Efficacy of early administration of sacubitril/valsartan after coronary artery revascularization in patients with acute myocardial infarction complicated by moderate-to-severe mitral regurgitation: a randomized controlled trial.

Effects of angiotensin receptor/neprilysin inhibitors (ARNI) on ventricular remodeling in patients with heart failure, especially heart failure with reduced ejection fraction (HFrEF), are better than those of angiotensin-converting enzyme inhibitors (ACEI). Acute myocardial infarction (AMI) complicated by mitral regurgitation exacerbates ventricular remodeling and increases the risk of heart failure. There is limited evidence on the effects of early administration of ARNI in patients with AMI complicated by mitral regurgitation. The aim of this trial was to examine the effectiveness and the safety of early administration of sacubitril/valsartan after coronary artery revascularization in patients with AMI complicated by moderate-to-severe mitral regurgitation. This was a randomized, single-blind, parallel-group, controlled trial. From June 2021 to June 2022, we enrolled 142 consecutive patients with AMI complicated by moderate-to-severe mitral regurgitation and followed them for 12 months. The patients received standard treatment for AMI and were randomly assigned to receive ARNI or benazepril. The primary efficacy end points were the differences in mitral regurgitant jet area (MRJA), mitral regurgitant volume (MRV), concentration of n-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume and end-systolic volume (LVEDV and LVESV) between groups and within groups at baseline, 1, 3, 6, and 12 months. Secondary end points included the rates of heart failure hospitalization, all-cause mortality, refractory angina, malignant arrhythmias, recurrent myocardial infarction, and stroke. Safety end points included the rates of hyperkalemia, renal dysfunction, hypotension, angioedema, and cough. The ARNI group had significantly lower NT-proBNP levels than the benazepril group at 1 month and later (P < 0.001). MRJA and MRV significantly improved in the ARNI group compared with the benazepril group at 12 months (MRJA: - 3.21 ± 2.18 cm2 vs. - 1.83 ± 2.81 cm2, P < 0.05; MRV: - 27.22 ± 15.22 mL vs. - 13.67 ± 21.02 mL, P < 0.001). The ARNI group also showed significant reductions in LVEDV and LVESV (P < 0.05) and improvement in LVEF (P < 0.05). Secondary end point analysis showed a significantly higher rate of heart failure hospitalization in the benazepril group compared with the ARNI group (HR = 2.03, 95% CI 1.12-3.68, P = 0.021). Safety end point analysis showed a higher rate of hypotension in the ARNI group (P < 0.05). Early use of sacubitril/valsartan after coronary artery revascularization in patients with AMI complicated by moderate-to-severe mitral regurgitation can significantly reduce mitral regurgitation, improve ventricular remodeling, and decrease heart failure hospitalization. Nevertheless, caution is needed to avoid hypotension. Chinese Clinical Trial Registry (ChiCTR2100054255) registered on December 11, 2021.

Relationship between social support and self-care ability among patients with breast cancer during rehabilitation: The multiple mediating roles of resilience and depression.

AIMS: To identify the multiple mediating effects of resilience and depression between social support and self-care ability among patients with breast cancer during rehabilitation to provide reference for developing and implementing targeted interventions. DESIGN: A cross-sectional study reported according to the STROBE checklist. METHODS: A convenience sample of 320 patients with breast cancer during rehabilitation was recruited from one hospital in China. Data were collected from April to August 2022 using a self-report questionnaire, including the demographic and clinical information, Appraisal of Self-Care Agency Scale-Revised, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale-10 item, and Patient Health Questionnaire-9. The mediation analysis was conducted using the SPSS Process macro. RESULTS: Self-care ability was positively associated with social support (ß = .229) and resilience (ß = .290), and negatively associated with depression (ß = -.208). The relationship between social support and self-care ability was mediated by resilience and depression, respectively, and together in serial. The multiple mediating effects accounted for 34.0% of the total effect of social support on self-care ability. CONCLUSION: Our findings identify resilience and depression as multiple mediators between social support and self-care ability and highlight the important roles of social support, resilience and depression in improving self-care ability. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should pay great attention to the underlying mechanisms of how social support affects patients' self-care ability during breast cancer rehabilitation. Integrated intervention programmes targeted at enhancing social support, building resilience and alleviating depression might be beneficial to the improvement of self-care ability. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.

Early Depletion of Neutrophils Reduces Retinal Inflammation and Neovascularization in Mice with Oxygen-Induced Retinopathy.

Retinal inflammation is a central feature of ocular neovascular diseases such as diabetic retinopathy and retinopathy of prematurity, but the contribution of neutrophils to this process is not fully understood. We studied oxygen-induced retinopathy (OIR) which develops in two phases, featuring hyperoxia-induced retinal vaso-obliteration in phase I, followed by retinal neovascularization in phase II. As neutrophils are acute responders to tissue damage, we evaluated whether neutrophil depletion with an anti-Ly6G mAb administered in phase I OIR influenced retinal inflammation and vascular injury. Neutrophils were measured in blood and spleen via flow cytometry, and myeloperoxidase, an indicator of neutrophil activity, was evaluated in the retina using Western blotting. Retinal vasculopathy was assessed by quantitating vaso-obliteration, neovascularization, vascular leakage, and VEGF levels. The inflammatory factors, TNF, MCP-1, and ICAM-1 were measured in retina. In the OIR controls, neutrophils were increased in the blood and spleen in phase I but not phase II OIR. In OIR, the anti-Ly6G mAb reduced neutrophils in the blood and spleen, and myeloperoxidase, inflammation, and vasculopathy in the retina. Our findings revealed that the early rise in neutrophils in OIR primes the retina for an inflammatory and angiogenic response that promotes severe damage to the retinal vasculature.

Natural variation of HTH5 from wild rice, Oryza rufipogon Griff., is involved in conferring high-temperature tolerance at the heading stage.

Global warming is a major abiotic stress factor, which limit rice production. Exploiting the genetic basis of the natural variation in heat resistance at different reproductive stages among diverse exotic Oryza germplasms can help breeding heat-resistant rice cultivars. Here, we identified a stable quantitative trait locus (QTL) for heat tolerance at the heading stage on chromosome 5 (qHTH5) in O. rufipogon Griff. The corresponding gene, HTH5, pertains to the pyridoxal phosphate-binding protein PLPBP (formerly called PROSC) family, which is predicted to encode pyridoxal phosphate homeostasis protein (PLPHP) localized to the mitochondrion. Overexpression of HTH5 increased the seed-setting rate of rice plants under heat stress at the heading stage, whereas suppression of HTH5 resulted in greater susceptibility to heat stress. Further investigation indicated that HTH5 reduces reactive oxygen species accumulation at high temperatures by increasing the heat-induced pyridoxal 5'-phosphate (PLP) content. Moreover, we found that two SNPs located in the HTH5 promoter region are involved with its expression level and associated with heat tolerance diversity. These findings suggest that the novel gene HTH5 might have great potential value for heightening rice tolerance to heat stress to the on-going threat of global warming.

A Review of Vision-Laser-Based Civil Infrastructure Inspection and Monitoring.

Structural health and construction security are important problems in civil engineering. Regular infrastructure inspection and monitoring methods are mostly performed manually. Early automatic structural health monitoring techniques were mostly based on contact sensors, which usually are difficult to maintain in complex infrastructure environments. Therefore, non-contact infrastructure inspection and monitoring techniques received increasing interest in recent years, and they are widely used in all aspects of infrastructure life, owing to their convenience and non-destructive properties. This paper provides an overview of vision-based inspection and vision-laser-based monitoring techniques and applications. The inspection part includes image-processing algorithms, object detection, and semantic segmentation. In particular, infrastructure monitoring involves not only visual technologies but also different fusion methods of vision and lasers. Furthermore, the most important challenges for future automatic non-contact inspections and monitoring are discussed and the paper correspondingly concludes with state-of-the-art algorithms and applications to resolve these challenges.

Application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy.

OBJECTIVES: To investigate the application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy. METHODS: Two hundred patients with acute ST-segment elevation myocardial infarction (STEMI) complicated with diabetes who underwent percutaneous coronary intervention (PCI) and found to have high thrombus burden in coronary artery admitted to our hospital from September 2018 to September 2020 were selected as subjects, and were divided into two groups according to the randomization method: the intravenous tirofiban bolus group and the intracoronary tirofiban bolus group, with 100 cases in each group. The levels of LVEF, LVESD and LVEDD were detected immediately after admission and 15 days after therapy, and the enzyme-linked immunosorbent assay was utilized to detect the levels of CK-MB, MMP-9 and hs-CRP. Furthermore, the levels of BNP, TNI, CR and UREA of the patients were analyzed, and the levels of ESR and FIB were detected with an automatic blood rheology analyzer to analyze the TIMI classification and the incidence of MACE in the two groups. RESULTS: Significant differences were seen between the two groups in the levels of various indicators after therapy. Fifteen days after therapy, the levels of LVEF and LVEDD were higher and the level of LVESD was lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of CK-MB, MMP-9 and BNP in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of TNI (p<0.05), CR and UREA in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group, with no statistical difference (p>0.05); Similarly, 3d after therapy, the levels of TNI, Cr and Urea, as well as ESR, FIB and hs-CRP were lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05). Compared with the intravenous tirofiban bolus group, the intracoronary tirofiban bolus group had a lower number of patients with Grade-0 and Grade-1, but a higher number of patients with Grade-2 and Grade-3 (p<0.05); Moreover, the incidence of MACE in the intracoronary tirofiban bolus group was lower than that in the intravenous tirofiban bolus group (p<0.05). CONCLUSION: In patients with STEMI complicated with diabetes who underwent PCI and found to have high thrombus burden in coronary artery, intracoronary bolus of tirofiban boasts superior therapeutic efficacy over intravenous bolus of tirofiban in significantly improving cardiac function, reducing myocardial cell damage, and improving renal function and myocardial inflammation of patients.

Fine mapping of the qHTB1-1QTL, which confers heat tolerance at the booting stage, using an Oryza rufipogon Griff. introgression line.

KEY MESSAGE: The qHTB1-1 QTL, controlling heat tolerance at the booting stage in rice, was fine mapped to a 47.1 kb region containing eight candidate genes. Two positional candidate genes showed significant changes in expression levels under heat stress. High-temperature stress at the booting stage has the potential to significantly limit rice production. An interspecific advanced backcrossed population between the Oryza sativa L. cultivar R53 and the wild Oryza rufipogon Griff accession HHT4 was used as the source material to develop a set of chromosome segment introgression lines to elucidate the genetic mechanism of the qHTB1-1 QTL in heat tolerance. A single-chromosome-segment introgression line, IL01-15, was used to develop secondary populations for the mapping of qHTB1-1 on chromosome 1 for heat tolerance at the booting stage. Using the BC5F2, BC5F3, and BC5F4 populations, we first confirmed qHTB1-1 and validated the phenotypic effect. The qHTB1-1 QTL explained 13.1%, 16.9%, and 17.8% of the phenotypic variance observed in the BC5F2, BC5F3, and BC5F4 generations, respectively. Using homozygous recombinants screened from larger BC6F2 and BC6F3 populations, qHTB1-1 was fine mapped within a 47.1 kb region between markers RM11633 and RM11642. Eight putative predicted genes were annotated in the region, and six genes were predicted to encode expressed proteins. The expression patterns of these six genes demonstrated that LOC_Os01g53160 and LOC_Os01g53220 were highly induced by heat stress in IL01-15 compared to R53. Sequence comparison of the gene-coding regions of LOC_Os01g53160 and LOC_Os01g53220 between R53 and IL01-15 revealed one synonymous and two nonsynonymous SNPs in exons, respectively. Our results provide a basis for identifying the genes underlying qHTB1-1 and indicate that markers linked to the qHTB1-1 locus can be used to improve the heat tolerance of rice at the booting stage by marker-assisted selection.

Comprehensive comparison of multiple quantitative near-infrared spectroscopy models for Aspergillus flavus contamination detection in peanut.

BACKGROUND: Aspergillus flavus is a major pollutant in moldy peanuts, and it has a large influence on the taste of food. The secondary metabolites of Aspergillus flavus, including aflatoxin B1 (AFB1) and aflatoxin B2 (AFB2), are highly toxic and can expose humans to high risk. The total mold count (TMC) is an important index to determine the contamination degree and hygiene quality of peanut. RESULTS: Quantitative calibration models were established based on full-band wavelengths and characteristic wavelengths, combined with chemometric methods, to explore the feasibility of the use of near-infrared spectroscopy (NIRS) for rapid detection of the TMC in peanuts. The successive projection algorithm (SPA) and elimination of uninformative variables (UVE) algorithms were used to extract the characteristic wavelengths. In comparison, the model built by original spectrum, selected with the UVE algorithm, gave the best result, with a correlation coefficient in a prediction set (RP ) of 0.9577, a root mean square error for the prediction set (RMSEP) of 0.2336 Log CFU/g, and a residual predictive deviation (RPD) of 3.5041. CONCLUSIONS: The results showed that NIRS is a rapid, practicable method for the quantitative detection of peanut Aspergillus flavus contamination. It is a promising method for detecting moldy peanuts and increasing peanut safety. © 2019 Society of Chemical Industry.

The effect of trimetazidine treatment in patients with type 2 diabetes undergoing percutaneous coronary intervention for AMI.

PURPOSE: Trimetazidine (TMZ) improves clinical outcomes in patients with chronic heart failure and stable coronary artery disease. No study has yet evaluated the efficacy of TMZ in type 2 diabetes patients with acute myocardial infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI). We performed this study to evaluate the efficacy TMZ in DM patients with AMI undergoing PCI, such as the effect on reductions in myocardial enzyme, improvements in liver function, modulation of glucose levels, and improvement in cardiac function. METHODS: For this randomized study, we enrolled 173 AMI patients with type 2 diabetes undergoing PCI between January 1, 2014, and January 1, 2016. All patients received aspirin and ticagrelor upon admission and throughout their hospitalization. Patients in the experimental group were treated with a loading dose of 60mg TMZ at admission, and 20 mg TMZ three times a day thereafter. 89 patients were included in experimental group, and 84 patients were included in control group. All patients received PCI treatments. The endpoints evaluated were serum creatine kinase and its isoenzyme (CK and CK-MB), cardiac troponin I (cTNI), serum creatinine (Cr), serum urea, blood glucose, serum glutamic pyruvic transaminase (ALT), serum glutamic oxaloacetictransaminase (AST), left atrial dimension (LA), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), and cardiac output (CO). FINDINGS: Compared with the control group, TMZ treatment significantly reduced CK and CK-MB on the second day in hospital ([797±582] vs. [1092±1114]; [80±60] vs. [105±100]; p=0.029, p=0.041, respectively), and cTNI after one and six days in hospital ([13.5±12.7] vs. [19.8±19.2]; [3.3±3.2] vs. [4.8±4.7]; two-tailed p=0.012). In addition, TMZ significantly lowered liver enzymes (ALT, AST) at 6days ([29.0±11.6] vs. [42.4±24.5]; [39.8±17.3] vs. [69.2±70.0]; two-tailed p=0.000), lowered glucose after 6days ([6.80±2.12] vs. [7.59±2.24]; p=0.019), and increased LVEF after ten to fourteen days ([58.4±8.6] vs. [54.9±8.4]; p=0.008). There were no significant effect on Cr and serum urea (p=0.988, p=0.569, respectively), nor on LA, LVEDD, and CO ([36.3±4.5] vs. [37.0±4.1], p=0.264; [52.0±4.9] vs. [53.1±4.6], p=0.128; [5.4±0.9] vs. [5.4±0.9], p=0.929, respectively). IMPLICATIONS: Among type 2 diabetic patients with AMI undergoing PCI, TMZ significantly reduces serum myocardial enzyme, improves liver function, adjusts blood glucose and improves cardiac function.

[Identification of Fertilized Chicken Eggs Based on Visible/Near-Infrared Spectrum During Early Stage of Incubation].

In the process of chicken egg hatching, some eggs can not be hatched successfully due to the absence of fertilization. These eggs not only cause a lot of waste, but also infect other normal eggs with bacteria. In the study, the fertilized eggs and clear eggs is identified by using the visible/near-infrared spectrum. It is of great necessity to get the best time of identifying the clear eggs in the early of hatching, so the variation of eggs' quality in the condition of hatching over time is studied. The results show that eggs are fresh after 24 hours' hatching and eggs can not be eaten after 72 hours' hatching while the best time of identification is within 36 hours. Static acquisition system is developed based on visible/near-infrared transmission spectrum for acquiring spectrum. Comparing the effect of the model of the different samples of same breed and samples of different breed, the different part of spectrum among fertilized eggs and clear eggs is deleted which caused by the color of eggshell and yolk, the effective spectral band are 355～590 and 670～1 025 nm. Adopting the pretreatment of PCA and comparing the accuracy of the various mathematical models with different time and the number of principal components decide the best number of principal components. Considering the production efficiency and comparing the different pretreatment methods of spectrum, for examples, SNV, MSC, Derivative correction and PCA, and various mathematical models are combined to establish the most efficient discriminant model. The result shows that the most efficient discriminant model is established with Fisher and based on the pretreatment of PCA after 24 hours' hatching. And the precision rate is 87.18%. The study provides a new way for nondestructive and online identification of the fertilized eggs and clear eggs.

Assessment of Ticagrelor Versus Clopidogrel Treatment in Patients With ST-elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

AIMS: Ticagrelor improves the clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). However, few studies have directly compared the efficacy and safety of ticagrelor against clopidogrel, an oral, thienopyridine-class antiplatelet drug. This study compared the efficacy and safety of ticagrelor and clopidogrel in patients with STEMI undergoing PPCI. METHODS: We enrolled 400 patients with STEMI undergoing PPCI at the Zhujiang Hospital of Southern Medical University and the First Hospital of Qinhuangdao, China, between January 01, 2013 and April 30, 2015. All patients received 300 mg of aspirin and were randomized to receive one of the following treatments: (1) a loading dose of clopidogrel (600 mg) before PPCI followed by clopidogrel (75 mg once daily for 1 year) post PPCI or (2) a loading dose of ticagrelor (180 mg) before PPCI followed by ticagrelor (90 mg twice daily for 1 year) post PPCI. Some patients were treated by intracoronary bolus of a glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitor [tirofiban (10 µg/kg) plus maintenance infusion (0.15 µg·kg·min) for 24-36 hours] in accordance with specified guidelines. The primary end points evaluated were major adverse cardiovascular and cerebrovascular event (MACCE) [defined as a composite of overall death, myocardial infarction (MI), unplanned revascularization, or stroke], stent thrombosis, and the composite end point of CV death, nonfatal MI, and stroke. The supplemental use of GPIIb/IIIa inhibitors in the clopidogrel and ticagrelor groups was monitored as another study end point, although the secondary safety end point evaluated was the incidence of bleeding events. RESULTS: Compared with the clopidogrel-treated group, ticagrelor treatment significantly reduced the incidence of MACCE [5 vs. 14; odds ratio (OR), 0.341; 95% confidence interval (CI), 0.120-0.964; P = 0.034] and the composite end points of cardiovascular death, nonfatal MI, and stroke (4 vs. 13; OR, 0.294; 95% CI, 0.094-0.916; P = 0.026). Fewer patients in the ticagrelor group received GPIIb/IIIa inhibitors after PPCI compared with those in the clopidogrel group (10 vs. 21; OR, 0.449; 95% CI, 0.206-0.979; P = 0.040). However, there were no significant differences between the groups in the incidences of all-cause mortality, nonfatal MI, unplanned revascularization, stroke, stent thrombosis (P = 0.522, P = 0.246, P = 0.246, P = 0.217, P = 0.246, respectively), or bleeding events (10 vs. 7; OR, 1.451; 95% CI, 0.541-3.891; P = 0.457). CONCLUSIONS: Among patients with STEMI undergoing PPCI, ticagrelor reduces the incidence of MACCE and the composite end point of cardiovascular death, nonfatal MI, and stroke compared with clopidogrel. Ticagrelor also reduces the need for GPIIb/IIIa inhibitors. However, no significant difference was observed in the risk of bleeding between the 2 groups.

Helix B Surface Peptide Protects Cardiomyocytes Against Hypoxia/Reoxygenation-induced Apoptosis Through Mitochondrial Pathways.

BACKGROUND: Helix B surface peptide (HBSP), a newly developed tissue-protective erythropoietin derivative, has beneficial effects on myocardial ischemia. This study aimed to investigate the cardio-protective effects of HBSP against hypoxia/reoxygenation (H/R) injury and its possible mechanism. METHODS: A rat-derived cardiomyocyte cell line (H9C2 cells) were established and pretreated with HBSP. The pretreated primary cultures were subjected to H/R and monitored for cell viability using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. Intracellular reactive oxygen species (ROS) levels, apoptosis, and mitochondrial membrane potential (ΔΨm) were detected by flow cytometry. The expression of cytochrome C and Bcl-2 family proteins, as well as the activities of caspases 3 and 9 were determined by Western blot analysis and a colorimetric method, respectively. RESULTS: HBSP reduced apoptotic cells in cardiomyocytes subjected to H/R. In HBSP-treated cardiomyocytes, the H/R-induced mitochondrial ROS production, ΔΨm collapse, and cytochrome C release from mitochondria to the cytosol significantly decreased. Moreover, HBSP inhibited the activation of caspases 9 and 3, as well as the alteration of Bcl-2 family proteins, which were induced by H/R. CONCLUSIONS: These results indicated that HBSP has protective effects against H/R-induced apoptosis by regulating the mitochondrial pathway. This mechanism involves inhibiting mitochondrial ROS generation, inhibiting caspase-3 activity, reducing ΔΨm collapse, reducing cytochrome release, and balancing anti and proapoptotic Bcl-2 family proteins.

Helix B Surface Peptide Protects against Acute Myocardial Ischemia-Reperfusion Injury via the RISK and SAFE Pathways in a Mouse Model.

OBJECTIVE: This study explores the effects of helix B surface peptide (HBSP) on myocardial infarct size (IS), cardiac function, cardiomyocyte apoptosis and oxidative stress damage in mouse hearts subjected to myocardial ischemia-reperfusion injury (MIRI) and also the mechanisms underlying the effects. METHOD: Male adult mice were subjected to 45 min of ischemia followed by 2 h of reperfusion; 5 min before the reperfusion, they were treated with HBSP or vehicle. MIRI-induced IS, cardiomyocyte apoptosis and cardiac functional impairment were determined and compared. Western blot analysis was then conducted to elucidate the mechanism of HBSP after treatment. RESULTS: HBSP administration before reperfusion significantly reduced the myocardial IS, decreased cardiomyocyte apoptosis, reduced the activities of superoxide dismutase and malondialdehyde and partially preserved heart function. As demonstrated by the Western blot analysis, HBSP after treatment upregulated Akt/GSK-3ß/ERK and STAT-3 phosphorylation; these inhibitors, in turn, weakened the beneficial effects of HBSP. CONCLUSION: HBSP plays a protective role in MIRI in mice by inhibiting cardiomyocyte apoptosis, reducing the MIRI-induced IS, oxidative stress and improving the heart function after MIRI. The mechanism underlying these effects of HBSP is related to the activation of the RISK (reperfusion injury salvage kinase, Akt/GSK-3ß/ERK) and SAFE (STAT-3) pathways.

A retrospective comparison of dexmedetomidine versus midazolam for pediatric patients with congenital heart disease requiring postoperative sedation.

We hypothesized that postoperative sedation with dexmedetomidine/fentanyl would be effective in infants and neonates with congenital heart disease and pulmonary arterial hypertension (PAH). Children who were <36 months of age, had congenital heart disease with PAH, and had been treated at our hospital between October 2011 and April 2013 (n = 187) were included in this retrospective study. Either dexmedetomidine/fentanyl (Group Dex) or midazolam/fentanyl (Group Mid) was used for postoperative sedation. The main outcome variables included delirium scores, supplemental sedative/analgesic drugs, ventilator use, and sedation time. Baseline demographics and clinical characteristics were similar between the two groups. The Pediatric Anesthesia Emergence Delirium scale (5.2 ± 5.3 vs. 7.1 ± 5.2 in the Dex and Mid groups, respectively; P = 0.016) and the incidence of delirium (18.2 vs. 32.0 % in the Dex and Mid groups, respectively; P = 0.039) were significantly lower in the Dex group than in the Mid group. Total sufentanil, midazolam, and propofol doses given during the operation did not differ between the two groups. Group Dex patients required significantly lower doses of adjunctive sedative/analgesic drugs than group Mid patients in the cardiac intensive care unit (CICU; midazolam, P = 0.007; morphine, P < 0.001). In conclusion, we found no differences between dexmedetomidine/fentanyl and midazolam/fentanyl in terms of the duration of sedation, mechanical ventilator use, and CICU stay in children with PAH. However, patients in the Dex group required a lower additional sedative/analgesic drugs and had a lower incidence of delirium than patients in the Mid group.

Effects of Tirofiban in Patients with Acute Myocardial Infarction and Diabetes Mellitus undergoing Primary Percutaneous Coronary Intervention.

OBJECTIVE: This study evaluated the efficacy and safety of early vs. late tirofiban administration in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) and diabetes mellitus (DM) undergoing primary percutaneous coronary intervention (pPCI). METHODS: 120 patients with STEMI and DM treated with pPCI were randomly divided into an observation group (n=60) and a control group (n=60). The observation group and the control group were intravenously injected with a bolus of tirofiban preoperatively or intraoperatively, respectively; both groups were then given an intravenous infusion over 24 h at 0.15 µg/kg/min. Thrombolysis in myocardial infarction (TIMI) grade flow, myocardial perfusion index, and functional heart parameters, as well as major adverse cardiovascular events and bleeding, were compared between the two groups. RESULTS: Functional heart parameters, including left ventricular ejection fraction and cardiac output, were significantly improved in the observation group 6 months after discharge. Thrombus aspiration, inflammatory factors, and cardiac troponin I (cTNI) were more significantly decreased in the observation group than in the control group. The sum-ST-segment elevation at 2 h after pPCI treatment in the observation group was better than that in the control group. There was no significant difference in the incidence of adverse reactions and bleeding between the two groups. CONCLUSION: The administration of tirofiban before reperfusion therapy compared with after reperfusion therapy is more effective in reducing the hyperthrombotic load, thrombus aspiration, inflammatory factors, and cTNI and can effectively improve myocardial perfusion and heart function.

Bread staling prediction with a multiobjective particle swarm optimization-based bread constitutive modeling method.

Aiming at the complex and cumbersome problems of current bread staling detection technology, a food constitutive modeling method based on the multiobjective particle swarm optimization (MOPSO) was proposed, which can quickly and efficiently identify the creep test parameters for bread, and predict the viscoelastic parameters of bread staling using the analyzed viscoelastic parameters, resulting in convenient and efficient detection of bread staling. Firstly, airflow-laser detection technology was used to carry out rapid, efficient, and non-destructive bread rheological tests to obtain bread creep test data. The MOPSO based on the Pareto set was then used to identify the generalized Kelvin model, and the discrimination accuracy was evaluated by using the inversion results established by the viscoelastic parameters, which resulted in efficient discrimination of creep test data of starch-based products represented by bread. Finally, using extreme learning machine regression (ELM), a prediction model between the analysis results and the moisture content of bread staling was established, and the prediction effect of the analysis results on bread staling was verified. The experimental results show that, when compared to finite element analysis (FEA) and non-linear regression (NLR) to identify creep parameters, the MOPSO overcomes the shortcomings of easy falling into the local optimal solution, is easy to implement, has strong global search ability, and is suitable for the analysis of high-dimensional viscoelastic models of complex foods. The correlation coefficient (R) of the prediction set established by the 12-membered viscoelastic parameters in the prediction model established by multi-element viscoelastic parameters and bread moisture content was 0.847, and the root mean square error (RMSE) was 0.021. This demonstrated that, when combined with MOPSO, airflow-laser detection technology could effectively identify the viscoelastic parameters of bread and establish a method suitable for monitoring bread staling in industrial production. The results of this study provide a reference for the identification of viscoelastic parameters of complex foods and to detect bread staling quickly and efficiently.

Assessment of kiwifruit firmness by using airflow and laser technique.

Firmness is a valid and widely acknowledged indication of fruit quality that is directly connected to physical structure and mechanical qualities. The deformation signals of kiwifruit for firmness assessment were acquired using an assessment system based on airflow and laser technology in this investigation. Using partial least squares regression (PLSR), genetic algorithm optimization of bp neural network (GA-BP), and an extreme learning machine (ELM), deformation data from kiwifruit was used to create models of Magness-Taylor penetration firmness prediction. The ELM model outperformed the PLSR model, and GA-BP model in the prediction set, with a correlation coefficient of 0.876 and a root mean squared error of 3.576 N in the prediction set. These findings showed that an assessment system based on airflow and laser techniques can be utilized to assess the firmness of kiwifruit quickly and nondestructively.

Discrimination of Inner Injury of Korla Fragrant Pear Based on Multi-Electrical Parameters.

Inner-injury fragrant pears are easily prone to rot during storage. Discriminating inner injury in the Korla fragrant pear from the normal pear is difficult as the flesh may be injured while the peel of the fruit remains intact. This study demonstrated the recognition of inner-injury pears based on their electric characteristics to pick out the inner-injury pears before storage. The electrical parameters parallel equivalent capacitance, quality factor, parallel equivalent inductance, parallel equivalent resistance, complex impedance, and phase angle were measured using the fruit electrical characteristic detection instrument. Principal component analysis and correlation analysis were used to determine the characteristic parameters, connected with the qualitative value of the fragrant pear to establish three discrimination models. When the measurement frequency was 100 kHz, compared with the Naïve Bayes and K-nearest neighbor models, the Support Vector Machine model with the characteristic parameters of quality factor, parallel equivalent resistance, and phase angle performed best. The recognition accuracy of the test set was 92.00%, the precision was 92.41%, the recall was 97.33%, and the F1 score was 0.95. Therefore, the electrical characteristic technique effectively detected the inner injury of fragrant pears and provided a new way to distinguish the inner injury of fruits.

Determination of beef tenderness based on airflow pressure combined with structural light three-dimensional (3D) vision technology.

The main factor affecting beef quality, consumer satisfaction, and purchase decisions is beef tenderness. In this study, a rapid nondestructive testing method for beef tenderness based on airflow pressure combined with structural light 3D vision technology was proposed. The structural light 3D camera was used to scan the 3D point cloud deformation information of the beef surface after the airflow acted on it for 1.8 s. Six deformation characteristics and three point cloud characteristics of the beef surface depression region were obtained by using denoising, point cloud rotation, point cloud segmentation, point cloud descending sampling, alphaShape, and other algorithms. A total of nine characteristics were mainly concentrated in the first five principal components (PCs). Therefore, the first five PCs were put into three different models. The results showed that the Extreme Learning Machine (ELM) model had a comparatively higher prediction effect for the prediction of beef shear force, with a root mean square error of prediction (RMSEP) of 11.1389 and a correlation coefficient (R) of 0.8356. In addition, the correct classification accuracy of the ELM model for tender beef achieved 92.96%. The overall classification accuracy reached 93.33%. Consequently, the proposed methods and technology can be applied for beef tenderness detection.

Detection of Specific Volatile Organic Compounds in Tribolium castaneum (Herbst) by Solid-Phase Microextraction and Gas Chromatography-Mass Spectrometry.

The red flour beetle, Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae), is a major storage pest that could lead to a wide range of damage. Its secretions have a significant impact on the quality of stored grain and food, leading to serious food safety problems such as grain spoilage and food carcinogenesis. This study investigates new detection techniques for grain storage pests to improve grain insect detection in China. The primary volatile organic chemicals (VOCs) in these secretions are identified using headspace solid-phase microextraction (HS-SPME) coupled with gas chromatography-mass spectrometry (GC-MS). The specific VOCs that are unique to T. castaneum are selected as criteria for determining the presence of T. castaneum in the granary. To obtain more specific VOCs, experiments were designed for the analysis of T. castaneum samples under different extraction times, two types of SPME fibers and two GC-MS devices of different manufacturers. The experimental results showed that 12 VOCs were detected at relatively high levels, seven of which were common and which were not detected in other grains and grain insects. The seven compounds are 1-pentadecene, 2-methyl-p-benzoquinone, 2-ethyl-p-benzoquinone, 1-hexadecene, cis-9-tetradecen-1-ol, m-cresol and paeonol. These seven compounds can be used as volatile markers to identify the presence of T. castaneum, which could serve as a research foundation for the creation of new techniques for T. castaneum monitoring.