Impact of Time-Varying Intensity of Mechanical Ventilation on 28-Day Mortality Depends on Fluid Balance in Patients With Acute Respiratory Distress Syndrome: A Retrospective Cohort Study

BackgroundRecent studies have mainly focused on the association between baseline intensity of mechanical ventilation (driving pressure or mechanical power) and mortality in acute respiratory distress syndrome (ARDS). It is unclear whether the association between the time-varying intensity of mechanical ventilation and mortality is significant and varies according to the fluid balance trajectories.MethodsWe conducted a secondary analysis based on the NHLBI ARDS Network’s Fluid and Catheter Treatment Trial (FACTT). The primary outcome was 28-day mortality. The group-based trajectory modeling (GBTM) was employed to identify phenotypes based on fluid balance trajectories. Bayesian joint models were used to account for informative censoring due to death during follow-up.ResultsA total of 1,000 patients with ARDS were included in the analysis. Our study identified two phenotypes of ARDS, and compared patients with Early Negative Fluid Balance (Early NFB) and patients with Persistent-Positive Fluid Balance (Persistent-PFB) accompanied by higher tidal volume, higher static driving pressure, higher mechanical power, and lower PaO2/FiO2, over time during mechanical ventilation. The 28-day mortality was 14.8% in Early NFB and 49.6% in Persistent-PFB (p < 0.001). In the Bayesian joint models, the hazard ratio (HR) of 28-day death for time-varying static driving pressure [HR 1.03 (95% CI 1.01–1.05; p < 0.001)] and mechanical power [HR 1.01 (95% CI 1.002–1.02; p = 0.01)] was significant in patients with Early NFB, but not in patients with Persistent-PFB.ConclusionTime-varying intensity of mechanical ventilation was associated with a 28-day mortality of ARDS in a patient with Early NFB but not in patients with Persistent-PFB

Comparison of the Effects of Acarbose and TZQ-F, a New Kind of Traditional Chinese Medicine to Treat Diabetes, Chinese Healthy Volunteers

Ethnopharmacological Relevance. TZQ-F has been traditionally used in Traditional Chinese Medicine as a formula for the treatment of diabetes. Aim of the Study. This study aims to compare the pharmacologic effects and gastrointestinal adverse events between TZQ-F and acarbose. Methods. The double-blind randomized placebo-controlled fivefold crossover study was performed in 20 healthy male volunteers. Plasma glucose, plasma IRI, and plasma C-peptide were measured to assess the pharmacologic effects. Flatus and bowel activity were measured to assess the adverse event of gastrointestinal effect. Results. 3 and 4 tablets of TZQ decreased the Cmax of plasma glucose compared with that of the previous day and with placebo. 3 tablets also decreased Cmax of plasma C-peptide compared with placebo. 4 tablets increased Cmax of plasma insulin after breakfast and the AUC of plasma C-peptide after breakfast and dinner. 2 tablets did not decrease plasma glucose and elevated the Cmax and AUC of C-peptide after breakfast and dinner, respectively. Acarbose 50 mg decreased the Cmax of plasma insulin and C-peptide after breakfast and the Cmax of plasma glucose and C-peptide after dinner. The subjects who received TZQ did not report any abdominal adverse events. Conclusions. 3 tablets of TZQ have the same effects as the acarbose

Electric field control of deterministic current-induced magnetization switching in a hybrid ferromagnetic/ferroelectric structure

All-electrical and programmable manipulations of ferromagnetic bits are highly pursued for the aim of high integration and low energy consumption in modern information technology1, 2, 3. Methods based on the spin–orbit torque switching4, 5, 6 in heavy metal/ferromagnet structures have been proposed with magnetic field7, 8, 9, 10, 11, 12, 13, 14, 15, and are heading toward deterministic switching without external magnetic field16, 17. Here we demonstrate that an in-plane effective magnetic field can be induced by an electric field without breaking the symmetry of the structure of the thin film, and realize the deterministic magnetization switching in a hybrid ferromagnetic/ferroelectric structure with Pt/Co/Ni/Co/Pt layers on PMN-PT substrate. The effective magnetic field can be reversed by changing the direction of the applied electric field on the PMN-PT substrate, which fully replaces the controllability function of the external magnetic field. The electric field is found to generate an additional spin–orbit torque on the CoNiCo magnets, which is confirmed by macrospin calculations and micromagnetic simulations

Qishen Yiqi dripping pills for chronic ischaemic heart failure:results of the CACT-IHF randomized clinical trial

10.1002/ehf2.12980ESC Heart Failure763881-389

A Self-Assembly of Single Layer of Co Nanorods to Reveal the Magnetostatic Interaction Mechanism

In this work, we report a self-assembly method to fabricate a single layer of Co nanorods to study their magnetostatic interaction behavior. The Co nanorods with cambered and flat tips were synthesized by using a solvothermal route and an alcohol–thermal method, respectively. Both of them represent hard magnetic features. Co nanorods with cambered tips have an average diameter of 10 nm and length of 100 nm with coercivity of 6.4 kOe, and flat-tip nanorods with a 30 nm diameter and 100 nm length exhibit a coercivity of 4.9 kOe. They are further assembled on the surface of water in assistance of surfactants. The results demonstrate that the assembly type is dependent on the magnetic induction lines direction. For Co nanorods with flat tips, most of magnetic induction lines are parallel to the length direction, leading to an assembly that is tip to tip. For Co nanorods with cambered tips, they are prone to holding together side by side for their random magnetic induction lines. Under an applied field, the Co nanorods with flat tips can be further aligned into a single layer of Co nanorods. Our work gives a possible mechanism for the magnetic interaction of Co nanorods and provides a method to study their magnetic behavior