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Background The transcatheter edge-to-edge repair (TEER) technique, facilitated by the MitraClip device, is a minimally invasive intervention designed for high-risk patients with mitral regurgitation (MR). This study conducts a retrospective analysis of death events associated with MitraClip implantation over a ten-year decade, utilizing data from the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database to evaluate trends in safety outcomes. Methods A comprehensive search of the publicly accessible MAUDE database was conducted to retrieve reports of deaths and injuries related to MitraClip implantation from October 2013 to September 2023. Duplicate reports and records from unrelated sources were excluded. The Cochran-Armitage test was performed to evaluate trends in the proportion of fatal events over time. Results During the 10-year period following FDA approval, the MAUDE database recorded a total of 927 death reports and 9,211 injury reports associated with MitraClip. After excluding duplicates and irrelevant reports, 592 death cases were analyzed. The most commonly reported complications were MR (26.69%), tissue damage (24.16%), and hypotension (22.13%). The most frequent device-related issues were incomplete coaptation (14.70%), difficulty removing the divice (6.42%), and failure to adhere or bond/positioning failure(4.90%). Notably, 76.94% of deaths occurred within one year of implantation. The proportion of fatal events demonstrated a gradual decline, from 15.9% in 2014–2015 to 3.5% in 2020–2021 ( p  < 0.0001). Conclusions This analysis of the MAUDE database indicates a gradual decline in the proportion of fatal events associated with MitraClip implantation, which may be attributed to growing operator experience and advancements in device design. Nonetheless, persistent focus is required on managing complications and addressing potential risks to further enhance device performance and optimize its clinical utility.

Background The relationship between the TyG index and MASLD in lean young populations remains unclear. Methods In this retrospective study, we analyzed data from individuals aged 18 to 35 Years old who underwent abdominal ultrasound examinations at a healthcare management center from January 2019 to December 2023. First, we categorized the TyG index into quartiles and used logistic regression models to examine the relationship between MASLD and TyG. Next, we applied restricted cubic splines (RCS) to assess whether the relationship between TyG and MASLD followed a nonlinear pattern. Additionally, we stratified the analysis by sex to explore whether the association between MASLD and TyG differed between males and females. Results A total of 20,242 participants (14763 women [72.9%]; [mean ± SD] age, 29.07 [3.60]) were included in the study. The overall incidence of MASLD was 5.1%. The median (IQR) TyG index was 8.0 (7.6, 8.2). The association between TyG index and the incidence of MASLD followed a reverse L-shaped, with a cut-off value of 8.3. For each 1-unit increase in the TyG index, the association was significant both below 8.3 (HR = 2.1; 95%CI: 1.4-3.4 ) and above this threshold (HR = 12.1; 95%CI: 8.2–17.8). A significant interaction between sex and the TyG index was observed ( P  < 0.001). Both males and females showing an increase in MASLD risk after the TyG index exceeded 8.3. Conclusion In young populations, higher TyG index is associated with an increased risk of MASLD, with distinct patterns observed between sexes. The risk of MASLD rises sharply once the TyG index exceeds 8.3.

The association between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the development of new carotid plaque in young adults requires further evidence from prospective studies.  In this study, young adults underwent abdominal and a carotid ultrasounds measurement were included. The carotid plaque progression was assessed in 2 years after baseline. MASLD is defined according to the liver ultrasound findings and self-reported alcohol consumption. Stepped adjusting multivariable logistic regression were employed to analyze the association between MASLD and the outcome. Subgroup analysis was conducted among sex and different amount of metabolic risk factors. A total of 36.54% (2411/6598) of all participants had MASLD at baseline. Among them, 626 (9.49%) participants were found new onset of carotid plaque in two years. Subjects who had progression of plaque had higher proportion of MASLD (53.99% vs 34.71%, SMD=0.396). Statistically significant positive associations were observed in unadjusted logistic regression models in overall or each sex, respectively. After fully adjustment, the association was only significant among female (OR:2.19, 95% CI: 1.28-3.72) and those had no metabolic risk factor (OR:1.67,95% CI:1.01-2.76). No significant associations were identified in all male subgroups, whereas the associations were still existing among female subgroups. MASLD was found to be a risk factor of progression of carotid plaque among females and those who had not suffered from metabolic risk factor. Prevention should be focused on young adults who have MASLD at physical examination to reduce their risk of future atherosclerosis.

Central sleep apnea (CSA) significantly impacts cardiovascular health, linking it to left atrial enlargement, atrial fibrillation, and impaired cardiac function in heart failure patients with reduced ejection fraction (EF). However, the relationship between CSA and left atrial size in individuals with preserved EF remains underexplored. This study aims to examine the relationship between left atrial size and CSA in snoring patients with preserved EF. An observational study was conducted involving 341 consecutive snoring patients from a cardiology department who underwent overnight polysomnography (PSG) and echocardiography. Patients with EF below 50%, pulmonary diseases or neuromuscular disorders were excluded. CSA was defined as a central apnea-hypopnea index (CAHI) of five or more events per hour. Inverse probability of treatment weighting (IPTW) and logistic regression models were employed to evaluate the relationship between CSA and left atrial size. Among the 341 patients, 33 (9.68%) were diagnosed with CSA, with a higher prevalence in males (10.0%) than females (8.91%). Left atrial enlargement (LAE) was observed in 172 patients (50.44%), predominantly in females (71.29%). CSA patients demonstrated significantly higher apnea-hypopnea index (AHI) (49.2/h vs 26.75/h, p < 0.01) and oxygen desaturation index (ODI) (44.9 vs 22.85, p < 0.01), alongside more sleep time with oxygen saturation < 90% (6.6% vs 2.35%, p = 0.01). Echocardiographic evaluations revealed that CSA patients had a greater left atrial anterior-posterior diameter(LAD-ap 42.73 ± 13.01 mm vs 38.15 ± 4.58 mm, p < 0.01) and a higher frequency of LAE (69.7% vs 48.38%, p = 0.02). Males with CSA had a significantly increased risk of LAE (OR: 4.54; 95% CI: 1.45-14.2) after IPTW adjustment, with significant associations persisting among those with risk factors such as smoking and dyslipidemia. This study highlights a significant association between CSA and left atrial enlargement in males with preserved EF, suggesting that CSA may contribute to atrial remodeling even without reduced ejection fraction.

Comparative analyses of metabolic biomarkers for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in young adults remain limited. While previous studies have examined metabolic predictors of MASLD, few have specifically focused on young adult populations in China, where rising obesity rates and lifestyle changes are creating new patterns of metabolic risk. In this retrospective study, young adults underwent abdominal ultrasounds and metabolic profiling were included in the analysis. Eleven blood lipid and glucose profiles were analyzed. MASLD is defined according to the liver ultrasound findings and self-reported alcohol consumption. Multivariable logistic regression and ROC curves were employed to analyze the association between each indicator and the outcome. Based on the five indicators most strongly indicators, the number of major risk factors for patients was defined, and a logistic regression model with adjusted covariates was used to investigate the impact of the coexistence of risk factors on MASLD. A total of 24.55% (n=10,332) of participants aged 35 years and under had MASLD. All indicators were significantly associated with MASLD separately after adjusting for covariates. Elevated TG/HDL-C ratio≥ 1.44 (OR: 3.87, 95% CI:3.62, 4.15), TyG ≥ 8.8 (OR: 3.78, 95% CI: 3.51, 4.07), and TG≥ 1.61mmol/L (OR: 3.62, 95% CI: 3.38, 3.88) exhibited the strongest associations with MASLD. ROC analysis indicated comparable predictive performance for TG/HDL ratio (AUC: 0.85, 95% CI:0.84, 0.85) and TyG (AUC: 0.83, 95% CI:0.83, 0.84). Cumulative risk factor analysis indicated that individuals with more risk factors suffered increasing risk compared to those with no risk factors. The associations were stable among participants with different amount of metabolic risk factors. Our study establishes that lipid ratios and insulin resistance indices maintain strong predictive value for MASLD in young Chinese adults, even when traditional metabolic risk factors are absent. These findings highlight the importance of incorporating TG/HDL-C ratio and TyG index into routine health screenings for early MASLD detection in young populations.

The transcatheter edge-to-edge repair (TEER) technique, facilitated by the MitraClip device, is a minimally invasive intervention designed for high-risk patients with mitral regurgitation (MR). This study conducts a retrospective analysis of death events associated with MitraClip implantation over a ten-year decade, utilizing data from the FDA's Manufacturer and User Facility Device Experience (MAUDE) database to evaluate trends in safety outcomes. A comprehensive search of the publicly accessible MAUDE database was conducted to retrieve reports of deaths and injuries related to MitraClip implantation from October 2013 to September 2023. Duplicate reports and records from unrelated sources were excluded. The Cochran-Armitage test was performed to evaluate trends in the proportion of fatal events over time. During the 10-year period following FDA approval, the MAUDE database recorded a total of 927 death reports and 9,211 injury reports associated with MitraClip. After excluding duplicates and irrelevant reports, 592 death cases were analyzed. The most commonly reported complications were MR (26.69%), tissue damage (24.16%), and hypotension (22.13%). The most frequent device-related issues were incomplete coaptation (14.70%), difficulty removing the divice (6.42%), and failure to adhere or bond/positioning failure(4.90%). Notably, 76.94% of deaths occurred within one year of implantation. The proportion of fatal events demonstrated a gradual decline, from 15.9% in 2014-2015 to 3.5% in 2020-2021 (p < 0.0001). This analysis of the MAUDE database indicates a gradual decline in the proportion of fatal events associated with MitraClip implantation, which may be attributed to growing operator experience and advancements in device design. Nonetheless, persistent focus is required on managing complications and addressing potential risks to further enhance device performance and optimize its clinical utility.

Background: The association between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the development of new carotid plaque in young adults requires further evidence from prospective studies. Methods: In this study, young adults underwent abdominal and a carotid ultrasounds measurement were included. The carotid plaque progression was assessed in 2 years after baseline. MASLD is defined according to the liver ultrasound findings and self-reported alcohol consumption. Stepped adjusting multivariable logistic regression were employed to analyze the association between MASLD and the outcome. Subgroup analysis was conducted among sex and different amount of metabolic risk factors. Results: A total of 36.54% (2411/6598) of all participants had MASLD at baseline. Among them, 626 (9.49%) participants were found new onset of carotid plaque in two years. Subjects who had progression of plaque had higher proportion of MASLD (53.99% vs 34.71%, SMD=0.396). Statistically significant positive associations were observed in unadjusted logistic regression models in overall or each sex, respectively. After fully adjustment, the association was only significant among female (OR:2.19, 95% CI: 1.28-3.72) and those had no metabolic risk factor (OR:1.67,95% CI:1.01-2.76). No significant associations were identified in all male subgroups, whereas the associations were still existing among female subgroups. Conclusion: MASLD was found to be a risk factor of progression of carotid plaque among females and those who had not suffered from metabolic risk factor. Prevention should be focused on young adults who have MASLD at physical examination to reduce their risk of future atherosclerosis. Keywords: MASLD, atherosclerosis, risk factor

The magnitude-frequency relationship is one of the most cited empirical equations by seismologists for studying seismic activity, and it has been widely used in earthquake forecasting and earthquake hazard analysis. Applying this equation to fit and analyze a large amount of CNC machine failure data, similar conclusions to those of seismology were obtained. The adaptive neural network ANFIS model was used to predict the b-value as an output quantity, associated with the fault level and number of faults. The sample data were tested separately using the ANFIS toolbox of MATLAB software and the Neural Net Fitting APP function. The ANFIS model has better accuracy in b-value prediction, which shows that the ANFIS model has certain ability to predict the parameters of the G-R Law. b-value prediction reflects the stability of CNC machine operation to a certain extent, and the change of b-value can speculate the possibility of CNC machine failure in continuous operation, which has certain reference significance for the normal operation of production.

The magnitude-frequency relationship is one of the most cited empirical equations by seismologists for studying seismic activity, and it has been widely used in earthquake forecasting and earthquake hazard analysis. Applying this equation to fit and analyze a large amount of CNC machine failure data, similar conclusions to those of seismology were obtained. The adaptive neural network ANFIS model was used to predict the b-value as an output quantity, associated with the fault level and number of faults. The sample data were tested separately using the ANFIS toolbox of MATLAB software and the Neural Net Fitting APP function. The ANFIS model has better accuracy in b-value prediction, which shows that the ANFIS model has certain ability to predict the parameters of the G-R Law. b value prediction reflects the stability of CNC machine operation to a certain extent, and the change of b-value can speculate the possibility of CNC machine failure in continuous operation, which has certain reference significance for the normal operation of production. The experimental data were obtained from the manufacturer of a series of CNC machine tools in use, covering a time span of up to seventeen years. The results show that the ANFIS model significantly outperforms the BP neural network in terms of accuracy.

Human esophageal cancer-related gene 4 (ECRG4) is a potential tumor suppressor gene isolated from human esophageal epithelial cells. Studies have shown that ECRG4 effectively inhibits the proliferation of tumor cells and induces apoptosis. However, the role of ECRG4 in laryngeal cancer has not yet been clearly defined. In this study, a human laryngeal cancer cell line stably overexpressing ECRG4 was established. The effect of ECRG4 on the proliferation and apoptosis of laryngeal cancer cells and the associated mechanisms were investigated. The Hep-2 human laryngeal carcinoma cell line exhibited a low basal level of ECRG4 expression and was selected for the present study. The eukaryotic expression plasmid pcDNA3.1-ECRG4 was constructed and introduced into Hep-2 cells by transfection reagents. Western blot analysis, reverse transcription-quantitative polymerase chain reaction and immunofluorescence staining confirmed high-level expression of ECRG4. The 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and colony formation assay showed that ECRG4 over-expression suppressed the proliferative capacity of laryngeal cancer cells in vitro. Cell cycle analysis showed that ECRG4 induced cell cycle arrest at the G0/G1 phase. Flow cytometric analysis and Hoechst staining demonstrated that overexpres-sion of ECRG4 significantly induced apoptosis. Western blot analysis confirmed that Bcl-2-associated X protein, cleaved-caspase-3 and cleaved-poly (ADP-ribose) polymerase were upregulated in the apoptotic process, whereas B-cell lymphoma 2 was downregulated. In conclusion, overexpression of ECRG4 inhibited laryngeal cancer cell proliferation and induced cancer cell apoptosis. Therefore, ECRG4 exhibits potential as an effective target in gene therapy for laryngeal cancer.