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Objective The present study investigated the predictive value of albuminuria for contrast-induced nephropathy (CIN) non-recovery in patients undergoing percutaneous coronary intervention (PCI). Methods We retrospectively enrolled 550 consecutive patients inflicted with CIN after PCI and reassessing kidney function among 1 week–12 months between January 2012 and December 2018. Patients were stratified into three groups according to urine albumin: negative group (urine dipstick negative), trace group (urine dipstick trace) and positive group (urine dipstick ≥ 1 +). The primary outcomes were CIN non-recovery (a decrease of serum creatinine which remains ≥ 25% or 0.5 mg/dL over baseline at 1 week–12 months after PCI in patients inflicted with CIN). The odds ratio (OR) of CIN non-recovery was analyzed by logistic regression using the negative urine dipstick group as the reference group. Results Overall, 88 (16.0%) patients had trace urinary albumin, 74 (13.5%) patients had positive urinary albumin and 40 (7.3%) patients developed CIN non-recovery. Patients with positive urinary albumin had significantly higher incidence of CIN non-recovery [negative (3.4%), trace (11.4%) and positive (23.0%), respectively; P P = 0.022; positive vs negative: OR 2.99, P = 0.021). These associations were consistent in subgroups of patients stratified by CIN non-recovery risk predictors. And CIN non-recovery was associated with an increased risk of long-term mortality during a mean follow-up period of 703 days (P Conclusion Preprocedural albuminuria was associated with CIN non-recovery in patients undergoing PCI.

Aim We investigated whether perioperative urine pH was associated with contrast-associated acute kidney injury (CA-AKI) in patients undergoing emergency percutaneous coronary intervention (PCI). Methods The study enrolled 1109 consecutive patients undergoing emergency PCI. Patients were divided into three groups based on perioperative urine pH (5.0–6.0, 6.5– 7.0, 7.5–8.5). The primary endpoint was the development of CA-AKI, defined as an absolute increase ≥ 0.3 mg/dL or a relative increase ≥ 50% from baseline serum creatinine within 48 h after contrast medium exposure. Results Overall, 181 patients (16.3%) developed contrast-associated acute kidney injury. The incidences of CA-AKI in patients with urine pH 5.0–6.0, 6.5–7.0, and 7.5–8.5 were 19.7%, 9.8%, and 23.3%, respectively. After adjustment for potential confounding factors, perioperative urine pH 5.0–6.0 and 7.5–8.5 remained independently associated with CA-AKI [odds ratio (OR)1.86, 95% confidence interval (CI) 1.25–2.82, P = 0.003; OR 2.70, 95% CI 1.5–4.68, P 2) (HR 5.587, 95% CI 1.178–30.599 vs. HR 2.487, 95% CI 1.331–4.579; overall interaction P Conclusion The urine pH and CA-AKI may underlie the V-shape relationship.

Background: The number of patients suffering from coronary heart disease with cancer is rising. There is scarce evidence concerning the biomarkers related to prognosis among patients undergoing per...

Pre-procedure liver insufficiency has been demonstrated as a poor prognostic factor after percutaneous coronary intervention (PCI). Recent research discovered that the aspartate aminotransferase-to-alanine aminotransferase ratio (De-Ritis ratio) reflects the severity of liver insufficiency and was associated with adverse outcomes. We aim to evaluate the predictive value of the De-Ritis ratio for contrast-associated acute kidney injury (CA-AKI) and long-term mortality in patients undergoing elective PCI.We retrospectively enrolled 5780 consenting patients undergoing elective PCI between January 2012 and December 2018. CA-AKI was defined as an increase in serum creatinine ≥0.3 mg/dl or ≥50% within 48 h after the administration of contrast media.The incidence of CA-AKI was 6.3% (n = 363). The De-Ritis ratio1.30 was identified as the best cut-off value for CA-AKI prediction. The De-Ritis ratio showed an area under the curve (AUC) of 0.636 [95% confidence interval (CI): 0.605-0.667] in predicting CA-AKI, which was significantly greater than alanine aminotransferase (p0.001) and aspartate aminotransferase (p = 0.012) alone. Furthermore, compared to currently recognized liver function assessment tools, the predictive value of the De-Ritis ratio on CA-AKI was similar to the MELD score (AUC: 0.636 vs 0.626, p = 0.631) and higher than the MELD-XI score (AUC: 0.636 vs 0.561, p0.001). Multivariate logistic analysis showed that the De-Ritis ratio1.30 was independently associated with CA-AKI (odds ratio=1.551, 95% CI: 1.185-2.030, p = 0.001). The addition of the De-Ritis ratio to the fully adjusted logistic regression model has significant incremental effects on the risk prediction for CA-AKI with a continuous net reclassification improvement of 0.395 (p0.001) and an integrated discrimination improvement of 0.005 (p = 0.018). Additionally, the De-Ritis ratio1.30 was significantly associated with long-term mortality (hazard ratio=1.285, 95% CI: 1.007-1.641, p = 0.044).The De-Ritis ratio was an independent risk factor for CA-AKI and long-term mortality in patients undergoing elective PCI.

Objective To explore the clinical outcomes and effect on intraoperative blood loss and postoperative pain of patients undergoing the retroperitoneal laparoscopic partial nephrectomy (RLPN) for complex renal tumors. Methods Fifty patients with complex renal tumor admitted to our hospital from February 2017 to February 2019 were selected as the research object and divided into the RLPN group (given the retroperitoneal laparoscopic partial nephrectomy, n = 24) and the OPN group (given the open partial nephrectomy, n = 26) by number table method to compare their various perioperative indicators and serum stress response and analyze the clinical effect of different surgical methods on the complex renal tumor. Results The clinical information of patients in both groups were not significantly different (P > 0.05); in addition to the operative time, the intraoperative blood loss, hospital stay, warm ischemia time, and numerical rating scale (NRS) scores of the RLPN group were clearly lower than those of the OPN group (P < 0.05); after treatment, patients in the RLPN group obtained significantly lower white blood cell (WBC) count, cortisol, and c-reactive protein (CRP) levels than the OPN group (P < 0.05); the renal glomerular filtration rate (GFR) of the affected side, quality of life scores, and 3-year overall survival rate of treated patients in the RLPN group were obviously higher than those in the OPN group (P < 0.05); and patients in the RPLN group had significantly lower incidence rate (P < 0.05). Conclusion Compared with OPN, RLPN is more worthy of promotion and application, because it has better treatment outcomes, significantly reduces intraoperative blood loss, alleviates the body stress response and postoperative pain, and improves the quality of life.

Background: Contrast-associated acute kidney injury (CA-AKI) is responsible for a substantial proportion of the observed mortality that occurs after percutaneous coronary intervention (PCI), particularly in elderly patients. However, there has been significant and debate over whether the optimal definition of CA-AKI persists over prolonged periods due to variations in the prevalence and effects on prognosis. In this study, we aimed to identify whether different definitions of CA-AKI exert differential impacts on long-term mortality when compared between elderly and non-elderly patients receiving elective PCI.Methods: We prospectively investigated 5,587 consenting patients undergoing elective PCI between January 2012 and December 2018. We considered two classical definitions of CA-AKI from the European Society of Urogenital Radiology (ESUR) and the Acute Kidney Injury Network (AKIN). Multivariable Cox regression analysis was used to investigate the association between CA-AKI and long-term mortality. We also performed interaction and stratified analyses according to age (≤75 or >75 years).Results: The incidence of CA-AKI according to the ESUR and AKIN definitions was 18.7 and 6.1%, respectively. After a median follow-up of 2.1 years, multivariable Cox regression analysis indicated that CA-AKI according to the AKIN definition was a risk factor for long-term mortality in the overall population [hazard ratio (HR) = 2.20; 95% confidential interval (CI): 1.51–3.22; p < 0.001]; however, this was not the case for the ESUR definition (HR = 1.27; 95% CI: 0.92–1.76; p = 0.153). Further interaction analysis identified a significant interaction between age and the ESUR definition (p = 0.040). Stratified analyses also found an association between the ESUR definition and long-term mortality in patients >75 years of age (p = 0.011), but not in patients ≤75 years of age (p = 0.657).Conclusion: As a stringent definition of CA-AKI, the AKIN definition was significantly associated with long-term mortality in both non-elderly and elderly patients. However, in elderly patients, the more lenient definition provided by the ESUR was also significantly correlated with long-term mortality, which could sensitively identify high-risk elderly patients and may provide a better alternative.

Neutrophil and albumin are well-known biomarkers of inflammation, which are highly related to contrast-associated acute kidney injury (CA-AKI). We aim to explore the predictive value of neutrophil percentage-to-albumin ratio (NPAR) for CA-AKI and long-term mortality in patients without chronic kidney disease (CKD) undergoing elective percutaneous coronary intervention (PCI).We retrospectively observed 5083 consenting patients from January 2012 to December 2018. CA-AKI was defined as an increase in serum creatinine ≥50% or 0.3 mg/dL within 48 h after contrast medium exposure.The incidence of CA-AKI was 5.6% (n=286). The optimal cut-off value of NPAR for predicting CA-AKI was 15.7 with 66.8% sensitivity and 61.9% specificity [C statistic=0.679; 95% confidence interval (CI), 0.666-0.691]. NPAR displayed higher area under the curve values in comparison to neutrophil percentage (p 0.001) and neutrophil-to-albumin ratio (NAR) (p 0.001), but not albumin (p = 0.063). However, NPAR significantly improved the prediction of CA-AKI assessed by the continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) compared to neutrophil percentage (NRI=0.353, 95% CI: 0.234-0.472, p 0.001; IDI=0.017, 95% CI: 0.010-0.024, p 0.001) and albumin (NRI=0.141, 95% CI: 0.022-0.260, p = 0.020; IDI=0.009, 95% CI: 0.003-0.015, p = 0.003) alone. After adjusting for potential confounding factors, multivariate analysis showed that NPAR15.7 was a strong independent predictor of CA-AKI (odds ratio =1.90, 95% CI: 1.38-2.63, p 0.001). Additionally, NPAR15.7 was significantly associated with long-term mortality during a median of 2.9 years of follow-up (hazard ratio =1.68, 95% CI: 1.32-2.13; p 0.001).NPAR was an independent predictor of CA-AKI and long-term mortality in patients without CKD undergoing elective PCI.

Aim: Accumulating evidence suggests that MELD-XI score holds the ability to predict the prognosis of congestive heart failure. However, most of the evidence is based on the end-stage heart failure population; thus, we aim to explore the association between the MELD-XI score and the prognosis in heart failure with preserved ejection fraction (HFpEF).Methods: A total of 30,096 patients hospitalized for HFpEF in Fujian Provincial Hospital between January 1, 2014 and July 17, 2020 with available measures of creatinine and liver function were enrolled. The primary endpoint was 60-day in-hospital all-cause mortality. Secondary endpoints were 60-day in-hospital cardiovascular mortality and 30-day rehospitalization for heart failure.Results: A total of 222 patients died within 60 days after admission, among which 75 deaths were considered cardiogenic. And 73 patients were readmitted for heart failure within 30 days after discharge. Generally, patients with an elevated MELD-XI score tended to have more comorbidities, higher NYHA class, and higher inflammatory biomarkers levels. Meanwhile, the MELD-XI score was positively correlated with NT-pro BNP, left atrial diameter, E/e' and negatively correlated with LVEF. After adjusting for conventional risk factors, the MELD-XI score was independently associated with 60-day in-hospital all-cause mortality [hazard ratio(HR) = 1.052, 95% confidential interval (CI) 1.022–1.083, P = 0.001], 60-day in-hospital cardiovascular mortality (HR = 1.064, 95% CI 1.013–1.118, P = 0.014), and 30-day readmission for heart failure (HR = 1.061, 95% CI 1.015–1.108, P = 0.009). Furthermore, the MELD-XI score added an incremental discriminatory capacity to risk stratification models developed based on this cohort.Conclusion: The MELD-XI score was associated with short-term adverse events and provided additional discriminatory capacity to risk stratification models in patients hospitalized for HFpEF.

Background DD was found to be associated with acute myocardial infarction (AMI) and renal insufficiency. However, it is uncertain whether DD is an independent risk factor of CI-AKI in patients undergoing pPCI. Methods We prospectively enrolled 550 consecutive patients with STEMI undergoing pPCI between January 2012 and December 2016. The predictive value of admission DD for CI-AKI was assessed by receiver operating characteristic (ROC) and multivariable logistic regression analysis. CI-AKI was defined as an absolute serum creatinine increase ≥0.3 mg/dl or a relative increase in serum creatinine ≥50% within 48 h of contrast medium exposure. Results Overall, the incidence of CI-AKI was 13.1%. The ROC analysis showed that the cutoff point of DD was 0.69 μg/ml for predicting CI-AKI with a sensitivity of 77.8% and a specificity of 57.3%. The predictive value of DD was similar to the Mehran score for CI-AKI (AUCDD = 0.729 vs AUCMehran = 0.722; p = 0.8298). Multivariate logistic regression analysis indicated that DD > 0.69 μg/ml was an independent predictor of CI-AKI (odds ratio [OR] = 3.37,95% CI:1.80–6.33, p 0.69 μg/ml was associated with an increased risk of long-term mortality during a mean follow-up period of 16 months (hazard ratio = 3.41, 95%CI:1.4–8.03, p = 0.005). Conclusion Admission DD > 0.69 μg/ml was a significant and independent predictor of CI-AKI and long-term mortality in patients undergoing pPCI.

Background Fluid management plays a pivotal role for heart failure (HF) patients. Medical fluid intake and output recording scheme by health care professional is complicated, which is not easily conducive to carry out by HF patients for self-management at home. This study aimed to optimize the professional fluid records for the self-management of HF patients and evaluate the effectiveness of this simplified recording scheme of fluid intake and output. Methods A randomized, non-blinded, non-inferiority trial with allocation concealment was conducted. Participants meeting the diagnostic criteria for HF were randomly assigned to professional recording group (PRG) and simplified recording group (SRG) according to the random allocation sequence generated by online tool. Days from admission to clinical stability (primary outcome), clinical congestion score (CCS), Minnesota Living with Heart Failure Questionnaire (MLHFQ) and frequency of electrolyte disturbances (secondary outcomes) were collected. The outcomes judges were blinded to group assignment.Results A total of 140 HF patients were enrolled and randomly divided into PRG (n=70) and SRG (n=70). Ultimately, 129 HF patients (PRG, n=65, and SRG, n=64) completed these experiments. Compared to PRG patients, SRG patients also improved their HF symptoms (including shortness of breath and fluid retention), and did not show the prolonged hospitalization time after similar intravenous diuretic treatment. Additionally, the parameters of clinical stability, CCS, MLHFQ, electrolyte disturbances and body weight in SRG patients were not inferior to that of PRG patients ( P >0.05). Conclusions This simplified fluid intake and output recording scheme was safe, efficient and non-inferior to the professional mode, which might effectively enhance their feasibility of self-management, and improve their quality of life in HF patients.

ObjectivesTo develop a model of in-hospital mortality using medical record front page (MRFP) data and assess its validity in case-mix standardisation by comparison with a model developed using the complete medical record data.DesignA nationally representative retrospective study.SettingRepresentative hospitals in China, covering 161 hospitals in modelling cohort and 156 hospitals in validation cohort.ParticipantsRepresentative patients admitted for acute myocardial infarction. 8370 patients in modelling cohort and 9704 patients in validation cohort.Primary outcome measuresIn-hospital mortality, which was defined explicitly as death that occurred during hospitalisation, and the hospital-level risk standardised mortality rate (RSMR).ResultsA total of 14 variables were included in the model predicting in-hospital mortality based on MRFP data, with the area under receiver operating characteristic curve of 0.78 among modelling cohort and 0.79 among validation cohort. The median of absolute difference between the hospital RSMR predicted by hierarchical generalised linear models established based on MRFP data and complete medical record data, which was built as ‘reference model’, was 0.08% (10th and 90th percentiles: −1.8% and 1.6%). In the regression model comparing the RSMR between two models, the slope and intercept of the regression equation is 0.90 and 0.007 in modelling cohort, while 0.85 and 0.010 in validation cohort, which indicated that the evaluation capability from two models were very similar.ConclusionsThe models based on MRFP data showed good discrimination and calibration capability, as well as similar risk prediction effect in comparison with the model based on complete medical record data, which proved that MRFP data could be suitable for risk adjustment in hospital performance measurement.

Xinlu Zhang,1,* Xu Wang,2,* Feng Hu,1 Boda Zhou,3 Hai-Bin Chen,1 Daogang Zha,1 Yili Liu,1 Yansong Guo,4 Lemin Zheng,2 Jiancheng Xiu1 1Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine, School of Basic Medical Sciences, and Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Health Science Center, 3Department of Cardiology, Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, and Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides of Ministry of Health, Peking University Third Hospital, Beijing, 4Department of Cardiovascular Medicine, Fujian Provincial Hospital, Fuzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Drag-reducing polymers (DRPs), when added in minute concentrations, have been shown to decrease peripheral vascular resistance. In this study, the effect of DRPs on the hypertension-induced left ventricular hypertrophy and aortic remodeling was evaluated in spontaneously hypertensive rats (SHR). Male SHR and age-matched Wistar rats were divided into four groups and received intravenous injection of normal saline (NS) or DRPs. Body weight (BW), heart rate (HR) and systolic blood pressure (SBP) were measured. Echocardiography was used to evaluate the changes in left ventricle (LV) function and global wall motion. The LV and aorta were stained by hematoxylin and eosin. Cell size of cardiomyocytes and aortic medial thickness were evaluated for each section. The expression of endothelin-1 (ET-1) of LV and aorta was examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry. There was no significant difference in the increase of SBP among SHR+NS, SHR+10DRP and SHR+20DRP groups. SHR+NS group had markedly smaller left ventricular end-systolic diameter and left ventricular end-diastolic diameter but bigger anterior and posterior systolic wall thicknesses, while there was no significant difference in fractional shortening and ejection fraction. The cross-sectional areas (CSAs) of cardiomyocytes and the medial thickness of the aorta in SHR+10 (ppm) DRP and SHR+20 (ppm) DRP groups were significantly reduced compared with SHR+NS group. The expression of ET-1 in SHR+10DRP and SHR+20DRP groups was significantly attenuated. These results suggest that chronic treatment with DRPs can protect against left ventricular hypertrophy and aortic remodeling. DRPs may offer a new approach to the treatment of left ventricular hypertrophy and aortic remodeling caused by hypertension. Keywords: aortic remodeling, drag-reducing polymers, ET-1, hypertension, left ventricular hypertrophy

Multiple studies have been dedicated to particle emissions from three dimensional printer (3D printer). They collectively have shown that 3D printers will emit significant ultrafine particles during their printing processes. An important step forward is to investigate the printing process in detail and help reducing emissions. This study investigates particle emissions from two filaments of acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) according to four steps (loading, heating, printing, and unloading) during the 3D printing process in constraint of product quality assessment. The results show that ABS filament triggers at least times higher particle emissions than PLA filament (ABS-printed product presents higher quality with higher nozzle temperature (240 °C); however, higher nozzle temperature triggers substantially higher particle emission. This study further identifies that the particle emissions are mostly triggered by the heating process rather than the printing process. It indicates that filament undergoes decomposition during the heating period after being loading into the extruder. As for product quality in terms of surface roughness and production deformation, ABS is not compatible to fast neither printing speed nor low nozzle temperature; the PLA filament exhibits significant tolerance to temperature and feed rate changes. An optimization, which is externally heating up both the extruder and platform before the filament is loaded, shows that pre-heating reduces particle emissions by 75% for ABS filament when compared with the conventional procedure.

Background: TNF-like cytokine 1A (TL1A) is a subgroup of the tumor necrosis factor superfamily that exerts pleiotropic effects on cell proliferation, inflammation, activation, and differentiation of immune cells. The purpose of the current study is to investigate the clinical significance of TL1A expression in coronary and peripheral blood of patients with acute coronary syndrome (ACS) to determine if TL1A levels can serve as an accurate prognostic indicator. Methods: A total of 141 patients undergoing coronary angiography were divided into 4 groups: Control (n = 35), Unstable Angina (UA) (n = 35), acute non-ST segment elevation myocardial infarction (NSTEMI) (n = 37), and acute ST segment elevation myocardial infarction (STEMI) (n = 34). The levels of TL1A, MPO, hs-CRP, and IL-10 were detected in coronary and peripheral blood using enzyme linked immunosorbent assay (ELISA), and the MACE incidence rates were compared during 26.3 months of follow-up. Results: TL1A levels were not significantly different between the UA group and control group. In the UA group, TL1A levels were not significantly different between coronary blood and peripheral blood. However, TL1A levels were higher in the STEMI and NSTEMI groups than in the control group (P

The aim of the study is to evaluate the association of pre-procedural N-terminal pro-B type natriuretic peptide (NT-proBNP) with contrast-induced acute kidney injury (CI-AKI) and long-term outcomes in elderly patients undergoing elective percutaneous coronary intervention (PCI).A total of 540 patients aged ≥ 75 years who had undergone elective PCI between January 2012 and December 2015 were enrolled in this study. Admission NT-proBNP levels were measured before PCI. CI-AKI was defined as a relative increase in serum creatinine (SCr) of ≥50%, or an absolute increase of ≥ 0.3 mg/dL, occurring within 48 hours after contrast medium exposure. The predictive value of NT-proBNP for predicting CI-AKI was assessed by receiver operating characteristic (ROC) and multivariable logistic regression analysis.A total of 54 (10.0%) patients developed CI-AKI. The best cutoff value of NT-pro-BNP for detecting CI-AKI was 1133 pg/mL with 66.7% sensitivity and 70.8% specificity according to the ROC analysis (C statistic = 0.719; 95% CI, 0.679-0.756). Multivariable analysis demonstrated that Lg-NT-proBNP is significantly related to CI-AKI (odds ratio [OR] = 3.892; 95% CI, 1.996-7.590; P < 0.001). Cox regression analysis showed that Lg-NT-proBNP is associated with long-term mortality (adjusted hazard ratio [HR] = 2.158; 95% CI, 1.246-3.740; P = 0.006) during follow-up.Pre-procedural NT-proBNP is a significant and independent predictor of CI-AKI and long-term mortality in elderly patients following elective PCI, and the best cutoff point for predicting CI-AKI was 1133 pg/mL.

Zhe-Bin You,1,* Kai-Yang Lin,2,* Wei-Ping Zheng,1 Chun-Jin Lin,1 Fan Lin,1 Tai-Lin Guo,1 Peng-Li Zhu,1 Yan-Song Guo2 1Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Cardiology, Fujian Provincial Hospital, Fujian Cardiovascular Institute, Fujian Medical University, Fuzhou, People’s Republic of China *These authors contributed equally to this work Purpose: Inflammatory factors play a critical role in contrast-induced acute kidney injury (CI-AKI). Prealbumin, a nutritional and inflammatory indicator, is a well-established predictor of short- and long-term outcomes in numerous clinical conditions. The current study investigated the association of pre-procedural prealbumin levels with CI-AKI and long-term outcomes in geriatric patients after elective percutaneous coronary intervention (PCI).Patients and methods: A total of 558 patients aged≥75years, who underwent elective PCI between January 2012 and December 2015, were selected for the current study. Pre-procedural prealbumin levels were measured before PCI. Multivariable logistic regression and Cox proportional hazard regression analyses were performed to identify the independent risk factors for CI-AKI and long-term mortality.Results: Out of 558 patients, 54 developed CI-AKI. The optimal cutoff value of prealbumin for detecting CI-AKI was 185.5mg/L with 62.7% sensitivity and 70.4% specificity based on the receiver operating characteristic analysis (C-statistic=0.710; 95% confidence interval [CI] 0.673–0.751). Multivariable analysis demonstrated that prealbumin≤185.5mg/L was significantly associated with CI-AKI (odds ratio [OR] 0.397; 95% CI 0.195–0.808; P=0.011). Cox regression analysis demonstrated that prealbumin≤185.5mg/L was associated with long-term mortality (adjusted hazard ratio [HR] 0.525; 95% CI 0.289–0.952; P=0.034) during the follow-up.Conclusion: Pre-procedural levels of prealbumin were independently associated with an increased risk of CI-AKI and long-term mortality in elderly patients undergoing elective PCI. Keywords: prealbumin, contrast-induced acute kidney injury, percutaneous coronary intervention, elderly&nbsp

Substantial environmental impact induced by continuously rising energy and resource consumption in industry has urged industrial enterprises to reform their current manufacturing towards an environmentally conscious scheme. To accomplish this aim, reducing production energy has been acknowledged as one of the essential tasks. To enhance the energy conservation of machine tools, an operation-mode based approach, which incorporates material removal simulation to determine the energy consumption of machining processes, is proposed and validated in this research. The validation results indicate that by applying the developed approach the energy for machining a product can be predicted accurately within a deviation of 10%. In addition, energy-efficient computer-aided manufacturing, in which machining strategies as well as process parameters can be optimized before the workpiece is launched for machining, can also be realized with applying the proposed approach. For the investigated case, 80% of overall energy-saving potential is identified, and the energy-saving can be estimated with uncertainty of less than 10%. ispartof: Journal of Cleaner Production vol:101 pages:348-359 status: published

Objective: Low free triiodothyronine (fT3) is common in elderly patients with cardiovascular disease. The purpose of this study was to evaluate the relationship between low fT3 and contrast-induced acute kidney injury (CI-AKI), including the long-term outcomes, in elderly patients after a percutaneous coronary intervention (PCI). Methods: A total of 350 patients aged ≥75 years who underwent PCI between January 2012 and December 2015 were consecutively enrolled. The perioperative thyroid function, including fT3, was measured before PCI. A low fT3 was defined as fT3

Incremental Sheet Forming processes have been characterized by their limited forming speed and accompanying lengthy production time. ISF has therefore been considered a process category suitable for small batch sizes or discrete part production only. The potential for greatly increasing the forming speed of incremental forming processes is studied here by means of axisymmetric incremental forming on a lathe. As an aluminium alloy commonly used in automotive applications, AA5182-O, is of interest for incremental forming at increased speed. In this paper the influence of an increasing feed rate on forming forces, temperature and formability is analyzed.

Intensive appeal for energy saving has driven the production industry towards more environmentally benign manufacturing. Diverse process settings in manufacturing can result in a high variance of energy consumption. Regarding process chains, the allocation of machining stock to each process is very crucial in terms of energy use. Optimization of material stock allowance and process parameters can effectively reduce the production energy. In this study, two cylindrical machining processes—turning and grinding—are compared at machine level with respect to energy intensity and surface roughness. A systematic energy-efficient approach, based on minimizing the production energy while complying with the required surface roughness, has been developed and validated to optimize the grinding stock for the turning-grinding process sequence. Compared to conventional stock allocation method, the developed approach results in more than 16 % of energy reduction for the turning-grinding process.

In order to mitigate the problems in CNC grinding of a camshaft caused by varying grinding depth along the periphery of the cam, a novel grinding strategy is proposed to keep the grinding depth constant during the process. In comparison with the current cam grinding strategy, analysis results derived from the modelling of the process indicate that it is applicable to keep the grinding depth constant. Consequently, in combination with a constant grinding infeed speed, the material removal rate (MRR) is also kept stable. With the same grinding depth, the volume of removed material in a certain single revolution with the new processing strategy is less than the conventional process. This new strategy can increase the grinding depth without causing grinding burns. Therefore, the total number of grinding revolutions/steps decreases dramatically. Moreover, experiments for comparison of both the single revolution machining and the whole cam grinding have been carried out on a CNC8325B camshaft grinder. The results show that the new process improves machining efficiency dramatically while ensuring the machining quality.

Introduction: D-dimer(DD) is associated acute renal injury, However, whether DD is an independent risk factor of contrast-induced acute kidney injury(CI-AKI) in patients undergoing primary percutan...

Patients with chronic kidney disease(CKD) have higher circulating levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP) than patients without CKD.This study aimed to evalute the predictive value of NT-proBNP for predicting CI-AKI in patients undergoing PCI, and to compare its value in

Energy reduction in industry has become one of the main objectives for achieving environment friendly manufacturing. In practice, optimization of energy consumption should be implemented while taking into consideration other parameters such as the obtained surface quality. In this paper, an approach which incorporates both energy consumption and surface roughness is presented for optimizing the cutting parameters in finish turning. Based on a new energy model and a surface roughness model, derived for a given machine tool, cutting parameters are optimized to accomplish a precise surface finish with minimum energy consumption. © 2012 The Authors. ispartof: pages:512-517 ispartof: 5th CIRP Conference on High Performance Cutting 2012 vol:1 issue:1 pages:512-517 ispartof: High Performance Cutting location:Zurich, Switzerland date:4 Jun - 7 Jun 2012 status: published

High variation can be observed in energy requirement values reported for unit processes as applied in discrete manufacturing. Different methods for determining such values have been suggested, ranging from theoretic energy determination till statistically determined time averaged values based on experimental process measurements. In this paper the theoretic process energy method is compared to results as obtained from two methods suggested for systematic determination of Life Cycle Inventory (LCI) database entries for unit processes. Examples from different process categories are presented to illustrate the discrepancies observed between the approaches and to illustrate the error range linked to the method selection. ispartof: CIRP Annals. Manufacturing Technology vol:61 issue:1 pages:63-66 status: published