Efficacy of guideline-directed medical treatment in heart failure with mildly reduced ejection fraction.

Heart failure with mildly reduced ejection fraction (HFmrEF) has received increasing attention following the publication of the latest ESC guidelines in 2021. However, it remains unclear whether patients with HFmrEF could benefit from guideline-directed medical treatment (GDMT), referring the combination of ACEI/ARB/ARNI, β-blockers, and MRAs, which are recommended for those with reduced ejection fraction. This study explored the efficacy of GDMT in HFmrEF patients. This was a retrospective cohort study of HFmrEF patients admitted to The First Affiliated Hospital of Dalian Medical University between 1 September 2015 and 30 November 2019. Propensity score matching (1:2) between patients receiving triple-drug therapy (TT) and non-triple therapy (NTT) based on age and sex was performed. The primary outcome was all cause death, cardiac death, rehospitalization from any cause, and rehospitalization due to worsening heart failure. Of the 906 patients enrolled in the matched cohort (TT group, n = 302; NTT group, N = 604), 653 (72.08%) were male, and mean age was 61.1 ± 11.92. Survival analysis suggested that TT group experienced a significantly lower incidence of prespecified primary endpoints than NTT group. Multivariable Cox regression showed that TT group had a lower risk of all-cause mortality (HR 0.656, 95% CI 0.447-0.961, P = 0.030), cardiac death (HR 0.599, 95% CI 0.380-0.946, P = 0.028), any-cause rehospitalization (HR 0.687, 95% CI 0.541-0.872, P = 0.002), and heart failure rehospitalization (HR 0.732, 95% CI 0.565-0.948, P = 0.018). In patients with HFmrEF, combined use of neurohormonal antagonists produces remarkable effects in reducing the occurrence of the primary outcome of rehospitalization and death. Thus, the treatment of HFmrEF should be categorized as HFrEF due to the similar benefit of neurohormonal blocking therapy in HFrEF and HFmrEF. [Abstract copyright: © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials

Background. Postpartum depression (PPD) does great harm to women following childbirth. The aim of this study was to conduct a systematic review of the literature to assess the efficacy and safety of CHM for the treatment of PPD. Methods. Published or ongoing registered trials were searched for from the inception of the various databases to December 31, 2015. Data extraction and methodology assessment were conducted independently by two researchers. RevMan 5.3 software was used to analyze the data. Results. Forty-seven registered clinical trials (RCTs) were identified and reviewed. The results showed CHM alone or in combination with routine treatments could reduce HAMD score, EPDS score, incidence of adverse events, TESS, and SERS. CHM combined with routine treatment was more effective in increasing serum estradiol levels and reducing progesterone levels than routine treatment alone. Meanwhile, pooled data revealed that MRLQS combined with routine treatments or MRLQS plus MSHS combined with routine treatments were more effective than other therapeutic methods in TCM. MRLQS plus MSHS alone was found to be an effective alternative when compared to routine treatments. Conclusions. This review suggested that CHM was safe and effective in the treatment of PPD. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more rigorously designed trials are warranted

Efficacy of guideline‐directed medical treatment in heart failure with mildly reduced ejection fraction

Aims: Heart failure with mildly reduced ejection fraction (HFmrEF) has received increasing attention following the publication of the latest ESC guidelines in 2021. However, it remains unclear whether patients with HFmrEF could benefit from guideline‐directed medical treatment (GDMT), referring the combination of ACEI/ARB/ARNI, β‐blockers, and MRAs, which are recommended for those with reduced ejection fraction. This study explored the efficacy of GDMT in HFmrEF patients. Methods: This was a retrospective cohort study of HFmrEF patients admitted to The First Affiliated Hospital of Dalian Medical University between 1 September 2015 and 30 November 2019. Propensity score matching (1:2) between patients receiving triple‐drug therapy (TT) and non‐triple therapy (NTT) based on age and sex was performed. The primary outcome was all cause death, cardiac death, rehospitalization from any cause, and rehospitalization due to worsening heart failure. Results: Of the 906 patients enrolled in the matched cohort (TT group, n = 302; NTT group, N = 604), 653 (72.08%) were male, and mean age was 61.1 ± 11.92. Survival analysis suggested that TT group experienced a significantly lower incidence of prespecified primary endpoints than NTT group. Multivariable Cox regression showed that TT group had a lower risk of all‐cause mortality (HR 0.656, 95% CI 0.447–0.961, P = 0.030), cardiac death (HR 0.599, 95% CI 0.380–0.946, P = 0.028), any‐cause rehospitalization (HR 0.687, 95% CI 0.541–0.872, P = 0.002), and heart failure rehospitalization (HR 0.732, 95% CI 0.565–0.948, P = 0.018). Conclusions: In patients with HFmrEF, combined use of neurohormonal antagonists produces remarkable effects in reducing the occurrence of the primary outcome of rehospitalization and death. Thus, the treatment of HFmrEF should be categorized as HFrEF due to the similar benefit of neurohormonal blocking therapy in HFrEF and HFmrEF

Quantitative analysis of the risk of hydrogen sulfide release from gas hydrates

The role that H2S plays in the global sulfur cycle has been studied extensively in recent years. This paper focuses on the influence of H2S released from gas hydrates on sulfur cycle and establishes a one-dimensional mathematical model to calculate the amount of H2S released from the dissociation of gas hydrates present in multiple layers in the Qiongdongnan Basin China. The results show that the sulfate and methane transition zone that covers an area of about 100 km2in the Qiongdongnan Basin contains 2.3 × 1012 g of pyrite, which requires 4.06 × 1011 mol of H2S for its formation. The H2S released from the dissociation of gas hydrates is 5.4 ×1011 mol, which is about 1.3 times that needed for the formation of pyrite. Therefore, the H2S released from the gas hydrates is an important source of H2S for the formation of pyrite in the sulfate-methane transition zone of Qiongdongnan Basin. According to the flux of H2S and the partial pressure of O2 (PO2) in the atmosphere, the critical value of the balance between the flux of H2S and PO2 turns out to be 0.13 mol kg−1∙bar−1. Furthermore, considering the effect of global sea-level changes, three risk modes are identified to categorize the amount of H2S released from the dissociation of gas hydrate into the atmosphere. We classify the periods from 5–12 Ma BP, 25–29 Ma BP, 47–52 Ma, and 57–61 Ma BP into the high-risk mode. Furthermore, the results show that a part of the H2S released from the gas hydrate dissociation is oxidized by the Fe (III) oxide metal, with much of the metal ions being released into the pore water. Another part of the H2S is re-oxidized by the O2 in the ocean, with much of SO42- released into the seawater. Therefore, the process also provides metal ions and SO42- to pore water or seawater when the H2S released from gas hydrate diffuses from the bottom. This paper provides new insights into the source of H2S in the ocean and shows that the H2S contained in gas hydrates plays an important role in the global sulfur cycle

Enhancing embedded AI-based object detection using multi-view approach

International audienceObject detection based on convolutional neural network (CNN) is widely used in multitude emergent applications. Yet, the deployment of CNNs on embedded devices at the edge with reduced resources and power budget poses a real challenge. In this paper, we address this issue by enhancing the detection performance without impacting the inference speed. We investigate the use of multi-view for the same scene to achieve better detection performance. A novel system of distributed smart cameras is proposed where each camera integrates a CNN for detection. Implementation results show that using light networks on the distributed cameras can lead to better detection performance and a reduction in the overall consumed power

Would energy poverty affect the wellbeing of senior citizens? Evidence from China

Energy poverty is a serious problem worldwide that negatively impacts the subjective well-being of elderly residents. This paper aims to explore this relationship. Firstly, based on 2011, 2013, 2015, and 2018 data of the China Health and Retirement Longitudinal Study (CHARLS) launched by Peking University for 125 prefecture-level cities, representing 32,490 observations, this paper effectively and multidimensionally measures the level of individual energy poverty. Secondly, a mediating model is adopted to study the causal effect between energy poverty and subjective well-being through the OLS and 2SLS methods using carefully selected instrumental variables to overcome potential endogeneity. Finally, through a variety of robustness tests, the stability of the above causal effects is verified. The results show that energy poverty negatively affects senior citizens&rsquo; subjective well-being. Health, depression level, and household food expenditure level can be used as the micro mechanism between the two variables. The above factors have a greater impact on those senior citizens with low educational backgrounds, from relatively low-income families, living alone, and having an urban household registration.</p

Design of earth‐abundant amorphous transition metal‐based catalysts for electrooxidation of small molecules: Advances and perspectives

Abstract Electrochemical oxidation of small molecules (e.g., water, urea, methanol, hydrazine, and glycerol) has gained growing scientific interest in the fields of electrochemical energy conversion/storage and environmental remediation. Designing cost‐effective catalysts for the electrooxidation of small molecules (ESM) is thus crucial for improving reaction efficiency. Recently, earth‐abundant amorphous transition metal (TM)‐based nanomaterials have aroused souring interest owing to their earth‐abundance, flexible structures, and excellent electrochemical activities. Hundreds of amorphous TM‐based nanomaterials have been designed and used as promising ESM catalysts. Herein, recent advances in the design of amorphous TM‐based ESM catalysts are comprehensively reviewed. The features (e.g., large specific surface area, flexible electronic structure, and facile structure reconstruction) of amorphous TM‐based ESM catalysts are first analyzed. Afterward, the design of various TM‐based catalysts with advanced strategies (e.g., nanostructure design, component regulation, heteroatom doping, and heterostructure construction) is fully scrutinized, and the catalysts’ structure‐performance correlation is emphasized. Future perspectives in the development of cost‐effective amorphous TM‐based catalysts are then outlined. This review is expected to provide practical strategies for the design of next‐generation amorphous electrocatalysts