Pre-existing Proton Pump Inhibitor Treatment and Short-Term Prognosis of Acute Myocardial Infarction Patients

IntroductionEvidence suspects proton pump inhibitor (PPI) use is a risk factor of poor prognosis of acute myocardial infarction (AMI). We aimed to investigate the association between pre-existing PPI use before emergency department (ED) visit and short-term prognosis of AMI patients.Materials and MethodsAMI patients admitted to ED were included and categorized as cohorts with or without pre-existing PPI use. Hospital mortality, length of hospital stay, being admitted to intensive care unit (ICU), and length of (total) ICU stay were studied as prognostic outcomes. Multivariable logistic regression or linear regression were used to estimate the associations between pre-existing PPI use and the outcomes after adjusting for potential confounders.ResultsA total of 2001 AMI patients were included. No significant difference was found in hospital mortality and length of ICU stay between cohorts; patients with pre-existing PPI use showed a significantly longer length of hospital stay (median 3.81 vs. 3.20 days, P = 0.002) but lower proportion of being admitted to ICU (25.59% vs. 40.83%, P < 0.001) compared to those without pre-existing PPI use. Pre-existing PPI use was not associated with hospital mortality [odds ratio (OR) 1.08, 95% confidence interval (CI) 0.58–1.99], length of hospital stay (β = 0.23, 95% CI −0.35 to 0.82), and length of ICU stay (β = −0.18, 95% CI −1.06 to 0.69), but was statistically significantly associated with lower risk of being admitted to ICU (OR 0.69, 95% CI 0.52–0.92).ConclusionThe current study does not support newly diagnosed AMI patients with pre-existing PPI use before ED visit would experience worse short-term prognosis than those without

Sensing and Quantifying a New Mechanism for Vehicle Brake Creep Groan

This paper investigates the creep groan of a vehicle’s brake experimentally, analytically, and numerically. Experimentally, the effects of acceleration on caliper and strut, noise, brake pressure, and tension are measured. The results show that the measured signals and their relevant spectra broadly capture the complex vibrations of creep groan. This includes the simple stick-slip, severe stick-slip vibrations/resonances, multiple harmonics, half-order harmonics; stick-slip-induced impulsive vibrations, steady/unstable vibrations, and their transitions. Analytically, a new mathematical model is presented to capture the unique features of half-order harmonics and the connections to fundamental stick-slip/resonant frequency and multiple harmonics. The analytical solution and the experimental results show that the vibro-impact of the brake pad-disc system can be triggered by severe stick-slip vibrations and is associated with instable, impulsive stick-slip vibration with wideband. The induced stick-slip vibro-impact can evolve into a steady and strong state with half-order, stick-slip fundamental, and multiple-order components. This new mechanism is different from all previously proposed mechanisms of creep groan in that we also view some type of creep groan as a stick-slip vibration-induced vibro-impact phenomenon in addition to conventional stick-slip phenomena. The new mechanism comprehensively explains the complex experimental phenomena reported in the literature. Numerically, the salient features of phase diagrams of instable stick-slip and vibro-impact are examined by using a seven-degree-of-freedom brake system model, which shows that the phase diagrams of the dynamics of creep groan with and without vibro-impact are substantially different. The phase diagram of the dynamics with vibro-impact is closer to the experimental results. In contrast to existing mechanisms, the proposed new mechanism encompasses the instable stick-slip nature of creep groan and elaborates the inherent connections and transition of the spectrogram. The new knowledge can be used to attain critical improvements to brake noise and vibration analysis and design. By applying the proposed new model in addition to existing models, all experimental phenomena in creep groan are elaborated and quantified

Distributions and Physical Properties of Molecular Clouds in the Third Galactic Quadrant: ll = [219.75, 229.75]∘^\circ and bb = [-5.25, 5.25]∘^\circ

We present the results of an unbiased $^{12}$CO/$^{13}$CO/C$^{18}$O ($J$ = 1-0) survey in a portion of the third Galactic quadrant (TGQ): $l$ = [219.75, 229.75]$^\circ$ and $b$ = [-5.25, 5.25]$^\circ$. The high-resolution and high-sensitivity data sets help to unravel the distributions and physical properties of the molecular clouds (MCs) in the mapped area. In the LSR velocity range from -1 to 85 km/s, the molecular material successfully traces the Local, Perseus, and Outer arms. In the TGQ, the Outer arm appears to be more prominent than that in the second Galactic quadrant (SGQ), but the Perseus arm is not as conspicuous as that in the SGQ. A total of 1,502 $^{12}$CO, 570 $^{13}$CO, and 53 C$^{18}$O molecular structures are identified, spanning over $\sim2$ and $\sim6$ orders of magnitude in size and mass, respectively. Tight mass-radius correlations and virial parameter-mass anticorrelations are observable. Yet, it seems that no clear correlations between velocity dispersion and effective radius can be found over the full dynamic range. The vertical distribution of the MCs renders evident pictures of the Galactic warp and flare.Comment: 22 pages, 13 figures, 7 tables (with machine-readable versions), published in ApJ

Between Big City and Authentic Village: Branding the Small Chinese City

While recent academic research has already produced an impressive corpus on big cities such as Shanghai and Beijing, the small Chinese city has been mostly ignored. In this article, I suggest that consideration of the small city can bring a new perspective on the wider urban fabric of which it is an element. Although small city governments have embraced urban entrepreneurialism with the same enthusiasm as China’s big cities, different configurations of space, branding and the everyday have nevertheless resulted. My case study of Kaili in Guizhou province indicates that the small city exists in a complex relationship with the big city and the village; it is pulled towards large-scale urbanization while simultaneously attempting to construct a unique city image based upon the evocation of rural cultural practices. The perspective from the small city thus suggests the need to consider the rural-urban divide – long a dominant geographical imagination of China – alongside other geographies, including a triad of the small city, the village and the big city

Fuzzy decision making in complex frameworks with generalized aggregation operators

[EN] This article presents a new aggregation system applied to fuzzy decision making. The fuzzy generalized unified aggregation operator (FGUAO) is a system that integrates many operators by adding a new aggregation process that considers the relevance that each operator has in the analysis. It also deals with an uncertain environment where the information is studied with fuzzy numbers. A wide range of particular cases and properties are studied. This approach is further extended by using quasi-arithmetic means. The paper ends studying the applicability in decision making problems regarding the European Union decisions. For doing so, the work uses a multi-person aggregation process obtaining the multi-person - FGUAO operator. An example concerning the fixation of the interest rate by the European Central Bank is presented. (C) 2018 Elsevier B.V. All rights reserved.We would like to thank the associate editor and the anonymous reviewers for valuable comments that have improved the quality of the paper. Support from the Chilean Government through the Fondecyt Regular program (project number 1160286), the University of Chile, the project PIEF-GA-2011-300062 of the European Commission and the Distinguished Scientist Fellowship Program of the King Saud University (Saudi Arabia), is gratefully acknowledged.Merigó -Lindahl, JM.; Gil-Lafuente, AM.; Yu, D.; Llopis Albert, C. (2018). Fuzzy decision making in complex frameworks with generalized aggregation operators. Applied Soft Computing. 68:314-321. https://doi.org/10.1016/j.asoc.2018.04.002S3143216

High-throughput functional analysis of autism genes in zebrafish identifies convergence in dopaminergic and neuroimmune pathways

Advancing from gene discovery in autism spectrum disorders (ASDs) to the identification of biologically relevant mechanisms remains a central challenge. Here, we perform parallel in vivo functional analysis of 10 ASD genes at the behavioral, structural, and circuit levels in zebrafish mutants, revealing both unique and overlapping effects of gene loss of function. Whole-brain mapping identifies the forebrain and cerebellum as the most significant contributors to brain size differences, while regions involved in sensory-motor control, particularly dopaminergic regions, are associated with altered baseline brain activity. Finally, we show a global increase in microglia resulting from ASD gene loss of function in select mutants, implicating neuroimmune dysfunction as a key pathway relevant to ASD biology