Percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder

OBJECTIVE: Ventricular septal defects resulting from post-traumatic cardiac injury are very rare. Percutaneous closure has emerged as a method for treating this disorder. We wish to report our experience in three patients who underwent percutaneous closure of a post-traumatic ventricular septal defect with a patent ductus arteriosus occluder. METHODS: We treated three patients with post-traumatic ventricular septal defects caused by stab wounds with knives. After the heart wound was repaired, patient examinations revealed ventricular septal defects with pulmonary/systemic flow ratios (Qp/Qs) of over 1.7. The post-traumatic ventricular septal defects were closed percutaneously with a patent ductus arteriosus occluder (Lifetech Scientific (Shenzhen) Co., LTD, Guangdong, China) utilizing standard techniques. RESULTS: Post-operative transthoracic echocardiography revealed no residual left-to-right shunt and indicated normal ventricular function. In addition, 320-slice computerized tomography showed that the occluder was well placed and exhibited normal morphology. CONCLUSION: Our experiences indicate that closure of a post-traumatic ventricular septal defect using a patent ductus arteriosus occluder is feasible, safe, and effective

Synthesis Report on the Implementation of Building Energy Codes in China

China building energy code and details to help improve building energy efficiency at global, national and local level

Plasmoid ejection and secondary current sheet generation from magnetic reconnection in laser-plasma interaction

Reconnection of the self-generated magnetic fields in laser-plasma interaction was first investigated experimentally by Nilson {\it et al.} [Phys. Rev. Lett. 97, 255001 (2006)] by shining two laser pulses a distance apart on a solid target layer. An elongated current sheet (CS) was observed in the plasma between the two laser spots. In order to more closely model magnetotail reconnection, here two side-by-side thin target layers, instead of a single one, are used. It is found that at one end of the elongated CS a fan-like electron outflow region including three well-collimated electron jets appears. The ($>1$ MeV) tail of the jet energy distribution exhibits a power-law scaling. The enhanced electron acceleration is attributed to the intense inductive electric field in the narrow electron dominated reconnection region, as well as additional acceleration as they are trapped inside the rapidly moving plasmoid formed in and ejected from the CS. The ejection also induces a secondary CS

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

Study on Sloshing Characteristics in a Liquid Cargo Tank under Combination Excitation

Sloshing is a common flow phenomenon in liquid cargo tanks and has a great negative impact on the stability and safety of ship navigation. It is important to understand the sloshing process of tanks under the excitation of complex external conditions for the transportation of liquid cargo. In this paper, the sloshing characteristics of a liquid cargo tank are studied under the combination excitation conditions of roll and surge. The pressure distribution characteristics at different positions of the cargo tank are discussed, along with the influence of different excitation conditions on the pressure of the cargo tank. The results show that under the condition of combination excitation, the fluid sloshes along the diagonal direction of the tank, and the peak liquid height and peak pressure are located on the diagonal corner of the tank. The peak pressure at the lowest point on the diagonal of the tank is proportional to the amplitude of the roll angle and surge, and the change in roll angle amplitude has a significant impact on the pressure and liquid height at different positions

Study on Sloshing Characteristics in a Liquid Cargo Tank under Combination Excitation

Sloshing is a common flow phenomenon in liquid cargo tanks and has a great negative impact on the stability and safety of ship navigation. It is important to understand the sloshing process of tanks under the excitation of complex external conditions for the transportation of liquid cargo. In this paper, the sloshing characteristics of a liquid cargo tank are studied under the combination excitation conditions of roll and surge. The pressure distribution characteristics at different positions of the cargo tank are discussed, along with the influence of different excitation conditions on the pressure of the cargo tank. The results show that under the condition of combination excitation, the fluid sloshes along the diagonal direction of the tank, and the peak liquid height and peak pressure are located on the diagonal corner of the tank. The peak pressure at the lowest point on the diagonal of the tank is proportional to the amplitude of the roll angle and surge, and the change in roll angle amplitude has a significant impact on the pressure and liquid height at different positions