64 research outputs found

    Proximal buddy in jail technique: A bail out technique to increase guide support

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      Background: During percutaneous coronary intervention, “buddy-in-jail” technique is often used to facilitate stent delivery in complex coronary artery lesions. However, the safety and efficacy of this tech­nique when used with different jailed wire and applied in different target vessel lesions remain elusive. The aim of this retrospective study was to analyze the effectiveness of “buddy-in-jail” technique in the tortuous and rigid lesions of both the common and neighboring coronary arteries. The effectiveness between hydrophilic-coated and non-hydrophilic-coated guide wire as jailed wires was also compared. Methods: The “buddy-in-jail” technique was applied in 15 patients after failed balloon or stent delivery into the target vessel lesion from June 2014 to December 2016. The safety and effectiveness of the “bud­dy-in-jail” technique was compared in the tortuous and rigid lesions of both the common and neighbor­ing coronary arteries and between hydrophilic-coated and non-hydrophilic-coated “jailed” wires. Results: Stent delivery was successful in 13 (86.7%) patients with the use of “buddy-in-jail” technique. The success rate was similar to the group using the common artery (87.5%) as a “buddy” vessel and the group using a neighboring artery (85.7%) as a “buddy” vessel (p > 0.05), and between hydrophilic- -coated (100%) and non-hydrophilic-coated “jailed” wire (77.8%) group (p > 0.05). All wires were successfully extracted without complications. Conclusions: The “buddy-in-jail” technique offers a potential alternative approach for the distal stent delivery in both the common and neighboring coronary arteries. Also, both hydrophilic and non-hydro­philic-coated wire could be safely and effectively used as “jailed” wire.

    Ceno: Non-uniform, Segment and Parallel Zero-knowledge Virtual Machine

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    In this paper, we explore a novel Zero-knowledge Virtual Machine (zkVM) framework leveraging succinct, non-interactive zero-knowledge proofs for verifiable computation over any code. Our approach divides program execution proof into two stages. In the first stage, the process breaks down program execution into segments, identifying and grouping identical sections. These segments are then proved through data-parallel circuits that allow for varying amounts of duplication. In the subsequent stage, the verifier examines these segment proofs, reconstructing the program\u27s control and data flow based on the segments\u27 duplication number and the original program. The second stage can be further attested by a uniform recursive proof. We propose two specific designs of this concept, where segmentation and parallelization happen at two levels: opcode and basic block. Both designs try to minimize control flow that affects the circuit size and support dynamic copy numbers, ensuring that computational costs directly correlate with the actual code executed (i.e., you only pay as much as you use). In our second design, in particular, by proposing an innovative data-flow reconstruction technique in the second stage, we can drastically cut down on the stack operations even compared to the original program execution. Note that the two designs are complementary rather than mutually exclusive. Integrating both approaches in the same zkVM could unlock more significant potential for accommodating diverse program patterns. We present an asymmetric GKR scheme to implement our designs, pairing a non-uniform prover and a uniform verifier to generate proofs for dynamic-length data-parallel circuits. The use of a GKR prover also significantly reduces the size of the commitment: GKR allows us to commit only the circuit\u27s input and output, whereas in Plonkish-based solutions, the prover needs to commit to all the witnesses

    Stator Flux Observer for Induction Motor Based on Tracking Differentiator

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    Voltage model is commonly used in direct torque control (DTC) for flux observing of asynchronous motor. In order to improve low-speed and dynamic performance of the voltage model, a modified low-pass filter (LPF) algorithm is proposed. Firstly, the tracking differentiator is brought in to modulate the measured stator current, which suppresses the measurement noise, and then amplitude and phase compensation is made towards the stator electromotive force (EMF), after which the stator flux is obtained through a low-pass filter. This method can eliminate the dynamic error of flux filtered by LPF and improve low-speed performance. Experimental results demonstrate effectiveness and improved dynamic performance of such method

    Association between Percentage of Neutrophils at Admission and in-Hospital Events in Patients ≥75 Years of Age with Acute Coronary Syndrome

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    Objective: The study aimed to evaluate the role of the neutrophil percentage (N%) at admission in predicting in-hospital major adverse cardiovascular events (MACE) in patients ≥75 years of age with acute coronary syndrome (ACS).Methods: A total of 1189 patients above 75 years of age with ACS hospitalized at the Second Xiangya Hospital between January 2013 and December 2017 were enrolled in this retrospective study. Receiver operator characteristic curve analysis was performed to calculate the optimal N% cut-off value for patient grouping. The in-hospital MACE consisted of acute left heart failure, stroke and any cause of death. Multivariable logistic analyses were used to assess the role of N% in predicting MACE in older patients with ACS.Results: The patients were divided into a high N% group (N% ≥74.17%, n=396) and low N% group (N%<74.17%, n=793) according to the N% cut-off value (N%=74.17%). The rate of MACEs during hospitalization was considerably higher in the high N% group than the low N% group (27.5% vs. 9.6%, P<0.001). After adjustment for other factors, high N% remained an independent risk factor for in-hospital MACE in older patients with ACS (odds ratio 1.779, 95% confidence interval 1.091–2.901, P=0.021).Conclusion: High N% at admission is an independent risk factor for in-hospital MACE in patients above 75 years of age with ACS

    In-Hospital Cardiac Arrest after Emotional Stress in a Patient Hospitalized with Gastrointestinal Symptoms and Chronic Anxiety Disorder

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    Background: We report an acute emotional stress–induced in-hospital cardiac arrest in a patient admitted with gastrointestinal symptoms after experiencing chronic anxiety disorder. Case Presentation: The patient was admitted to the Second Xiangya Hospital, Central South University, with gastrointestinal symptoms and chronic anxiety disorder, and experienced cardiac arrest during hospitalization after acute emotional stress. Malignant ventricular tachycardia and cardiogenic shock were evidenced in this patient after the acute emotional stress. Severe and extensive coronary spasm was confirmed by emergency coronary angiography, and coronary spasm was relieved by intracoronary injection of nitroglycerin. The patient recovered from myocardial infarction with nonobstructive coronary arteries. However, the patient developed acute kidney dysfunction and severe pulmonary infection and eventually died of respiratory circulatory failure on the ninth day after the successful rescue. Conclusions: Acute emotional stress on top of chronic anxiety disorder in patients hospitalized for noncardiovascular reasons might lead to the development of life-threatening cardiovascular diseases, including coronary artery spasm and myocardial infarction with nonobstructive coronary arteries. Psychological management is of importance to improve the outcome of these patients. </p

    Clinical Significance of Angiographically Detectable Neovascularity in Patients with Cardiac Myxoma

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    Background: Myxomas are the most common primary cardiac tumors. Angiographically detectable neovascularity (ADN) of myxoma is increasingly being reported as a result of the use of coronary angiography (CAG) to detect coronary artery disease. However, the clinical significance of these findings is not fully understood. Methods: We enrolled 59 patients with cardiac myxoma who also underwent CAG between January 2013 and October 2018. Patients were followed up for a mean of 28.9 months (range 1–69 months). The clinical features, echocardiography measurements, pathological examination findings, CAG results, and outcomes during follow-up were compared between patients with ADN and patients without ADN. Results: ADN was found in 25 patients (42.4%). The arteries feeding the ADN included the right coronary artery ( n=15), the left circumflex coronary artery ( n=7), and both arteries ( n=3). The patients with ADN had a higher proportion of eosinophils (3.2% vs. 2.2%, P=0.03) and higher low-density lipoprotein cholesterol level (2.7 mmol/L vs. 2.2 mmol/L, P=0.02). Myxoma pedicles were more likely to be located in the interatrial septum in patients with ADN (96% vs. 73.5%, P=0.02). No significant correlation was observed between the groups in clinical manifestations, atrial arrhythmia, myxoma size, cardiac chamber size, left ventricular ejection fraction, and the prevalence of complication with coronary artery disease [16% in the ADN group ( n=4) vs. 20.6% in the non-ADN group ( n=7), P=0.66]. However, patients with ADN tended to have a lower incidence of major adverse cardiac and cerebrovascular events on long-term follow-up (0% vs. 14.7%, P=0.07). Conclusion: CAG-detected ADN in patients with cardiac myxoma is associated with a borderline lower rate of major adverse cardiac and cerebrovascular events. </p

    In Vitro Uptake of 140 kDa Bacillus thuringiensis Nematicidal Crystal Proteins by the Second Stage Juvenile of Meloidogyne hapla

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    Plant-parasitic nematodes (PPNs) are piercing/sucking pests, which cause severe damage to crops worldwide, and are difficult to control. The cyst and root-knot nematodes (RKN) are sedentary endoparasites that develop specialized multinucleate feeding structures from the plant cells called syncytia or giant cells respectively. Within these structures the nematodes produce feeding tubes, which act as molecular sieves with exclusion limits. For example, Heterodera schachtii is reportedly unable to ingest proteins larger than 28 kDa. However, it is unknown yet what is the molecular exclusion limit of the Meloidogyne hapla. Several types of Bacillus thuringiensis crystal proteins showed toxicity to M. hapla. To monitor the entry pathway of crystal proteins into M. hapla, second-stage juveniles (J2) were treated with NHS-rhodamine labeled nematicidal crystal proteins (Cry55Aa, Cry6Aa, and Cry5Ba). Confocal microscopic observation showed that these crystal proteins were initially detected in the stylet and esophageal lumen, and subsequently in the gut. Western blot analysis revealed that these crystal proteins were modified to different molecular sizes after being ingested. The uptake efficiency of the crystal proteins by the M. hapla J2 decreased with increasing of protein molecular mass, based on enzyme-linked immunosorbent assay analysis. Our discovery revealed 140 kDa nematicidal crystal proteins entered M. hapla J2 via the stylet, and it has important implications in designing a transgenic resistance approach to control RKN

    Underwater Turbid Media Stokes-Based Polarimetric Recovery

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    Underwater optical imaging for information acquisition has always been an innovative and crucial research direction. Unlike imaging in the air medium, the underwater optical environment is more intricate. From an optical perspective, natural factors such as turbulence and suspended particles in the water cause issues like light scattering and attenuation, leading to color distortion, loss of details, decreased contrast, and overall blurriness. These challenges significantly impact the acquisition of underwater image information, rendering subsequent algorithms reliant on such data unable to function properly. Therefore, this paper proposes a method for underwater image restoration using Stokes linearly polarized light, specifically tailored to the challenges of underwater complex optical imaging environments. This method effectively utilizes linear polarization information and designs a system that uses the information of the first few frames to calculate the enhanced images of the later frames. By doing so, it achieves real-time underwater Stokes linear polarized imaging while minimizing human interference during the imaging process. Furthermore, the paper provides a comprehensive analysis of the deficiencies observed during the testing of the method and proposes improvement perspectives, along with offering insights into potential future research directions

    MicroRNAs and mesenchymal stem cells: hope for pulmonary hypertension

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    AbstractPulmonary hypertension is a devastating and refractory disease and there is no cure for this disease. Recently, microRNAs and mesenchymal stem cells emerged as novel methods to treat pulmonary hypertension. More than 20 kinds of microRNAs may participate in the process of pulmonary hypertension. It seems microRNAs or mesenchymal stem cells can ameliorate some symptoms of pulmonary hypertension in animals and even improve heart and lung function during pulmonary hypertension. Nevertheless, the relationship between mesenchymal stem cells, microRNAs and pulmonary hypertension is not clear. And the mechanisms underlying their function still need to be investigated. In this study we review the recent findings in mesenchymal stem cells - and microRNAs-based pulmonary hypertension treatment, focusing on the potential role of microRNAs regulated mesenchymal stem cells in pulmonary hypertension and the role of exosomes between mesenchymal stem cells and pulmonary hypertension
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