Clinical study of a new nutritional index for predicting long-term prognosis in patients with coronary atherosclerotic heart disease following percutaneous coronary intervention

Background and Objective: Some patients continue to experience major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in frigid places. Indexes of inflammation and nutrition alone were shown to predict outcomes in patients with PCI. However, the clinical predictive value of mixed indicators is unclear. This study aimed to assess the predictive value of the albumin/neutrophil/lymphocyte ratio (NLR) on the long-term prognosis of patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI). Methods: A total of 608 post-PCI CHD patients were categorized into low- and high-index groups based on the optimal cut-off values for albumin and NLR. The primary outcome was a composite endpoint comprising all-cause mortality and major adverse cerebrovascular events. The secondary outcome was the comparison of the predictive efficiency of the new nutritional index, albumin/NLR, with that of albumin or NLR alone. Results: Over the five-year follow-up period, 45 patients experienced the composite endpoint. The incidence of endpoint events was significantly higher in the low-index group (12%) compared to the high-index group (4.9%). Receiver operating characteristic (ROC) curve analysis revealed that the albumin/NLR index had a larger area under the curve (AUC: 0.655) than albumin (AUC: 0.621) or NLR (AUC: 0.646), indicating superior predictive efficiency. The prognostic nutritional index had an AUC of 0.644, further supporting the enhanced predictive value of the albumin/NLR index over individual nutritional and inflammatory markers. Conclusion: The albumin/neutrophil/lymphocyte ratio is independently associated with the long-term prognosis of CHD patients post-PCI and demonstrates superior predictive efficiency compared to individual nutritional and inflammatory markers.

Multi-circular formation control with reinforced transient profiles for nonholonomic vehicles:A path-following framework

This article investigates a multi-circular path-following formation control with reinforced transient profiles for nonholonomic vehicles connected by a digraph.A multi-circular formation controller endowed with the feature of spatial-temporal decoupling is devised for a group of vehicles guided by a virtual leader evolving along an implicit path,which allows for a circumnavigation on multiple circles with an anticipant angular spacing.In addition,notice that it typically imposes a stringent time constraint on time-sensitive enclosing scenarios,hence an improved prescribed performance control(IPPC)using novel tighter behavior boundaries is presented to enhance transient capabilities with an ensured appointed-time convergence free from any overshoots.The significant merits are that coordinated circumnavigation along different circles can be realized via executing geometric and dynamic assignments independently with modified transient profiles.Furthermore,all variables existing in the entire system are analyzed to be convergent.Simulation and experimental results are provided to validate the utility of suggested solution.

Path-Following Based on Nonlinear Model Predictive Control with Adaptive Path Preview

This paper presents a Nonlinear Model Predictive Controller(NMPC)for the path following of autonomous vehicles and an algorithm to adaptively adjust the preview distance.The prediction model includes vehicle dynamics,path following dynamics,and system input dynamics.The single-track vehicle model considers the vehicle’s coupled lateral and longitudinal dynamics,as well as nonlinear tire forces.The tracking error dynamics are derived based on the curvilinear coordinates.The cost function is designed to minimize path tracking errors and control effort while considering constraints such as actuator bounds and tire grip limits.An algorithm that utilizes the optimal preview distance vector to query the corresponding reference curvature and reference speed.The length of the preview path is adaptively adjusted based on the vehicle speed,heading error,and path curvature.We validate the controller performance in a simulation environment with the autonomous racing scenario.The simulation results show that the vehicle accurately follows the highly dynamic path with small tracking errors.The maximum preview distance can be prior estimated and guidance the selection of the prediction horizon for NMPC.

A Novel Prescribed-Performance Path-Following Problem for Non-Holonomic Vehicles

The issue of achieving prescribed-performance path following in robotics is addressed in this paper,where the aim is to ensure that a desired path within a specified region is accu-rately converged to by the controlled vehicle.In this context,a novel form of the prescribed performance guiding vector field is introduced,accompanied by a prescribed-time sliding mode con-trol approach.Furthermore,the interdependence among the pre-scribed parameters is discussed.To validate the effectiveness of the proposed method,numerical simulations are presented to demonstrate the efficacy of the approach.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

缺乏位置信息的视觉移动机器人leader-following编队控制

针对视觉移动机器人编队在缺乏位置信息情况下的控制问题,提出一种基于视觉的leader-following编队反馈控制方法。该方法利用leader标志物特征点在follower摄像机像平面上的坐标信息设计了观测器,对leader与follower间的相对位置进行估计,基于相对位置估计量与它们速度的关系,设计出leader-following编队反馈控制器,通过Lyapunov理论证明了闭环系统的稳定性。仿真结果表明,该控制方法能有效解决缺乏位置信息情况下视觉移动机器人编队的控制问题。

Pulmonary arterial hypertension confirmed by right heart catheterization following COVID-19 pneumonia: A case report and review of literature

BACKGROUND Pulmonary arterial hypertension(PAH)is a disease of the arterioles resulting in an increased resistance in pulmonary circulation with associated high pressures in the pulmonary arteries,causing irreversible remodeling of the pulmonary arterial walls.Coronavirus disease 2019(COVID-19)has been associated with development of new onset PAH in the literature leading to symptoms of dyspnea,cough and fatigue that persist in spite of resolution of acute COVID-19 infection.However,the majority of these cases of COVID related PAH were diagnosed using echocardiographic data or via right heart catheterization in mechanically ventilated patients.CASE SUMMARY Our case is the first reported case of COVID related PAH diagnosed by right heart catheterization in a non-mechanically ventilated patient.Right heart catheterization has been the gold standard for diagnosis of pulmonary hypertension.Our patient had right heart catheterization four months after her initial COVID-19 infection due to persistent dyspnea.CONCLUSION This revealed new onset PAH that developed following her infection with COVID-19,an emerging sequela of the infection.

Leader-following多自主体系统时变编队跟踪控制

考虑时变时延,研究了高阶leader-following多自主体系统的分布式时变编队跟踪控制问题.针对连续高阶多自主体系统,设计了基于观测器的时变编队跟踪控制协议,通过状态变换,将系统的时变编队跟踪控制问题,转变为误差系统的稳定性问题.然后利用图论及李雅普诺夫稳定定理,研究了系统实现时变编队跟踪控制的充分条件,并且指出时变编队参考函数与时变时延无关.最后,数据仿真结果证明了所设计的协议能使follower自主体实现时变编队,并且跟踪leader自主体的轨迹.

Finite-Time Sideslip Differentiator-Based LOS Guidance for Robust Path Following of Snake Robots

This paper presents a finite-time sideslip differentiator-based line-of-sight(LOS)guidance method for robust path following of snake robots.Firstly,finite-time stable sideslip differentiator and adaptive LOS guidance method are proposed to counteract sideslip drift caused by cross-track velocity.The proposed differentiator can accurately observe the cross-track error and sideslip angle for snake robots to avoid errors caused by calculating sideslip angle approximately.In our method,the designed piecewise auxiliary function guarantees the finite-time stability of position errors.Secondly,for the case of external disturbances and state constraints,a Barrier Lyapunov functionbased backstepping adaptive path following controller is presented to improve the robot’s robustness.The uniform ultimate boundedness of the closed-loop system is proved by analyzing stability.Additionally,a gait frequency adjustment-based virtual velocity control input is derived to achieve the exponential convergence of the tangential velocity.At last,the availability and superiority of this work are shown through simulation and experiment results.

Constrained Moving Path Following Control for UAV With Robust Control Barrier Function

This paper studies the moving path following(MPF)problem for fixed-wing unmanned aerial vehicle(UAV)under output constraints and wind disturbances.The vehicle is required to converge to a reference path moving with respect to the inertial frame,while the path following error is not expected to violate the predefined boundaries.Differently from existing moving path following guidance laws,the proposed method removes complex geometric transformation by formulating the moving path following problem into a second-order time-varying control problem.A nominal moving path following guidance law is designed with disturbances and their derivatives estimated by high-order disturbance observers.To guarantee that the path following error will not exceed the prescribed bounds,a robust control barrier function is developed and incorporated into controller design with quadratic program based framework.The proposed method does not require the initial position of the UAV to be within predefined boundaries.And the safety margin concept makes error-constraint be respected even if in a noisy environment.The proposed guidance law is validated through numerical simulations of shipboard landing and hardware-in-theloop(HIL)experiments.

基于SHERPA和HEART的老年人车载信息系统界面设计研究

目的改善老年驾驶员对车载信息系统界面的使用体验。方法提出基于SHERPA(系统人为错误减少与预测方法)和HEART(人误评估与减少技术)的老年人车载信息系统界面设计研究方法。首先,成立焦点小组对评估界面进行SHERPA定性分析,绘制车载信息系统界面层次任务分析图,通过错误分类表定义错误类型;其次,运用HEART定量分析错误类型,设定差错诱发条件,确定各条件的影响评估比例,从而计算人误概率;最后,在此基础上,分析差错诱发条件,归纳差错发生原因,根据差错纠正措施进行设计改良,对改良界面进行结果验证。结论该方法可以有效发现与老年人车载信息系统界面显著相关的差错诱发条件,既可帮助设计师找到交互设计改良的重点,也可减少老年驾驶员对车载信息系统界面的误操作情况。

LSTM-DPPO based deep reinforcement learning controller for path following optimization of unmanned surface vehicle

To solve the path following control problem for unmanned surface vehicles(USVs),a control method based on deep reinforcement learning(DRL)with long short-term memory(LSTM)networks is proposed.A distributed proximal policy opti-mization(DPPO)algorithm,which is a modified actor-critic-based type of reinforcement learning algorithm,is adapted to improve the controller performance in repeated trials.The LSTM network structure is introduced to solve the strong temporal cor-relation USV control problem.In addition,a specially designed path dataset,including straight and curved paths,is established to simulate various sailing scenarios so that the reinforcement learning controller can obtain as much handling experience as possible.Extensive numerical simulation results demonstrate that the proposed method has better control performance under missions involving complex maneuvers than trained with limited scenarios and can potentially be applied in practice.

Regeneration of the heart:f rom molecular mechanisms to clinical therapeutics

Heart injury such as myocardial infarction leads to cardiomyocyte loss,fibrotic tissue deposition,and scar formation.These changes reduce cardiac contractility,resulting in heart failure,which causes a huge public health burden.Military personnel,compared with civilians,is exposed to more stress,a risk factor for heart diseases,making cardiovascular health management and treatment innovation an important topic for military medicine.So far,medical intervention can slow down cardiovascular disease progression,but not yet induce heart regeneration.In the past decades,studies have focused on mechanisms underlying the regenerative capability of the heart and applicable approaches to reverse heart injury.Insights have emerged from studies in animal models and early clinical trials.Clinical interventions show the potential to reduce scar formation and enhance cardiomyocyte proliferation that counteracts the pathogenesis of heart disease.In this review,we discuss the signaling events controlling the regeneration of heart tissue and summarize current therapeutic approaches to promote heart regeneration after injury.

Knowledge,perceptions,and practice towards adverse events following immunization surveillance among vaccination workers in Zhejiang province,China

Objective:To access the level of knowledge,perceptions,and practice towards adverse events following immunization(AEFI)surveillance among vaccination workers in Zhejiang province,China.Methods:This was a cross-sectional survey involving 768 vaccination workers.Data were collected using self-administered questionnaires and analyzed by using SAS 9.3 software.Knowledge,perceptions,and practice on AEFI surveillance were summarized using frequency tables.The mean±SD value was used as the cut-off for defining good(values≥mean)and poor(values<mean)knowledge,perceptions or practice.Binary logistic regression analysis was used to determine sociodemographic variables associated with knowledge,perceptions,and practice towards AEFI.Results:The proportions of good knowledge,perceptions and practice on AEFI surveillance were 78.13%,57.81%and 66.15%,respectively.Having a higher education background,longer years of experience,previous training on AEFI and≥30 years of age were factors associated with good knowledge,perceptions and practice on AEFI surveillance among vaccination workers.Conclusions:Over half of the respondents had good knowledge,perceptions and practice on AEFI surveillance work.Interventions on improving the vaccination workers’knowledge,perceptions and practice on AEFI surveillance should be considered in order to develop a more effective surveillance system.

Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Awareness of the Importance of Cardiopulmonary Resuscitation Skills Following the Sudden Cardiac Arrest of Damar Hamlin during a Buffalo Bills Game

Background: Cardiopulmonary resuscitation (CPR) is a life-saving skill that is often overlooked until a tragic event occurs. A popular NFL player, Damar Hamlin, safety for the Buffalo Bills, suffered a cardiac arrest on January 2, 2023. Due to prompt intervention and CPR, Hamlin survived the arrest and is playing again. This research sought to understand how people respond to this event on the internet. It also seeks to understand how this response can be used to raise CPR awareness. Design and Methods: Using Google Trends and Twitter data, we searched, downloaded, and retrospectively analyzed search interests relative to Hamlin’s cardiac arrest for a one-year duration. We searched for related keywords in the United States from March 2022 to March 2023, including “Damar Hamlin”, “sudden cardiac death”, “heart attack”, and “CPR”. Results: There was a significant rise in post-event Google searches that combined the terms “Damar Hamlin” and “SCD” (M = -28898.88, SE = 1537.66;t = 1.62, p Conclusion: Based on the analytics of these platforms, it can be concluded that there were active discussions and an awareness of life-saving skills such as CPR along with Hamlin’s cardiac event by his fans, as demonstrated by the data gathered from these platforms. This can provide us with valuable insight into human behavior and help us leverage this knowledge to promote health.

Left bundle branch pacing vs biventricular pacing in heart failure patients with left bundle branch block:A systematic review and meta-analysis

BACKGROUND Left bundle branch pacing(LBBP)is a novel pacing modality of cardiac resynchronization therapy(CRT)that achieves more physiologic native ventricular activation than biventricular pacing(BiVP).AIM To explore the validity of electromechanical resynchronization,clinical and echocardiographic response of LBBP-CRT.METHODS Systematic review and Meta-analysis were conducted in accordance with the standard guidelines as mentioned in detail in the methodology section.RESULTS In our analysis,the success rate of LBBP-CRT was determined to be 91.1%.LBBP CRT significantly shortened QRS duration,with significant improvement in echocardiographic parameters,including left ventricular ejection fraction,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in comparison with BiVP-CRT.CONCLUSION A significant reduction in New York Heart Association class and B-type natriuretic peptide levels was also observed in the LBBP-CRT group vs BiVP-CRT group.Lastly,the LBBP-CRT cohort had a reduced pacing threshold at follow-up as compared to BiVP-CRT.

Therapeutic Routes of a Group of Heart Failure Patients Followed in a Cameroonian Urban Setting

Background: Heart failure (HF) is a rising global health problem. Patients with HF tend to use several therapies obtained via different treatment routes to relieve their symptoms. It is rampant in sub-Saharan Africa (SSA), leading to poor health-seeking behaviours and worsened HF health outcomes. We aimed to describe the different therapeutic routes of HF patients from the onset of their first symptom until treatment in a specialised cardiology centre to identify and rebuke harmful therapeutic routes. Materials and Methods: This was a cross-sectional study at the Yaoundé Central Hospital in Cameroon between December 2018 to July 2019. Patients were recruited by consecutive convenient sampling. Adult patients aged above 18 years with confirmed HF were included using the Framingham criteria. Variables relating to socio-demographic and clinical data and the health-seeking behaviours of HF patients were studied. Results: We included 132 patients with a mean age of 62.90 years (62.88% women). Very few patients (0.90%) followed an ideal route;60.71% of subjects had a pseudo-ideal route, 19.64% accessed a specialised facility directly, and 21.42% used an erratic route. At the arrival time in a cardiology unit, 49.24% and 35.61% of our subjects were in NYHA stage III and IV HF compared to 15.15% for stage II. None of them was in Stage I. Conclusion: Most heart failure patients in Cameroon have resorted to non-specialised care, which worsens their clinical presentation. There is an urgent need for health education of HF patients in our context.

Establishing delivery route-dependent safety and efficacy of living biodrug mesenchymal stem cells in heart failure patients

BACKGROUND Mesenchymal stem cells(MSCs)as living biopharmaceuticals with unique properties,i.e.,stemness,viability,phenotypes,paracrine activity,etc.,need to be administered such that they reach the target site,maintaining these properties unchanged and are retained at the injury site to participate in the repair process.Route of delivery(RoD)remains one of the critical determinants of safety and efficacy.This study elucidates the safety and effectiveness of different RoDs of MSC treatment in heart failure(HF)based on phase II randomized clinical trials(RCTs).We hypothesize that the RoD modulates the safety and efficacy of MSCbased therapy and determines the outcome of the intervention.AIM To investigate the effect of RoD of MSCs on safety and efficacy in HF patients.METHODS RCTs were retrieved from six databases.Safety endpoints included mortality and serious adverse events(SAEs),while efficacy outcomes encompassed changes in left ventricular ejection fraction(LVEF),6-minute walk distance(6MWD),and pro-B-type natriuretic peptide(pro-BNP).Subgroup analyses on RoD were performed for all study endpoints.RESULTS Twelve RCTs were included.Overall,MSC therapy demonstrated a significant decrease in mortality[relative risk(RR):0.55,95%confidence interval(95%CI):0.33-0.92,P=0.02]compared to control,while SAE outcomes showed no significant difference(RR:0.84,95%CI:0.66-1.05,P=0.11).RoD subgroup analysis revealed a significant difference in SAE among the transendocardial(TESI)injection subgroup(RR=0.71,95%CI:0.54-0.95,P=0.04).The pooled weighted mean difference(WMD)demonstrated an overall significant improvement of LVEF by 2.44%(WMD:2.44%,95%CI:0.80-4.29,P value≤0.001),with only intracoronary(IC)subgroup showing significant improvement(WMD:7.26%,95%CI:5.61-8.92,P≤0.001).Furthermore,the IC delivery route significantly improved 6MWD by 115 m(WMD=114.99 m,95%CI:91.48-138.50),respectively.In biochemical efficacy outcomes,only the IC subgroup showed a significant reduction in pro-BNP by-860.64 pg/mL(WMD:-860.64 pg/Ml,95%CI:-944.02 to-777.26,P=0.001).CONCLUSION Our study concluded that all delivery methods of MSC-based therapy are safe.Despite the overall benefits in efficacy,the TESI and IC routes provided better outcomes than other methods.Larger-scale trials are warranted before implementing MSC-based therapy in routine clinical practice.

Effect of continuous nursing on treatment compliance and side effect management of coronary heart disease

BACKGROUND There are relatively few studies on continuing care of coronary heart disease(CHD),and its research value needs to be further clarified.AIM To investigate the effect of continuous nursing on treatment compliance and side effect management in patients with CHD.METHODS This is a retrospective study with patients from January 2021 to 2023.The study was divided into two groups with 30 participants in each group.Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS)were used to assess patients'anxiety and depression,and medical coping questionnaire was used to assess patients'coping styles.The pelvic floor dysfunction questionnaire(PFDI-20)was used to assess the status of pelvic floor function,including bladder symptoms,intestinal symptoms,and pelvic symptoms.RESULTS SAS score decreased from 57.33±3.01before treatment to 41.33±3.42 after treatment,SDS score decreased from 50.40±1.45 to 39.47±1.57.The decrease of these two indexes was statistically significant(P<0.05).PFDI-20 scores decreased from the mean 16.83±1.72 before treatment to 10.47±1.3the mean after treatment,which was statistically significant(P<0.05).CONCLUSION The results of this study indicate that pioneering research in continuous care of CHD has a positive impact on improving patients'treatment compliance,reducing anxiety and depression levels,and improving coping styles and pelvic floor functional status.