Effectiveness and safety of oral anticoagulant therapy in patients with atrial fibrillation with prior gastrointestinal bleeding: A systematic review and meta-analysis

BackgroundGastrointestinal bleeding (GIB) commonly complicates anticoagulant therapy for patients with atrial fibrillation (AF). However, AF patients with prior GIB were excluded from most randomized controlled trials on anticoagulation therapy. Therefore, we conducted a systematic review and meta-analysis to assess the effect of oral anticoagulant (OAC) therapy in this specific population.MethodsRandomized trials and observational studies reporting the data about the resumption of OAC therapy among AF patients with prior GIB were included. The search was performed in the PubMed and Embase databasesup to March 2022. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled by a random-effects model with an inverse variance method.ResultsA total of 7 studies involving 57,623 patients were included. Compared with no anticoagulant therapy, OAC therapy was associated with decreased risks of stroke or systemic embolism (HR = 0.71, 95% CI: 0.59–0.84) and all-cause death (HR = 0.66, 95% CI: 0.60–0.72), but there was no significant difference in the risk of recurrent GIB (HR = 1.22, 95% CI: 0.94–1.59). Compared with vitamin K antagonists, non-vitamin K antagonist oral anticoagulants (NOACs) were associated with reduced risks of stroke or systemic embolism (HR = 0.61, 95% CI: 0.54–0.68), all-cause mortality (HR = 0.86, 95% CI: 0.75–0.99), major bleeding (HR = 0.75, 95% CI: 0.66–0.84), and GIB recurrence (HR = 0.83, 95% CI: 0.72–0.96).ConclusionsIn AF patients with prior GIB, OAC therapy (especially NOACs) demonstrated superior effectiveness compared with no anticoagulant therapy

Alantolactone exerts anti-proliferative and apoptotic effects on BGC823 and SGC7901 cells via activation of p38MAPK and inhibition of NF-κB signaling pathway

Purpose: To investigate the anti-proliferative and apoptotic influences of alantolactone on gastric carcinoma (GC) cell lines, and the mechanism(s) involved. Methods: Human gastric cancer cell line (BGC823) and gastric adenocarcinoma lymph node metastasis cell line (SGC7901) were maintained in Ham’s F12 medium supplemented with 10 % heatinactivated fetal bovine serum (FBS). In each group of cancer cell line, 5 groups of cells were used: control and four alantolactone groups which were treated with increasing concentrations of alantolactone (5 - 30 μM) for varying periods. Proliferation was determined using MTT assay, while realtime quantitative polymerase chain reaction (qRT-PCR) was used to assay the expressions of apoptosis- and metastasis-related genes. The expressions of p38MAPK and nuclear transcription factor-κB (NF-κB) in BGC823 and SGC7901 cells were measured with Western blotting. Results: Phosphorylated protein (p-p38 protein) expression was significantly higher in both groups of GC cells, relative to control (p < 0.05). The expressions of NF-κB in plasma protein were markedly higher in both groups of GC cells than in control group, but the corresponding expressions in nuclear protein were significantly lower in both groups of GC cells, relative to control (p < 0.05). Conclusion: Alantolactone exerts anti-proliferative and apoptotic effects on BGC823 and SGC7901 cells via mechanisms involving activation of the p38MAPK, and inhibition of the NF-κB signaling pathways. Thus, alantolactone may be a new and effective anti-gastric cancer drug

Single image super-resolution quality assessment: a real-world dataset, subjective studies, and an objective metric

Numerous single image super-resolution (SISR) algorithms have been proposed during the past years to reconstruct a high-resolution (HR) image from its low-resolution (LR) observation. However, how to fairly compare the performance of different SISR algorithms/results remains a challenging problem. So far, the lack of comprehensive human subjective study on large-scale real-world SISR datasets and accurate objective SISR quality assessment metrics makes it unreliable to truly understand the performance of different SISR algorithms. We in this paper make efforts to tackle these two issues. Firstly, we construct a real-world SISR quality dataset (i.e., RealSRQ ) and conduct human subjective studies to compare the performance of the representative SISR algorithms. Secondly, we propose a new objective metric, i.e., KLTSRQA , based on the Karhunen-Loéve Transform (KLT) to evaluate the quality of SISR images in a no-reference (NR) manner. Experiments on our constructed RealSRQ and the latest synthetic SISR quality dataset (i.e., QADS ) have demonstrated the superiority of our proposed KLTSRQA metric, achieving higher consistency with human subjective scores than relevant existing NR image quality assessment (NR-IQA) metrics. The dataset and the code will be made available at https://github.com/Zhentao-Liu/RealSRQ-KLTSRQA

Drug-Tolerant Cancer Cells Show Reduced Tumor-Initiating Capacity: Depletion of CD44+ Cells and Evidence for Epigenetic Mechanisms

Cancer stem cells (CSCs) possess high tumor-initiating capacity and have been reported to be resistant to therapeutics. Vice versa, therapy-resistant cancer cells seem to manifest CSC phenotypes and properties. It has been generally assumed that drug-resistant cancer cells may all be CSCs although the generality of this assumption is unknown. Here, we chronically treated Du145 prostate cancer cells with etoposide, paclitaxel and some experimental drugs (i.e., staurosporine and 2 paclitaxel analogs), which led to populations of drug-tolerant cells (DTCs). Surprisingly, these DTCs, when implanted either subcutaneously or orthotopically into NOD/SCID mice, exhibited much reduced tumorigenicity or were even non-tumorigenic. Drug-tolerant DLD1 colon cancer cells selected by a similar chronic selection protocol also displayed reduced tumorigenicity whereas drug-tolerant UC14 bladder cancer cells demonstrated either increased or decreased tumor-regenerating capacity. Drug-tolerant Du145 cells demonstrated low proliferative and clonogenic potential and were virtually devoid of CD44+ cells. Prospective knockdown of CD44 in Du145 cells inhibited cell proliferation and tumor regeneration, whereas restoration of CD44 expression in drug-tolerant Du145 cells increased cell proliferation and partially increased tumorigenicity. Interestingly, drug-tolerant Du145 cells showed both increases and decreases in many “stemness” genes. Finally, evidence was provided that chronic drug exposure generated DTCs via epigenetic mechanisms involving molecules such as CD44 and KDM5A. Our results thus reveal that 1) not all DTCs are necessarily CSCs; 2) conventional chemotherapeutic drugs such as taxol and etoposide may directly target CD44+ tumor-initiating cells; and 3) DTCs generated via chronic drug selection involve epigenetic mechanisms

Strong Convergence Theorems for Common Fixed Points of Multistep Iterations with Errors in Banach Spaces

We establish strong convergence theorem for multi-step iterative scheme with errors for asymptotically nonexpansive mappings in the intermediate sense in Banach spaces. Our results extend and improve the recent ones announced by Plubtieng and Wangkeeree (2006), and many others

Strong Convergence Theorems for Common Fixed Points of Multistep Iterations with Errors in Banach Spaces

We establish strong convergence theorem for multi-step iterative scheme with errors for asymptotically nonexpansive mappings in the intermediate sense in Banach spaces. Our results extend and improve the recent ones announced by Plubtieng and Wangkeeree (2006), and many others.</p

Numerical simulation of mold filling of semi-solid slurry based on viscosity theory

The mold filling of semi-solid slurry involves intricate theory and physical phenomenon. The influence of inner gate shape and filling speed on free surface and liquid-solid distribution is investigated by adopting finite element numerical simulation. The effect of viscosity is considered in the modelling. The results show that the inner gate shape affects the free surface. The filling speed of 3 m/s is favorable for the uniform distribution of solid-liquid phases. It has important guiding significance for the optimization of semi-solid forming process and molding design

Frailty-originated early rehabilitation reduces postoperative delirium in brain tumor patients: Results from a prospective randomized study

Objective: To investigate the impact of frailty-originated, evidence-based early activity training on postoperative delirium in patients who have undergone brain tumor resection. Methods: A randomized controlled trial was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine, from July 2019 to June 2020. Data on the patients' general information, incidence and duration of delirium, duration of hospital stay, and activities of daily living were collected. From the first day after surgery, the patients were randomly assigned to either the traditional care group or the frailty-originated rehabilitation towards intracranial tumors using distinct evidence (FORTITUDE) group. Non-parametric, chi-square, and log-rank tests were used to compare the onset time and duration of postoperative delirium and activities of daily living performed by the participants between the two groups. Results: In total, 291 patients, 150 and 141 in the control group and FORTITUDE group, respectively, participated in the study. Patients in the FORTITUDE group had a lower incidence of postoperative delirium (15.6% vs. 28.7%, P ​= ​0.007), delayed onset of delirium (Z ​= ​−2.108, P ​= ​0.035), shorter duration of postoperative delirium (χ2 ​= ​26.67, P ​< ​0.001), shorter hospital stay (Z ​= ​−2.037, P ​= ​0.042), and higher scores in the activities of daily living one week (Z ​= ​−2.304, P ​= ​0.021) and one month (Z ​= ​−2.724, P ​= ​0.006) after surgery than in the control group. Conclusions: The FORTITUDE program was safe and effective in reducing the incidence and duration of postoperative delirium and improving the quality of life of patients who underwent brain tumor resection