Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients:A comprehensive analysis

BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.

Influence of lens position as detected by an anterior segment analysis system on postoperative refraction in cataract surgery

AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 patients(102 eyes)were enrolled in the final analysis.An anterior segment biometry measurement was performed preoperatively with Sirius and Lenstar.The results of predicted lens position(PLP)and IOL power were automatically calculated by the software used by the instruments.Effective lens position(ELP)was measured manually using Sirius 3 mo postoperatively.Pearson's correlation analysis and linear regression analysis were used to determine the correlation of lens position to other parameters.RESULTS:PLP and ELP were positively correlated to axial length(AL;r=0.42,P<0.0001 and r=0.49,P<0.0001,respectively).There was a weak correlation between the peLP(ELP-PLP)and the prediction error of spherical refraction(peSR;r=0.34,P<0.0001).The peLP of Softec HD IOL differed statistically from those of both the TECNIS ZCB00 and Sensor AR40E IOLs.Multiple linear regression was used to obtain the prediction formula:ELP=0.66+0.63×[aqueous depth(AQD)+0.6 LT](r=0.61,P<0.0001),and a new variable(AQD+0.6 LT)was found to have the strongest correlation with ELP.CONCLUSION:The Sirius anterior segment analysis system is helpful to predict ELP,which reduces postoperative refraction error.

Analysis of normal human retinal vascular network architecture using multifractal geometry

AIM：To apply the multifractal analysis method as a quantitative approach to a comprehensive description of the microvascular network architecture of the normal human retina.METHODS：Fifty volunteers were enrolled in this study in the Ophthalmological Clinic of Cluj-Napoca,Romania,between January 2012 and January 2014. A set of 100 segmented and skeletonised human retinal images,corresponding to normal states of the retina were studied. An automatic unsupervised method for retinal vessel segmentation was applied before multifractal analysis. The multifractal analysis of digital retinal images was made with computer algorithms,applying the standard boxcounting method. Statistical analyses were performed using the Graph Pad In Stat software.RESULTS：The architecture of normal human retinal microvascular network was able to be described using the multifractal geometry. The average of generalized dimensions（D_q）for q=0,1,2,the width of the multifractal spectrum（Δα=α_（max）-α_（min））and the spectrum arms＇ heights difference（│Δf│）of the normal images were expressed as mean±standard deviation（SD）：for segmented versions,D_0=1.7014±0.0057; D_1=1.6507±0.0058; D_2=1.5772±0.0059; Δα=0.92441±0.0085; │Δf│= 0.1453±0.0051; for skeletonised versions,D_0=1.6303±0.0051; D_1=1.6012±0.0059; D_2=1.5531± 0.0058; Δα=0.65032±0.0162; │Δf│= 0.0238±0.0161. The average of generalized dimensions（D_q）for q=0,1,2,the width of the multifractal spectrum（Δα）and the spectrum arms＇ heights difference（│Δf│）of the segmented versions was slightly greater than the skeletonised versions.CONCLUSION：The multifractal analysis of fundus photographs may be used as a quantitative parameter for the evaluation of the complex three-dimensional structure of the retinal microvasculature as a potential marker for early detection of topological changes associated with retinal diseases.

Application Research of an Intelligent Detection Algorithm for Vehicle Trajectory Route Deviation

In the vehicle trajectory application system, it is often necessary to detect whether the vehicle deviates from the specified route. Trajectory planning in the traditional route deviation detection is defined by the driver through the mobile phone navigation software, which plays a more auxiliary driving role. This paper presents a method of vehicle trajectory deviation detection. Firstly, the manager customizes the trajectory planning and then uses big data technologies to match the deviation between the trajectory planning and the vehicle trajectory. Finally, it achieves the supervisory function of the manager on the vehicle track route in real-time. The results show that this method could detect the vehicle trajectory deviation quickly and accurately, and has practical application value.

Micro segment analysis of supercritical methane thermal-hydraulic performance and pseudo-boiling in a PCHE straight channel

The printed circuit heat exchanger(PCHE) is receiving wide attention as a new kind of compact heat exchanger and is considered as a promising vaporizer in the LNG process. In this paper, a PCHE straight channel in the length of 500 mm is established, with a semicircular cross section in a diameter of 1.2 mm.Numerical simulation is employed to investigate the flow and heat transfer performance of supercritical methane in the channel. The pseudo-boiling theory is adopted and the liquid-like, two-phase-like, and vapor-like regimes are divided for supercritical methane to analyze the heat transfer and flow features.The results are presented in micro segment to show the local convective heat transfer coefficient and pressure drop. It shows that the convective heat transfer coefficient in segments along the channel has a significant peak feature near the pseudo-critical point and a heat transfer deterioration when the average fluid temperature in the segment is higher than the pseudo-critical point. The reason is explained with the generation of vapor-like film near the channel wall that the peak feature related to a nucleateboiling-like state and heat transfer deterioration related to a film-boiling-like state. The effects of parameters, including mass flow rate, pressure, and wall heat flux on flow and heat transfer were analyzed.In calculating of the averaged heat transfer coefficient of the whole channel, the traditional method shows significant deviation and the micro segment weighted average method is adopted. The pressure drop can mainly be affected by the mass flux and pressure and little affected by the wall heat flux. The peak of the convective heat transfer coefficient can only form at high mass flux, low wall heat flux, and near critical pressure, in which condition the nucleate-boiling-like state is easier to appear. Moreover,heat transfer deterioration will always appear, since the supercritical flow will finally develop into a filmboiling-like state. So heat transfer deterioration should be taken seriously in the design and safe operation of vaporizer PCHE. The study of this work clarified the local heat transfer and flow feature of supercritical methane in microchannel and contributed to the deep understanding of supercritical methane flow of the vaporization process in PCHE.

采用蒸汽再加热的船用蒸汽推进装置冷凝加热系统的热力学分析

The thermodynamic(energy and exergy)analysis of a condensate heating system,its segments,and components from a marine steam propulsion plant with steam reheating is performed in this paper.It is found that energy analysis of any condensate heating system should be avoided because it is highly influenced by the measuring equipment accuracy and precision.All the components from the observed marine condensate heating system have energy destructions lower than 3 kW,while the energy efficiencies of this system are higher than 99%.The exergy efficiency of closed condensate heaters continuously increases from the lowest to the highest steam pressures(from 70.10%to 92.29%).The ambient temperature variation between 5℃and 45℃notably influences the exergy efficiency change of both low pressure heaters and the low pressure segment equal to 31.61%,12.37%,and 18.35%,respectively.

Preface

Micromechanics aims mainly at establishing the quantitative relation between the macroscopic mechanical behavior and the microstructure of heterogeneous materials.

Segmental hair analysis for flunitrazepam and 7-aminoflunitrazepam in users:a comparison to existing literature

The availability of more quantitative data on flunitrazepam(FLU)and 7-aminoflunitrazepam(7AF)would aid in obtaining a better understanding of the interpretation of FLU concentrations in human hair.The purpose of this study was to provide concentrations of FLU and 7AF in hair segments of 22 FLU users.Quantitative data regarding hair concentrations of FLU and 7AF from various types of cases were also reviewed to give a comprehensive overview of the comparability of different studies.Three to six 1 cm segments of scalp hair from 22 FLU users were analyzed by a liquid chromatography–tandem mass spectrometry(LC–MS/MS)method.FLU and its metabolite were confirmed in the hair segments from all cases.Concentrations of FLU and 7AF in the segments ranged from 0.01–0.16 ng/mg(median of 0.03)and 0.01–0.34 ng/mg(median of 0.09),respectively.Most cases had FLU and 7AF distributions along the hair segments that were suggestive of repeated drug use.A summary of the published concentrations gives valuable data and can assist forensic investigators in their estimations of drug use history and patterns.

Determination of barbiturates in hair samples by using a validated UHPLC-HRMS method: application in investigation of drug-facilitated sexual assault

In recent years,benzodiazepines and benzodiazepine-like drugs are the most common substances associated with drug-facilitated sexual assaults(DFSA);however,barbiturates are also detected occasionally.Segmental hair analysis provides useful information on the historic pattern of drug use,enabling differentiation between single exposure in DFSA cases and chronic use.However,sensitive and specific methods for barbiturate analysis in hair samples are needed.Herein,we present an ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry(UHPLC-HRMS)method for qualitative and quantitative determination of seven barbiturates in hair samples.Firstly,a hair strand was decontaminated and then freeze-milled in liquid nitrogen.Next,50mg of powdered hair was extracted with methanol in an ultrasonic bath for 10 min in the presence of 10 ng phenobarbital-d5.The supernatant was dried under nitrogen gas,and the pellet was dissolved in 100 μL mobile phase.Afterwards,10 μL of the suspension was injected into the UHPLC-HRMS system.The present method involved two UHPLC conditions for determination of barbiturates(I)and identification of the structural isomers amobarbital and pentobarbital(II).This method showed satisfactory linearity in a range of 0.02–20.00 ng/mg for UHPLC conditions I and II,both with a high determination coefficient(0.9991–0.9999).The selectivity,intra-and interday precision,accuracy and matrix effect of the method were acceptable.Next,the validated method was applied to investigate an authentic DFSA case.Hair samples(black,approximate 25cm long)were collected 3 months after the assault,and the proximal segments(0–5 cm from the root;each segment was 1 cm long)were analysed.Amobarbital was detected at a concentration of<LOQ(limit of quantification)and 0.09 ng/mg in the second and third 1-cm hair segment but not in the other segments.Thus,our method was successful in determining barbiturate concentration in human hair after a single-dose exposure,showing its potential for application in the investigation of DFSA cases.