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BackgroundStatins are frequently prescribed with direct oral anticoagulants (DOACs), and previous studies have raised concerns about the increased risk of intracerebral hemorrhage or other major bleeding in concurrent statins and DOACs use. The objective of this study is to evaluate the risk of major bleeding in non-valvular atrial fibrillation patients taking DOACs with or without statins.MethodsThis nationwide, retrospective cohort study used data from the Taiwan National Health Insurance Research Database, enrolled a total of 90,731 non-valvular atrial fibrillation patients receiving rivaroxaban, dabigatran, apixaban or edoxaban from January 1st, 2012 to December 31st, 2017. Major bleeding was defined as a hospitalization or emergency department visit with a primary diagnosis of intracerebral hemorrhage, gastrointestinal tract bleeding, urogenital tract bleeding, or other sites of bleeding. Adjusted incidence rate ratios (IRR) and differences of major bleeding between person-quarters of DOACs with or without statins were estimated using a Poisson regression and inverse probability of treatment weighting using the propensity score.Results50,854 (56.0%) of them were male with a mean age of 74.9 (SD, 10.4) years. Using DOACs without statins as a reference, the adjusted IRR for all major bleedings in concurrent use of DOACs and statins was 0.8 (95% CI 0.72–0.81). Lower major bleeding risk was seen in both low-to-moderate-intensity statins (IRR: 0.8, 95% CI 0.74–0.84) and high-intensity statins (IRR: 0.8, 95% CI 0.74–0.88). Concurrent use of DOACs and statins decreased the risk for intracerebral hemorrhage with an IRR of 0.8 (95% CI 0.66–0.93), and gastrointestinal tract bleeding with an IRR of 0.7 (95% CI 0.69–0.79). The protective effect of statins on intracerebral hemorrhage was observed only in female patients (IRR 0.67, 95% CI 0.51–0.89), but not in male patients (IRR 0.87, 95% CI 0.70–1.08).ConclusionsAmong non-valvular atrial fibrillation patients who were taking DOACs, concurrent use of statins decreased major bleeding risk, including intracerebral hemorrhage and gastrointestinal tract bleeding. Considering this and other cardioprotective effects, statins should be considered in all eligible patients prescribed with DOACs.

Additional file 2: Supplementary Figure 1. The illustration of path analyses models. We used path analyses to evaluate whether Z-SUM scores of 18F-THK-5351 uptake intensity mediated the associations between stroke volume and cognitive performance. We selected cognitive functions showing significant correlations with both stroke volume and Z-sum scores as the endogenous variables. Further, we adjusted for age, education, and depressive symptoms (a) and anxiety (b) co-variables.

Additional file 5. Inferences of selected genes to Marbach, TRRUSTv2 and ENCODE TF-Targets dataset.

Additional file 14: Supplementary Table 12. Clinical characteristics of patients with hemorrhagic and ischemic stroke

Additional file 3. Monotonic descending pattern genes with DE ≤ 4.

Additional file 6: Supplementary Table 5. Associations of total Z-SUM scores of 18F-THK-5351 uptake intensity with cognitive function in model II

Additional file 8. TO-GCN robustness analysis.

Additional file 1. MDS plot and heatmap.

Additional file 10: Supplementary Figure 2. Path analyses of stroke effects on cognition via total or ipsilateral Z-SUM-4 scores after age, education and anxiety adjustment. Stroke volume contributes significantly to cognitive function as well as total and ipsilateral Z-SUM-4 scores in patients with either left-hemispheric (a, b) or right-hemispheric (c, d) stroke. Further, ipsilateral Z-SUM-4 scores can partly mediate language influence from stroke volume in patients with left-hemispheric stroke (b). Likewise, total and ipsilateral Z-SUM-4 scores can partly mediate executive influence from stroke volume in patients with right-hemispheric stroke (c, d)

Additional file 4. Monotonic ascending pattern genes with DE ≤ 4.

Additional file 12: Supplementary Table 10. Comparisons of the contralateral Z-SUM scores of stroke patients with the average Z-SUM scores of bilateral hemispheres of healthy subjects

Additional file 2. TF in TO-GCN.

Additional file 6. List of enriched pathways in each level.

Additional file 9: Supplementary Table 8. Correlations of contralateral Z-SUM scores with cognitive performance in patients with left and right hemisphere stroke

Additional file 11: Supplementary Table 9. Effects of stroke volume and Z-SUM-4 score on cognitive function after adjustment for age, education and depressive symptoms (A~D) and anxiety (E~H)

Additional file 8: Supplementary Table 7. Demographic data, imaging findings and cognitive results between patients with left and right hemisphere stroke

Additional file 1: Supplementary Table 1. Tests for neuropsychological function and stroke severity evaluation

Additional file 7: Supplementary Table 6. Associations of total Z-SUM scores of 18F-THK-5351 uptake intensity with cognitive function in model III

Additional file 13: Supplementary Table 11. The correlations between total Z-SUM scores and cognitive function in ischemic stroke patients

Additional file 3: Supplementary Table 2. The comparisons of total Z-SUM scores between the presence and absence of vascular risk factors in stroke patients and healthy subjects

Additional file 4: Supplementary Table 3. Correlations of total Z-SUM scores with demographic, vascular and neurodegenerative features

Table S1. The standardized uptake value ratios (SUVRs) of 18F-THK-5351 PET and diffusion tensor imaging parameters in the bilateral cerebral hemispheres. (DOCX 45Â kb)

In this paper, a novel single stage step up/down AC/DC converter is proposed for small wind power BLDC generators. Basically, the proposed converter is derived by integrating a brushless DC generator (BLDCG), a full diode bridge, and a C'uk DC to DC converter to achieve same robustness as a traditional diode rectifier but without incurring large torque ripple trouble. Also, it can not only generate continuous output current but also can step up/down the generator terminal voltage to cope with the wind speed variation flexibly for achieving larger operation range of the system. Moreover, a unique scalar dynamic model of the BLDCG is proposed for simplifying the dynamic control of the system. Finally, some simulation results are given for demonstrating the feasibility of the proposed converter.

In this paper, a new module structure of phase locked loop (PLL) speed controller is first proposed for permanent magnet brushless dc (PMBLDC) motor drives to achieve both fast response and high accuracy. The proposed standard module renders the controller design rather simple and straightforward. In addition, in order to reduce the drive cost, a phase current sensing scheme is adopted to properly integrate with the PWM control of the PLL controller. A prototype is also constructed to verify the feasibility of the proposed variable speed drive. It is seen that the proposed drive is rather suitable for practical applications.

In this paper, first, an equivalent scalar dynamic model for the three-phase brushless dc (BLDC) motor is derived to simplify the control of the electric vehicle (EV) drive. Then, an equivalent armature current sensing technique is proposed for synthesizing the three-phase line current by using the low-side switches of the inverter as current sensors. No additional current sensors are required and no extra power loss is generated. Third, the proposed equivalent current sensing technique is dedicatedly integrated with the PWM control for convenient closed-loop torque control implementation. Finally, a prototype EV drive system is constructed by using a 36V, 100A, 8-poles BLDC motor and a CPLD. Experimental results show that the proposed EV drive can indeed achieve the desired performance. Moreover, it is seen that with the above simplification and integration, the proposed EV drive controller circuit can be easily integrated into a single chip.

Due to the sinusoidal air gap flux waveform of interior permanent magnet (IPM) motors, an expensive encoder is usually required for the drive. In this paper, a robust and low cost hall-sensor-based rotor position signal synthesizer is first proposed for traction motor drives. Then, a double-band hysteresis current controller is adopted for the inverter to further reduce switching loss. Also, a digital signal processor, namely TI TMS320F240 is used to implement the speed controller. Experimental results show that, for common traction motor applications, the proposed IPM traction motor drive can satisfy the desired performance without using an expensive and delicate encoder.