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Vortex-induced vibration (VIV) is a typical of large amplitude vibration for slender structure. Predicting the amplitude and wind speed range for VIV is vital and challenging in the wind-resistance design. The 4:1 rectangular cross-section cylinder is one of the representative structure for fundamental wind-induced vibration analysis. In this study, a novel wake-oscillator model tailored for predicting VIV in a 4:1 rectangular cylinder is proposed. Besides structural responses, this model can also conceptually reproduce the shedding behaviors of the vortices around the cylinder. For this purpose, two oscillators are employed and attached to the structure in the model. Oscillator 1, mounted on the rear face, simulates the swaying motion of the wake vortex. Oscillator 2, attached to the windward face, represents the variations in the main vortices generated from the leading edges. Governing functions of the two oscillators are derived according to the zero circulation assumption of the target region. The parameters are determined with accordance to both the rigid and aero-elastic model tests. The model's validity is examined through the comparison of the predicted response amplitudes with experimental data. Results demonstrate that the model can effectively predict the cylinder's responses across various Scruton numbers, using a single set of model parameters. This model is further applied to investigate the underlying mechanics of VIV excitation, focusing on the provided wind load and vibrating frequencies of Oscillators 1 and 2. These analyses helps to understand the structural VIV phenomenon. [ABSTRACT FROM AUTHOR]

Thromboelastography is a quantitative test widely used to measure the efficiency of blood clotting. However, awaiting the results of maximum amplitude (MA) is necessary for determining the need for platelet- and fibrinogen-containing products. A more rapid prediction of MA could facilitate faster preparation and administration of blood transfusion products, thereby resulting in coagulation improvement. In this retrospective study, we hypothesized that early amplitude at 10 min (A10) could be a predictor of MA. Therefore, we investigated whether MA can be rapidly inferred from thromboelastographic 6 s (TEG6s) measurements and evaluated its correlation with A10. We extracted TEG6s measurements obtained in operating rooms and intensive care units of our hospital between January 2018 and December 2022. The correlation of MA with display items of TEG6s results, including reaction time, kinetics, α angle, activated clotting time, and A10, was evaluated. The relationship between citrated rapid TEG (CRT)-A10 and CRT-MA, as well as between citrated functional fibrinogen (CFF)-A10 and CFF-MA, were evaluated if A10 and MA showed a good correlation. The results showed good correlations between CRT-A10 and CRT-MA, as well as between CFF-A10 and CFF-MA. Therefore, evaluating A10 using TEG6s could predict MA. [ABSTRACT FROM AUTHOR]

Corrosion significantly impacts the safety of steel structures, and neglecting its influence can lead to serious engineering accidents. In this study, a novel method for identifying the extent of corrosion on Q235 steel plates using Lamb waves is proposed. Numerical analysis of wave propagation on steel plates with varying corrosion depths and areas is conducted using COMSOL software. During the analysis, a sinusoidal modulated signal with five wave peaks is selected. Using the empirical mode decomposition, two novel corrosion identification factors, specifically the maximum amplitude based on the A0 wave packet and the energy of the Intrinsic Mode Function component, are found to be effectively reflected the extent of corrosion on steel plates. Empirical models for these two corrosion identification factors are developed as functions of corrosion areas (radius) and corrosion depths. By using the inverse operation of the suggested empirical models, it becomes possible to determine the corrosion depth and radius of the corrosion pit. To validate the proposed empirical models, experiments are conducted on Q235 steel plates subjected to accelerated corrosion testing in a 20% hydrochloric acid solution. The characteristics of wave propagation on the steel plates are investigated. A comparison between the corrosion extent predicted by the empirical models and the experimental results is made. The results demonstrates that the corrosion identification factor based on the energy of the Intrinsic Mode Function component is more accurate than the one based on the maximum amplitude of the A0 wave packet. In conclusion, the corrosion identification factor based on the energy of the Intrinsic Mode Function component can accurately predict the extent of corrosion on Q235 steel plates, and it can be effectively employed for the quantitative evaluation of corrosion extent, providing valuable insights for the safety assessment of in-service steel structures. [ABSTRACT FROM AUTHOR]

Objective: Sepsis is related to impaired hemostasis, starting with a subclinical coagulation activation known as hypercoagulability. The term for the coagulopathy process that occurs during the pathogenesis of sepsis is sepsis-induced coagulopathy (SIC). Appropriate information can be obtained using thromboelastography (TEG) to identify hemostatic disorders. This study aimed to assess the TEG parameter's diagnostic value for SIC in septic patients. Design: An analytical observational study with a cross-sectional design was conducted on septic patients treated in the Intensive Care Unit (ICU) of Dr. Hasan Sadikin General Hospital Bandung. TEG examinations were performed with TEG® 5000 Thrombelastograph® Hemostasis Analyzer. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic result's accuracy and to calculate the discriminatory value of the area under the curve (AUC). Setting: Dr. Hasan Sadikin General Hospital Bandung. Patients and participants: The participants were patients aged between 18-65 years old, treated in the ICU, with a diagnosis of sepsis established with Sequential Organ Failure Assessment (SOFA) score criteria. The minimum sample size was calculated with a one-sample sensitivitybased formula with type 1 error or α set at 10%, type 2 or β error set at 20%, resulting in a minimum sample size of 35 patients. Results: It was revealed that patients with SIC had higher abnormal mean parameter TEG and SOFA scores than patients without SIC (p<0.001). α angle sensitivity was 85.7% with a specificity of 78.6%, while maximum amplitude (MA) had a sensitivity of 80.9% with a specificity of 78.6%. The coagulation index (CI) was 90.5% sensitive and 85.7% specific. The AUC diagnosis value of CI and MA was 0.876 and 0.886, respectively. Conclusion: It is concluded that TEG parameters had an average to strong diagnostic value for SIC and could be used as routine examination for intervention in septic patients. [ABSTRACT FROM AUTHOR]

Background: Examination of the platelet aggregation test (PAT) and Maximum Amplitude -- Thromboelastography (MA-TEG) are two ways of assessing platelet function. Examination of the platelet aggregation test aims to detect any disturbance of platelet function based on changes in light transmission after adding an agonist. At the same time, the MA parameter of TEG shows the strength of the clot, which is related to platelet count and function, as well as their interaction with fibrin. This study aims to analyze the relationship between the results of the platelet aggregation test and the MA parameter of TEG in assessing platelet function in COVID-19 patients. Method: The type of research used is correlation research with a sampling technique, purposive sampling. Examination of PAT used the Aggregometer Chrono-Log Model 490 while checking MA values used a Thromboelastography 5000. The correlations for the variables studied were analyzed statistically. Results: The results of PAT in COVID-19 patients for each agonist showed different results. Most of the epinephrine and ADP agonists (60%) showed normoaggregation. In comparison, most collagen agonists (66.6%) showed hypoaggregation, while the value of the parameter MA-TEG in COVID-19 patients showed increased results: 75.2 (34.8 - 82.2). The correlation between each PAT agonist and MA-TEG showed no correlation. This conclusion is drawn based on the p-value > 0.05. Each p-value between variables is epinephrine with MA-TEG = 0.689, ADP with MA-TEG = 0.945 and collagen with MA-TEG) = 0.282.Conclusion: There is no significant correlation between PAT and TEG's MA parameter in assessing platelet function in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Patients with tumors generally present with accompanying activation of the coagulation system, which may be related to tumor stage. To our knowledge, few studies have examined the activation of the coagulation system in reference to lymph node metastasis within gastric cancer. This study aimed to investigate the correlation between multiple coagulation-related factors and lymph node metastasis in patients with gastric cancer after excluding the influence of tumor T stage. Materials and methods: We retrospectively evaluated the relationship between lymph node metastasis and coagulation-related factors in 516 patients with T4a stage gastric cancer. We further analyzed influencing factors for lymph node metastasis and verified the predictive value of maximum amplitude (MA, a parameter of thromboelastography which is widely used to assess the strength of platelet-fibrinogen interaction in forming clots) in reference to lymph node metastasis. Results: Platelet counts (P=0.011), fibrinogen levels (P=0.002) and MA values (P=0.006) were statistically significantly higher in patients with T4a stage gastric cancer presenting with lymph node metastasis than in those without lymph node metastasis. Moreover, tumor N stage was statistically significantly and positively correlated with platelet count (P<0.001), fibrinogen level (P=0.003), MA value (P<0.001), and D-dimer level (P=0.010). The MA value was an independent factor for lymph node metastasis (b=0.098, 95% CI: 1.020-1.193, P=0.014) and tumor N stage (b=0.059, 95% CI: 0.015-0.104, P=0.009), and could be used to predict the presence of lymph node metastasis in patients with gastric cancer (sensitivity 0.477, specificity 0.783, P=0.006). The independent influencing factors for MA value mainly included platelet levels, fibrinogen levels, D-dimer and hemoglobin levels; we found no statistically significant correlations with tumor diameter, tumor area, and other evaluated factors. Conclusion: We conclude that MA value is an independent influencing factor for lymph node metastasis and tumor N stage in patients with T4a stage gastric cancer. The MA value has important value in predicting the presence or absence of lymph node metastasis in patients with gastric cancer. [ABSTRACT FROM AUTHOR]

Objectives: The development and progression of malignancies are closely linked to hypercoagulability. As an early type of lung adenocarcinoma, ground glass nodules (GGNs) have been detected increasingly. Blood Maximum amplitude (MA) and mean platelet volume (MPV) are related to various conditions of hypercoagulability. Therefore, the role of MA and MPV in diagnosing lung adenocarcinoma cancer featured with GGNs was investigated in this case-control study. Methods: The analyzed data of this study is derived from GGNs patients and healthy individuals in West China (Airport) Hospital Sichuan University. The differences between GGNs patients and healthy individuals were determined by one-way ANOVA, logistic regression or chi-squared test. The accuracy of diagnostic was performed by receiver operating characteristic curve (ROC). The relative mRNA expressions were studied by RT-qPCR. Results: 470 patients diagnosed with GGNs which benign lesions (BN group) are inflammatory and malignant lesions (LC group) are adenocarcinoma in stage IA, and 235 healthy subjects (HC group) were enrolled in this study. Levels of MA and MPV were increased in LC group compared with BN and HC group (p < 0.001, p < 0.001). When we combined MA and MPV, MA and MPV presented a sensitivity (SEN) of 0.809 and a specificity (SPE) of 0.774. And the area under the curve (AUC) increased to 0.871 (0.837–0.900) when confidence interval was 95%. Conclusion: This study demonstrates that there have been systemic changes in coagulation disorders in the pathogenesis of GGNs. The diagnostic ability to different lung adenocarcinoma cancer featured with GGNs from benign or healthy controls can be improved by the combination of MA and MPV. Maximum amplitude and MPV may be used as biomarkers to detect lung adenocarcinoma cancer featured with GGNs. [ABSTRACT FROM AUTHOR]

Objectives: The development and progression of malignancies are closely linked to hypercoagulability. As an early type of lung adenocarcinoma, ground glass nodules (GGNs) have been detected increasingly. Blood Maximum amplitude (MA) and mean platelet volume (MPV) are related to various conditions of hypercoagulability. Therefore, the role of MA and MPV in diagnosing lung adenocarcinoma cancer featured with GGNs was investigated in this case-control study. Methods: The analyzed data of this study is derived from GGNs patients and healthy individuals in West China (Airport) Hospital Sichuan University. The differences between GGNs patients and healthy individuals were determined by one-way ANOVA, logistic regression or chi-squared test. The accuracy of diagnostic was performed by receiver operating characteristic curve (ROC). The relative mRNA expressions were studied by RT-qPCR. Results: 470 patients diagnosed with GGNs which benign lesions (BN group) are inflammatory and malignant lesions (LC group) are adenocarcinoma in stage IA, and 235 healthy subjects (HC group) were enrolled in this study. Levels of MA and MPV were increased in LC group compared with BN and HC group (p < 0.001, p < 0.001). When we combined MA and MPV, MA and MPV presented a sensitivity (SEN) of 0.809 and a specificity (SPE) of 0.774. And the area under the curve (AUC) increased to 0.871 (0.837-0.900) when confidence interval was 95%. Conclusion: This study demonstrates that there have been systemic changes in coagulation disorders in the pathogenesis of GGNs. The diagnostic ability to different lung adenocarcinoma cancer featured with GGNs from benign or healthy controls can be improved by the combination of MA and MPV. Maximum amplitude and MPV may be used as biomarkers to detect lung adenocarcinoma cancer featured with GGNs. [ABSTRACT FROM AUTHOR]

• The utilization of Thromboelastography (TEG) to guide individualized antiplatelet therapy ensures safety. • Individualized antiplatelet therapy demonstrates a notable reduction in the occurrence of adverse events. • It is important to exercise caution when administering individualized antiplatelet therapy to elderly patients with concurrent coronary heart disease. This research aims to investigate the impact of individualized antiplatelet therapy guided by thromboelastography with platelet mapping (TEG-PM) on the clinical outcomes of patients with non-cardiogenic ischemic stroke. Among a total of 1264 patients, 684 individuals diagnosed with non-cardiogenic ischemic stroke underwent TEG-PM testing. Based on the adjustment of antiplatelet medication, these patients were divided into individual and control groups. Within the individual group, in accordance with the TEG-PM test results, a Maximum amplitude (MA) value greater than 47mm was defined as high residual platelet reactivity (HRPR), while an MA value less than 31mm was defined as low residual platelet reactivity (LRPR). Patients with arachidonic acid (AA) less than 50% and adenosine diphosphate (ADP) less than 30% were classified as aspirin-resistant or clopidogrel-resistant. Treatment strategies for antiplatelet medication were subsequently adjusted accordingly, encompassing increment, decrement, or replacement of drugs. Meanwhile, the control group maintained their original medication regimen without alterations. The individual group included 487 patients, while the control group had 197. In the individual group, approximately 175 patients (35.9%) were treated with increased medication dosages, 89 patients (18.3%) with reduced dosages, and 223 patients (45.8%) switched medications. The results showed that the incidence rate of ischemic events in the individual group was lower than that of the control group (5.54% vs. 12.6%, P = 0.001), but no significant difference was observed in bleeding events. Cox regression analysis revealed age (hazard ratio, 1.043; 95% CI, 1.01-1.078; P = 0.011) and coronary heart disease (hazard ratio, 1.902; 95% CI, 1.147-3.153; P = 0.013) as significant risk factors for adverse events. Individualized antiplatelet therapy based on TEG-PM results can reduce the risk of ischemic events in patients with non-cardiogenic ischemic stroke without increasing the risk of bleeding events or mortality. Advanced age and coronary heart disease were identified as risk factors affecting the outcomes of individualized antiplatelet therapy. [ABSTRACT FROM AUTHOR]

Impulse waves generated by the collapse of pillar-shaped rock masses in Three Gorges, China, have attracted the attention of both researchers and local authorities owing to their catastrophic consequences. In this work, particle imaging velocimetry (PIV) was used to study impulse waves generated by the collapse of granular pillars during a series of physical experiments. Subsequently, the scenes of particles collapsing into water and the resulting impulse waves were analysed in terms of the solid/fluid fields. The energy obtained by the water during this process is mainly derived from the volume encroachment and continuous thrusting of particles. As indicated by the experimental results, as the aspect ratio (a) of the pillar and water depth increased, the potential energy of the granular pillar became more prone to reduction, whereas the efficiency of energy conversion to the liquid phase reduced. At constant water depth and granular pillar width, the maximum amplitude generated by the collapse of the granular pillar remained essentially the same (i.e., "saturation" was achieved) once the aspect ratio exceeded a certain threshold. The maximum impulse wave (the primary wave) formed before the main body of particles collapsed, resulting in the "saturation" of the maximum amplitude. When the kinetic energy of the particles reaches the maximum, the ratio of energy dissipation of the particles is the lowest; as the energy of water reaches the maximum, the particle collapse process does not end. The dynamic analysis of the impulse waves generated by the collapse of granular pillars provides a new approach to obtain an in-depth understanding of landslides and impulse waves. This can provide technical guidelines for disaster prevention and mitigation of impulse waves generated by bank collapse or coastline collapse. [ABSTRACT FROM AUTHOR]

Maximum amplitude and its corresponding maximum-amplitude solution are defined in an addition-min fuzzy relation inequalities system. The maximum-amplitude solution could be viewed as a stable solution, since it is able to survive the biggest fluctuation or perturbation appearing in its components. For solving the maximum amplitude and maximum-amplitude solution, we construct a relevant optimization problem and then convert it into several subproblems. Some auxiliary functions and index sets are introduced to deal with these subproblems. Algorithm I is developed to find their optimal solutions. Based on the optimal solutions of the subproblems, we further propose Algorithm II for obtaining the maximum amplitude and maximum-amplitude solution of an addition-min fuzzy relation inequalities system. Numerical examples illustrate the validness and efficiency of our proposed algorithms. [ABSTRACT FROM AUTHOR]

Fracture mechanics behavior and acoustic emission (AE) characteristics of fractured rock mass are related to underground engineering safety construction, disaster prediction, and early warning. In this study, the failure evolution characteristics of intact and fracture (e.g., single fracture, parallel fractures, cross fractures, and mixed fractures) coal were studied and contrasted with each other on the basis of the distribution of max amplitude of AE. The study revealed some meaningful results, where the value of b (i.e., the distribution characteristic of max amplitude of AE) could represent the failure evolution process of intact and fractured coal. The maximum amplitude distribution of AE events was characterized by Gaussian normal distribution, and the probability of the maximum amplitude of AE events corresponding to 35∼50 dB was the largest. In the stress range of 60∼80%, AE events and maximum amplitude increased rapidly, and the corresponding b value decreased. The energy of AE events showed a downward trend after reaching the maximum value at about 80% stress level. Under the same stress level, the more complex the fracture was, the larger the b value of coal–rock mass was, and the stronger the inhibition effect on the fracture expansion caused by the internal fracture distribution was. Due to the anisotropy of coal–rock mass with a single crack, the distribution of the b value was more discrete, while the anisotropy of coal–rock mass with mixed crack decreased, and the dispersion of the b value decreased. The deformation of cracked coal mainly caused by the adjustment of cracks during the initial loading b value experienced a trend of decreasing first, then increasing, and then decreasing in the loading process. When the load reached 0.8 times of the peak strength, the b value had a secondary decreasing trend, indicating the macroscopic failure of the sample, which could be used as a precursor criterion for the complete failure of coal–rock mass.

Patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) exhibit complex hemostatic defects. Thromboelastography (TEG) can be used to reveal global hemostasis in patients with liver disease; however, little is known about the association between TEG and the outcome of patients with HBV-related ACLF. The present study aimed to investigate the value of TEG for predicting 90 day mortality in patients with HBV-related ACLF. A total of 51 patients with HBV-related ACLF, 26 patients with chronic hepatitis B (CHB) and 26 healthy controls (HC) were enrolled in the present study. TEG, standard coagulation tests, routine blood tests, biochemical markers and demographic variables were recorded and assessed for prognostic value. The results indicated that a prolonged reaction and kinetics (K) time, a shortened α angle and a decreased maximum amplitude (MA) and coagulation index (CI) were observed in patients with HBV-related ACLF, compared with CHB and HC subjects. Patients with HBV-related ACLF in the mortality group exhibited a decrease in α angle, MA, lysis at 30 min, CI, fibrinogen and platelet count, and an increase in K time, international normalized ratio (INR) and the model for end-stage liver disease (MELD) score in comparison with the survival group. MA and INR were two independent predictors of 90 day mortality in patients with HBV-related ACLF, with hazard ratios of 0.918 (95% CI, 0.867-0.971; P=0.003) and 3.141 (95% CI, 1.843-5.354; P<0.001) respectively. When predicting 90 day mortality, MA + INR exhibited the highest area under the receiver operating characteristic curve, followed by INR, MELD score and MA. Patients with ACLF and MA ≤51.5 mm exhibited a poorer outcome than those with MA >51.5 mm, as revealed via the Kaplan-Meier analysis. In summary, the findings of the present study suggested that TEG MA was associated with 90 day mortality in patients with HBV-related ACLF, and a combination of MA and INR was superior to MA, INR and MELD score in terms of prognostic value. [ABSTRACT FROM AUTHOR]

Thromboelastography (TEG) is regularly used for monitoring abnormalities of the coagulation system in patients with sepsis. However, it is unclear whether TEG parameters are associated with sepsis-induced coagulopathy (SIC). Thus, we aimed to assess the diagnostic value of TEG for SIC. The medical records of patients who underwent TEG from January 2016 to December 2016 were analyzed retrospectively. The patients were divided into sepsis group and non-sepsis group. Baseline patient characteristics and coagulation function indexes were compared. Receiver–operating characteristic curve analysis was used to determine predictors of SIC. A total of 167 patients were included, of whom 84 had sepsis. The clot formation speed (K) was significantly higher(P < 0.001), and the maximum amplitude (MA) and angle were significantly lower (both P < 0.001) in the sepsis group than that in non-sepsis group. Patients with SIC had higher Sepsis-related Organ Failure Assessment scores than those patients without SIC (P < 0.001). The area under the curve of K for diagnosing SIC was 0.910. The area under the curve of angle and MA for excluding SIC was 0.895 and 0.882, respectively. Thus, TEG parameters have good diagnostic value for SIC. [ABSTRACT FROM AUTHOR]

Background: In current practice, the status of residual low-frequency acoustic hearing in hearing preservation cochlear implantation (CI) is unknown until activation two to three weeks postoperatively. The intraoperatively measured electrically evoked compound action potential (ECAP), a synchronous response from electrically stimulated auditory nerve fibers, is one of the first markers of auditory nerve function after cochlear implant surgery and such may provide information regarding the status of residual low-frequency acoustic hearing. Purpose: This study aimed to evaluate the relationship between intraoperative ECAP at the time of CI and presence of preoperative and postoperative low-frequency acoustic hearing. Research Design: A retrospective case review. Study Sample: Two hundred seventeen adult ears receiving CI (42 Advanced Bionics, 82 Cochlear, and 93 MED-EL implants). Interventions: Intraoperative ECAP and CI. Data Collection and Analysis: ECAP measurements were obtained intraoperatively, whereas residual hearing data were obtained from postoperative CI activation audiogram. A linear mixed model test revealed no interaction effects for the following variables: manufacturer, electrode location (basal, middle, and apical), preoperative low-frequency pure-tone average (LFPTA), and postoperative LFPTA. The postoperative residual low-frequency hearing status was defined as preservation of unaided air conduction thresholds ≥90 dB at 250 Hz. Electrode location and hearing preservation data were analyzed individually for both the ECAP threshold and ECAP maximum amplitude using multiple t-tests, without assuming a consistent standard deviation between the groups, and with alpha correction. Results: The maximum amplitude, in microvolts, was significantly higher throughout apical and middle regions of the cochlea in patients who had preserved low-frequency acoustic hearing as compared with those who did not have preserved hearing (p=0.0001 and p=0.0088, respectively). ECAP threshold, in microamperes, was significantly lower throughout the apical region of the cochlea in patients with preserved low-frequency acoustic hearing as compared with those without preserved hearing (p 5 0.0099). Basal electrode maximum amplitudes and middle and basal electrode thresholds were not significantly correlated with postoperative low-frequency hearing. Conclusions: Apical and middle electrode maximum amplitudes and apical electrode thresholds detected through intraoperative ECAP measurements are significantly correlated with preservation of low-frequency acoustic hearing. This association may represent a potential immediate feedback mechanism for postoperative outcomes that can be applied to all CIs. [ABSTRACT FROM AUTHOR]

Thromboelastography (TEG) is used for monitoring abnormal blood coagulation in critically ill patients. However, the correlation between TEG parameters and long-term survival in these patients is unknown. We aimed to quantify the effect of TEG on longterm survival of critically ill patients. Critically ill patients undergoing TEG were retrospectively examined. Baseline patient characteristics and coagulation function indexes were compared. Cox regression, receiver-operating characteristic curve analysis, and Kaplan-Meier survival estimate curve were performed. We included 167 critically ill patients. Clot formation speed (K) and reaction time (R) were higher, whereas maximum amplitude (MA) and angle were lower in the mortality group than in the survival group (P < .01). All TEG parameters were risk factors for 2-year survival in critically ill patients (P < .01). The area under the curve of MA for predicting 2-year survival was 0.756 (95% confidence interval: 0.670-0.841). The Kaplan-Meier survival estimate curve analysis showed that MA predicted 2-year survival of critically ill patients(P < .01). Maximum amplitude can effectively predict 2-year survival of critically ill patients, indicating the influence of the coagulation system on these patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the relationship between thromboelastography adenosine diphosphate maximum amplitude (TEG-ADPMA) and recurrent ischemic events in patients with minor ischemic stroke or high-risk transient ischemic attack (TIA).Methods: A total of 265 patients received dual antiplatelet therapy were consecutively enrolled. High on-treatment platelet reactivity (HTPR) to ADP was assessed by TEG-ADPMA and detected the CYP2C19 genotype; recurrent ischemic events were followed up for 90 days after onset. The difference of recurrent ischemic events was analyzed with or without HTPR to ADP by the Kaplan-Meier, and further to determine the difference of recurrent ischemic events in each group according to TEG-ADPMA-based tertile distribution.Results: A total of 23 (8.6%) patients had recurrent ischemic events. TEG-ADPMA greater than or equal to 48 mm had good predictive value. Whether these patients were divided into 2 groups or 3 groups, the HTPR to ADP group had higher risk of recurrent ischemic events than the normal on-treatment platelet reactivity to ADP group by the Kaplan-Meier (all, P < .05). The tertile distribution map showed that the results of recurrent ischemic events were statistically significant in the third tertile group compared with the other two groups (all, P < .03); also, the third tertile group had a higher rate of carriers of at least 1 CYP2C19 reduced-function allele than the other two groups (P < .05).Conclusions: In patients with minor ischemic stroke and high-risk TIA, the TEG-ADPMA could predict recurrent ischemic events and has auxiliary effect on clinical decision-making. [ABSTRACT FROM AUTHOR]

In nature, fish have gained wonderful swimming ability over the thousands of years of evolution. As the fish swims, its body, namely, it's dorsal or tail fin undulates and then alternating waves are sent down the body towards the tip of the tail. These waves generate a jet in the wake and hence a forward force, namely thrust. Scientific studies have already shown that undulatory swimming is a highly effective means of continuous locomotion and has been successfully adopted in many kinds of robotic fishes currently being developed. However, our latest research found that if wave velocity that defines the undulatory motion of the body or the 'fin' is less than a specific value, the fishlike body with undulatory motion also has the capability to harvest kinetic energy from flowing fluid. This finding proposes a new energy-harvesting concept which could offer a new and promising solution to support the long-distance voyage of a biomimetic robotic fish. [ABSTRACT FROM AUTHOR]

Background & objectives: Coagulation and haemostasis are dynamic processes. The haemostatic changes in liver disease affect all aspects of coagulation. The prothrombin time (PT)/ international normalized ratio (INR) was developed to monitor oral anticoagulant therapy and the activated partial thromboplastin time to investigate inheritable single factor deficiencies. Viscoelastic tests such as thromboelastogram (TEG) give information about dynamics of clot formation (coagulation factor and anticoagulant activity), clot strength (platelets and fibrinogen) and clot stability (finbrinolysis and factor XIII). Administration of blood products before invasive procedures is still guided by INR and platelet count in patients of liver disease. This study was aimed to evaluate the validity of TEG to predict post-procedural bleed after central venous cannulation in patients with cirrhosis. Methods: Ninety patients aged 20-70 yr diagnosed with liver cirrhosis requiring elective central venous catheter (CVC) insertion were studied. Platelet count, INR, serum creatinine, TEG and Child- Turcotte-Pugh (CTP) score were recorded before the procedure. Right-sided internal jugular vein was cannulated. On the basis of presence or absence of post-procedural bleed, patients were divided into bleeding and non-bleeding groups. The CTP score, component of TEG (R - reaction time, K - coagulation time, MA - maximum amplitude and α - angle) and laboratory parameters of both the groups were compared. Results: Bleeding was seen more when CTP scores were ⩾10 (P=0.05). The K time of 3.05 min or more on thromboelastograph was a significant predictor of bleeding [area under the curve (AUC) 0.694, P=0.047]. MA of 48.8 mm or more was a significant predictor of non-bleeding. INR ⩾2.6 was a significant predictor of bleeding (AUC 0.765, P=0.005). K time had a low-positive predictive value of 20 per cent and the positive and negative likelihood ratios of 1.87 and 0.48, respectively. Interpretation & conclusions: Our results show that the cut-off value for INR ⩾2.6 and K time ⩾3.05 min predict bleeding and MA ⩾48.8 mm predicts non-bleeding in patients with cirrhosis undergoing central venous pressure catheter cannulation. [ABSTRACT FROM AUTHOR]