Search

Abstract Background Direct oral anticoagulants are the established drugs for treating pulmonary thromboembolism. The advantage of direct oral anticoagulants over conventional therapy for clot lysis and right ventricular unloading in the acute phase remains unclear. This study aimed to evaluate the effect of acute treatment with direct oral anticoagulants on clot dissolution and right ventricular unloading in intermediate high-risk pulmonary thromboembolism. Methods Thirty patients with intermediate high-risk pulmonary thromboembolism admitted between November 2012 and December 2018 were included; 21 and 9 were treated with direct oral anticoagulants and conventional therapy, respectively. We compared the efficacy of clot dissolution and right ventricular unloading for intermediate high-risk pulmonary thromboembolism between direct oral anticoagulant and conventional therapy in the acute phase. Efficacy was assessed by computed tomography obstruction index, right/left ventricular ratio, and brain natriuretic peptide levels between baseline and at discharge. Results Computed tomography obstruction index, right ventricular/left ventricular ratio, and brain natriuretic peptide levels were significantly lower at discharge than at admission in both groups. The rate of improvement in computed tomography obstruction index was significantly higher in the direct oral anticoagulant therapy group than in the conventional therapy group (64 ± 15% vs. 47 ± 16%; p = 0.01). There were no significant differences in the rate of improvement in right ventricular/ left ventricular ratio and brain natriuretic peptide levels between the two groups. Conclusions Compared with conventional therapy, direct oral anticoagulants significantly reduced pulmonary artery clot burden conventional therapy in the acute treatment of intermediate high-risk pulmonary thromboembolism.

Coronary computed tomographic angiography (CCTA) is becoming the first-line investigation for establishing the presence of coronary artery disease and, with fractional flow reserve (FFRCT), its haemodynamic significance. In patients without significant epicardial obstruction, its role is either to rule out atherosclerosis or to detect subclinical plaque that should be monitored for plaque progression/regression following prevention therapy and provide risk classification. Ischaemic non-obstructive coronary arteries are also expected to be assessed by non-invasive imaging, including CCTA. In patients with significant epicardial obstruction, CCTA can assist in planning revascularisation by determining the disease complexity, vessel size, lesion length and tissue composition of the atherosclerotic plaque, as well as the best fluoroscopic viewing angle; it may also help in selecting adjunctive percutaneous devices (e.g., rotational atherectomy) and in determining the best landing zone for stents or bypass grafts.

Abstract Balloon pulmonary angioplasty (BPA) is beneficial for patients with chronic thromboembolic pulmonary disease (CTEPD) with pulmonary hypertension (PH). However, the clinical benefit of BPA for the patients with CTEPD without PH remains unknown. In this study, we aimed to evaluate the efficacy, safety, and long‐term outcomes of BPA in patients with CTEPD without PH. We retrospectively analyzed the data from 84 CTEPD patients with mean pulmonary artery pressure (mPAP)

The study was conducted to determine the effects of supplementing probiotics and concentrates on intake and growth performance of Sahelian does fed Brachiaria decumbens grass. Twenty-four Sahelian does averaging one year and weighing 13.3 ± 1.16 kg were assigned randomly in a 2 × 2 factorial arrangement to four treatments in a Completely Randomized Design with 6 replicates and used to measure intake and live weight changes for 14 weeks. The factors were levels of concentrate and probiotics. Blood samples were taken for the determination of haematological and biochemical parameters. The results revealed differences (P

Background Recently, machine learning algorithms have identified preprocedural γ‐glutamyl transferase (GGT) as a significant predictor of long‐term mortality after coronary revascularization in the SYNTAX (Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and Cardiac Surgery) trial. The aim of the present study is to investigate the impact of preprocedural GGT on 10‐year all‐cause mortality in patients with complex coronary artery disease after revascularization. Methods and Results The SYNTAX trial was a randomized trial comparing PCI with coronary artery bypass grafting in 1800 patients with complex coronary artery disease. The present report is a post hoc subanalysis of the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended Survival) trial, an investigator‐driven extended 10‐year follow‐up of the SYNTAX trial. The association between preprocedural GGT and 10‐year all‐cause mortality was investigated. The mean values of GGT for men and women were 43.5 (SD, 48.5) and 36.4 (SD, 46.1) U/L, respectively. In multivariable Cox regression models adjusted by traditional risk factors, GGT was an independent predictor for all‐cause death at 10‐year follow‐up, and each SD increase in log‐GGT was associated with a 1.24‐fold risk of all cause death at 10‐year follow‐up (95% CI, 1.10–1.40). According to previously reported sex‐related GGT thresholds, patients with higher GGT level had a 1.74‐fold risk of all‐cause death at 10‐year follow‐up (95% CI, 1.32–2.29) compared with patients with lower GGT level. Conclusions Preprocedural GGT is an independent predictor of 10‐year mortality after coronary revascularization in patients with complex coronary artery disease. In patients with elevated GGT, strong secondary prevention may be required after revascularization and must be studied prospectively. Registration URL: https://clinicaltrials.gov/study/NCT03417050.

A novel and concise synthetic method for arenastatin A, a cytotoxic cyclic depsipeptide of marine origin, was developed in this study. The convergent assembly of the four segments, including the cross-metathesis reaction, gave a cyclization precursor, and Fmoc deprotection caused simultaneous macrocyclization. The Corey–Chaykovsky reaction using a chiral sulfur ylide afforded arenastatin A with complete stereoselectivity in the longest linear sequence of seven reaction steps from the known compound. Using this synthetic method, some analogs of segment B were prepared through a late-stage diversification strategy. The simple SN2 reaction of the thiolate toward the tosylate precursor, prepared using almost the same synthetic method as described above, provided the desired sulfide analogs.

This study aimed to determine the growth performance, nutrient digestibility and carcass characteristics of grower rabbits fed diets containing graded Bambusa vulgaris leaf meal (BVLM) levels. Thirty rabbits weighing an average of 999 g were allocated in a Completely Randomized Design (CRD) to five treatments (BVLM 0%, which was the control diet, BVLM 5%, BVLM 10%, BVLM 15% and BVLM 20%) with six replicates. The rabbits were adapted to the assigned diets for one week and fed for ten weeks. Feed intake, live weight changes and feed conversion ratio were the performance parameters measured. Existing market prices for feed items were used to appraise the diets economically. A digestibility study was undertaken during the 10th week. No mortality was recorded during the study. Before termination of the feeding trial, 15 rabbits (3 from each treatment) were selected randomly, taken off feed for 24 hours and humanely slaughtered. Carcass parameters and weights of internal organs were measured and recorded. Results revealed that live weight changes, feed intake and feed conversion ratio were similar for all treatments. However, the cost of feed/kg and feed/kg gain decreased linearly with an increase in the inclusion level of BVLM. The results also showed that BVLM could be utilized in up to 15% of grower rabbit diets without lowering nutrient digestibility and dressing percentage. It was concluded that BVLM could be used up to 20% of the diet of grower rabbits to reduce the cost of feed/kg and cost of feed/kg gain without any adverse effects on live weight changes and weights of internal organs.

Abstract [Figure: see text]In this study, the chemical and nutritional characteristics of the leaves of Bambusa balcooa and Oxytenanthera abyssinica bamboos, and the straws of AGRA and Amankwatia rice varieties were evaluated using three analytical methods; proximate analysis, detergent fiber analysis and in vitro gas production. Data were analyzed using General Linear Model procedures in Minitab Statistical Software at a 5% significant level. Results showed that the leaves of B. balcooa had the highest (P

AbstractA 14-week feeding trial was conducted to evaluate the effects of supplementing probiotics and concentrates on carcass characteristics and meat quality of Sahelian does fed a basal diet of Brachiaria decumbens grass. Twenty-four does weighing averagely 13.3 ± 1.16 kg and aged averagely 12 months were randomly allocated to four treatments of six does each in a Completely Randomised Design with 2 × 2 factorial arrangement. The factors were levels of probiotics (0 and 100 g per 100 kg of concentrate) and concentrate (500 g and 1000 g per day). On the last day of the feeding trial, three goats per treatment were slaughtered by severing the jugular veins of the throat and trachea without stunning. Carcass characteristics were determined, and meat samples from longissimus lumborum were taken for analysis of the proximate composition and evaluation of fatty acid profile. The results showed that supplementing higher levels of concentrate and probiotics led to improved dressing percentage without any deleterious effect on the weights of internal organs, increased crude protein content and reduced crude fat content of the meat. The results further showed reductions in saturated fatty acid concentrations and increases in unsaturated fatty acid concentrations. It was concluded that the probiotics could be incorporated at 100 g per 100 kg of the concentrate and fed at 1000 g/d for improved carcass quality.

Background: We report on the clinical management and outcome of an 11-year-old dog diagnosed with suspected refractory immune-mediated anaemia (IMHA) and treated with equine placental extract supplementation. Case Description: The patient had received standard treatment with subcutaneous infusion of prednisone (2 mg/kg) and oral administration (1.3 mg/kg semel in die [sid]), with limited success as haematocrit (HCT) values continued to fall rapidly, and the patient continued to have severe symptoms of fatigue. The patient was then put on equine placental extract supplements, after which the patient's physical exhaustion was improved, and although the HCT level initially continued to fall, it eventually began to rise and remained near normal for approximately 2 years. Significant reduction in prednisone use was achieved with placental supplementation. Conclusion: Equine placental supplementation may be useful as a new complementary therapy for suspected refractory IMHA. [Open Vet J 2023; 13(5.000): 668-676]

Abstract Background This study was conducted to alleviate a common difficulty in chest X-ray image diagnosis: The attention region in a convolutional neural network (CNN) does not often match the doctor’s point of focus. The method presented herein, which guides the area of attention in CNN to a medically plausible region, can thereby improve diagnostic capabilities. Methods The model is based on an attention branch network, which has excellent interpretability of the classification model. This model has an additional new operation branch that guides the attention region to the lung field and heart in chest X-ray images. We also used three chest X-ray image datasets (Teikyo, Tokushima, and ChestX-ray14) to evaluate the CNN attention area of interest in these fields. Additionally, after devising a quantitative method of evaluating improvement of a CNN’s region of interest, we applied it to evaluation of the proposed model. Results Operation branch networks maintain or improve the area under the curve to a greater degree than conventional CNNs do. Furthermore, the network better emphasizes reasonable anatomical parts in chest X-ray images. Conclusions The proposed network better emphasizes the reasonable anatomical parts in chest X-ray images. This method can enhance capabilities for image interpretation based on judgment.

Makaluvamine J, a pyrroloiminoquinone alkaloid of marine sponge origin, and its analogs were synthesized and assessed for their potential to develop as a novel and selective growth inhibitor targeting human pancreatic cancer PANC-1 cells. Ts-damirone B, a common precursor featuring a pyrroloiminoquinone core structure, was synthesized through Bartoli indole synthesis and IBX-mediated oxidation. Late-stage diversification at N-5 and N-9 yielded makaluvamine J and several analogs. A structure–activity relationship (SAR) analysis highlighted the significance of the lipophilic side chain at N-9 for the growth inhibitory activity of PANC-1 cells. The modest alkyl group at N-5 was found to improve selectivity against other cancer cells. Among the prepared analogs, the tryptamine analog 24 showed potent and selective cytotoxicity (IC50 = 0.029 µM, selective index = 13.1), exceeding those of natural products.

Background The prognostic impact of optical coherence tomography–diagnosed culprit lesion morphology in acute coronary syndrome (ACS) has not been systematically examined in real‐world settings. Methods and Results This investigator‐initiated, prospective, multicenter, observational study was conducted at 22 Japanese hospitals to identify the prevalence of underlying ACS causes (plaque rupture [PR], plaque erosion [PE], and calcified nodules [CN]) and their impact on clinical outcomes. Patients with ACS diagnosed within 24 hours of symptom onset undergoing emergency percutaneous coronary intervention were enrolled. Optical coherence tomography–guided percutaneous coronary intervention recipients were assessed for underlying ACS causes and followed up for major adverse cardiac events (cardiovascular death, myocardial infarction, heart failure, or ischemia‐driven revascularization) at 1 year. Of 1702 patients with ACS, 702 (40.7%) underwent optical coherence tomography–guided percutaneous coronary intervention for analysis. PR, PE, and CN prevalence was 59.1%, 25.6%, and 4.0%, respectively. One‐year major adverse cardiac events occurred most frequently in patients with CN (32.1%), followed by PR (12.4%) and PE (6.2%) (log‐rank P

IntroductionThe selection of appropriate plant species, particularly those tailored to supplement ruminants raised under agrosilvopastoral systems, remains a persistent challenge.ObjectiveIn a 30-day study, the feed intake, growth performance, and manure characteristics of West African dwarf (WAD) goats fed bamboo leaf supplement were evaluated. Materials and methodsA total of 30 animals with an average weight of 9.9 ± 0.21 kg were divided into a control group, and four bamboo-supplemented groups, following a 2 x 2 factorial arrangement within a completely randomized design. Each group had six animal replicates and received the following dietary treatments: T1 (control) – 400g of basal diet composed of 60% Megathyrsus maximus and 40% Bridelia ferruginea leaves per day; T2—basal diet composed of the T1 diet supplemented with 400 g of Oxytenanthera abyssinica (A. Rich.) Munro leaves per day; T3—basal diet composed of the T1 diet supplemented with 400 g of Bambusa balcooa (Beema) leaves per day; T4—basal diet composed of the T1 diet supplemented with 600 g of O. abyssinica (A. Rich.) leaves per day; and T5—basal diet composed of the T1 diet supplemented with 600 g of B. balcooa leaves per day. The data were analyzed using generalized linear model procedures in Minitab Statistical Software at a 5% significance level. ResultsThe results showed varied (p < 0.05) dry matter compositions spanning from 894.3 to 910 g/kg with the highest contents of crude protein (194 g/kg), nitrogen (31 g/kg), crude fibre (302 g/kg), ash (156 g/kg), acid detergent fibre (429 g/kg), and acid detergent lignin (3.6 g/kg) recorded for B. ferruginea. The leaves of Bambusa balcooa contained the highest neutral detergent fibre (481 g/kg) while M. maximus had the highest organic matter content (911 g/kg). Significant interaction effect (p < 0.05) was observed between the supplement type and the supplementation level, impacting various parameters including feed intake ranging from 398 g (T1) to 469 g (T3) per day, weight gain from 27 g (T1) to 72 g (T2) per day, feed conversion efficiency from 6% (T1) to 15% (T2), manure output from 241 g (T2) to 260 g (T5) per day, carbon- nitrogen (C: N) ratio from 9 (T2) to 20 (T5), faecal acidity levels from 4 (T1) to 5 (T4). Comparatively, higher daily dry matter intake was recorded for the animal groups fed the B. balcooa supplement than their counterparts fed the O. abyssinica supplement. However, the O. abyssinica supplemented groups were more efficient in converting feed to body weight, with feed conversion efficiency approximately 9% higher than the B. balcooa-supplemented groups. Furthermore, in general, the animal groups that received a daily supplement of 400 g gave higher feed efficiency, with performance approximately 3.2% higher compared to the groups receiving 600 g. Likewise, these groups displayed higher faecal N output while concurrently achieving a reduced C: N ratio, indicative of enhanced nutrient utilization and potential environmental benefits. ConclusionTo conclude, integrating 400 grams of bamboo leaves into animal diet can enhance basal diet consumption, accelerate animal growth, and yield manure akin to chemical fertilizers, making it a valuable strategy for bamboo-integrated agro-silvopastoral systems practitioners.

Abstract We sought to verify the reliability of machine learning (ML) in developing diabetes prediction models by utilizing big data. To this end, we compared the reliability of gradient boosting decision tree (GBDT) and logistic regression (LR) models using data obtained from the Kokuho-database of the Osaka prefecture, Japan. To develop the models, we focused on 16 predictors from health checkup data from April 2013 to December 2014. A total of 277,651 eligible participants were studied. The prediction models were developed using a light gradient boosting machine (LightGBM), which is an effective GBDT implementation algorithm, and LR. Their reliabilities were measured based on expected calibration error (ECE), negative log-likelihood (Logloss), and reliability diagrams. Similarly, their classification accuracies were measured in the area under the curve (AUC). We further analyzed their reliabilities while changing the sample size for training. Among the 277,651 participants, 15,900 (7978 males and 7922 females) were newly diagnosed with diabetes within 3 years. LightGBM (LR) achieved an ECE of 0.0018 ± 0.00033 (0.0048 ± 0.00058), a Logloss of 0.167 ± 0.00062 (0.172 ± 0.00090), and an AUC of 0.844 ± 0.0025 (0.826 ± 0.0035). From sample size analysis, the reliability of LightGBM became higher than LR when the sample size increased more than $$10^4$$ 10 4 . Thus, we confirmed that GBDT provides a more reliable model than that of LR in the development of diabetes prediction models using big data. ML could potentially produce a highly reliable diabetes prediction model, a helpful tool for improving lifestyle and preventing diabetes.