Analyses of stiffened plates resting on the viscoelastic foundation subjected to a moving vehicle by a cell-based smoothed triangular plate element

Recently, a cell-based smoothed discrete shear gap method (CS-FEM-DSG3) based on the firstorder shear deformation theory (FSDT) was proposed for static and free vibration analyses of Mindlin plates. The CS-FEM-DSG3 uses three-node triangular elements that can be easily generated automatically for arbitrary complicated geometric domains. This paper further extends the CS-FEMDSG3 for static, free vibration, and dynamic response of the stiffened plate resting on viscoelastic foundation subjected to a moving vehicle. The viscoelastic foundation is modeled by discrete springs and dampers whereas the stiffened plate can be considered as the combination between the Mindlin plate and the Timoshenko beam elements. The moving vehicle is transformed into one concentrated load at its central point. Some numerical examples are investigated and numerical results show that the CS-FEMDSG3 overcomes shear-locking phenomena and has a fast convergence. The results also illustrate the good agreement of the CS-FEM-DSG3 for static and free vibration analyses of un-stiffened plate compared with the previous published methods. In addition, the numerical results for dynamic analysis of stiffened plates by the CS-FEM-DSG3 also show the expected property in which the deflection of the stiffened plate is much smaller than those of the un-stiffened plate

Medication Adherence in Cardiovascular Diseases

Cardiovascular disease is a significant cause of death globally. While effective long-term medications that reduce the risk of morbidity and mortality related to cardiovascular disease are readily available, nonadherence to prescribed medications remains a significant reason for suboptimal management. Consequently, this might lead to increased morbidity and mortality and healthcare costs. Medication nonadherence causes are myriad and complicated, with factors at the patient, healthcare provider, and health system levels. Many clinical trials have investigated interventions to target these factors for improving medication adherence, including improving patient education, testing behavioral interventions, implementing medication reminder tools, reducing medication costs, utilizing social support, utilizing healthcare team members, and simplifying medication dosing regimens. This book chapter describes factors influencing medication adherence and highlights the impact of varying levels of adherence on patients’ clinical and economic outcomes. We also summarize interventions for improving medication adherence in cardiovascular disease

Insulin signaling and its application

The discovery of insulin in 1921 introduced a new branch of research into insulin activity and insulin resistance. Many discoveries in this field have been applied to diagnosing and treating diseases related to insulin resistance. In this mini-review, the authors attempt to synthesize the updated discoveries to unravel the related mechanisms and inform the development of novel applications. Firstly, we depict the insulin signaling pathway to explain the physiology of insulin action starting at the receptor sites of insulin and downstream the signaling of the insulin signaling pathway. Based on this, the next part will analyze the mechanisms of insulin resistance with two major provenances: the defects caused by receptors and the defects due to extra-receptor causes, but in this study, we focus on post-receptor causes. Finally, we discuss the recent applications including the diseases related to insulin resistance (obesity, cardiovascular disease, Alzheimer’s disease, and cancer) and the potential treatment of those based on insulin resistance mechanisms

THÀNH PHẦN HÓA HỌC VÀ HOẠT TÍNH CHỐNG OXY HÓA CỦA CÁC DỊCH CHIẾT TỪ HOA XUYẾN CHI (Bidens pilosa)

Bidens pilosa is used in traditional medicine in Vietnam. The antioxidant potential of the ethanol extract and fractions from the flowers of Bidens pilosa was evaluated through DPPH and ABTS radical scavenging and the total antioxidant capacity method. The ethyl acetate fraction exhibits the highest activity with the lowest IC50 value (IC50 = 31.54 μg·mL–1 and IC50 = 35.33 μg·mL–1 for DPPH and ABTS radical scavenging capacity), and the total antioxidant capacity was 85.05 ± 0.28 mg GA·g–1. The composition of Bidens pilosa flowers: the total phenolic, total flavonoid, polysaccharides, and triterpenoid, was examined by using the colorimetric method, and their quantities are equivalent to 59.35 ± 0.83 mg GAE·g–1, 42.35 ± 1.50 mg QE·g–1, 4.44 ± 0.02%, and 32.88 ± 0.66 mg acid oleanolic·g–1, respectively. Specifically, the polysaccharide and total triterpenoid content of Bidens pilosa flowers was reported for the first time.Xuyến chi đã được sử dụng trong các bài thuốc cổ truyền Việt Nam. Khả năng chống oxy hóa của cao toàn phần và các cao phân đoạn từ hoa cây Xuyến chi được đánh giá thông qua ba mô hình: tổng khả năng chống oxy hoá, khả năng bắt gốc tự do DPPH và khả năng bắt gốc ABTS. Kết quả cho thấy cao ethyl acetate có khả năng chống oxy hóa tốt nhất với IC50 nhỏ nhất (IC50 = 31,54 μg·mL–1 và           IC50 = 35,33 μg·mL–1 tương ứng với khả năng bắt gốc DPPH và ABTS) và hàm lượng các chất chống oxy hóa cao nhất (85,05 ± 0,28 mg·g–1 acid gallic). Hàm lượng các hợp chất có hoạt tính sinh học (tổng các hợp chất phenol, tổng flavonoid, tổng triterpenoid và polysaccharide) trong dịch chiết hoa cây Xuyến chi được xác định bằng phương pháp trắc quang. Hàm lượng tổng các hợp chất phenol và flavonoid là 59,35 ± 0,83 mg GAE·g–1 và 42,35 ± 1,50 mg QE·g–1; hàm lượng polysacharide và triterpenoid là 4,44 ± 0,02% và 32,88 ± 0,66 mg acid oleanolic·g–1. Lần đầu tiên, tổng hàm lượng triterpenoid và polysacharide trong hoa Xuyến chi được công bố

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke