Clinical Efficacy and Safety Comparison of Rivaroxaban and Dabigatran for Nonvalvular Atrial Fibrillation Patients Undergoing Percutaneous Left Atrial Appendage Closure Operation

Objective: Due to the clinical complexity of warfarin, novel oral anticoagulation (NOAC) has been a feasible and safe alternative anticoagulant approach during left atrial appendage closure (LAAC). This study was designed to compare the efficacy and safety of rivaroxaban and dabigatran for nonvalvular atrial fibrillation patients undergoing percutaneous LAAC.Methods: One single and prospective cohort study was performed among patients who received anticoagulation with dabigatran or rivaroxaban. All patients were medicated with a 3-month course of NOAC to facilitate device endothelialization, followed by dual antiplatelet therapy until 6 months, then lifelong aspirin after discharge. Repeated transesophageal echocardiography was scheduled to evaluate thrombosis formation on occluders and thrombus dissolution ability.Results: A total of 262 consecutive patients were initially enrolled. A final number of 250 patients were analyzed; two patients were excluded due to procedure failure and 10 patients had a loss of follow-up; 97 were from the dabigatran group and 153 from the rivaroxaban group. Three patients (1.9%) in the rivaroxaban group and eight (8.2%) in the dabigatran group were experiencing device-related thrombosis (DRT) events during follow-ups. Cumulative Kaplan–Meier estimates showed that the incidence of DRT was lower under rivaroxaban medication during the 6-month follow-ups (p = 0.038*, OR = 3.843, 95%CI: 0.991–14.836). The transesophageal echocardiography (TEE) results showed that the average length and width of DRT in the rivaroxaban group was significantly lower compared with that in the dabigatran group (2.16 vs. 1.60 mm, p = 0.017*, and 1.71 vs. 1.30 mm, p = 0.003*, respectively). The thrombosis dissolved after the switch from dabigatran or rivaroxaban to warfarin within the target range, represented by the average length and width of thrombus with the cooperation of secondary TEE for the dabigatran and rivaroxaban groups (0.64 vs. 0.40 mm, p = 0.206, and 0.43 vs. 0.27 mm, p = 0.082, respectively). No significant difference was found between the two groups with respect to the levels of coagulation parameters, cardiac function, and bleeding events.Conclusion: Compared to dabigatran, post-procedural rivaroxaban anticoagulation might be advantageous in preventing DRT complications expected after LAAC, without increasing the risk of hemorrhage

Kinetics of the neutralising antibody response in patients with hand, foot, and mouth disease caused by EV-A71: A longitudinal cohort study in Zhengzhou during 2017-2019

BACKGROUND: Hand, foot, and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) poses a serious threat to children's health. Kinetics of the neutralising antibody (NAb) response in EV-A71 infected HFMD patients remains unclear. The ideal sampling time of paired serum samples for serological diagnosis of EV-A71 infection is not well defined. METHODS: HFMD inpatients admitted to Henan Children's Hospital between February 15, 2017 and February 15, 2018 were enrolled. Serial serum samples collected during hospitalisation and up to 1.5 years after discharge were tested for NAb against EV-A71. Random intercept modelling with B-spline was conducted to characterize the kinetics of the EV-A71 NAb response over time after illness onset. FINDINGS: A total of 524 serum samples from 264 EV-A71 RNA positive HFMD inpatients were collected. NAb titres of EV-A71 infected patients were estimated to increase from 40 (95% CI: 9-180) at the day of onset to the peak of 2417 (95% CI: 1859-3143) at day 13, then remained above 1240 until 26 months. For serological diagnosis of EV-A71 infection, if at least a 4-fold rise in titre was used as the criteria, the acute phase serum should be collected at 0-4 days, the corresponding convalescent serum should be collected 14.9 days (95% CI: 9.1-23.8) after illness onset. INTERPRETATION: EV-A71 infection induced a strong and persistent humoral immune response in HFMD patients. The findings provide a scientific support for determining the collection time of paired serum samples for serological diagnosis of EV-A71 infected HFMD patients. FUNDING: National Science Fund for Distinguished Young Scholar

SN 2017gmr: An Energetic Type II-P Supernova with Asymmetries

We present high-cadence UV, optical, and near-infrared data on the luminous Type II-P supernova SN2017gmr from hours after discovery through the first 180 days. SN2017gmr does not show signs of narrow, high-ionization emission lines in the early optical spectra, yet the optical light-curve evolution suggests that an extra energy source from circumstellar medium (CSM) interaction must be present for at least 2 days after explosion. Modeling of the early light curve indicates a ∼500 Re progenitor radius, consistent with a rather compact red supergiant, and latetime luminosities indicate that up to 0.130±0.026 Me of 56Ni are present, if the light curve is solely powered by radioactive decay, although the 56Ni mass may be lower if CSM interaction contributes to the post-plateau luminosity. Prominent multipeaked emission lines of Hα and [O I] emerge after day 154, as a result of either an asymmetric explosion or asymmetries in the CSM. The lack of narrow lines within the first 2 days of explosion in the likely presence of CSM interaction may be an example of close, dense, asymmetric CSM that is quickly enveloped by the spherical supernova ejecta

New Generation Perovskite Solar Cells with Solution-Processed Amino-substituted Perylene Diimide Derivative as Electron-Transport Layer

In this research work, for the first time, we introduced amino-substituted perylene diimide derivative (N-PDI) as an alternative electron transport layer (ETL) to replace the commonly used TiO2 in planar heterojunction perovskite solar cells. Two types of device structures i.e., glass/FTO/N-PDI/CH3NH3PbI3-xClx/spiro-MeOTAD/Au, and polyethylene terephthalate (PET)/ITO/N-PDI/CH3NH3PbI3-xClx/spiro-MeOTAD/Au, were fabricated on both rigid and flexible substrates using room-temperature solution processing technique. Based on the proposed device structures, the power conversion efficiency (PCE) of 17.66% was obtained based on glass/FTO rigid substrates, and a PCE of 14.32% was achieved based on PET/ITO flexible substrates. Results revealed that the terminal amino group in N-PDI resulting in the enhanced wetting capability of surfaces to perovskite, and the lower the surface work function of FTO substrate as well as passivate the surface trap states of perovskite films. Our results confirm that small molecule semiconductor N-PDI can serve as an effective electron-transport material for achieving high-performance perovskite solar cells and draw molecular design guidelines for electron-selective contacts with perovskite

Application of Feature Point Matching Technology to Identify Images of Free-Swimming Tuna Schools in a Purse Seine Fishery

Tuna fish school detection provides information on the fishing decisions of purse seine fleets. Here, we present a recognition system that included fish shoal image acquisition, point extraction, point matching, and data storage. Points are a crucial characteristic for images of free-swimming tuna schools, and point algorithm analysis and point matching were studied for their applications in fish shoal recognition. The feature points were obtained by using one of the best point algorithms (scale invariant feature transform, speeded up robust features, oriented fast and rotated brief). The k-nearest neighbors (KNN) algorithm uses ‘feature similarity’ to predict the values of new points, which means that new data points will be assigned a value based on how closely they match the points that exist in the database. Finally, we tested the model, and the experimental results show that the proposed method can accurately and effectively recognize tuna free-swimming schools

Application of Feature Point Matching Technology to Identify Images of Free-Swimming Tuna Schools in a Purse Seine Fishery

Tuna fish school detection provides information on the fishing decisions of purse seine fleets. Here, we present a recognition system that included fish shoal image acquisition, point extraction, point matching, and data storage. Points are a crucial characteristic for images of free-swimming tuna schools, and point algorithm analysis and point matching were studied for their applications in fish shoal recognition. The feature points were obtained by using one of the best point algorithms (scale invariant feature transform, speeded up robust features, oriented fast and rotated brief). The k-nearest neighbors (KNN) algorithm uses ‘feature similarity’ to predict the values of new points, which means that new data points will be assigned a value based on how closely they match the points that exist in the database. Finally, we tested the model, and the experimental results show that the proposed method can accurately and effectively recognize tuna free-swimming schools

Assessment of Cities’ Adaptation to Climate Change and Its Relationship with Urbanization in China

Global climate change has led to more frequent occurrences of extreme, dangerous events; therefore, it is urgent to enhance cities’ adaptation to climate change. Focusing on the impact of high temperature, low temperature, drought, and flooding, we established multi-dimensional assessment systems covering natural, economic, and social elements for cities’ climate change adaptations. Based on the assessment systems, studies on adaptation to climate change were conducted in 248 cities in China using the entropy weight method, coefficient of variation method, and exploratory spatial data analysis; with the help of geographically weighted regression (GWR), the relationships between four types of urbanization and cities’ adaptation to climate events were explored. The results showed the following: (1) High-administrative-level cities had higher adaptation than ordinary prefecture-level cities. (2) The differences in adaptation to the four types of climate events between cities within each of the seven regions in China presented significantly different spatial patterns. (3) Under the four types of climate events, the global spatial correlations of cities’ adaptations in China were positive. The agglomeration characteristics of adaptation were mainly H–H and L–L agglomerations. (4) When analyzing the impacts of four types of urbanization on cities’ adaptation to climate events, the fitting effects of GWR models were far better than those of OLS models. Population urbanization, economic urbanization, land urbanization, and industrial urbanization had different impacts on adaptation. Under the influence of social and economic development, the urbanization regression coefficients of different cities had significant spatial differences