Cumulative Survival Research Articles

Adjustment of the ACEF score by the triglyceride glucose index improves the prediction of clinical outcomes in patients undergoing percutaneous coronary intervention

BackgroundThe ACEF score (age, creatinine, and left ventricular ejection fraction) and the triglyceride-glucose (TyG) index have been identified as robust risk prediction models for adverse outcomes post-percutaneous coronary intervention (PCI) in coronary atherosclerotic heart disease (CHD) patients. This study aimed to assess whether incorporating the TyG index enhances the predictive ability of the ACEF score and enhances risk stratification for CHD patients undergoing PCI.MethodsThis observational cohort study enrolled 1248 patients diagnosed with CHD who underwent PCI at the Third People’s Hospital of Chengdu, China, between May 2018 and December 2022. Receiver operating characteristic (ROC) curves were employed to establish the optimal cutoff values for the TyG index and ACEF score. The primary endpoint event was defined as major adverse cardiac and cerebrovascular events (MACCEs). Cumulative survival curves were plotted using the Kaplan–Meier method. Univariable and multivariable Cox regression analyses were conducted to identify predictors of MACCEs. The predictive ability of the ACEF score and the TyG index was assessed using the area under the ROC curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI).ResultsOver a median follow-up period of 30.60 months, 214 patients experienced MACCEs. Kaplan-Meier survival analysis demonstrated a significant association between elevated ACEF score (> 1.27) and TyG index levels (> 8.82) with a heightened incidence of MACCEs (HR = 2.018, 95%CI 1.593–2.789; HR = 2.057, 95%CI 1.572–2.691; Log-Rank test, both P < 0.001). Multivariable Cox regression analysis revealed that even after adjusting for multiple confounders, both the ACEF score and TyG index remained as predictors of MACCEs (HR = 1.702, 95%CI 1.210–2.394, P = 0.002; HR = 1.575, 95%CI 1.296–1.916, P < 0.001). Additionally, the addition of the ACEF score and TyG index into the conventional risk model significantly improved the ability to predict MACCEs, as evidenced by the increase in the C-statistic value from 0.664 to 0.703, along with notable improvements in continuous NRI (0.391), categorical NRI (0.107), and IDI (0.033) (all P < 0.001).ConclusionThe combination of the TyG index and the ACEF score enhances the predictive ability for long-term MACCEs in patients with CHD undergoing PCI.

Sinus Bone Graft Stability and Implant Survival Following Transalveolar Sinus Floor Elevation in Severely Atrophic Maxilla: A Retrospective Study With 5-8 Years of Follow-Up.

To evaluate the clinical and radiographic results of transalveolar sinus floor elevation (TSFE) with grafting in cases of severely atrophic maxilla. A retrospective analysis of clinical and radiographic data was conducted. Between 2015 and 2018, a total of 105 implants were placed in 105 patients over a follow-up period of 5-8 years. Implant failures and endo-sinus bone gain (ESBG) were assessed. Statistical models were established to investigate the potential influencing factors of implant survival and ESBG. Six patients with six implants were lost, resulting in cumulative survival rates of 94% for both patient- and implant-based analyses. The 8-year cumulative survival rate was significantly lower for residual bone height (RBH) < 4 mm (88%) compared to RBH 4-6 mm (98%). ESBG ≥ 4 mm and ESBG ≥ 6 mm were observed in 89.90% and 58.59% of implant sites, respectively. According to the log-rank Mantel-Cox analysis results, none of the factors examined were significantly related to implant failure, except for RBH (p = 0.038) at baseline. The linear mixed-model regression results showed that the final ESBG was positively correlated with implant insertion site (p = 0.003), implant length (p < 0.001), sinus floor elevation (SFE) methods (p = 0.010), and RBH (p < 0.001). Within the limitations of this study, it has been established that TSFE with grafting was a reliable method for implant placement in the posterior atrophic maxilla ridges with RBH ranging from 4 to 6 mm. Nevertheless, caution was advised when considering its application in cases where the initial bone height falls below 4 mm.

A Two-Center Study of a Prognostic Model Related to Acute Kidney Injury After Allogeneic Hematopoietic Stem Cell Transplantation in Children: Development of a New Predictive Dynamic Nomogram.

The purpose of this study was to develop a straightforward, easy-to-use online dynamic nomogram for the identification of children who are at high risk of developing acute kidney injury (AKI) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This was a two-center study in which 242 children in Henan Provincial Children's Hospital composed the training cohort, and 115 children in the First Affiliated Hospital of Zhengzhou University composed the validation cohort. Kaplan-Meier survival analysis was used to compare survival between children with nonacute kidney injury (NAKI) and children with AKI. Multivariate logistic regression analysis was used to identify risk factors for AKI in children who underwent HSCT. The selected variables were utilized to construct nomograms, which were validated via the concordance index (C-index), decision curve analysis, calibration curve analysis, and receiver operating characteristic (ROC) curve analysis. Cumulative survival was significantly lower in children with AKI than in children without kidney injury (p<0.01). Eight variables were included in the nomogram: hepatic veno-occlusive disease (HVOD), graft-versus-host disease (GVHD), ferritin, C-reactive protein (CRP), Cytomegalovirus infection (CMV), thrombotic microangiopathy (TMA), human leukocyte antigen (HLA), and nephrotoxic drugs. The nomogram calibration curves in the training and validation cohorts were highly comparable to the standard curves. The areas under the curve (AUCs) of the prediction model were 0.963 and 0.910 in the training cohort and validation cohort, respectively. The decision curve analysis (DCA) revealed that the model had a significant clinical benefit. The occurrence of AKI affects the prognosis of children who undergo HSCT. We developed a dynamic online nomogram for predicting AKI in children who underwent allo-HSCT on the basis of eight variables. The predictive value and clinical benefit of the nomogram model were acceptable.

One-Year Outcomes of Trabeculotomy with 120°, 180°, or 360° Schlemm’s Canal Incision for Primary Open-Angle Glaucoma: A Retrospective Study

Background/Objectives: Primary open-angle glaucoma (POAG), if caused by elevated intraocular pressure (IOP), may require a trabeculotomy (LOT), in which the trabecular meshwork (TM) and Schlemm’s canal (ISC) are incised. However, the association between the incision angle and outcomes remains unclear. Therefore, in this study, we investigated the surgical outcomes of a trabeculotomy combined with cataract surgery in patients with POAG over a 12-month follow-up period. Methods: We included 66 patients (corresponding to 83 eyes) with POAG who underwent trabeculotomy ab externo with a metal probe (M-LOT: 120° incision of the TM and ISC), ab interno with a Kahook Dual Blade® (K-LOT: 180° incision of the TM and ISC), or ab interno with a 5-0 nylon suture (S-LOT: 360° incision of the TM and ISC) between January 2015 and December 2022. We assessed IOP, the percentage reduction from preoperative IOP, the number of IOP-lowering medications taken, the incidence of postoperative complications, and the success rate using Kaplan–Meier survival analysis. Results: The median IOP was significantly lower than the baseline across all three groups. The number of IOP-lowering medications taken was significantly reduced only in the M-LOT group. The mean percentage reduction from the preoperative IOP in the K-LOT group was significantly lower than that in the M and S-LOT groups. Beween those subjected to an ab ineterno LOT, the S-LOT group demonstrated a significantly higher rate of IOP reduction 12 months after the operation compared to the K-LOT group. Kaplan–Meier cumulative survival analyses revealed a lower success rate for the K-LOT group than for the M and S-LOT groups. The M-LOT group had the lowest incidence of hyphema and IOP spikes, whereas the S-LOT group had the highest incidence of these complications. Conclusions: The M-, K-, and S-LOTs had different surgical outcomes during the 12 months of follow-up, with the M-LOT group showing the fewest complications. These results will help in selecting the most suitable trabeculotomy strategy for patients with POAG. Based on the postoperative outcomes of the ab interno K- and S-LOTs, a wider incision of the TM and ISC leads to effective IOP reduction.

Comparison of short-to medium-term ischemia and bleeding risks between unfractionated heparin and bivalirudin in patients with acute coronary syndrome after PCI

Objective: To compare the short-and medium-term ischemia and bleeding risk between unfractionated heparin and bivalirudin in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods: A total of 742 patients with ACS who underwent emergency PCI in Xinxiang Central Hospital of Henan Province from January 2016 to June 2022 were selected and divided into unfractionated heparin group (385 cases) and bivalirudin group (357 cases) according to the anticoagulant regimen. All patients were followed up for 6 months. The incidence of ischemic and bleeding events at 30 days and 6 months after operation were compared between the two groups. Multivariate Cox proportional regression model was used to analyze the risk factors of ischemic and bleeding events in the two groups. Kaplan Meier method was used to calculate the cumulative survival rate, and log rank method was used to analyze the difference in survival rates. Results: The age of 742 patients was (62.5±14.8) years old, and male accounted for 58.5% (434 cases). The age of unfractionated heparin group was (61.8±14.8) years old, and male accounted for 59.2% (228 cases); The age of bivalirudin group was (63.3±14.8) years old, and male accounted for 57.7% (206 cases). The incidence of bleeding events at 30 days and 6 months in the unfractionated heparin group were 6.8% (26 cases) and 9.9% (38 cases), respectively, which were higher than 3.4% (12 cases) and 4.5% (16 cases) in the bivalirudin group (all P0.05); The incidence of ischemic events at 30 days and 6 months in the unfractionated heparin group were 7.5% (29 cases) and 11.2% (43 cases), respectively, which were not observed to be significantly different with those in the bivalirudin group [6.2% (22 cases) and 9.5% (34 cases)] (all P0.05). Compared with patients using bivalirudin, the HR value (95%CI) of bleeding events after emergency PCI in patients using unfractionated heparin was 1.964 (1.317-3.125) (P0.05), and the HR value (95%CI) of ischemic events was 0.948(0.595-1.510) (P0.05). The cumulative incidence of bleeding events was 9.9% in unfractionated heparin group and 4.5% in bivalirudin group (P=0.005); The cumulative incidence of ischemic events was 11.2% in unfractionated heparin group and 9.5% in bivalirudin group (P=0.459). Conclusions: The incidence of short-term hemorrhage events in ACS patients treated with bivalirudin anticoagulation after emergency PCI is lower than that of unfractonated heparin, which can reduce the risk of short-term hemorrhage.

Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis

BackgroundHSip Osteoporotic fractures are common complications with high mortality in patients undergoing maintenance hemodialysis (MHD). It remains unclear whether surgical or conservative should be adopted for hip fractures in MHD patients.MethodsA retrospective analysis was conducted in Tianjin Hospital of Tianjin University from August 2019 to August 2023. A total of 43 MHD patients with hip fracture were included, with 30 cases in the surgical group and 13 cases in the conservative group. The differences in cumulative survival rates, time to first ambulation, Harris score, Barthel index, and incidence of complications were compared.ResultsThe surgical group had remarkable lower mortality rates as compared with the conservative group at 1, 2, 3, 6, 12, 24 months (13.33 VS. 38.46%, 26.67 VS. 53.85%, 26.67 VS. 53.85%, 26.67 VS. 61.54%, 26.67 VS. 61.54%, and 26.67 VS. 69.23%). In the surgical treatment group, the first ambulation time was reduced to 28 (26) days, which was superior to the conservative group (134.17 ± 43.18 days, P &amp;lt; 0.001). The Harris score at 1 month (61.50 ± 4.10) and the Barthel index at 3 months (95, 11.25) were also significantly higher (P &amp;lt; 0.001). Furthermore, the surgical group had a significantly lower overall incidence of complications (60.00 vs. 92.31%, P = 0.034). The risk of death and complications of surgical treatment was only 23.0 and 32.4% of conservative treatment in MHD patients with hip fracture.ConclusionSurgical treatment is effective and safe and should be the first choice for hip fracture in MHD patients.

Analysis of long-term outcomes after surgical treatment of patients with complicated forms of colon cancer

The aim of the study. To evaluate long-term outcomes in patients who underwent surgery due to complications of colon cancer in a general surgical hospital. Materials and methods. The study group included 71 (100 %) patients with complicated forms of colon cancer. Radical surgical interventions were performed in 48 (67.6 %) patients, palliative cytoreductive operations – in 18 (25.4 %) hospitalized patients, symptomatic – in 5 (7.0 %) patients. Results. In the postoperative period, only 37 (58.7 %) patients sought help from an oncologist at the third level of medical care. The remaining 26 (41.3 %) patients refused to consult an oncologist and specific treatments for whatever reason. Conclusions. Of the 37 (58.7 %) operated patients who sought oncological care, a chemotherapy course was initiated for 19 (51.4 %), dynamic follow-up without specific treatments was recommended for 7 (18.9 %) patients and symptomatic treatments according to the standards of palliative medical care – for 9 (24.3 %). During the follow-up period, among 43 (68.3 %) patients with non-metastatic cancer, 6 (14.0 %) of the operated patients had local recurrences, 8 (18.6 %) – regional, and 12 (27.9 %) – distant ones. In 17 (39.5 %) patients, no findings on recurrent colon cancer were revealed. Cumulative 1-year and 3-year survival rates in this category of patients were 56.3 ± 5.9 % and 38.0 ± 5.8 %, respectively.

Comparison of Culturing Methods of Primary Vaginal Fibroblasts

Importance Vaginal fibroblast function is altered in people with pelvic organ prolapse. Thus, it is important to study vaginal fibroblasts to better understand the pathophysiology of prolapse. Objective This study aimed to compare 3 culturing methods of primary vaginal fibroblasts. Study Design This was an in vitro study. Patients who were undergoing surgery for vaginal prolapse were recruited. Excess vaginal epithelial tissue that would have otherwise been discarded was collected. The vaginal fibroblasts from each participant were cultured via (1) 3-hour digest, (2) coverslip, and (3) gelatin-coat methods. Differences in the efficiency of cell isolation, expression of known fibroblast-associated genes, and cellular function were compared between the 3 methods using one-way analysis of variance and Tukey test for post hoc pairwise comparisons (P &lt; 0.05). Results Five patients with pelvic organ prolapse were recruited. Fibroblasts cultured via the 3-hour digest method became confluent within 3–5 days in a 100-mm dish compared to 2–3 weeks in a 6-well dish for the coverslip and gelatin-coat methods. Cells from all culture methods expressed similar amounts of vimentin and α smooth muscle actin. There were no significant differences in morphology; gene expression levels of MMP1, MMP2, ACTA2, COL1A1, COL3A1, and LOXL1 on qPCR; cell viability; proliferation; and migration between the 3 culturing methods. Conclusion Culturing primary vaginal fibroblasts via the 3-hour digest, coverslip, and gelatin-coat methods similarly resulted in reliable primary vaginal fibroblast growth and function.

New Transformed Versions of the Lindley-G family with Discrete Transformer: Properties and Applications

In this research paper, two new discrete distributions have been developed by considering Poisson and Geometric distribution as baseline distributions in the Lindley-G family. Some statistical and mathematical properties such as moments, index of dispersion, hazard and reliability functions are explored. The maximum likelihood method has been used to estimate unknown parameters in the proposed distribution. The performance of the MLE have been assessed through simulation study. The applicability of the proposed distribution over some competing distributions have been studied using a real-life data set.. KEYWORDS :Lindley-G family, Hazard rate function, Index of dispersion, Discrete baseline distribution.

Endovascular treatment for carotid stenosis developing after neck radiotherapy

Aims: One of the causes of carotid stenosis is radiation therapy to the neck area. Cervical irradiation is frequently used in the treatment of head and neck cancers. However; the ionizing effect of radiation causes arteritis, which can lead to acceleration of fibrosis or atherosclerosis, thrombosis, stenosis, or occlusion. Carotid stenosis due to radiation is relatively rare. Accordingly, in this study, our aim was to assess the feasibility, safety and preliminary efficacy of endovascular therapy for carotid stenosis developing after neck radiotherapy. Methods: This study was a retrospective review of a prospectively maintained database of a consecutive unselected group of symptomatic and asymptomatic patients with carotid artery stenosis developing after neck radiotherapy. Data was collected from 2017 to 2023. A total of 17 patients who developed carotid stenosis due to neck radiotherapy were included in the study. Neck irradiation was applied in 76.5% of cases due to laryngeal cancer. All statistical analysis was performed using R version 4.2.1 (The R Foundation for Statistical Computing, Vienna, Austria; https://www.r-project.org). Univariate analysis was performed using ?2 and Wilcoxon tests. Cumulative survival estimates were assessed using the life-table method. Results: One patient had a technical failure due to a difficult aortic arch. Because of the degree of stenosis (40?) was not serious in conventional angiography of 2 patients, medical follow-up was decided. 3 patients were admitted to the emergency department due to acute ischemic stroke. Endarterectomy was performed in 4 patients due to the complex structure of the aortic arch and carotid arteries for carotid artery stending. The number of patients with stenosis in the right carotid was 10, while the number of patients with stenosis in the left carotid was 7. No restenosis was observed in patients with stent placement in follow-up carotid Doppler and CT angiography performed 3 months later. Additionally, no new neurodeficit was observed in the neurological examinations 3 months later. Conclusion: This retrospective study demonstrates that endovascular treatment for carotid stenosis developing after neck radiotherapy is safe, effective and reliable.

What is the influence of the operator on the long-term survival of posterior partial lithium disilicate restorations in an undergraduate setting?

To evaluate the influence of the (undergraduate) operator on the survival and success rate of posterior partial lithium disilicate restorations. Patients who received at least one posterior partial lithium disilicate restoration between 2009-2019 by undergraduates at the Center for Dentistry and Oral Hygiene in Groningen were included. Operator- (academic year (4th, 5th, 6th year)), patient- (presence of a nightguard, caries risk, age), tooth- (endodontic status, inlay/onlay, position of the restoration outline) and technique-related factors (cement type, rubber dam use, Immediate Dentin Sealing) on the survival and success rate were analyzed using multilevel Cox regression (p < 0.05). In total, 637 restorations were placed in 373 patients. On the level of survival, 100 restorations failed during the observation period (median follow-up: 70 months, interquartile range 48-99 months): 26 extractions, 61 restoration replacements and 13 biological complications. The overall 5- and 10-year cumulative survival rates were 89.1% (95% CI: 86.5%-91.7%) and 77.6% (95% CI: 73.1%-82.5%) respectively. Multilevel Cox regression showed a medium to high caries risk (HR: 1.57; 95% CI: 1.21-2.04) and an approximal outline located within 3 mm of the bone (HR: 1.52; 95% CI: 1.05-2.22) as significant risk factors for failure. The academic year had no statistically significant effect. The 10-year survival and success of lithium disilicate posterior partial indirect restorations placed by undergraduates was not significantly affected by the academic year of the operator. When a clear treatment protocol is followed, patient and tooth related factors rather than academic year of the operator appear to have a significant influence on the quality of posterior partial lithium disilicate restorations.

A multicenter retrospective study on comparing the efficacy and safety of the therapy of intermittent cyclophosphamide and corticosteroids versus rituximab for primary membranous nephropathy.

Few clinical studies compare the long-term remission, relapse, and safety of rituximab (RTX) or a combination of intermittent intravenous infusion of cyclophosphamide (CTX) and oral corticosteroid for primary membranous nephropathy (PMN) patients. We collected multicenter retrospective data on PMN patients with nephrotic syndrome who received RTX or intermittent intravenous CTX with oral corticosteroids between 1 January 2019 and 31 January 2024. Patients were followed up until two years after receiving immunotherapy. The primary outcomes were a composite of complete or partial remission rates at 6, 12, and 24months. The secondary outcomes were the relapse and safety evaluation. Forty patients treated with RTX and 27 with the CTX regime were available for analysis. No significant difference in the remission rate at 6, 12, or 24months was observed between the two groups (p>.05). Kaplan-Meier's survival analysis showed that the relapse-free cumulative survival rate of the RTX group was superior to that of the CTX group (p=.023). Compared with baseline, both the media of urine protein and serum albumin levels in the two groups showed a significant improvement at 6months and maintained through to the second year. No significant difference in the occurrence of total side effects between the two groups (p=.160). There was no difference in remission rates and safety between RTX versus intermittent intravenous CTX combined with oral corticosteroid treatment for patients with PMN within 2years. RTX appeared to have benefits in terms of prolonging relapse-free survival.

Rhabdomyolysis in Severe Fever With Thrombocytopenia Syndrome: Associations With Acute Kidney Injury and Mortality.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis caused by a novel bunyavirus. Until recently, rhabdomyolysis in SFTS was not elucidated. The objective of this study was to investigate the prevalence and clinical characteristics of rhabdomyolysis and its association with AKI and prognosis in patients with SFTS. A total of 231 consecutive patients diagnosed with SFTS were enrolled, including 144 (62.3%) patients in the no rhabdomyolysis group and 87 (37.7%) patients in the rhabdomyolysis group. Clinical characteristics and laboratory parameters of SFTS patients were compared between the no rhabdomyolysis and rhabdomyolysis groups. Patients with rhabdomyolysis had more frequency of confusion, cough, sputum, chest distress, abdominal pain, petechia and ecchymosis, headache, myalgia, and myasthenia than those without rhabdomyolysis. Compared with patients in the no rhabdomyolysis group, patients in the rhabdomyolysis group had higher serum levels of laboratory parameters referring to liver, kidney, pancreas, heart, coagulation system injury, and higher viral load. The cumulative survival rate of patients with rhabdomyolysis was significantly lower than that of patients without rhabdomyolysis. Furthermore, univariate and multivariate binary logistic regression analyses demonstrated that rhabdomyolysis was an independent predictor for acute kidney injury and mortality in patients with SFTS. Rhabdomyolysis may be an important contributing factor to adverse outcomes and its effects on mortality may be mediated by acute kidney injury in SFTS. The early detection and effective intervention of rhabdomyolysis may decrease the mortality of patients with SFTS.

Effect of leading edge tubercles bionic blade of high speed pump jet propulsor on cavitation suppression

The occurrence of cavitation in hydraulic machinery is a matter of significant concern, as it presents a substantial risk to the reliable functioning of pump jet propulsors. The point of this study is to find out how well bionic blades with different kinds of leading edge (LE) tubercles distribution stop cavitation in high-speed pump jet propulsors. Furthermore, it examines their performance in various cavitation scenarios. The study conducts a thorough evaluation of the function of bionic blades in mitigating cavitation and maintaining performance by analyzing head, efficiency, cavitation shape, pressure distribution, entropy production, vortex flow, and pressure pulsations. In the absence of reaching the cavitation critical point, the bionic blade 1 (BB1) model exhibited a head that was 2.65% greater than that of the original blade (OB) model. Additionally, it had the highest level of effectiveness among the three bionic blades in preventing cavitation, causing a 5%–8% delay. Furthermore, the LE tubercles not only successfully inhibited cavitation but to some degree stimulated the formation of both tip clearance cavitation and tip leakage cavitation. The BB1 model did a better job of controlling entropy production and vortex flow during the inception to collapse of cavitation. This led to lower losses, more consistent flow properties, and higher efficiency compared to the OB model. Analysis of the pressure pulsations shows that BB1 exhibits a reduction in pulsation intensity across all cavitation numbers, indicating excellent dynamic stability.

Survival of People Living with HIV/AIDS from Pre-ART Era to Treat-all Era - China, 1985-2022.

A comprehensive analysis of nationwide survival trends for people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS, PLWHA) from the initial reported case to present has not been conducted. This study evaluated the survival outcomes of PLWHA reported in China from 1985 to 2022. We analyzed data from PLWHA recorded in the National HIV/AIDS Comprehensive Response Information Management System from 1985 to 2022. Survival rates were calculated using Kaplan-Meier curves, and factors associated with survival time were analyzed using Cox proportional hazard models. Progressive relaxation of antiretroviral therapy initiation criteria led to significant improvements in survival rates across different diagnostic periods in China. The 1-year and 5-year cumulative survival rates increased from 85.2% and 66.1% in the 1985-2003 cohort to 91.1% and 81.4% in the 2016-2022 cohort. Cox proportional hazard analysis revealed elevated mortality risks among males, individuals aged ≥65 years, those with injection drug use or other transmission routes, hospital-tested patients, and those with lower CD4 counts at diagnosis or without treatment. Antiretroviral therapy has effectively reduced mortality risk among PLWHA in China. Future efforts should focus on expanding HIV testing to reduce the proportion of late diagnoses with lower CD4 counts and providing targeted, differentiated services for older populations to further decrease mortality risk among PLWHA.

Coronary Artery Bypass Grafting Plus Mitral Valve Plasty May Not Provide More Advantage in Patients with Coronary Heart Disease and Moderate Ischemic Mitral Regurgitation: An Inverse Probability of Treatment Weighting Retrospective Cohort Study.

To compare the efficacy of isolated off-pump coronary artery bypass grafting (OPCABG) and of coronary artery bypass grafting (CABG) plus mitral valve plasty (MVP) in treating coronary heart disease with moderate ischemic mitral regurgitation to find a better surgical method. Clinical data of 822 patients diagnosed with coronary heart disease and moderate ischemic mitral regurgitation were analyzed retrospectively. Patients were divided into the OPCABG and CABG+MVP groups according to surgical methods. Baseline data of both groups were corrected, and clinical efficacy of the two surgical methods was analyzed and compared using the propensity score inverse probability of treatment weighting (IPTW) method. There were no significant differences in the use of mammary artery grafts, number of grafts, and blood product consumption between the two groups (P>0.05) after IPTW. However, the CABG+MVP group had a significantly longer operation time than the OPCABG group (4.13 ± 0.85 hours vs. 5.65 ± 1.02 hours, P<0.001). No statistically significant differences in postoperative major adverse cardiac and cerebrovascular events were observed between the two groups. However, the intra-aortic balloon pump rate was higher in the CABG+MVP group than in the OPCABG group (12.3% vs. 25.0%, P=0.012). Although CABG+MVP can improve ischemic mitral regurgitation significantly (95.4% vs. 81.2%, P<0.001), there were no significant differences in the cumulative survival rate and the incidence of major adverse cardiac and cerebrovascular events between the groups (P>0.05) after IPTW. CABG+MVP may not provide more advantage in patients with coronary heart disease and moderate ischemic mitral regurgitation.

Analyzing Chemical Decay in Environmental Nanomaterials Using Gamma Distribution with Hybrid Censoring Scheme

This study addresses the challenges of estimating decay times for chemical components, focusing on hydroxylated fullerene C60(OH)29, which poses potential environmental risks due to its persistence and transformation in soil. Given the complexities of real-world experiments such as limited sample availability, time constraints, and the need for efficient resource use, a framework using the Gamma distribution based on hybrid Type-II censoring schemes was developed to model the decay time. The Gamma distribution’s flexibility and mathematical properties make it well-suited for reliability and decay analysis, capturing variable hazard rates and accommodating different censoring structures. We employ maximum likelihood estimation (MLE) and Bayesian methods to estimate the model’s parameters, consequently estimating the reliability and hazard functions. The large sample theory for MLE is used to approximate variances for constructing asymptotic confidence intervals. Additionally, we utilize the Markov chain Monte Carlo technique within the Bayesian framework to ensure robust parameter estimation. Through simulation studies and statistical tests—such as Chi-Square, Kolmogorov–Smirnov, and others—we assess the Gamma distribution’s fit and compare its performance with other distributions, validating the proposed model’s effectiveness.

Survival and Success of 3D-Printed Versus Milled Immediate Provisional Full-Arch Restorations: ARetrospective Analysis.

To evaluate and compare the survival rates of 3D-printed and chairside milled resin polymethylmethacrylate (PMMA) immediate temporary provisional full-arch implant restorations using prosthetic survival as the primary outcome. Records of 335 routine patients receiving 443 temporary six-implant retained maxillary or mandibular prosthetic restorations between January 2019 and January 2022 at a private clinic (Dr Sobczak Clinical Centre, Radosc, Poland) were considered for this retrospective analysis. The analysis compared prosthetic and implant failure rates between printed and milled restorations as primary and secondary outcomes, respectively. Patient-related and treatment-related characteristics between groups were compared using the Chi-square test and Mann-Whitney U-test, respectively. Group-specific cumulative prosthetic survival was qualitatively and quantitively compared using Kaplan-Meier, generalized linear mixed models and univariate cox proportional hazard analyses. Prosthetic survival was set into context to implant survival using Chi-square tests. A multivariable cox proportional hazards model with frailty was used to identify confounding factors affecting prosthetic survival. Prosthetic failure rates of milled and printed temporary restorations were 13.01% and 11.25% over the average follow-up period of 307.7 ± 115.5 days, respectively. The corresponding 180-day cumulative prosthetic survival rates were 92.4% and 93%. Hazard ratios for the prosthetic failure of milled and printed restorations did not show a statistical difference (p = 0.794). Implant failure rates in restorations that experienced prosthetic failure (17.31%) were higher compared to restorations without failures (5.63%), with a 3.2 times significantly higher odds of failure for a prosthesis experiencing implant loss (p = 0.003). Gender, presence of teeth at treatment baseline, smoking, and bone augmentation were identified as confounding factors impacting prosthetic survival. Chairside 3D-printed restorations may represent an equivalent treatment modality to established chairside milled restorations for immediate full-arch therapy. Provisional prosthetic survival may impact implant survival and treatment success.

First‐year movement and survival of stocked Striped Bass in a coastal system inferred from individually marked fish

AbstractObjectiveStock enhancement programs support many fisheries worldwide, including those for Striped Bass Morone saxatilis. Understanding survival and movement after stocking can help to inform stocking strategies. The goal of this research was to evaluate stocking success by tracking movement and survival of phase II Striped Bass (200–250 mm total length) in the Great Pee Dee River system of coastal South Carolina. The objectives of this study were to (1) determine daily movement across river basins and identify areas where Striped Bass congregate during their first year to infer potential nursery habitat; and (2) estimate first‐year survival poststocking.MethodsHydroacoustic transmitters were surgically implanted into 28 phase II Striped Bass prior to stocking on December 1, 2020. Fish were monitored on 74 fixed receivers that were distributed throughout the Great Pee Dee River system. Daily survival and movement were estimated using a multi‐state Cormack–Jolly–Seber model. We evaluated multiple models to describe survival (e.g., constant, daily random effect model, and varying by season) and capture probability (e.g., constant and varying by zone).ResultDaily persistence probability was high for all zones, and most fish spent most of their time in the delta region at the confluence of the Great Pee Dee and Waccamaw rivers. Median daily survival was greater than 0.986 across all days, and cumulative survival after the 323‐day period of the study was 0.131. Survival was highest in winter and lowest in summer.ConclusionsThis study provides insights into the fate of stocked phase II Striped Bass in their first year poststocking. We identified potential nursery habitat that could be critical for successful long‐term viability of this population. We suggest that stocking locations be moved closer to the nursery habitats in the delta region of the Great Pee Dee River–Waccamaw River confluence and closer to Winyah Bay.

Labyrinth seal design for space applications

Labyrinth seals, extensively used in space applications, serve to prevent the loss of liquid lubricants and shield satellite subsystems from contamination. These seals are essential for the reliable functioning of bearings and for protecting satellite subsystems from contamination. This study compares analytical predictions of lubricant loss against experimental measurements and computer simulations to optimize labyrinth seal configurations. Analytical models tend to overestimate mass loss by 5–8 times compared to experimental data, indicating limited reliability for complex seal geometries. Simulations using MolFlow+ and COMSOL Multiphysics align closely with experimental results, providing accurate mass loss predictions. Key findings highlight that labyrinth length, width, and surface roughness are critical factors in minimizing evaporative mass loss. Notably, stepped labyrinth seals with relief grooves and optimized step positioning effectively reduce molecular beaming effects and improve sealing performance compared to straight geometries. Effective sealing not only reduces mission failures but also helps to minimize space debris, thereby promoting safer satellite missions.