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BACKGROUND: Arrhythmogenic cardiomyopathy (ACM) is characterized by progressive myocardial fibro-fatty infiltration accompanied by trabecular disarray. Traditionally, two-dimensional (2D) instead of 3D fractal dimension (FD) analysis has been used to evaluate trabecular disarray. However, the prognostic value of trabecular disorder assessed by 3D FD measurement remains unclear. PURPOSE: To investigate the prognostic value of right ventricular trabecular complexity in ACM patients using 3D FD analysis based on cardiac MR cine images. STUDY TYPE: Retrospective. POPULATION: 85 ACM patients (mean age: 45 ± 17 years, 52 male). FIELD STRENGTH/SEQUENCE: 3.0T/cine imaging, T2-short tau inversion recovery (T2-STIR), and late gadolinium enhancement (LGE). ASSESSMENT: Using cine images, RV (right ventricular) volumetric and functional parameters were obtained. RV trabecular complexity was measured with 3D fractal analysis by box-counting method to calculate 3D-FD. Cox and logistic regression models were established to evaluate the prognostic value of 3D-FD for major adverse cardiac events (MACE). STATISTICAL TESTS: Cox regression and logistic regression to explore the prognostic value of 3D-FD. C-index, time-dependent receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) to evaluate the incremental value of 3D-FD. Intraclass correlation coefficient for interobserver variability. P < 0.05 indicated statistical significance. RESULTS: 26 MACE were recorded during the 60 month follow-up (interquartile range: 48-67 months). RV 3D-FD significantly differed between ACM patients with MACE (2.67, interquartile range: 2.51 ~ 2.81) and without (2.52, interquartile range: 2.40 ~ 2.67) and was a significant independent risk factor for MACE (hazard ratio, 1.02; 95% confidence interval: 1.01, 1.04). In addition, prognostic model fitness was significantly improved after adding 3D-FD to RV global longitudinal strain, LV involvement, and 5-year risk score separately. DATA CONCLUSION: The myocardial trabecular complexity assessed through 3D FD analysis was found associated with MACE and provided incremental prognostic value beyond conventional ACM risk factors. EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 1.
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Strategies on the construction of enantiomerically pure silicon-stereogenic silanes generally relies on desymmetrization of prochiral and symmetric substrates. However, dynamic kinetic asymmetric transformations of organosilicon compounds have remained underdeveloped and unforeseen owing to a lack of an effective method for deracemization of the static silicon stereocenters. Here we report the first Rh-catalyzed dynamic kinetic asymmetric intramolecular hydrosilylation (DyKAH) with "silicon-centered" racemic hydrosilanes that enables the facile preparation of silicon-stereogenic benzosiloles in good yields and excellent enantioselectivities. The special rhodium catalyst controlled by non-diastereopure-type mixed phosphine-phosphoramidite ligand with axial chirality and multiple stereocenters can induce enantioselectivity efficiently in this novel DyKAH reaction. Density functional theory (DFT) calculations suggest that the amide moiety in chiral ligand plays important role in facilitating the SN 2 substitution of chloride ion to realize the chiral inversion of silicon center.
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BACKGROUND: This study aims to evaluate the use and effectiveness of case management in clinical nursing education. METHODS: A sample of 181 nurses at the N3-N5 level were selected for clinical nursing education and divided into two groups using the random number method. The control group (n = 90) received traditional training, and the observation group (n = 91) received a case management model of training. The theoretical knowledge, nursing skills, training satisfaction, job stress, workplace mindfulness, career satisfaction, and job happiness of the two groups were compared. In addition, 50 patients were selected as subjects for each group, and their satisfaction with the nursing care that they received was also measured and compared. RESULTS: Theoretical knowledge and nursing skills scored higher in the observation group than in the control group (p < 0.05), and overall training satisfaction was higher in the observation group than in the control group (p < 0.05). After training, job stress in the observation group was lower than in the control group (p < 0.05), while workplace mindfulness, career satisfaction, and job happiness were higher in the observation group than in the control group (p < 0.05). In terms of nursing quality, on all indicators, the observation group scored higher than the control group (p < 0.05), and the patients' nursing satisfaction scores were higher in the observation group than in the control group (p < 0.05). CONCLUSION: Case management can improve the professionalism and overall skills of nurses at the N3-N5 levels. It is conducive to reducing job stress, enhancing workplace mindfulness, improving career satisfaction and job happiness, and improving the quality of nursing, thereby providing patients with better nursing care.
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OBJECTIVE: To study the anti-feeding effect of total ginsenoside of ginseng stems and leaves on Heliothis dipsacea larvae. METHOD: The natural growing condition for lavae was simulated indoors. The anti-feeding effect of total ginsenoside on Heliothis dipsacea larvae was studied by leaf disc test. RESULT: The total ginsenoside appeared showed a significant antifeeding effect. The Heliothis dipsacea larvae fed with the leaves of soybean treated with 2.0%, 1.0% and 0.5% total ginsenoside, respectively. At 8 h, non-selective anti-feeding rate were 93.40%, 83.42% and 75.19%, and selective anti-feeding rate were 77.53% , 73.58% and 58.86%. CONCLUSION: The toatal ginsenoside had significant inhibition effect on Heliothis dipsacea larvae, and inhibition effect increases as the increase of concentration ginsenoside.
