Tenecteplase versus alteplase in treatment of acute ST-segment elevation myocardial infarction: A randomized non-inferiority trial.

BACKGROUND: A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI. METHODS: In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints. RESULTS: From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a -15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: -3.4%; 95% confidence interval [CI]: -11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: -0.5%; 95% CI: -5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. CONCLUSION: rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI. TRIAL REGISTRATION: www.ClinicalTrials.gov (No. NCT02835534).

An Adaptive Data Gathering Scheme for Multi-Hop Wireless Sensor Networks Based on Compressed Sensing and Network Coding.

Joint design of compressed sensing (CS) and network coding (NC) has been demonstrated to provide a new data gathering paradigm for multi-hop wireless sensor networks (WSNs). By exploiting the correlation of the network sensed data, a variety of data gathering schemes based on NC and CS (Compressed Data Gathering--CDG) have been proposed. However, these schemes assume that the sparsity of the network sensed data is constant and the value of the sparsity is known before starting each data gathering epoch, thus they ignore the variation of the data observed by the WSNs which are deployed in practical circumstances. In this paper, we present a complete design of the feedback CDG scheme where the sink node adaptively queries those interested nodes to acquire an appropriate number of measurements. The adaptive measurement-formation procedure and its termination rules are proposed and analyzed in detail. Moreover, in order to minimize the number of overall transmissions in the formation procedure of each measurement, we have developed a NP-complete model (Maximum Leaf Nodes Minimum Steiner Nodes--MLMS) and realized a scalable greedy algorithm to solve the problem. Experimental results show that the proposed measurement-formation method outperforms previous schemes, and experiments on both datasets from ocean temperature and practical network deployment also prove the effectiveness of our proposed feedback CDG scheme.

Design and Analysis of Bionic Cutting Blades Using Finite Element Method.

Praying mantis is one of the most efficient predators in insect world, which has a pair of powerful tools, two sharp and strong forelegs. Its femur and tibia are both armed with a double row of strong spines along their posterior edges which can firmly grasp the prey, when the femur and tibia fold on each other in capturing. These spines are so sharp that they can easily and quickly cut into the prey. The geometrical characteristic of the praying mantis's foreleg, especially its tibia, has important reference value for the design of agricultural soil-cutting tools. Learning from the profile and arrangement of these spines, cutting blades with tooth profile were designed in this work. Two different sizes of tooth structure and arrangement were utilized in the design on the cutting edge. A conventional smooth-edge blade was used to compare with the bionic serrate-edge blades. To compare the working efficiency of conventional blade and bionic blades, 3D finite element simulation analysis and experimental measurement were operated in present work. Both the simulation and experimental results indicated that the bionic serrate-edge blades showed better performance in cutting efficiency.

Cooperative search and rescue with artificial fishes based on fish-swarm algorithm for underwater wireless sensor networks.

This paper presents a searching control approach for cooperating mobile sensor networks. We use a density function to represent the frequency of distress signals issued by victims. The mobile nodes' moving in mission space is similar to the behaviors of fish-swarm in water. So, we take the mobile node as artificial fish node and define its operations by a probabilistic model over a limited range. A fish-swarm based algorithm is designed requiring local information at each fish node and maximizing the joint detection probabilities of distress signals. Optimization of formation is also considered for the searching control approach and is optimized by fish-swarm algorithm. Simulation results include two schemes: preset route and random walks, and it is showed that the control scheme has adaptive and effective properties.