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Anomalous origin of the left coronary artery from the pulmonary artery is associated with high mortality if not timely surgery. We reviewed our experience with anomalous origin of the left coronary artery from the pulmonary artery to assess the preoperative variables predictive of outcome and post-operative recovery of left ventricular function.
A retrospective review was conducted and collected data from patients who underwent anomalous origin of the left coronary artery from the pulmonary artery repair at our institute from April 2005 to December 2019. Left ventricular function was assessed by ejection fraction and the left ventricular end-diastolic dimension index. The outcomes of reimplantation repair were analysed.
A total of 30 consecutive patients underwent anomalous origin of the left coronary artery from the pulmonary artery repair, with a median age of 14.7 months (range, 1.5–59.6 months), including 14 females (46.67%). Surgery was performed with direct coronary reimplantation in 12 patients (40%) and the coronary lengthening technique in 18 (60%). Twelve patients had concomitant mitral annuloplasty. There were two in-hospital deaths (6.67%), no patients required mechanical support, and no late deaths occurred. Follow-up echocardiograms demonstrated significant improvement between the post-operative time point and the last follow-up in ejection fraction (49.43%±19.92% vs 60.21%±8.27%, p < 0.01) and in moderate or more severe mitral regurgitation (19/30 vs 5/28, p < 0.01). The left ventricular end-diastolic dimension index decreased from 101.91 ± 23.07 to 65.06 ± 12.82 (p < 0.01).
Surgical repair of anomalous origin of the left coronary artery from the pulmonary artery has good mid-term results with low mortality and reintervention rates. The coronary lengthening technique has good operability and leads to excellent cardiac recovery. The decision to concomitantly correct mitral regurgitation should be flexible and be based on the pathological changes of the mitral valve and the degree of mitral regurgitation.
ABSTRACT IMPACT: Novel adipokines like tetranectin help explain why some people progress from obesity to diseases like diabetes, atherosclerosis, and dislipidemia OBJECTIVES/GOALS: Obesity has an established association with diabetes, dyslipidemia, and atherosclerosis. Preventing progression from obesity to insulin resistance requires understanding of the regulatory mechanisms involved in the loss of insulin sensitivity. Adipose tissue is well known to function as an endocrine organ that produces many kinds of adipokines. METHODS/STUDY POPULATION: Blood sample analysis from human patients and mice was used to determine associations between tetranectin and obesity. Samples were tested with a monoclonal anti-tetranectin antibody for detection with western blot. A tetranectin mutant knock out mouse line was compared to wild type littermates on high fat diet for 4 months. Insulin tolerance tests and glucose tolerance were used to determine progression to insulin resistance and glucose intolerance. Histological analysis of metabolic tissue was used to demonstrate adipocyte hypertrophy and liver steatosis. RESULTS/ANTICIPATED RESULTS: In the current study, we report the identification and initial characterization of a novel adipokine tetranectin. Tetranectin, which is coded by the C-type lectin domain family 3 member B (CLEC3B) gene, is ubiquitously expressed in various mouse tissues, whereas it is highly enriched in white adipose tissue. We found that the serum level of tetranectin was much higher in both obese and diabetic patients. Knocking out the tetranectin gene in mice protected against glucose intolerance in males but reduced insulin and glucose tolerance in females, without effects on food intake and body weight for either sex. Mechanistically, tetranectin targets liver tissues and its deficiency increases lipid accumulation in hepatocytes in females. DISCUSSION/SIGNIFICANCE OF FINDINGS: We have identified a novel adipokine which mediates a different metabolic crosstalk among tissues to maintain systemic glucose and lipid metabolism in different genders. Further investigation of tetranectin’s function could yield a new target for precise therapeutic treatment for obesity and its associated metabolic diseases in different genders
This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.
This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.
There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.
The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
Continuous hBN films have been grown by means of a radio-frequency-sputtering technology, and their material properties have been investigated. The prepared hBN films can achieve good smoothness in a large area. The surface morphologies and compositions of the hBN films on Si substrate and Al film have been characterized, indicating that there is no difference. The 101-phase peak of hBN film is the strongest, and the optical band gap of the fabricated film is 5.84 eV. An attempt on the fabrication of the hBN based resistive switching (RS) device has been made by using an Ag/hBN/Al structure, leading to the observation of a clear and stable RS behavior. The device exhibits a resistance window (high-resistivity state/low-resistivity state) of around 102, and the RS behaviors of hBN film prepared by sputtering were first observed. It has been found that the opening voltage for the device is changed when a different cycle voltage is applied because of the built-in electric field increasing with the increase of applied cycle voltage. The mechanism of the RS behavior has been analyzed, which lay a foundation for the application of hBN as RS material in resistive random access memory to improve the storage density.
Limited literatures report the management of congenital left atrial appendage aneurysm (LAAA) which is extremely rare. Chest X-ray firstly showed an enlarged left cardiac silhouette for a 3-year-old patient with pneumonia. Echocardiography and magnetic resonance imaging confirmed a large cyst attached to the left atrium. Aneurysmectomy was performed through lateral thoracotomy using step-by-step method and under the guidance of transoesophageal echocardiography. We aim to show the safety and efficacy of this approach applied to children associated with congenital LAAA.
Electric-powered disposable unmanned aerial vehicles (UAVs) have wide applications due to their advantages in terms of long time flight and load capacity. Thus, improving their endurance has become an important task to enhance the performance of these UAVs. To achieve this, we investigated a battery dumping strategy which splits the battery into several packs that are used and dumped in sequence to reduce the dead weight. The Peukert effect is also considered. In this paper, the sensitivity analysis method was employed to analyse the endurance benefits for different battery weight ratios, Peukert constants and capacities, quantitatively. The results show that the endurance benefits are significantly affected by all three parameters. For ideal batteries, the endurance can be improved by 20% and 28% respectively when employing a double-pack or triple-pack battery strategy (for a battery weight ratio of 0.4), but these benefits will fall rapidly if the Peukert constant exceeds 1.0 or the battery weight declines. Besides, the endurance will be 10% longer if the lift coefficient rather than the velocity remains constant after the battery packs are dumped at a Peukert constant of 1.2.
Hydrogen is a promising alternative fuel for efficient energy production and storage, with water splitting considered one of the cleanest, environmentally friendly, and sustainable approaches to generate hydrogen. Electrochemically catalyzed water splitting plays an important role in energy conversion for the development of hydrogen-based energy sources. Porphyrin and macrocycle derivatives are versatile and can electrochemically catalyze water splitting efficiently. Because of the significance of molecule activation of electrochemical water splitting, this article covers recent progress in hydrogen evolution and oxygen evolution reactions catalyzed by porphyrin and macrocycle derivatives.
Self-assembly techniques are powerful and efficient methods for the synthesis of nanoscale materials. Using these techniques and their combination with other bottom-up fabrication processes, materials with hierarchical features can be produced with form and function in multiple length scales. We synthesize multifunctional nanoparticles through surfactant-assisted noncovalent interactions using nanoparticle building blocks. Self-assembly of these nano-building blocks results in functional materials that exhibit well-defined morphologies and hierarchical architectures for a wide range of applications. Hierarchically structured porphyrin nanocrystals can be synthesized through surfactant micelle-confined noncovalent interactions of photoactive porphyrins. We can amplify the intrinsic advantages of individual photoactive porphyrins by engineering them into well-defined active nanostructures. Through kinetic control, these nanocrystals exhibit precisely defined size, shape, and spatial arrangement of the individual porphyrins, which facilitates intermolecular mass and energy transfer. These self-assembly techniques provide remarkable flexibility to design morphologies and architectures that produce desirable properties for practical applications including photocatalysis, photodegradation, and phototherapy.
This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment.
This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization.
A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects.
After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.
Photocatalytic hydrogen production from water is a facile and clean approach to convert rich solar energy into chemical fuel. Developing efficient and robust catalysts to accelerate water-splitting speed is key. Porphyrins exist widely in green plants and are a key photosensitizer to absorb and transfer light energy to other parts of the photosynthesis system of plants. They are considered an ideal model to construct artificial photocatalysts for hot-carrier-mediated hydrogen production. This article discusses recent achievements in constructing porphyrin-based photocatalysts for hydrogen production, including porphyrin molecules, self-assembled porphyrins, metal–organic frameworks, conjugated porphyrin polymers, and hybrid nanomaterial-based photocatalysts. The design and synthesis principles, structure–property relationships, as well as urgent issues to be solved in the future for every type of photocatalyst are also discussed.
The self-assembly of optically active building blocks into functional nanocrystals as high-activity photocatalysts is a key in the field of photocatalysis. Cobalt porphyrin with abundant catalytic properties is extensively studied in photocatalytic water oxidation and CO2 reduction. Here, we present the fabrication of cobalt porphyrin nanocrystals through a surfactant-assisted interfacial self-assembly process using Co-tetra(4-pyridyl) porphyrin as building block. The self-assembly process relies on the combined noncovalent interactions such as π-π stacking and axial Co-N coordination between individual porphyrin molecules within surfactant micelles. Tuning different reaction conditions (temperature, the ratio of co-solvent DMF) and types of surfactant, various nanocrystals with well-defined 1D to 3D morphologies such as nanowires, nanorods and nano hexagonal prism were obtained. Due to the ordered accumulation of molecules, the nanocrystals exhibit the properties of the enhanced capability of visible light capture and can conduce to improve the transport and separation efficiency of the photogenerated carriers, which is important for photocatalysis. Further studies of photocatalytic CO2 reduction are being performed to address the relationship between the size and shape of the nanocrystals with the photocatalytic activity.
To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.
A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.
Pregnant women (n 1910) in 2017.
After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.
Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.
Radiation exposure during paediatric cardiac catheterisation procedures should be minimised to “as low as reasonably achievable”. The aim of this study was to evaluate the effectiveness of a modified radiation safety protocol in reducing patient dose during paediatric interventional cardiac catheterisation.
Radiation dose data were retrospectively extracted from January 2014 to December 2015 (Standard group) and prospectively collected from January 2016 to December 2017 (Low-dose group) after implementation of a modified radiation safety protocol. Both groups included five most common procedures: atrial septal defect closure, patent ductus arteriosus closure, perimembranous ventricular septal defect closure, pulmonary valvuloplasty, and supraventricular tachycardia ablation.
Median air Kerma was 48.4, 50.5, 29.75, 149, 218, and 12.9 mGy for atrial septal defect closure, pulmonary valvuloplasty, patent ductus arteriosus closure <20 kg, ventricular septal defect closure <20 kg, ventricular septal defect closure ≧20 kg, and supraventricular tachycardia ablation in Standard group, respectively, which significantly decreased to 18.75, 20.7, 11.5, 41.9, 117, and 3.3 mGy in Low-dose group (p < 0.05). This represents a reduction in dose to each patient between 46 and 74%. Among five procedural types in Low-dose group, dose of ventricular septal defect closure was the highest with median air Kerma of 62.5 mGy, dose area product of 364.7 μGy.m2, and dose area product per body weight of 21.5 μGy.m2/kg, respectively, along with the longest fluoroscopy time of 9.9 minutes.
We provided a feasible radiation safety protocol with specific settings on a case-by-case basis. Increasing awareness and adequate training of a practical radiation dose reduction program are essential to improve radiation protection for children.
The design and engineering of the size and shapes of photoactive building blocks enable the fabrication of functional nanocrystals, especially for applications in light harvesting, photocatalytic synthesis, water splitting, and photodegradation. Synthesis of such nanocrystals has been demonstrated recently through noncovalent interactions such as π–π stacking and ligand coordination using optically active porphyrin as a functional building block. Depending on the kinetic conditions, the resulting nanocrystals exhibit well-defined one- to three-dimensional shapes such as spheres, nanowires, and nano-octahedra. These well-defined porphyrin nanocrystals show interesting size- and shape-dependent photocatalytic activity. This article reviews the synthesis and formation of porphyrin nanocrystals with controlled size and shape. Important photocatalytic processes such as photodegradation of organic pollutants, photocatalytic water splitting and hydrogen production, and photosynthesis of metallic fuel-cell catalysts are highlighted. Insights on size- and shape-dependent properties are discussed.
Photocatalytic water splitting to form hydrogen can effectively alleviate energy and environmental problems attracting wide attention. However, the current photocatalysts have low photocatalytic efficiencies due to the narrow absorption spectrum, which is far from the actual application requirements. Herein, we use the as-prepared zinc porphyrin self-assemblies to visible-light-drive photocatalytic hydrogen evolution with Pt as the cocatalyst and ascorbic acid (AA) as the sacrificial agent. The results exhibit morphology-dependent performance and hexagonal stacks achieved optimal H2 evolution rate (47.1 mmol/h/g), then followed by nanodiscs, nanorod and tetragonal stacks, meanwhile the nanorods with different aspect ratios show size-dependent properties. The UV-vis absorption and photoluminescence spectra and the shortening of decay time of the corresponding ZnTPyP aggregates reveal that the well-defined self-assembled porphyrin networks are J-aggregation and boost efficient energy transfer with respect to monomer. Such porphyrin self-assemblies are standing for one of the most promising photosensitizers in photocatalysis field and provide an important reference for designing the next generation of hydrogen production.
We study numerically the dynamics of an insoluble surfactant-laden droplet in a simple shear flow taking surface viscosity into account. The rheology of drop surface is modelled via a Boussinesq–Scriven constitutive law with both surface tension and surface viscosity depending strongly on the surface concentration of the surfactant. Our results show that the surface viscosity exhibits non-trivial effects on the surfactant transport on the deforming drop surface. Specifically, both dilatational and shear surface viscosity tend to eliminate the non-uniformity of surfactant concentration over the drop surface. However, their underlying mechanisms are entirely different; that is, the shear surface viscosity inhibits local convection due to its suppression on drop surface motion, while the dilatational surface viscosity inhibits local dilution due to its suppression on local surface dilatation. By comparing with previous studies of droplets with surface viscosity but with no surfactant transport, we find that the coupling between surface viscosity and surfactant transport induces non-negligible deviations in the dynamics of the whole droplet. More particularly, we demonstrate that the dependence of surface viscosity on local surfactant concentration has remarkable influences on the drop deformation. Besides, we analyse the full three-dimensional shape of surfactant-laden droplets in simple shear flow and observe that the drop shape can be approximated as an ellipsoid. More importantly, this ellipsoidal shape can be described by a standard ellipsoidal equation with only one unknown owing to the finding of an unexpected relationship among the drop’s three principal axes. Moreover, this relationship remains the same for both clean and surfactant-laden droplets with or without surface viscosity.
Previous studies on capsule dynamics in shear flow have dealt with Newtonian fluids, while the effect of fluid viscoelasticity remains an unresolved fundamental question. In this paper, we report a numerical investigation of the dynamics of capsules enclosing a viscoelastic fluid and which are freely suspended in a Newtonian fluid under simple shear. Systematic simulations are performed at small but non-zero Reynolds numbers (i.e.
) using a three-dimensional front-tracking finite-difference model, in which the fluid viscoelasticity is introduced via the Oldroyd-B constitutive equation. We demonstrate that the internal fluid viscoelasticity presents significant effects on the deformation behaviour of initially spherical capsules, including transient evolution and equilibrium values of their deformation and orientation. Particularly, the capsule deformation decreases slightly with the Deborah number De increasing from 0 to
. In contrast, with De increasing within high levels, i.e.
, the capsule deformation increases continuously and eventually approaches the Newtonian limit having a viscosity the same as the Newtonian part of the viscoelastic capsule. By analysing the viscous stress, pressure and viscoelastic stress acting on the capsule membrane, we reveal that the mechanism underlying the effects of the internal fluid viscoelasticity on the capsule deformation is the alterations in the distribution of the viscoelastic stress at low De and its magnitude at high De, respectively. Furthermore, we find some new features in the dynamics of initially non-spherical capsules induced by the internal fluid viscoelasticity. Particularly, the transition from tumbling to swinging of oblate capsules can be triggered at very high viscosity ratios by increasing De alone. Besides, the critical viscosity ratio for the tumbling-to-swinging transition is remarkably enlarged with De increasing at relatively high levels, i.e.
, while it shows little change at low De, i.e. below
In this paper, a new type of stabilized finite element method is discussed for Oseen equations based on the local L2 projection stabilized technique for the velocity field. Velocity and pressure are approximated by two kinds of mixed finite element spaces, Pl2–P1, (l = 1,2). A main advantage of the proposed method lies in that, all the computations are performed at the same element level, without the need of nested meshes or the projection of the gradient of velocity onto a coarse level. Stability and convergence are proved for two kinds of stabilized schemes. Numerical experiments confirm the theoretical results.
The oxidation behavior of nonstoichiometric Ti2AlCx (x = 0.69) powders synthesized by combustion synthesis was investigated in flowing air by means of simultaneous thermal gravimetric analysis-differential thermal analysis, X-ray diffraction, X-ray photoelectron spectroscopy, and scanning electron microscope/energy dispersive spectroscopy, with an effect of powder size. The oxidation of the fine Ti2AlC powders with the size of about 1 μm starts at 300 °C and completes at 980 °C, while with increasing the powder size around 10 μm the corresponding temperature increases to 400 and 1040 °C, respectively. The oxidation of nonstoichiometric Ti2AlCx (x = 0.69) powders is controlled by surface reaction in 400–600 °C, and mainly diffusion in 600–900 °C, with the corresponding oxidation activation energy of 2.35 eV and 0.12 eV, respectively. In other words, the critical temperature of changing oxidation controlling step is around 600 °C. The oxidation products were mainly rutile-TiO2 and α-Al2O3. The tiny white flocculent particles of α-Al2O3 appeared on the surface of fine Ti2AlC powders and increased with increasing the oxidation temperature.