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Given the aesthetic, cultural, ecological, and economic value of the date agro-system in Southwestern Tunisia, different management and conservation strategies have been warrantee to optimize land productivity sustainably. However, the inefficiency of the adopted management actions resulted in a continuous loss of soil fertility and decreasing fruit quality. Thus, the present paper attempts to evaluate accurately the evolution of the principal factors influencing date palm production and agricultural activities sustainability in the region. Integrated approaches of various irrigation water quality indices and geostatistical analysis coupled with field investigation and farming survey were applied to evaluate the evolution of key parameters influencing the development of date palm sustainably. The obtained results of the research indicate that the progressive land degradation is due to the effects of poorquality of water used for irrigation (EC between 674.4 and 5450 µs/cm, SAR exceeding locally 20 and about 80% of all the samples waters are of undoubtful quality according to the calculated indices), inappropriate irrigation scheduling (physiologic drought that might reach 3 months), traditional basin irrigation technique (decreasing of yield productivity, locally of 0.23, 0.23 and 0.25 kg m−3), an indigenous knowledge (sandy amendment, biologic compost, gravity improved irrigation…..). Also climate variability has leaded to furthermore degradation of crop quality. The degradation of date palm culture will be a great challenge for environmental conservation, food security and socio-economic values of the region unless a reasonable management take place, a flexible strategy based on indigenous knowledge of landowner, and scientific-based outlines with climate risks evaluation. The present paper might be useful to policy makers as a multi-disciplinary research covering most of the important aspects of date palm production.

Objective. The initial recanalization rate of coronary chronic total occlusions (CTOs) is >85% when performed by experienced operators, but only 10% of prior failed CTO patients receive reattempted recanalization. This retrospective study analyzed the success rate and strategies used in reattempt percutaneous coronary intervention (PCI) of CTOs after prior failures. Methods. Overall, 206 patients with 212 CTOs were enrolled. All patients with prior recanalization failures received reattempt PCIs from January 2015 to March 2019 at Zhongshan Hospital, Fudan University. Data on clinical factors (age, sex, comorbidities, left ventricular ejection fraction, history of cigarette usage, and revascularization), angiographic characteristics of CTOs (target lesion, Japanese Chronic Total Occlusion (J-CTO) score, the morphology of CTO lesions, and collateral channel scale), strategies (procedural approach and use of devices), and major adverse events were obtained and analyzed. Results. The mean age of enrolled patients was 60.96 ± 12.36 years, with a male predominance of 90.3%. Of the patients, 47.1% had a prior myocardial infarction and 70.4% underwent stent implantation previously, while the in-stent occlusion rate was 6.6%. CTOs were primarily localized in the left anterior descending artery (43.9%) and the right coronary artery (43.9%). 80.7% of lesions were classified as very difficult (J-CTO score ≥3), and the overall success rate was 81.1%. In multivariable regression analysis, J-CTO score, collateral channel scale, application of coronary multispiral computed tomography angiography, dual injection, intravascular ultrasound, active greeting technique, parallel wiring, and CTO morphology were predictors of recanalization success. There were no significant differences in rates of procedural complications between the final recanalization success and failure groups. Conclusions. Recanalization of complex CTOs is associated with high success rate and low complication rates when performed by high-volume CTO operators and after multiple reattempts.

Background: PCSK9 (proprotein convertase subtilisin/kexin 9), mainly secreted by the liver and released into the blood, elevates plasma low-density lipoprotein cholesterol by degrading low-density lipoprotein receptor. Pleiotropic effects of PCSK9 beyond lipid metabolism have been shown. However, the direct effects of PCSK9 on platelet activation and thrombosis, and the underlying mechanisms, as well, still remain unclear. Methods: We detected the direct effects of PCSK9 on agonist-induced platelet aggregation, dense granule ATP release, integrin αIIbβ3 activation, α-granule release, spreading, and clot retraction. These studies were complemented by in vivo analysis of FeCl 3 -injured mouse mesenteric arteriole thrombosis. We also investigated the underlying mechanisms. Using the myocardial infarction (MI) model, we explored the effects of PCSK9 on microvascular obstruction and infarct expansion post-MI. Results: PCSK9 directly enhances agonist-induced platelet aggregation, dense granule ATP release, integrin αIIbβ3 activation, P-selectin release from α-granules, spreading, and clot retraction. In line, PCSK9 enhances in vivo thrombosis in a FeCl 3 -injured mesenteric arteriole thrombosis mouse model, whereas PCSK9 inhibitor evolocumab ameliorates its enhancing effects. Mechanism studies revealed that PCSK9 binds to platelet CD36 and thus activates Src kinase and MAPK (mitogen-activated protein kinase)–extracellular signal-regulated kinase 5 and c-Jun N-terminal kinase, increases the generation of reactive oxygen species, and activates the p38MAPK/cytosolic phospholipase A2/cyclooxygenase-1/thromboxane A 2 signaling pathways downstream of CD36 to enhance platelet activation, as well. Using CD36 knockout mice, we showed that the enhancing effects of PCSK9 on platelet activation are CD36 dependent. It is important to note that aspirin consistently abolishes the enhancing effects of PCSK9 on platelet activation and in vivo thrombosis. Last, we showed that PCSK9 activating platelet CD36 aggravates microvascular obstruction and promotes MI expansion post-MI. Conclusions: PCSK9 in plasma directly enhances platelet activation and in vivo thrombosis, and MI expansion post-MI, as well, by binding to platelet CD36 and thus activating the downstream signaling pathways. PCSK9 inhibitors or aspirin abolish the enhancing effects of PCSK9, supporting the use of aspirin in patients with high plasma PCSK9 levels in addition to PCSK9 inhibitors to prevent thrombotic complications.

Activity level measurement and fusion rules are the two key factors of image fusion. In the fusion method based on neural networks, the activity level measurements are realized by dividing the image into small blocks and predicting the sharpness of each block; then, the global decision graph guiding fusion is generated according to the predicted results. However, these two tasks are serial in nature, which makes it difficult to complete them simultaneously while achieving satisfactory fusion performance. Therefore, a new multi-focus microscopic image fusion method is proposed in this paper to quickly fuse multiple histological microscopic images from different focusing planes to generate full-focus images. The improved SegNet network was used to detect the unfocused regions. Considering that two or more images are needed for fusion, a parallel fusion strategy is proposed herein to generate clear fusion images based on multiple images instead of pairwise decision graphs. Compared with the convolutional neural network, the proposed network has better representation ability and can extract and fuse the most ideal features to provide a more accurate fusion decision. Compared with the traditional Segnet network, it is lightweight, which greatly improves computing speed and achieves real-time fusion.

Background: Emerging evidence indicates that the worldwide incidence of early-onset coronary artery disease (EOCAD) is increasing. The genetic background has been assumed to harbor pathogenic risk, although the existing findings are mainly restricted to Caucasians. Little is known regarding the clinical profiles of patients with EOCAD and the extent to which genetic factors are related to disease susceptibility and outcomes in Asian people, especially ethnic Chinese. Methods and Results: The Genetic characteristics of coRonary Artery disease (CAD) in ChiNese young aDults (GRAND) study is a multicenter, hospital-based observational clinical study, combined of case-control design and longitudinal prospective cohort. Six thousand nationally representative patients who underwent coronary angiography at 38 centers have been enrolled since May 2017. Clinical data of patients with EOCAD (aged ≤45 years) are collected at the baseline to delineate conventional risk factors, clinical profiles, and therapeutic options of EOCAD and compared with data for patients with late-onset CAD (aged ≥65 years) and age-matched controls without CAD. The patients are followed for 3 years to trace major adverse cardiovascular (CV) events: cardiac death, nonfatal myocardial infarction, and ischemia-driven revascularization. Functional variants contributing to EOCAD risk are identified by high-depth whole-exome sequencing. The genetic profiles are further linked to disease severity and prognosis. A multi-dimensional risk score is established to predict prevalent EOCAD and incident CV events among young Chinese adults. Conclusions: The GRAND study will generate a thorough understanding of the clinical characteristics and genetic basis of EOCAD and may pave the way for genetic screening, early prevention, and future drug discovery for CAD in young Chinese generations.

Crossbar accelerators with a resistive random-access memory (ReRAM) are a promising solution for accelerating neural network applications. The advantages of achieving high computation throughput per watt make ReRAM-based crossbar accelerators become a potential solution for accelerating inference operations in the Internet of Things and edge devices. Due to the analog variation errors, the launched ReRAM-based crossbar accelerators can only perform well when each ReRAM cell is used to represent a limited number of data bits. To make such ReRAM-based crossbar accelerators applicable in wide application scenarios, several proposed researches target at binary neural networks and focus on the chip designs in relieving the implementation challenges on computation accuracy for realizing single-bit ReRAM-based crossbar accelerators. Even though several small-sized ReRAM-based crossbar accelerators are announced, the scalability issue hinders ReRAM-based crossbar accelerators from being scaled up. That is, when there are more and more wordline in an ReRAM-based crossbar accelerator, the analog variation error is amplified and thus seriously degrades the computation accuracy. In this work, we propose an adaptive data manipulation strategy to substantially reduce analog variation errors so as to fill up the gap on scaling up the ReRAM-based crossbar accelerators. In particular, a weight-rounding design is proposed to manipulate data to minimize overlapping variation so that the number of wordlines can be scaled up. In addition, an input subcycling design is proposed to further trade tolerable errors with neural networks’ execution time. Moreover, a bitline redundant design is proposed to trade acceptable space overhead for eliminating the analog variation errors. The emulation experiments show that the proposed adaptive data manipulation strategy can improve the accuracy in running MNIST and CIFAR-10 by $1.3\times $ and $2.6\times $ with nearly no management penalty and hardware cost. The experimental results also show the close-to-ideal-case accuracy by substantially reducing analog variation errors.

Two representative programs, MICH-PAVE and KENLAYER, are selected and compared to many key aspects of their analysis algorithms to achieve an in-depth understanding of the features of the Finite Element Method and elastic layered system theory in nonlinear material analysis of the structure of asphalt pavement. Furthermore, by conducting a case study, the impact of using different analysis methods on the calculation results is presented. Moreover, the feasibility of the equivalent resilient modulus obtained by the Finite Element Method is discussed. The results show that the difference among the nonlinear analysis algorithms used by the two software packages is mainly reflected in the determination of the initial resilient modulus, the stress correction, and the convergence condition. Besides, the Finite Element Method could consider the variation of the resilient modulus induced by the change in the stress condition in both the radial and the depth directions simultaneously. In contrast, the theory of the elastic layered system only considers the dependence of the resilient modulus on the stress in the depth direction. Additionally, the use of diverse nonlinear analysis methods has different levels of impact on mechanical responses. Finally, the equivalent resilient modulus obtained by nonlinear analysis can be used to calculate mechanical responses of pavement structure except the surface deflection in a linear analysis.

Background In recent years, disasters occurred frequently all over the world, and the role of nurses in public health emergencies and disaster emergencies was highlighted under the background of the covid19 epidemic. However, there was a lack of education and evaluation. Our study aims to cross-cultural adapt the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC) and evaluate the reliability and validity of the Chinese version. Methods We translated the scale following the translation-integration-back translation-expert review procedure, adapted according to Chinese culture. We evaluated the reliability and validity of the scale, and a total sample of 911 nurse data from the Yangtze River Delta Regional Nursing Alliance Hospital was gathered. Results The Chinese version of NPDCC included 45 items, 5 factors (critical thinking skills, special diagnostic skills, general diagnostic skills, technical skills, and communication skills) were extracted from the analysis, which could explain the 68.289% of the total variance. The content validity index was 0.925. The Cronbach's α of the total NPDCC score was 0.978, and 0.884-0.945 for every factor. The split-half for the scale was 0.930, and every factor was 0.861-0.894. Conclusions The Chinese version of NPDCC has excellent reliability and validity, and it is suitable to measure nurses' perceptions of disaster core competencies in China. The next step is to promote the application in a large scale.

Background Obesity is often considered as a risk factor of cardiovascular events, but recent researches showed conflicting results regarding to the effect of body weight on prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between body mass index (BMI) and clinical outcomes of CAD in Asian population. Methods A total of 4315 patients from the FOCUS registry were enrolled into this analysis. Patients were divided into 4 groups according to BMI: lean group (BMI 30 kg/m2). Follow-up was continued to 3 years to evaluate clinical outcomes, and the primary endpoint was a composite of all-cause death and myocardial infarction (MI). Results Patients with higher BMI were more likely to be associated with cardiovascular risk factors like hypertension, hypercholesterolemia and diabetes, but not smoking. At the end of the follow-up period, however, the incidence of a composite endpoint of all-cause death and MI was significantly lower in the higher BMI (overweight and obese) subsets, as compared with the lower BMI group (5.2% vs. 8.0%, p Conclusions In Asian patients with CAD, an inverse association between BMI and long-term prognosis was observed. Although overweight or obese patients were associated with more metabolism-associated comorbidities, they had significantly lower adverse events at 3-year follow up after percutaneous coronary intervention.

In this work, a laser-induced fluorescence (LIF) detection system built in a modular assembling mode was developed based on commercial LEGO blocks and 3D printed blocks. We designed and fabricated a variety of 3D printed building blocks fixed with optical components, including laser light source, filters, lens, dichroic mirror, photodiode detector, and control circuits. Utilizing the relatively high positioning precision of the plug-in blocks, a modular construction strategy was adopted using the flexible plug-in combination of the blocks to build a highly sensitive laser-induced fluorescence detection system, LIFGO. The LIFGO system has a simple structure which could be constructed by inexperienced users within 3 h. We optimized the structure and tested the performance of the LIFGO system, and its detection limits for sodium fluorescein solution in 100 μm i.d. and 250 μm i.d. capillaries were 7 nM and 0.9 nM, respectively. Based on the LIFGO system, we also built a simple capillary electrophoresis (CE) system and applied it to the analysis of DNA fragments to demonstrate its application possibility in biochemical analysis. The separation of 7 fragments in DL500 DNA markers were completed in 600 s. Because of the features of low cost (less than $100) and easy-to-build construction, we introduced the LIFGO system to the experimental teaching of instrumental analysis for undergraduate students. The modular construction form of the LIF detection system greatly reduces the threshold of instrument construction, which is conducive to the popularization of the LIF detection technique in routine laboratories as well as the reform of experimental teaching mode.

Inflammation plays an important role in aortic dissection (AD). Macrophages are critically involved in the inflammation after aortic injury. Neuraminidases (NEUs) are a family of enzymes that catalyze the cleavage of terminal sialic acids from glycoproteins or glycolipids, which is emerging as a regulator of macrophage-associated immune responses. However, the role of neuraminidase 1 (NEU1) in pathological vascular remodeling of AD remains largely unknown. This study sought to characterize the role and identify the potential mechanism of NEU1 in pathological aortic degeneration. After β-aminopropionitrile monofumarate (BAPN) administration, NEU1 elevated significantly in the lesion zone of the aorta. Global or macrophage-specific NEU1 knockout (NEU1 CKO) mice had no baseline aortic defects but manifested improved aorta function, and decreased mortality due to aortic rupture. Improved outcomes in NEU1 CKO mice subjected to BAPN treatment were associated with the ameliorated vascular inflammation, lowered apoptosis, decreased reactive oxygen species production, mitigated extracellular matrix degradation, and improved M2 macrophage polarization. Furthermore, macrophages sorted from the aorta of NEU1 CKO mice displayed a significant increase of M2 macrophage markers and a marked decrease of M1 macrophage markers compared with the controls. To summarize, the present study demonstrated that macrophage-derived NEU1 is critical for vascular homeostasis. NEU1 exacerbates BAPN-induced pathological vascular remodeling. NEU1 may therefore represent a potential therapeutic target for the treatment of AD.

The vacuum preloading method is commonly adopted for improving the soft ground that the embankment of the railway line is laid on. The PIV (Particle Image Velocimetry) technique is a powerful tool in observing the formation of the soil column, a phenomenon that is unique to the dredged slurry when treated by vacuum preloading. However, it is not clear to what extent the motions of the slurry particles can be represented by the PIV tracers. In this paper, a mesoscopic model has been established by using the CFD-DEM method to reproduce the vacuum consolidation process of the slurry, in which the PVD (Prefabricated Vertical Drain) membrane, the slurry particles, and the tracers are described by the DEM, and the pore water is governed by the CFD method. Eight computational cases that can cover a broad range of material parameters governing the PIV model tests on the dredged slurry have been designed and studied by the established model. The representativeness of the PIV tracer is evaluated by comparing the statistic displacement of the tracer to that of the slurry particles. It is found that for the commonly used tracer, the carbon powder, can reliably represent the particle motions of the slurry since the difference in displacements of the tracer and the slurry particles is smaller than 6.5% if the diameter ratio between the tracer and the slurry particle is within 1.8.

Background Vulnerable plaques are characterized by infiltration of inflammatory cells, playing a key role in the progression of acute coronary events. It's important to clarify the inflammatory mechanism of unstable plaque formation. Several clinical trials have demonstrated that dapagliflozin could reduce major adverse cardiac events in whether diabetic or non-diabetic patients. However, the underlying cardioprotective mechanism of dapagliflozin remains unclear. This study was aimed to investigate the role of dapagliflozin in regulating macrophage pyroptosis and vulnerable plaque formation. Methods 20 ApoE−/− mice (control) were fed with high fat diet while another 20 ApoE−/− mice were challenged with high fat diet plus dapagliflozin for 12 weeks. The extent and instability of atherosclerotic plaque was determined by oil-red staining, HE staining, immunofluorescence staining and electron microscopy. Changes in subsets of immune cells were evaluated by flow cytometry. Plasma cytokines were assessed by ELISA. Microarray analysis was applied to detect gene expressions while Western blot and real-time PCR was used to assess gene expression levels. Results Morphology studies revealed that dapagliflozin could inhibit plaque formation and reduce instability in ApoE−/− mice. FACS data showed that dapagliflozin could decrease CD11b+Ly6Chigh M1 macrophages differentiation and inhibit foam cells formation in ApoE−/− mice. Microarray analysis and in vitro studies exhibited that dapagliflozin could induce the down regulation of NLRP3, caspase-1, IL-1β, IL-18 and MMP-7/10/12/14 to retard macrophage pyroptosis and foam cell formation. Conclusions We have characterized a novel role for dapagliflozin in modulating atherosclerotic lesion development and progression. We envision that this study may provide several potential therapeutic targets for treatment of acute coronary syndromes. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Shanghai Sailing Program

Background Drug-eluting stent (DES) with durable polymers have been proven to cause late or very late adverse events. Biodegradable polymer-coated DES was developed to address the risk by avoiding persistent inflammatory irritation from persistent polymers. However, it is unknown whether the benefits of biodegradable polymer DES will occur over longer time. Methods The trial was a prospective, multicenter and randomized non-inferiority clinical trial done in China. Patients with indications for stent implantation were assigned into Cordimax and Xience V group in a 2:1 allocation. The composite of cardiac death, target vessel myocardial infarction (TV-MI), or clinically indicated target lesion revascularisation (CI-TLR) was the primary endpoint target lesion failure (TLF). The pre-specified endpoint at five years was major adverse cardiac event (MACE) which was defined as a composite of all-cause death, non-fatal myocardial infarction (MI), and CI-TLR. Results 3266 patients (88.3%) completed 5-year follow-up. No difference was observed for TLF between Cordimax (7.5%) and Xience V (8.3%) group (RR: 0.90, 95% CI: 0.70 to 1.15, P = 0.39). MACE occurred in 280 patients (11.4%) in Cordimax group and 162 patients (13.1%) in Xience V group (RR: 0.85, 95% CI: 0.69 to 1.05, P = 0.13). The incidence of definite or probable stent thrombosis did not differ in both groups (Cordimax 0.7%, Xience V 0.9%; RR: 0.78, 95% CI: 0.36 to 1.66; P = 0.51). Conclusion The biodegradable polymer Cordimax stent showed a comparable result to the durable polymer Xience V stent at 5 years, showing its long-term safety and efficacy performance. Trial registration: This study is registered with ClinicalTrials.gov, number NCT03185221 (14/06/2017).

Background: Whether the role of plasma heat shock protein 70 (HSP70) in acute myocardial infarction (AMI) is protective or detrimental remains debated, and the relationship between HSP70 and total occlusion remains elusive.Methods: A total of 112 patients with primary diagnosis of AMI and 52 patients with chronic coronary syndrome (CCS) were enrolled into the study. Plasma HSP70 level was determined by ELISA on day 1 and day 7 after the onset of AMI and was examined before angiography in patients with CCS. Peak NT-proBNP, high-sensitivity C-reactive protein (CRP), troponin T (cTnT), and left ventricular ejection fraction were measured.Results: Plasma HSP70 was significantly higher in CCS than AMI (P < 0.0001), and it showed a significant decrease from day 1 to day 7 after AMI (P < 0.01). Elevated HSP70 was associated with decreased levels of LDL-C (P < 0.05), peak cTnT (R = −0.3578, P < 0.0001), peak NT-proBNP (R = −0.3583, P < 0.0001), and peak CRP (R = −0.3539, P < 0.0001) and a lower diagnosis of AMI (R = −0.4016, P < 0.0001) and STEMI (R = −0.3675, P < 0.0001), but a higher diagnosis of total occlusion in target vessels (R = 0.1702, P < 0.05). HSP70 may provide certain predictive value for the diagnosis of AMI, STEMI, and total occlusion in target vessels, and the area under the receiver operating characteristic curves were 0.7660, 0.7152, and 0.5984, respectively. HSP70 was also negatively associated with in-hospital stay (P < 0.001) and positively correlated with left ventricular ejection fraction (LVEF) at 1-year follow-up (P < 0.05), despite no association with in-hospital major adverse cardiovascular events (MACE).Conclusion: Plasma HSP70 level was found to decrease from day 1 to day 7 post-AMI, but the overall level of patients with AMI was lower than that of patients with CCS. However, the ability of HSP70 to identify clinically significant AMI and STEMI was moderate, and the predictive value to total occlusion was slight.

Objective: We aimed to assess the association of erectile dysfunction (ED) with the extent of coronary atherosclerosis, and to examine whether revascularization and medication use have an impact on ED status in patients with early onset of coronary artery disease (EOCAD).Methods: International Index of Erectile Function (IIEF-5) was used to evaluate sexual function in 296 male patients with EOCAD (age, 39.9 ± 4.8 years), and 354 male controls (age, 40.6 ± 4.4 years). The extent of coronary atherosclerosis was measured by Gensini score. Endothelial function was evaluated by two vasomotor indexes including endothelin-1 (ET-1) and nitric oxide (NO) by ELISA.Results: ED was more frequent (57.8 vs. 31.1%, P < 0.001) and serious (IIEF-5 score:17.7 ± 6.0 vs. 21.6 ± 5.0, P < 0.001) among EOCAD patients than that among controls. IIEF-5 score was negatively correlated with Gensini score (r = −0.383, P < 0.001). The adjusted odds ratio (OR) for the presence of ED (EOCAD vs. controls) was 1.88 [95% confidential interval (CI), 1.12-3.18]. However, ET-1 and NO attenuated the association between ED and EOCAD (adjusted OR: 1.54, 95% CI: 0.84-2.80). IIEF-5 score increased after coronary revascularization in patients not on beta-blockers (18.71 ± 4.84 vs. 17.59 ± 6.05, P < 0.001) as compared with baseline, while stayed unchanged in the subgroup using beta-blockers (17.82 ± 5.12 vs. 17.70 ± 5.98, P = 0.09).Conclusions: ED was common in patients with EOCAD, and associated with the severity of coronary atherosclerosis. Endothelial dysfunction may be a pathophysiologic mechanism underlying both ED and EOCAD. Coronary revascularization confers a benefit in ED amelioration, while this effect did not appear in patients using beta-blocker.

Background: Angiography-derived index of microcirculatory resistance (angio-IMR) is an emerging pressure-wire-free index to assess coronary microvascular function, but its diagnostic and prognostic value remains to be elucidated.Methods and Results: The study population consisted of three independent cohorts. The internal diagnostic cohort enrolled 53 patients with available hyperemic microcirculatory resistance (HMR) calculated from myocardial blood flow and pressure. The external diagnostic cohort included 35 ischemia and no obstructive coronary artery disease (INOCA) patients and 45 controls. The prognostic cohort included 138 coronary artery disease (CAD) patients who received PCI. Angio-IMR was calculated after the estimation of angiography-derived fractional flow reserve (angio-FFR) using the equation of angio-IMR = estimated hyperemic Pa × angio-FFR × [vessel length/(K × Vdiastole)]. The primary outcome was a composite of cardiac death or readmission due to heart failure at 28 months after index procedure. Angio-IMR demonstrated a moderate correlation with HMR (R = 0.74, p < 0.001) and its diagnostic accuracy, sensitivity, specificity, and area under the curve to diagnose INOCA were 79.8, 83.1, 78.0, and 0.84, respectively, with a best cut-off of 25.1. Among prognostic cohort, patients with angio-IMR ≥25.1 showed a significantly higher risk of cardiac death or readmission due to heart failure than those with an angio-IMR p = 0.004). Angio-IMR ≥25.1 was an independent predictor for cardiac death or readmission due to heart failure (HR 11.15, 95% CI 1.76–70.42, p = 0.010).Conclusions: Angio-IMR showed a moderate correlation with HMR and high accuracy to predict microcirculatory dysfunction. Angio-IMR measured after PCI predicts the risk of cardiac death or readmission due to heart failure in patients with CAD.Clinical Trial Registration: Diagnostic and Prognostic Value of Angiography-derived IMR (CHART-MiCro), NCT04825028.

In this study, considering the non-uniform action of actual wheel loads, the influence of bonding conditions at the surface layer/base and base/subbase interfaces on the structure of flexib...

In the present study, a novel biodegradable Zn-0.8Cu coronary artery stent was fabricated and implanted into porcine coronary arteries for up to 24 months. Micro-CT analysis showed that the implanted stent was able to maintain structural integrity after 6 months, while its disintegration occurred after 9 months of implantation. After 24 months of implantation, approximately 28 ± 13 vol% of the stent remained. Optical coherence tomography and histological analysis showed that the endothelialization process could be completed within the first month after implantation, and no inflammation responses or thrombosis formation was observed within 24 months. Cross-section analysis indicated that the subsequent degradation products had been removed in the abluminal direction, guaranteeing that the strut could be replaced by normal tissue without the risk of contaminating the circulatory system, causing neither thrombosis nor inflammation response. The present work demonstrates that the Zn-0.8Cu stent has provided sufficient structural supporting and exhibited an appropriate degradation rate during 24 months of implantation without degradation product accumulation, thrombosis, or inflammation response. The results indicate that the Zn-0.8Cu coronary artery stent is promising for further clinical applications. Statement of Significance Although Zn and its alloys have been considered to be potential candidates of biodegradable metals for vascular stent use, by far, no Zn-based stent with appropriate medical device performance has been reported because of the low mechanical properties of zinc. The present work presents promising results of a Zn-Cu biodegradable vascular stent in porcine coronary arteries. The Zn-Cu stent fabricated in this work demonstrated adequate medical device performance both in vitro and in vivo and degraded at a proper rate without safety problems induced. Furthermore, large animal models have more cardiovascular similarities as humans. Results of this study may provide further information of the Zn-based stents for translational medicine research. This work was supported by the National Key Research & Development Program of China (No. 2016YFC1102500 ), the National Natural Science Foundation of China (No. 31700819 ), the Fundamental Research Funds for the Central Universities (No. 06500098 ), and the Young Elite Scientists Sponsorship Program by CAST (YESS, No. 2018QNRC001 ). As chief scientist, Professor Haijun-Zhang initiated the study and also participated in key details of the experimental processes. Scopus

The structural mechanics analysis of the Portland cement concrete pavement (PCCP) is considerably complicated and distinctive. From the application viewpoint, the capabilities and characteristics of two typical professional finite element software products, named KENSLABS and EverFE, are analyzed. The similarities and differences between these two programs are compared. The comparisons focus on some key factors of modeling and solution strategies, such as element type, meshing, traffic load and temperature curling, boundary conditions, and contact conditions. Based on one specific case example, the two software products were conducted to demonstrate their main functions. The research results clarify the performance of the two software products for structural analysis of cement concrete pavement and indicate each application conditions from their respective features, which can provide valuable references for software users and program developers.

The current study aimed to explore the effect of self-acupoint massage (SEAM) on blood glucose level and quality of life in community-dwelling older adults with type 2 diabetes mellitus (T2DM). Sixty-six older adults with T2DM were enrolled and randomly divided into observation and control groups. Participants in the control group received routine nursing interventions, whereas participants in the observation group received a SEAM intervention in addition to routine nursing interventions. After 12 weeks of SEAM, glycosylated hemoglobin (HbA1c) levels in the observation group decreased from 8.35% ( SD = 1.84%) at baseline to 7.29% ( SD = 1.38%) ( p < 0.01). Total score of the Diabetes-Specific Quality of Life Scale (DSQLS) in the observation group improved from 45.96 ( SD = 4.29) at baseline to 41.3 ( SD = 3.89) ( p < 0.01). The physiological dimension of the DSQLS in the observation group improved from 49.65 ( SD = 7.33) at baseline to 38.54 ( SD = 4.68) ( p < 0.01). As SEAM effectively decreased older adults' HbA1c level and improved their quality of life, it can be used as a complementary approach to routine nursing interventions for community-dwelling older adults with T2DM. [ Journal of Gerontological Nursing, 45 (8), 43–48.]

Introduction. Although coronary artery disease (CAD) presentations and clinical outcomes differ by sex, little is known about premature CAD (PCAD). The present analysis aimed to evaluate the gender-related differences of PCAD in an Asian population from the FOCUS registry. Methods. A total of 1397 Asian young patients with angiographically confirmed CAD undergoing drug-eluting stent implantation were included in this analysis and divided into two groups according to the genders. Patients were followed up for three years and clinical outcomes were compared between groups. Results. Young women were older and more likely to have hypertension and diabetes than men (all p pp p>0.05). Conclusion. Despite remarkable differences in clinical characteristics between Asian males and females with PCAD, the two groups did not differ significantly in clinical outcomes.

Objective: The aim of the study is to assess the predictors of failure of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions using a retrograde approach. Methods: The present study retrospectively enrolled all 211 patients who underwent retrograde CTO PCI from January 2009 to December 2015 at Shanghai Institute of Cardiovascular Disease. Multivariate Cox regression analysis was used to assess potential predictors of retrograde CTO PCI failure including sex, vascular access site, sheath size, prior PCI, prior coronary artery bypass grafting, history of myocardial infarction, target vessel of CTO, J-CTO score, retrograde wire crossing collaterals, and reverse controlled antegrade and retrograde subintimal tracking (CART) use. Results: Of the 211 patients studied, retrograde CTO PCI was successful in 115 (54.5%) patients, and in an additional 46 (21.8%) with an antegrade approach after retrograde failure. For the 50 (23.7%) patients who failed both retrograde and antegrade approaches, the most common (50% [25/50]) reason was inability to cross collaterals with the retrograde wire. This group of patients had fewer instances of a prior PCI (P < 0.05). Retrograde CTO PCI failure rate was lower with increasing sheath size and with either radial-only or one radial and one femoral access versus femoral-only access (P < 0.05). A multivariate Cox regression analysis showed that the inability to cross collaterals with the retrograde wire (hazard ratio, 5.52 [95% confidence interval, 2.08–12.81];P < 0.001), no prior PCI (3.27 [1.24–8.58];P = 0.01), and no reverse CART use (4.19 [1.33–13.19];P = 0.03) were an independent predictors of retrograde CTO PCI failure. Conclusion: Independent predictors of retrograde CTO PCI failure were the inability to cross collaterals with the retrograde wire, no prior PCI, and no reverse CART use. Vascular access site and sheath size do not have effect on the success of the retrograde approach.

Building-integrated photovoltaics (BIPV) makes it possible to utilize building surfaces for power generation. However, BIPV is facing challenges of high material costs, difficulty of scaling, and inefficient collection of indirect solar radiation. Therefore, solar concentrators collecting non-normal-incidence sunlight while maintaining concentration factors are promising for economic non-active-tracking photovoltaic systems. Here, we demonstrate a new design for dielectric total internal reflection concentrators (DTIRCs) that increase both the acceptance angle and the concentration ratio with tunable side and top profiles, and calculate the annual collectible sun power to prove that our new design receives more power compared to traditional concentrator designs.

The landscape of CDC20 gene expression and its biological impacts across different types of cancers remains largely unknown. Here, a pan-cancer analysis was performed to analyze the role of Cdc20 in various human cancers. Our results indicated that the expression levels of the CDC20 gene were significantly elevated in bladder cancer, breast cancer, colon cancer, rectum cancer, stomach cancer, esophageal cancer, head and neck cancer, kidney cancer, liver cancer, lung cancer, prostate cancer, pancreatic cancer, and uterine cancer. In addition, the expression of CDC20 was significantly and positively correlated with the increase of clinical stages in multiple cancer types, including breast cancer, kidney cancer, and lung cancer, et al. Among 33 cancer subtypes in the TCGA dataset, the high expression of CDC20 was correlated with poor prognosis in 10 cancer types. Furthermore, the abundance of phosphorylated Cdc20 in the primary tumor was elevated and correlated with increased tumor grade. Next, we sought to elucidate the oncogenic role by analyzing its association with immune infiltration. For most cancer types, the CDC20 expression was positively correlated with the infiltration of cancer-associated fibroblasts and myeloid-derived suppressor cells. To further understand its functional activity, we explored the classic Cdc20 downstream substrates, which were found to be mutually exclusive with the expression of Cdc20. Moreover, the pan-cancer analysis of the molecular function of Cdc20 indicated that BUB1, CCNA2, CCNB1, CDK1, MAD2L1, and PLK1 might play a critical role in interaction with Cdc20. The abundance of Cdc20 was further validated at transcriptional and translational levels with a publicly available dataset and clinical tumor tissues. The knockdown of Cdc20 dramatically inhibited tumor growth both in vivo and in vitro. Therefore, our studies delineated the oncogenic role of CDC20 and its prognostic significance at the pan-cancer level and proved its functional activity in Cdc20 high expression cancer types. Our studies will merits further molecular assays to understand the potential role of Cdc20 in tumorigenesis and provide the rationale for developing novel therapeutic strategies.

Osteoarthritis (OA) is the most common articular degenerative disease characterized by chronic pain, joint inflammation, and movement limitations, which are significantly influenced by aberrant epigenetic modifications of numerous OA-susceptible genes. Recent studies revealed that both the abnormal activation and differential expression of histone deacetylases (HDACs) might contribute to OA pathogenesis. In this study, we investigated the chondroprotective effects of a marine-derived HDAC inhibitor, panobinostat, on anterior cruciate ligament transection (ACLT)-induced experimental OA rats. The intra-articular administration of 2 or 10 µg of panobinostat (each group, n = 7) per week from the 6th to 17th week attenuates ACLT-induced nociceptive behaviors, including secondary mechanical allodynia and weight-bearing distribution. Histopathological and microcomputed tomography analysis showed that panobinostat significantly prevents cartilage degeneration after ACLT. Moreover, intra-articular panobinostat exerts hypertrophic effects in the chondrocytes of articular cartilage by regulating the protein expressions of HDAC4, HDAC6, HDAC7, runt-domain transcription factor-2, and matrix metalloproteinase-13. The study indicated that HDACs might have different modulations on the chondrocyte phenotype in the early stages of OA development. These results provide new evidence that panobinostat may be a potential therapeutic drug for OA.

OBJECTIVES The aim of this study was to investigate the influences of accumulated experience on rotational atherectomy (RA) operation regarding to in-hospital outcomes in the drug-eluting stent (DES) era. METHODS Between 2015 and 2019, 540 de novo lesions with calcified coronary lesions treated by RA and DES implantation at our center were retrospectively assessed. In-hospital major adverse cardiac events (MACE) were defined as all cause death, cardiac death, target vessel revascularization, and stroke. RESULTS From 2015 to 2019, RA operations were 22, 60, 102, 157, and 199 cases, respectively. Rates of procedural complications were 4.5, 3.3, 11.8, 8.3, and 7.5%, respectively. Rates of in-hospital MACE were 0, 0, 3.9, 2.5, and 2.0%, respectively. Compared with planned RA, bailout RA was associated with more contrast use (207.5 ± 82.8 ml vs. 189.2 ± 70.0 ml, p = .008). As for procedural complications and in-hospital outcomes, no differences were observed between two strategies. Logistic regression revealed that hypertension was independently associated with complications (OR 5.830, 95% CI 1.382-24.591, p = .016). For MACE, independent risk factors were heart failure (OR 17.593, 95% CI 1.475-209.816, p = .023) and procedural complications (OR 127.629, 95% CI 15.135-1,076.258, p

Textures are the most important element for simulating real-world scenes and providing realistic and immersive sensations in many applications. Procedural textures can simulate a broad variety of surface textures, which is helpful for the design and development of new sensors. Procedural texture generation is the process of creating textures using mathematical models. The input to these models can be a set of parameters, random values generated by noise functions, or existing texture images, which may be further processed or combined to generate new textures. Many methods for procedural texture generation have been proposed, but there has been no comprehensive survey or comparison of them yet. In this paper, we present a review of different procedural texture generation methods, according to the characteristics of the generated textures. We divide the different generation methods into two categories: structured texture and unstructured texture generation methods. Example textures are generated using these methods with varying parameter values. Furthermore, we survey post-processing methods based on the filtering and combination of different generation models. We also present a taxonomy of different models, according to the mathematical functions and texture samples they can produce. Finally, a psychophysical experiment is designed to identify the perceptual features of the example textures. Finally, an analysis of the results illustrates the strengths and weaknesses of these methods.

The aim of this study was to investigate the correlation of coronary flow reserve (CFR) assessed by rest/stress myocardial perfusion imaging with dynamic single-photon emission computed tomography (SPECT) with intracoronary pressure-derived fractional flow reserve (FFR) in patients with single-vessel coronary artery disease (CAD). Patients with suspected or known stable CAD who were referred for invasive coronary angiography were prospectively enrolled. Both invasive FFR and SPECT were performed in subjects with single-vessel intermediate coronary stenosis. A cutoff value of

The mechanical analysis of interlayer bonding problem of asphalt pavement is performed by the elastic layered system theory or finite element method (FEM); then, a lot of specialized programs based on the above theories emerged successively, of which BISAR3.0 and EverStressFE are quite representative. In order to further clarify the characteristics of BISAR3.0 and EverStressFE for investigating interlayer bonding problem of asphalt pavement, this paper will carry out a comprehensive comparison from the specific realization viewpoint, such as the principle of interlayer bonding, modeling, calculation processing, and result treatment, and a specific example will be given to compare and analyze their functions. The results indicate that the two programs have certain comparability in analyzing the interlayer bonding problem of asphalt pavement, which will contribute to the foundation for the rational selection of asphalt pavement structure mechanical analysis program.

Background: To determine the relationship between eosinophil-to-monocyte ratio (EMR) on admission and one-month and long-term all-cause mortality in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (P-PCI). Methods: A total of 426 consecutive STEMI patients treated with P-PCI were enrolled and categorized in terms of tertiles of EMR on admission between September 2015 and October 2017. Final follow-up for long-term outcomes was January 2017. Results: As EMR decreased, all-cause mortality at 1 month (mean, 29.5±3.5 days) and at mean 14.1± 7.8 months follow-up increased (P=0.012, P=0.003, respectively). Kaplan-Meier survival curve analysis showed EMR was associated with 1-month and long-term all-cause mortality (P=0.048, P=0.015, respectively). In multivariate Cox proportional hazards analysis, EMR was independently associated with one-month and long-term mortality (hazard ratio =0.097; 95% CI, 0.010–0.899; P=0.04; hazard ration =0.176; 95% CI, 0.045–0.694; P=0.013). The area under the curve of EMR for the prediction of 1-month and long-term total mortality in receiver operating characteristic analysis was 0.789 (95% CI, 0.658–0.921; P=0.003) and 0.752 (95% CI, 0.619–0.884; P=0.001), respectively. Conclusions: EMR on admission was independently correlated with 1-month and long-term all-cause mortality in STEMI patients undergoing P-PCI, suggesting EMR as a potential simple, useful, and inexpensive index for risk stratification of STEMI patients.

Mammalian skeletal muscles are composed of two major fibre types (I and II) that differ in terms of size, metabolism and contractile properties. In general, slow-twitch type I fibres are rich in mitochondria and have a greater insulin sensitivity than fast-twitch type II skeletal muscles. Although not widely appreciated, a forced induction of the slow skeletal muscle phenotype may inhibit the progress of obesity and diabetes. This potentially forms the basis for targeting slow/oxidative myofibers in the treatment of obesity. In this context, a better understanding of the molecular basis of fibre-type specification and plasticity may help to identify potential therapeutic targets for obesity and diabetes.

Background The management of diagonal branch (D) occlusion is still controversary. The association between the flow loss of D and the prognosis remains unclear. We aim to detect the impact of D flow on cardiac function and clinical outcomes in patients with anterior ST-segment elevation myocardial infarction (STEMI). Methods Patients with anterior STEMI undergoing primary percutaneous coronary intervention (PCI) at our clinic between October 2015 and October 2018were reviewed. Anterior STEMI due to left anterior descending artery (LAD) occlusion with or without loss of the main D flow (TIMI grade 0–1 or 2–3) was enrolled in the analysis. The short- and long-term incidence of major adverse cardiac events (MACEs, a composite of all-cause death, target vessel revascularization and reinfarction) and left ventricular ejection fraction (LVEF) were analyzed. Results A total of 392 patients (mean age of 63.9 years) with anterior STEMI treated with primary PCI was enrolled in the study. They were divided into two groups, loss (TIMI grade 0–1, n = 69) and no loss (TIMI grade2–3, n = 323) of D flow, before primary PCI. Compared with the group without loss of D flow, the group with loss of D flow showed a lower LVEF post PCI (41.0% vs. 48.8%, p = 0.003). Meanwhile, loss of D flow resulted in the higher in-hospital, one-month, and 18-month incidence of MACEs, especially in all-cause mortality (all p Conclusion Loss of the main D flow in anterior STEMI patients was independently associated with the higher in-hospital incidences of MACEs and all-cause death as well as the lower LVEF.

Biomass-based energy sources as an alternative to conventional fossil fuel have gained public attention due to the increasing rate of environmental pollutions and depletion of fossil energy source. For diesel engines, comparisons on fuel sustainability and First Law of Thermodynamics are common to inspect biodiesel’s potential in replacing conventional diesel fuel. However, the present work focuses on the energetic and exergetic comparisons of a light-duty diesel engine fuelled with fossil diesel and neat Palm Methyl Ester (PME). This study also covers emission characteristics and exergy destruction rate under varying engine operating parameters and fuel types. It was revealed that the best engine thermal efficiency when fuelled with fossil diesel and PME are 22.1% (2750 rpm, 1950W) and 24.3% (3000 rpm, 2400W), respectively. Additionally, the exergy efficiencies of the diesel engine at the same operating conditions appear to be approximately 2% lower than their First Law counterparts. This can be attributed to the generation of the entropy in reactions which destroyed the fuels’ potential. The availability destroyed rates were observed to have significant impacts on the exergy efficiencies of the diesel engine. Thus, heat transfer and exhaust exergy rates were investigated since they are the main factors for this outcome. In general, the use of PME fuel will be more beneficial in terms of exergy destruction, engine’s thermal and exergy efficiencies due to its higher oxygen content which improves the fuel combustion process.

AIMS This study sought to demonstrate the incidence, predictors, and management of microcatheter collateral channel (CC) tracking failure in retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. METHODS AND RESULTS Prospectively collected data from 371 consecutive retrograde CTO-PCI procedures between March 2015 and January 2018 were retrospectively analysed. The incidence of initial microcatheter CC tracking failure was 22.5% in 280 procedures with wire CC tracking success. For septal collaterals, CC grade 0-1 collaterals (odds ratio [OR]: 8.3; p

Therapies aimed at minimizing adverse remodeling in cardiovascular diseases on a molecular and cellular basis are urgently needed. Exosomes are nanosized lipid vesicles released from various cells that are able to mediate intercellular signaling and communication via their cargos. It has been increasingly demonstrated that exosomes from cardiomyocytes or stem/progenitor cells can promote cardiac repair and regeneration, but their mechanism has not been fully explained. Immune responses mediated by immune cells also play important and complicated roles in the progression of various cardiovascular diseases such as myocardial infarction and atherosclerosis. Exosomes derived from immune cells have shown pleiotropic effects on these pathological states, whether similar to or different from their parent cells. However, the underlying mechanism remains obscure. In this review, we first describe the biological characteristics and biogenesis of exosomes. Then we critically examine the emerging roles of exosomes in cardiovascular disease; the exosomes we focus on are derived from immune cells such as dendritic cells, macrophages, B cells, T cells, as well as neutrophils and mast cells. Among the cardiovascular diseases we discuss, we mainly focus on myocardial infarction and atherosclerosis. As active intercellular communicators, exosomes from immune cells may offer prospective diagnostic and therapeutic value in cardiovascular disease.

Aiming at the problems of blurred pupil edge and occlusion of upper and lower eyelids in low resolution images, a heuristic pupil region segmentation method is proposed, which mainly uses the gray level features of pupil region to locate. Firstly, N points are randomly initialized on the whole graph. Each point is iterated in a random step and direction to find the location of the pixel whose gray value is less than the global minimum gray value. When all points in the graph are not moving, all points are selected as seed stores to grow the region. The region after growing is the pupil region. Finally, isolated points are removed by morphological changes. And fill the hole. The results show that the algorithm can overcome the pupil pose change, eyelid, eyelash occlusion and other problems, and show good robustness and accuracy compared with other algorithms.

The purpose of this study was to examine whether gender differences existed and how the predictors were linked to acculturative stress across gender among a national sample of 1639 immigrant Chinese, Filipino, Vietnamese, and other Asian Americans. The data were from the National Latino and Asian American Study (NLAAS) conducted in 2002 and 2003, the first national epidemiological household survey of Asian Americans in the United States. The participants took part in face-to-face interviews, which were conducted with computer-assisted interviewing software in Mandarin, Cantonese, Tagalog, Vietnamese, and English. After fitted bivariate correlations to examine the relationships between acculturative stress and psychosocial variables, data were analyzed using two multiple regressions to identify the most significant predictors of acculturative stress for men and women separately. Results indicated that the psychosocial predictors of acculturative stress varied with gender status. For all men and women, longer years in the U.S., higher English proficiency, and less perceived discrimination predicted related to less acculturative stress. Social network was not the predictor for both men and women. Age of immigration, marital status, family cohesion and social position were additional significant predictors of acculturative stress only for men, but not for women. The implications of these results were discussed.

This study simulates the situation that users are required to wait when they encounter a buffer when watching online video, and investigates the influence of the duration and type of loading on time perception. The task was to estimate the perceived loading time. Results (1) the accuracy of time perception decreased with the time of loading. (2) the type of loading is related to time perception. The larger the amount of information contained in loading, the shorter the time perception of viewing video. (3) there is interaction between the duration of loading presentation and the type of loading. The results show that the amount of information and waiting time are related to time perception.

Biodiesel is commonly produced via transesterification process, usually through the use of batch type reactor. There are significant gaps in batch reactor technologies, where the importance of operating conditions are often concluded based on the steady-state conditions. In this study, a Pareto-Hierarchical framework were employed, based on results of a 4-factor 3-level full factorial Design of Experiments. Four parameters of interest such as agitation speed, catalyst loading, methanol-to-oil ratio, and temperature, were firsts analysed using transient Pareto approach followed by hierarchical clustering. The results indicate that low methanol: oil ratio favours transesterification at the beginning, with increasing importance as the process proceeds. From it, the magnitude of standardised effect increases from 0.38 to 14.21, representing an over 37-fold improvement. Conversely, agitation speed showed a reduction of 37-fold in standardised effect throughout the transesterification process, plateauing around mid-way of the reaction. Catalyst loading and temperature shared similar trends, as they influence the activation energy. Their standardised effects peak at 180 s which is in the middle of the physical-limiting regime. Therefore, this study provides a framework to develop an analyses to make dynamic optimisation strategy better in terms of economics and yield efficiency.

With the constantly advancing of urbanization in our country, new urban districts are constantly emerging. High intensity development and construction not only caused a large amount of resource consumption, but also has brought many ecological problems. Therefore, the construction of new urban districts must pay attention to the construction of ecological civilization. Taking the new district of the southern Taihu Lake in Huzhou as an example, this paper combed the contents and the methods of the planning and construction about new urban districts in the concept of ecological civilization. On the basis of the analysis of the current situation, the paper proposes the construction strategy of the southern Taihu Lake from four aspects, such as the high level of design, high standard of control, high-tech innovation and high strength of safeguard, in order to provide some revelations for follow-up construction of the new district.

Population aging is a global problem in the 21st century, especially in China, where the elderly population is huge and has become a severe social reality. Therefore, how to make the elderly enjoy their old age and spend their old age happily in the community environment is a problem facing the current society. In this paper, CNKI is taken as the literature source, and relevant keywords such as community aging landscape and elderly community landscape from 2010 to 2020 are searched. The related research hotspots in recent ten years are analyzed by VOSviewer data visualization software, and the current research status is briefly described. It can be seen from the analysis that the research methods are gradually scientific and systematic, and the research hotspots are gradually changing from the formal landscape of the elderly community to more practical and targeted target landscapes such as health care and healing, microclimate and gardening therapy, and the trend of cross-disciplinary research is gradually obvious. On this basis, this paper attempts to analyze the future development trend of the aging community landscape by domestic scholars, with a view to providing help for further research.

A data-driven model is used to analyse the global effects of biodiesel on the energy–water–food (EWF) nexus, and to understand the complex environmental correlation. Several criteria to measure the sustainability of biodiesel and four main limiting factors for biodiesel production are discussed in this paper. The limiting factors includes water stress, food stress, feedstock quantity and crude oil price. The 155-country model covers crude oil prices ranging from USD10/bbl to USD160/bbl, biodiesel refinery costs ranging from -USD0.30/L to USD0.30/L and 45 multi-generation biodiesel feedstocks. The model is capable of ascertaining changes arising from biodiesel adoption in terms of light-duty diesel engine emissions (NO, CO, UHC and smoke opacity), water stress index (WSI), dietary energy supply (DES), Herfindahl–Hirschman index (HHI) and short-term energy security. With the addition of potential biodiesel production, the renewable energy sector of global primary energy profile can increase by 0.43%, with maximum increment up to 10.97% for Malaysia. At current crude oil price of USD75/bbl and refinery cost of USD0.1/L, only Benin, Ireland and Togo can produce biodiesel profitably. The model also shows that water requirement varies non-linearly with multi-feedstock biodiesel production as blending ratio increases. Out of the 155 countries, biodiesel production is limited by feedstock quantity for 82 countries, 47 are limited by crude oil price, 20 by water stress and 6 by food stress. The results provide insights for governments to set up environmental policy guidelines, in implementing biodiesel technology as a cleaner alternative to diesel.

Background: Here, we determined miR-499 involvement in the protective effect of ischemic postconditioning (IPC) against myocardial ischemia/reperfusion (I/R) injury and identified the underlying mechanisms. Methods: To investigate the cardioprotective effect of IPC-induced miR-499, rats were divided into the following five groups: sham, I/R, IPC, IPC + scramble, and IPC + antagomiR-499. Hemodynamic indexes were measured by carotid-artery intubation to assess left ventricular function . Ischemia and infarction areas of rat hearts were determined by Evans blue and triphenyltetrazolium chloride staining, and cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick-end-labeling assay. Results: IPC attenuated I/R-induced infarct size of the left ventricle (45.28 ± 5.40% vs. 23.56 ± 6.20%, P < 0.05), myocardial apoptosis, and decreased creatine kinase (1867.31 ± 242.41% vs. 990.21 ± 172.39%, P < 0.05), lactate dehydrogenase (2257.50 ± 305.11% vs. 1289.11 ± 347.28%, P < 0.05), and malondialdehyde levels (7.18 ± 1.63% vs. 4.85 ± 1.52%, P < 0.05). Additionally, left ventricular systolic pressure, +dp/dtmax, and -dp/dtmax were elevated, and left ventricular end diastolic pressure was significantly reduced in the IPC group. Furthermore, IPC-mediated cardiac protection against I/R injury was inhibited in vivo and in vitro by knockdown of cardiac miR-499, suggesting that miR-499 may participate in the protective function of IPC against I/R injury through targeting programmed cell death 4 (PDCD4). Conclusion: Our data revealed that IPC-regulated miR-499 plays an important role in IPC-mediated cardiac protection against I/R injury by targeting PDCD4.

Combustion in HCCI engines is a controlled auto ignition process of well-mixed fuel, air and residual gas. Since the ignition of HCCI combustion is completely controlled by chemical kinetics, and is directly affected by the fuel composition, equivalence ratio, and thermodynamic state of the mixture, there is no direct control on the start of combustion process. Therefore, HCCI combustion is easy to become unstable, especially at lower and higher engine loads. In this study, cycle-to-cycle variations of an HCCI combustion engine fuelled with diesel were investigated on a modified single-cylinder engine. The experiments were conducted at different injection pressures, EGR rates, and intake pressures at constant engine speed of 1500 rpm. One hundred consecutive combustion cycles for each test conditions at steady state operation were recorded. Consequently, cycle-to-cycle variations of the main combustion parameters and performance parameters were analyzed. Coefficients of variation (COV) of every parameter were calculated to evaluate the cycle-to-cycle variations of HCCI combustion. This provides basis for closed loop control of diesel HCCI combustion phasing.

Self-Recirculation-Casing-Treatment (SRCT) is a widely employed method to enhance aerodynamic stability of a centrifugal compressor. This paper investigated unsteady effects of SRCT on the flow in a transonic centrifugal compressor via numerical method validated by experimental test. Firstly the static pressure distribution in the compressor without SRCT is measured for information of boundary conditions as well as validation. Then a 1-D unsteady model of a single passage is built and validated based on the experimental results. Next, the 1-D model of a passage with SRCT is built to investigate the unsteady influence of the SRCT on the flow in the passage. Finally 3-D unsteady CFD is employed to investigate the detailed influence of SRCT on the flow field in impeller passages. Results show that the topology of the passage with SRCT can remarkably damp the distortion propagating from downstream, hence depress the magnitude of the inlet flow distortion. Furthermore, the width of the rear slot in SRCT is the key factor for the damping effect. The 3-D simulation results further show that the fluctuations of the re-circulated flow rate via the front slot is depressed by the SRCT which is attributed to the damping effect of its configuration.

Objective We aimed to investigate short-term outcomes of the XINSORB bioresorbable sirolimus-eluting scaffold in human coronary artery. Background Bioresorbable scaffolds are considered to be the fourth milestone in percutaneous coronary intervention. Methods Thirty patients with symptomatic ischemic coronary disease were enrolled and treated with the XINSORB scaffolds that were 3.0 × 12, 15, and 18 mm in size. The primary angiographic endpoint was late luminal loss (LLL), whereas the primary clinical endpoint was major adverse cardiac events (MACEs) at the 6 month follow-up. In a subset of 19 patients, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) were performed at follow-up. Results The success rates of the procedure and the device were both 100%. Twenty-seven patients received angiographic follow-up. All patients were clinically assessed. Neither MACEs nor stent thrombus-related events were recorded. The percentage of diameter stenosis at follow-up was similar to that at postprocedure. In-scaffold and periscaffold LLL were 0.17 ± 0.12 and 0.13 ± 0.24 mm, respectively. No in-stent restenosis was detected. IVUS showed that the mean areas of the lumen, scaffold, and neointima at follow-up were 6.27 ± 0.69, 6.48 ± 0.70, and 0.20 ± 0.09 mm2, while in-device stenosis was 3.1 ± 1.3%. OCT showed that 97.9% of the struts presented a preserved box, while 2.1% had an open box after 6 months. A total of 95.9% of the struts were covered by neointima. Conclusions This first-in-human study demonstrates the effectiveness and safety of the XINSORB scaffold in treating single de novo coronary lesions. © 2016 Wiley Periodicals, Inc.

Premature coronary artery disease (PCAD) is increasingly common in Asian countries; however, less is known regarding its characteristics and clinical outcomes. This study aims to describe clinical characteristics and investigate clinical outcomes in real-world Asian patients with PCAD.A total of 4700 Asian patients undergoing drug-eluting stent implantation were included in our study and divided into PCAD group and mature CAD (MCAD) group according to their onset age. All patients were followed up for 3 years to observe their clinical outcomes.Patients with PCAD were more likely to be associated with acute coronary syndrome (ACS; P = .03) and acute occlusive lesion ( P.001). Reference diameter ( P.001) and lesion diameter stenosis ( P = .001) were significantly greater in PCAD group. Conversely, the MCAD group was more likely to be associated with left main disease, severe calcification lesion and small vessel involvement. The cumulative incidences of major adverse cardiovascular event (MACE; P = .007), cardiovascular death ( P.001), and all cause death ( P.001) were significantly lower in PCAD group than those in MCAD group.Although more often manifested as ACS, PCAD is associated with lower risks of MACE and cardiovascular death than MCAD in real-world Asian population.

Free-standing carbon nanotube films or buckypaper can provide a significant platform to develop practical applications of nanocarbon materials. For this research, buckypaper with high thermal conductivity (20 W/m K) and large surface area (350 m2/g) was mass produced in-house to investigate for use in lightweight thermal management devices. Floating catalyst chemical vapor deposition carbon nanotube sheets were also studied in this work. We introduced two manufacturing techniques to use the sheets for heat dissipation: (1) printing conductive composite ink on the sheets to make lightweight thermal devices, such as heat sinks and (2) assembling the sheets directly into 3D structures that were mounted on the back of heat-generating devices. These manufacturing techniques resulted in extremely lightweight, high-performance heat dissipation devices compared with other heat sink materials.