Transcatheter Versus Surgical Closure of Perimembranous Ventricular Septal Defects in Children A Randomized Controlled Trial

ObjectivesThe objective of this study was to evaluate the safety and efficacy of the surgical versus transcatheter approach to correct perimembranous ventricular septal defects (pmVSDs) in a prospective, randomized, controlled clinical trial.BackgroundpmVSD is a common congenital heart disease in children. Surgical closure of pmVSD is a well-established therapy but requires open-heart surgery with cardiopulmonary bypass. Although the transcatheter approach is associated with significant incidence of complete atrioventricular block, it may provide a less invasive alternative. Critical comparison of the safety and efficacy of the 2 interventions necessitates a prospective, randomized, controlled trial.MethodsBetween January 2009 and July 2010, 229 children with pmVSD were randomly assigned to surgical or transcatheter intervention. Clinical, laboratory, procedural, and follow-up data over a 2-year period were compared.ResultsNeither group had mortality or major complications. However, statistical analysis of the 2 groups demonstrated significant differences (p < 0.001) in minor adverse events (32 vs. 7), quantity of blood transfused, duration of the procedure, median hospital stay, median intensive care unit stay, median hospitalization cost, and median blood loss. During a median follow-up of 2 years, the left ventricular end-diastolic dimension of both groups returned to normal and there was no difference in closure rate, adverse events, and complications between groups.ConclusionsTranscatheter device closure and surgical repair are effective interventions with excellent midterm results for treating pmVSD in children. Transcatheter device closure has a lower incidence of myocardial injury, less blood transfused, faster recovery, shorter hospital stay, and lower medical expenses. (Transcatheter Closure Versus Surgery of Perimembranous Ventricular Septal Defects; NCT00890799

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

Friction and wear analysis of the external return spherical bearing pair of axial piston pump/motor

By discretizing the contact area between the external retainer plate and the external spherical hinge, a mathematical model for the force relation of an arbitrary contact point in the external return spherical bearing pair was established and a mathematical expression for the friction power of the external return spherical bearing pair was deduced. The influences of the slant inclination of the external swash plate, pump shaft rotating speed, eccentricity, spring force and number of discrete contact points on the friction power were also analysed. The results show that the power fluctuation amplitude of the discrete contact point in the external return spherical bearing pair increases with increasing slant inclination of the external swash plate, pump shaft rotating speed and spring force; the total friction power was found to increase linearly. However, the power fluctuation amplitude of the discrete contact point in the external return spherical bearing pair was found to decrease with increasing eccentricity, with the total friction power decreasing nonlinearly until reaching a certain value. The distribution shape of the friction power of the discrete contact point is only affected by eccentricity. If the eccentricity is large, the friction power of the discrete point presents a double-peak distribution, whereas if it is small, a multiple-peak distribution is observed

Topographic Factors Drive Short-Term Understory Revegetation in Burned Areas

Fire is a disturbance factor in forest ecosystems which has an important influence on vegetation succession. In order to reveal the natural recovery characteristics of the understory vegetation and its response to topographic factors (elevation, slope position, aspect and slope) after fire in subtropical forests, a typical subtropical forest (Xide County, China) was selected as the study area. Based on quadrat surveys and correlation analyses, the main results of this study were as follows. (1) Within four months after a fire, a total of 71 species, 52 genera and 20 families of understory vegetation species were increased, representing a rapid recovery after a fire. The total number of genera and species of understory vegetation increased by 157% and 209%, respectively. (2) Different burning intensities had different effects on the recovery of vegetation species diversity. The change in Margalef richness index was the most significant, increasing by 5.44 and 5.16 in lightly and severely burned areas, respectively. (3) The vegetation community could be divided into six types after restoration. (4) Elevation and slope were significantly correlated with the diversity and distribution characteristics of understory vegetation in the burned area. This study is useful to understand the characteristics of the short-term natural recovery of understory vegetation in subtropical forests after fire, to identify the relationship between vegetation and topographic factors in burned areas, and to provide a scientific basis for vegetation recovery

Topographic Factors Drive Short-Term Understory Revegetation in Burned Areas

Fire is a disturbance factor in forest ecosystems which has an important influence on vegetation succession. In order to reveal the natural recovery characteristics of the understory vegetation and its response to topographic factors (elevation, slope position, aspect and slope) after fire in subtropical forests, a typical subtropical forest (Xide County, China) was selected as the study area. Based on quadrat surveys and correlation analyses, the main results of this study were as follows. (1) Within four months after a fire, a total of 71 species, 52 genera and 20 families of understory vegetation species were increased, representing a rapid recovery after a fire. The total number of genera and species of understory vegetation increased by 157% and 209%, respectively. (2) Different burning intensities had different effects on the recovery of vegetation species diversity. The change in Margalef richness index was the most significant, increasing by 5.44 and 5.16 in lightly and severely burned areas, respectively. (3) The vegetation community could be divided into six types after restoration. (4) Elevation and slope were significantly correlated with the diversity and distribution characteristics of understory vegetation in the burned area. This study is useful to understand the characteristics of the short-term natural recovery of understory vegetation in subtropical forests after fire, to identify the relationship between vegetation and topographic factors in burned areas, and to provide a scientific basis for vegetation recovery

3D Locating System for Pests’ Laser Control Based on Multi-Constraint Stereo Matching

To achieve pest elimination on leaves with laser power, it is essential to locate the laser strike point on the pest accurately. In this paper, Pieris rapae (L.) (Lepidoptera: Pieridae), similar in color to the host plant, was taken as the object and the method for identifying and locating the target point was researched. A binocular camera unit with an optical filter of 850 nm wavelength was designed to capture the pest image. The segmentation of the pests’ pixel area was performed based on Mask R-CNN. The laser strike points were located by extracting the skeleton through an improved ZS thinning algorithm. To obtain the 3D coordinates of the target point precisely, a multi-constrained matching method was adopted on the stereo rectification images and the subpixel target points in the images on the left and right were optimally matched through fitting the optimal parallax value. As the results of the field test showed, the average precision of the ResNet50-based Mask R-CNN was 94.24%. The maximum errors in the X-axis, the Y-axis, and the Z-axis were 0.98, 0.68, and 1.16 mm, respectively, when the working depth ranged between 400 and 600 mm. The research was supposed to provide technical support for robotic pest control in vegetables