupling theoretical systems.

Clinical practice of rapid antigen tests for SARS-CoV-2 Omicron variant:A single-center study in China

Responding to the fast-spreading SARS-CoV-2 Omicron variant, to improve screening efficiency, rapid antigen tests(RATs) were first added as a supplementary detection method in China in mid-March, 2022. What and how big a role RATs should play need to be supported by clinical data. Here, RAT performance and relevant factors in comparison with nucleic acid amplification tests(NAATs) were assessed in Omicron-infected inpatients. From the NAAT results, nasopharyngeal swabs(NPs) performed better than oropharyngeal swabs(OPs). RATs tested on NAAT positive NPs performed better than those with OP-positive samples. The RAT positivity rate was strongly associated with high levels of N and OFR1ab genes, especially in NPs where patients also had significantly longer hospital stays and shorter days from symptom onset to RAT testing. Self-performed RATs had a detection accuracy that was comparable to professionally performed RATs when the subjects were well guided. The antigen negative rate of the studied patients was 100% at discharge. These findings suggest that, in addition to a supplementary detection role, RATs can be an important strategy for evaluating the disease progression of Omicron-infected inpatients. This study provides important clinical data to support better rules regarding RATs under China’s COVID-19 prevention and control policy.