Natural fibres are very versatile materials, their properties vary with chemical composition and physical structure. The effects of alkali, silane and combined alkali and silane treatments on the mechanical （tensile...Natural fibres are very versatile materials, their properties vary with chemical composition and physical structure. The effects of alkali, silane and combined alkali and silane treatments on the mechanical （tensile）, morphological, and structural properties of Pine Apple Leave Fibres （PALF） and Kenaf Fibres （KF） were investigated with the aim to improve their com- patibility with polymer matrices. The effectiveness of the alkali and saline treatments in the removal of impurities from the fibre surfaces was confirmed by Scanning Electron Microscopy （SEM） and Fourier Transform Infrared spectrometry （FTIR） ob- servation. The morphological study of treated PALF and KF by SEM indicates that silane treated fibres have less impurities and lignin and hemicelluloses removed than those by other chemical treatments. Silane treated PALF and KF display better tensile strength than those of untreated, alkaline and NaOH-silane treated. Droplet test indicates that the lnterfacial Stress Strength （IFSS） of alkali and silane treated PALF and KF are enhanced whereas silane treated fibres display highest IFSS. It is assumed that fibre treatments will help to develop high performance KF and PALF reinforced polymer composites for industrial appli- cations.展开更多
Polypropylene （PP） matrix composites reinforced with chemically treated Almond Shell （AS） particles with and without compatibilizer （PP-g-MA） was prepared by a twin-screw extrusion at loading of 20 wt.% AS parti...Polypropylene （PP） matrix composites reinforced with chemically treated Almond Shell （AS） particles with and without compatibilizer （PP-g-MA） was prepared by a twin-screw extrusion at loading of 20 wt.% AS particles. Two types of chemical treatments （alkali treatment with sodium hydroxide and etherification with dodecane bromide） of the particles were carried out to improve the interface adhesion between particles and PP matrix. Results show that chemical modifications of AS particles affect the mechanical and viscoelastic properties of AS/PP composites. The composites reinforced with alkali treated particles and the compatibilized matrix lead to a notable increase in the Young＇s modulus （14%） compared to the composites with untreated AS particles. The ductility of composite was also evaluated by the yield strain, and results show a notable increase （31%） compared to that of composites with untreated particles. The thermal stability increased with the use of etherification （385 ℃）, with gains in the temperature up to 23 ℃ compared to neat PP （362 ℃）. The achieved results show that the AS/PP composites can be used in several applications. A thermoplastic matrix compsite mixed with treated AS particles appears to be a good alternative to obtain environmentally friendly products.展开更多
A hybrid conceptual design approach was introduced in this study to develop a conceptual design of oil palm polymer composite automotive crash box(ACB). A combination of theory of inventive problem solving(TRIZ), morp...A hybrid conceptual design approach was introduced in this study to develop a conceptual design of oil palm polymer composite automotive crash box(ACB). A combination of theory of inventive problem solving(TRIZ), morphological charts and biomimetics was applied where the foremost requirements in terms of the material characteristics, function specifications, force identification, root cause analysis, geometry profile and design selection criteria were considered. The strategy was to use creations of nature to inspire five innovative conceptual designs of the ACB structure and the AHP method was applied to perform the pairwise analysis of selecting the best ACB conceptual design. A new conceptual design for a composite ACB was conceived bearing in mind the properties of natural fibre, unlike those of conventional materials such as steel alloys and aluminium alloys. The design with the highest ranking(26.6 %) was chosen as the final conceptual design, which was the one with a honeycomb structure for the outermost profile, reinforced with a spider web structure inside the part, supported by fibre foam structure extracted from the woodpecker sponge tissue at the centre to maximize the energy absorption capability. The new design could solve the problem of bending collapse which is a major cause of failure to absorb maximum impact energy for ACB during collision. However, the final conceptual design will still need several modifications for production and assembly purposes, which will be completed in a further study.展开更多
Phenylacetaldehyde(PAH),an aromatic compound,is present in a diverse range of fruits including overripe bananas and prickly pear cactus,the two major host fruits for Drosophila melanogaster.PAH acts as a potent ligand...Phenylacetaldehyde(PAH),an aromatic compound,is present in a diverse range of fruits including overripe bananas and prickly pear cactus,the two major host fruits for Drosophila melanogaster.PAH acts as a potent ligand for the ionotropic receptor 84a(IR84a)in the adult fruit fly and it is detected by the IR84a/IR8a heterotetrameric complex.Its role in the male courtship behavior through IR84a as an environmental aphrodisiac is of additional importance.In D.melanogaster,two distinct kinds of olfactory receptors,that is,odorant receptors(ORs)and ionotropic receptors(IRs),perceive the odorant stimuli.They display unique structural,molecular,and functional characteristics in addition to having different evolutionary origins.Traditionally,olfactory cues detected by the ORs such as ethyl acetate,1-butanol,isoamyl acetate,1-octanol,4-methylcyclohexanol,etc.classified as aliphatic esters and alcohols have been employed in olfactory classical conditioning using fruit flies.This underlines the participation of OR-activated olfactory pathways in learning and memory formation.Our study elucidates that likewise ethyl acetate(EA)(an OR-responsive odorant),PAH(an IR-responsive aromatic compound)too can form learning and memory when associated with an appetitive gustatory reinforcer.The association of PAH with sucrose(PAH/SUC)led to learning and formation of the long-term memory(LTM).Additionally,the Orco^(1),Ir84a^(MI00501),and Ir8a^(1)mutant flies were used to confirm the exclusive participation of the IR84a/IR8a complex in PAH/SUC olfactory associative conditioning.These results highlight the involvement of IRs via an IR-activated pathway in facilitating robust olfactory behavior.展开更多
BACKGROUND Even though percutaneous coronary intervention(PCI)improved the survival of patients with acute myocardial infarction,still multivessel coronary artery disease remains an important factor burdening prognosi...BACKGROUND Even though percutaneous coronary intervention(PCI)improved the survival of patients with acute myocardial infarction,still multivessel coronary artery disease remains an important factor burdening prognosis and it is being associated with a worse prognosis compared to single-vessel disease(SVD).AIM To compare the clinical profile and outcomes after the primary PCI in young patients with SVD vs multivessel disease(MVD).METHODS The retrospective cohort of patients were divided into two groups:SVD and MVD group.The study population consisted of both male and female young(≤45 years)patients presented with ST-elevation myocardial infarction(STEMI)at the National Institute of Cardiovascular Disease,Karachi,Pakistan and undergone primary PCI from 1 st July 2017 to 31 st March 2018.Pre and postprocedure management of the patients was as per the guidelines and institutional protocols.RESULTS A total of 571 patients with STEMI,≤45 years were stratified into two groups by the number of vessels involved,342(59.9%)with SVD and 229(40.1%)with MVD.The average age of these patients was 39.04±4.86 years.A lower prevalence of hypertension and diabetes was observed in SVD as compare to MVD group(25.1%vs 38%,P<0.01;11.7%vs 27.5%,P<0.001)respectively.While,smoking was more prevalent among the SVD group as compare to MVD group(36.3%vs 28.4%,P=0.05).The high-C Lesion was observed in a significantly higher number of younger patients with MVD as compared to SVD group(48.8%vs 39.2%,P=0.021).Post-procedure thrombolysis in myocardial infarction flow grade was found to be not associated with the number of diseased vessels with a P value of 0.426 and thrombolysis in myocardial infarction flow grade III was observed in 98%vs 96.5%of the patients is SVD vs MVD group.CONCLUSION The MVD comprised of around 40%of the young patients presented with STEMI.Also,this study shows that diabetes and hypertension have a certain role in the pathogenesis of multivessel diseases,therefore,preventive measures for diabetes and hypertension can 展开更多
The application of natural fibers as reinforcement in composite material has increased due to environmental concerns,low cost,degradability and health concerns.The purpose of this study is to identify the best type of...The application of natural fibers as reinforcement in composite material has increased due to environmental concerns,low cost,degradability and health concerns.The purpose of this study is to identify the best type of bamboo fibers to be used as reinforcement for kenaf(K)/bamboo hybrid composite.There were three types of bamboo fibers evaluated in this study which include bamboo mat(B),bamboo fabric(BF)and bamboo powder(BP).Chemical composition of B,BF,BP and K fibers were analyzed in this study.The effect of different types of bamboo fibers on tensile,impact,and morphological properties were investigated.The B/epoxy composites displayed the highest tensile strength(53.03 MPa)while K/epoxy composite had the highest tensile modulus(4.71 GPa).Scanning electron micrographs of B/epoxy composites displayed better fiber/matrix interfacial bonding in comparison to other studied composites.Results showed that impact strength of BF-based composite was highest(45.70 J/m).In conclusion,the tensile strength of B/epoxy composite is superior to the other bamboo reinforced composites and will be further evaluated in the next study.展开更多
Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly ...Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly trusted members of society, can help mitigate climate change effects in their countries. Objectives: The present study assessed perceptions of physicians from four South Asian countries (Bangladesh, Bhutan, India, and Pakistan). We hypothesized that physicians from these countries will be aware and knowledgeable about health effects of climate change. Methods: We conducted a cross-sectional online survey of physicians between March and July 2022. Data of 201 physicians was analyzed using the Kruskal-Wallis test and Dunn’s post hoc method. Results: Physicians from four South Asian countries were attuned to the health risks associated with climate change. A majority of physicians (86.6%) believed that climate change would make health conditions in their countries more severe or frequent (Bangladesh 83.3%;Bhutan 70%;India 91% and Pakistan 90.8%). The most common health effect related to climate change was illnesses related to reduced outdoor air quality (54.3%). Common barriers to discuss climate change with patients from all four countries were physicians’ lack of knowledge (strongly agree, 13.8%;agree 47.7%) in how to approach the issue with patients, lack of time (strongly agree, 12%;agree, 48%) and their perception that patients were not interested in knowing about climate change (strongly agree, 8.6%;agree, 42.6%). More than half (56.2%) of the physicians reported no training (Bangladesh, 51.7%;Bhutan, 80%;India, 44.6%;Pakistan, 63.1%) and approximately 30% reported less than 20 hours of training (Bangladesh, 28.3%;Bhutan, 15.0%;India, 39.3%;Pakistan, 27.7%) in climate-change-related health effects. Conclusion: While additional large-scale research is needed to understand the trends observed in our pilot study, our findings identify the need to introduce interventions to improve physicians’ 展开更多
This research focused on the dynamic mechanical and thermal properties of woven mat jute/kenaf/jute(J/K/J)and kenaf/jute/kenaf(K/J/K)hybrid composites.Dynamic mechanical analysis(DMA)and Thermo-gravimetric Analysis(TG...This research focused on the dynamic mechanical and thermal properties of woven mat jute/kenaf/jute(J/K/J)and kenaf/jute/kenaf(K/J/K)hybrid composites.Dynamic mechanical analysis(DMA)and Thermo-gravimetric Analysis(TGA)were used to study the effect of layering sequence on the thermal properties of kenaf/jute hybrid composites.The DMA results;it was found that the differences in the stacking sequence between the kenaf/jute composites do not affect their storage modulus,loss modulus and damping factor.From the TGA and DMA results,it has been shown that stacking sequence has given positive effect to the kenaf/jute hybrid composite compared to pure epoxy composite.This is because kenaf and jute fibre has increased the Tg values of the composites,thus affect the thermal degradation.Results showed that the storage modulus for kenaf/jute hybrid composites increased compared with pure epoxy composites with increasing temperature and the values of remained almost the same at glass transition temperature(Tg),the hybrid composite perhaps due to the improved fibre/matrix interface bonding.The preliminary analysis could provide a new direction for the creation of a novel hybrid composite which offers unique properties which cannot be accomplished in a single material system.展开更多
MXenes have emerged as versatile 2D materials that are already gaining paramount attention in the areas of energy,catalyst,electromagnetic shielding,and sensors.The unique surface chemistry,graphene-like mo rphology,h...MXenes have emerged as versatile 2D materials that are already gaining paramount attention in the areas of energy,catalyst,electromagnetic shielding,and sensors.The unique surface chemistry,graphene-like mo rphology,high hydrophilicity,metal-like conductivity with redox capability identifies MXenes,as an ideal material for surface-related applications.This short review summarizes the most recent reports that discuss the potential application of MXenes and their hybrids as a transducer material for advanced sensors.Based on the nature of transducing signals,the discussion is categorized into three sections,which include electrochemical(bio)sensors,gas sensors,and finally,electro-chemiluminescence&fluorescent sensors.The review provides a concise summary of all the analytical merits obtained subsequent to the use of MXenes,followed by endeavors that have been made to accentuate the future perspective of MXenes in sensor devices.展开更多
Microglia,the resident immune cells of the brain,are increasingly implicated in the regulation of brain health and disease.Microglia perform multiple functions in the central nervous system,including surveillance,phag...Microglia,the resident immune cells of the brain,are increasingly implicated in the regulation of brain health and disease.Microglia perform multiple functions in the central nervous system,including surveillance,phagocytosis and release of a variety of soluble factors.Importantly,a majority of their functions are closely related to changes in their metabolism.This natural inter-dependency between core microglial properties and metabolism offers a unique opportunity to modulate microglial activities via nutritional or metabolic interventions.In this review,we examine the existing scientific literature to synthesize the hypothesis that microglial phagocytosis of amyloid beta(Aβ)aggregates in Alzheimer’s disease(AD)can be selectively enhanced via metabolic interventions.We first review the basics of microglial metabolism and the effects of common metabolites,such as glucose,lipids,ketone bodies,glutamine,pyruvate and lactate,on microglial inflammatory and phagocytic properties.Next,we examine the evidence for dysregulation of microglial metabolism in AD.This is followed by a review of in vivo studies on metabolic manipulation of microglial functions to ascertain their therapeutic potential in AD.Finally,we discuss the effects of metabolic factors on microglial phagocytosis of healthy synapses,a pathological process that also contributes to the progression of AD.We conclude by enlisting the current challenges that need to be addressed before strategies to harness microglial phagocytosis to clear pathological protein deposits in AD and other neurodegenerative disorders can be widely adopted.展开更多
In this study,the best manufacturing process will be selected to build an automotive crash box using green oil palm natural fibre-reinforced polyurethane composite materials.This paper introduces an approach consist o...In this study,the best manufacturing process will be selected to build an automotive crash box using green oil palm natural fibre-reinforced polyurethane composite materials.This paper introduces an approach consist of technical aspects(T),the economic point of view(E)and availability(A),and it’s also called as TEA requirement.This approach was developed with the goal of assisting the design engineer in the selection of the best manufacturing process during the design phase at the criteria selection stage.In this study,the TEA requirement will integrate with the analytical hierarchy process(AHP)to assist decision makers or manufacturing engineers in determining the most appropriate manufacturing process to be employed in the manufacture of a composite automotive crash box(ACB)at the early stage of the product development process.It is obvious that a major challenge in the manufacturing selection process is lack of information regarding manufacturing of ACB using natural fibre composite(NFC).There have been no previous studies that examined ranking manufacturability processes in terms of their suitability.Therefore,the TEA-AHP hybrid method was introduced to provide unprejudiced criteria-ranking selection prior to evaluation of pairwise comparisons.At the end of this study,the pulforming process was selected as the best manufacturing process for fabrication of the ACB structural component.展开更多
This paper focuses on the study of the effect of modification of Oil Palm Empty Fruit Bunch(OPEFB)and sugarcane bagasse(SCB)biomass as potential reinforcement for composites panel and thermal insulation.Both fibres we...This paper focuses on the study of the effect of modification of Oil Palm Empty Fruit Bunch(OPEFB)and sugarcane bagasse(SCB)biomass as potential reinforcement for composites panel and thermal insulation.Both fibres were treated with three types of chemicals:2%silane,4%H2O2 and 4%H2O2-2%silane for 3 h.The influence of modified fibres content in composites was examined by structural changes using image analyser,Fourier transform infrared(FTIR),Scanning Electron Microscopy(SEM),tensile,interracial shear strength(IFSS)and thermal characteristic.The diameter of both fibres was reduced after treatment and showed decreasing of lignin and hemi-cellulose in fibre.Tensile strength has been increased by 2%silane treatment for both fibres and 4%H2O2 treatment displays higher result for IFSS.Thermal properties of treated SCB fibre with silane display higher residual content and better thermal stability.SEM charac-terization showed that 2%silane treatment removed silica bodies of OPEFB fibre while 4%H2O2 treatment uniformly filled porosity of SCB fibre.Finally,results revealed that treated OPEFB fibre is enough to improve compatibility and mechanical properties,while treated SCB fibre was effective in thermal stability for fabrication of composite materials.展开更多
A pulse current technique was conducted in a boron-doped diamond （BDD） anode system for electrochemical waste- water treatment. Due to the strong generation and weak absorption of hydroxyl radicals on the diamond su...A pulse current technique was conducted in a boron-doped diamond （BDD） anode system for electrochemical waste- water treatment. Due to the strong generation and weak absorption of hydroxyl radicals on the diamond surface, the BDD elec- trode possesses a powerful capability of electrochemical oxidation of organic compounds, especially in the pulse current mode. The influences of pulse current parameters such as current density, pulse duty cycle, and frequency were investigated in terms of chemical oxygen demand （COD） removal, average current efficiency, and specific energy consumption. The results demon- strated that the relatively high COD removal and low specific energy consumption were obtained simultaneously only if the current density or pulse duty cycle was adjusted to a reasonable value. Increasing the frequency slightly enhanced the COD re- moval and average current efficiency. A pulse-BDD anode system showed a stronger energy saving ability than a constant-BDD anode system when the electrochemical oxidation of phenol of the two systems was compared. The results prove that the pulse current technique is more cost-effective and more suitable for a BDD anode system for real wastewater treatment. A kinetic analysis was presented to explain the above results.展开更多
Polylactic acid(PLA)possesses good mechanical and biodegradability properties which make it a suitable material for polymer composites whereas brittleness and high costs limit its utilization in various applications.T...Polylactic acid(PLA)possesses good mechanical and biodegradability properties which make it a suitable material for polymer composites whereas brittleness and high costs limit its utilization in various applications.The reinforcement of natural fibres with biopolymers has been formed to be an efficient technique to develop composites having the ability to be fully biodegradable.This study concerns with the incorporation of various percentages of untreated and alkali-treated Coir Fibres(CF)and pineapple leaf fibres(PALF)in PLA biocomposites and characterizations of flexural,morphological and dynamic mechanical properties.Flexural properties showed that the treated C1P1 hybrid composites(C1P1A)displayed highest flexural strength(35.81 MPa)and modulus(5.28 GPa)among all hybrid biocomposites.Scanning Electron Microscopy(SEM)revealed a behaviour of fibre-matrix adhesion in untreated treated biocomposites.SEM observation revealed good dispersion of the fillers in PLA.Dynamic mechanical analysis revealed that C1P1A showed highest glass transition temperature(Tg)and storage modulus(E')while untreated C3P7 displayed the least Tg and E'.Overall findings showed that alkali-treated hybrid biocomposites(CF/PALF/PLA)especially C1P1A have improved flexural properties,dynamic and morphological properties over untreated biocomposites.Success of these findings will provide attracting consideration of these hybrid biocomposites for various lightweight uses in a broad selection of industrial applications such as biomedical sectors,automobile,construction,electronics equipment,and hardware tools.展开更多
An Information-Centric Network(ICN)provides a promising paradigm for the upcoming internet architecture,which will struggle with steady growth in data and changes in accessmodels.Various ICN architectures have been de...An Information-Centric Network(ICN)provides a promising paradigm for the upcoming internet architecture,which will struggle with steady growth in data and changes in accessmodels.Various ICN architectures have been designed,including Named Data Networking(NDN),which is designed around content delivery instead of hosts.As data is the central part of the network.Therefore,NDN was developed to get rid of the dependency on IP addresses and provide content effectively.Mobility is one of the major research dimensions for this upcoming internet architecture.Some research has been carried out to solve the mobility issues,but it still has problems like handover delay and packet loss ratio during real-time video streaming in the case of consumer and producer mobility.To solve this issue,an efficient hierarchical Cluster Base Proactive Caching for Device Mobility Management(CB-PC-DMM)in NDN Vehicular Networks(NDN-VN)is proposed,through which the consumer receives the contents proactively after handover during the mobility of the consumer.When a consumer moves to the next destination,a handover interest is sent to the connected router,then the router multicasts the consumer’s desired data packet to the next hop of neighboring routers.Thus,once the handover process is completed,consumers can easily get the content to the newly connected router.A CB-PCDMM in NDN-VN is proposed that improves the packet delivery ratio and reduces the handover delay aswell as cluster overhead.Moreover,the intra and inter-domain handover handling procedures in CB-PC-DMM for NDN-VN have been described.For the validation of our proposed scheme,MATLAB simulations are conducted.The simulation results show that our proposed scheme reduces the handover delay and increases the consumer’s interest satisfaction ratio.The proposed scheme is compared with the existing stateof-the-art schemes,and the total percentage of handover delays is decreased by up to 0.1632%,0.3267%,2.3437%,2.3255%,and 3.7313%at the mobility speeds of 5 m/s,10 m/s,15 m/s,20 m/s,and展开更多
INTRODUCTION Worldwide, cancer is an important cause of mortality in children aged over 1 year. Numerically, the major cancers include acute lymphoblastic leukemia, CNS tumors and lymphomas. Cancer incidence is increa...INTRODUCTION Worldwide, cancer is an important cause of mortality in children aged over 1 year. Numerically, the major cancers include acute lymphoblastic leukemia, CNS tumors and lymphomas. Cancer incidence is increasing in children globally as well as in Pakistan but the etiology is poorly understood. There are an estimated 160 000 new cases and 90 000 deaths per year worldwide in children aged under 15 years.The exact incidence in Pakistan is not known as there is no national tumor registry展开更多
Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we anal...Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4-85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug;spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.展开更多
The aim of the present study was to develop sugar palm fiber(SPF)reinforced thermoplastic polyurethane(TPU)composites and to investigate the effects of fiber surface modification by 2%silane treatment and fiber loadin...The aim of the present study was to develop sugar palm fiber(SPF)reinforced thermoplastic polyurethane(TPU)composites and to investigate the effects of fiber surface modification by 2%silane treatment and fiber loading(0,10,20,30,40 and 50 wt%)on the mechanical and thermal properties of the obtained composites.Surface treatment was employed to improve the fiber-matrix interface,which was expected to boost the mechanical strength of the composites,in terms of tensile,flexural and impact properties.Thermal properties were also investigated by thermal gravimetric analysis(TGA)and dynamic mechanical analysis(DMA)to assess the thermal stability of the developed composites.Furthermore,scanning electron microscopy(SEM)was used to study the tensile fracture samples of composites with a view towards evaluating the effects of fiber surface treatments on the fiber/matrix interfacial bonding.The findings of this study reveal that the silane treatment has determined good bonding and linkage of the cellulose fiber to the TPU matrix,hence contributing to enhanced mechanical and thermal properties of the composites.The composite formulation with 40 wt%sugar palm fiber loading showed optimum values such as 17.22 MPa for tensile,13.96 MPa for flexural,and 15.47 kJ/m^2 for impact strength.Moreover,the formulations with higher fiber content exhibited satisfactory values of storage modulus and thermal degradation,while their good interfacial adhesion was evidenced by SEM images.展开更多
BACKGROUND Cardiogenic shock(CS)is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates.Primary percutaneous coro-nary intervention(PCI)has been shown to improve outco...BACKGROUND Cardiogenic shock(CS)is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates.Primary percutaneous coro-nary intervention(PCI)has been shown to improve outcomes in patients with CS.AIM To investigate the immediate mortality rates in patients with CS undergoing primary PCI and identify mortality predictors.METHODS We conducted a retrospective analysis of 305 patients with CS who underwent primary PCI at the National Institute of Cardiovascular Diseases,Karachi,Pak-istan,between January 2018 and December 2022.The primary outcome was immediate mortality,defined as mortality within index hospitalization.Uni-variate and multivariate logistic regression analyses were performed to identify predictors of immediate mortality.RESULTS In a sample of 305 patients with 72.8%male patients and a mean age of 58.1±11.8 years,the immediate mortality rate was found to be 54.8%(167).Multivariable analysis identified Killip class IV at presentation[odds ratio(OR):2.0;95%co-nfidence interval(CI):1.2-3.4;P=0.008],Multivessel disease(OR:3.5;95%CI:1.8-6.9;P<0.001),and high thrombus burden(OR:2.6;95%CI:1.4-4.9;P=0.003)as independent predictors of immediate mortality.CONCLUSION Immediate mortality rate in patients with CS undergoing primary PCI remains high despite advances in treatment strategies.Killip class IV at presentation,multivessel disease,and high thrombus burden(grade≥4)were identified as independent predictors of immediate mortality.These findings underscore the need for aggressive management and close monitoring of patients with CS undergoing primary PCI,particularly in those with these high-risk characteristics.展开更多
文摘Natural fibres are very versatile materials, their properties vary with chemical composition and physical structure. The effects of alkali, silane and combined alkali and silane treatments on the mechanical （tensile）, morphological, and structural properties of Pine Apple Leave Fibres （PALF） and Kenaf Fibres （KF） were investigated with the aim to improve their com- patibility with polymer matrices. The effectiveness of the alkali and saline treatments in the removal of impurities from the fibre surfaces was confirmed by Scanning Electron Microscopy （SEM） and Fourier Transform Infrared spectrometry （FTIR） ob- servation. The morphological study of treated PALF and KF by SEM indicates that silane treated fibres have less impurities and lignin and hemicelluloses removed than those by other chemical treatments. Silane treated PALF and KF display better tensile strength than those of untreated, alkaline and NaOH-silane treated. Droplet test indicates that the lnterfacial Stress Strength （IFSS） of alkali and silane treated PALF and KF are enhanced whereas silane treated fibres display highest IFSS. It is assumed that fibre treatments will help to develop high performance KF and PALF reinforced polymer composites for industrial appli- cations.
文摘Polypropylene （PP） matrix composites reinforced with chemically treated Almond Shell （AS） particles with and without compatibilizer （PP-g-MA） was prepared by a twin-screw extrusion at loading of 20 wt.% AS particles. Two types of chemical treatments （alkali treatment with sodium hydroxide and etherification with dodecane bromide） of the particles were carried out to improve the interface adhesion between particles and PP matrix. Results show that chemical modifications of AS particles affect the mechanical and viscoelastic properties of AS/PP composites. The composites reinforced with alkali treated particles and the compatibilized matrix lead to a notable increase in the Young＇s modulus （14%） compared to the composites with untreated AS particles. The ductility of composite was also evaluated by the yield strain, and results show a notable increase （31%） compared to that of composites with untreated particles. The thermal stability increased with the use of etherification （385 ℃）, with gains in the temperature up to 23 ℃ compared to neat PP （362 ℃）. The achieved results show that the AS/PP composites can be used in several applications. A thermoplastic matrix compsite mixed with treated AS particles appears to be a good alternative to obtain environmentally friendly products.
基金Project(6369107)supported by the Ministry of Higher Education,Malaysia
文摘A hybrid conceptual design approach was introduced in this study to develop a conceptual design of oil palm polymer composite automotive crash box(ACB). A combination of theory of inventive problem solving(TRIZ), morphological charts and biomimetics was applied where the foremost requirements in terms of the material characteristics, function specifications, force identification, root cause analysis, geometry profile and design selection criteria were considered. The strategy was to use creations of nature to inspire five innovative conceptual designs of the ACB structure and the AHP method was applied to perform the pairwise analysis of selecting the best ACB conceptual design. A new conceptual design for a composite ACB was conceived bearing in mind the properties of natural fibre, unlike those of conventional materials such as steel alloys and aluminium alloys. The design with the highest ranking(26.6 %) was chosen as the final conceptual design, which was the one with a honeycomb structure for the outermost profile, reinforced with a spider web structure inside the part, supported by fibre foam structure extracted from the woodpecker sponge tissue at the centre to maximize the energy absorption capability. The new design could solve the problem of bending collapse which is a major cause of failure to absorb maximum impact energy for ACB during collision. However, the final conceptual design will still need several modifications for production and assembly purposes, which will be completed in a further study.
基金funding of Researchers Supporting Project Number(RSPD2023R710)from King Saud University,Riyadh,Saudi Arabia.
文摘Phenylacetaldehyde(PAH),an aromatic compound,is present in a diverse range of fruits including overripe bananas and prickly pear cactus,the two major host fruits for Drosophila melanogaster.PAH acts as a potent ligand for the ionotropic receptor 84a(IR84a)in the adult fruit fly and it is detected by the IR84a/IR8a heterotetrameric complex.Its role in the male courtship behavior through IR84a as an environmental aphrodisiac is of additional importance.In D.melanogaster,two distinct kinds of olfactory receptors,that is,odorant receptors(ORs)and ionotropic receptors(IRs),perceive the odorant stimuli.They display unique structural,molecular,and functional characteristics in addition to having different evolutionary origins.Traditionally,olfactory cues detected by the ORs such as ethyl acetate,1-butanol,isoamyl acetate,1-octanol,4-methylcyclohexanol,etc.classified as aliphatic esters and alcohols have been employed in olfactory classical conditioning using fruit flies.This underlines the participation of OR-activated olfactory pathways in learning and memory formation.Our study elucidates that likewise ethyl acetate(EA)(an OR-responsive odorant),PAH(an IR-responsive aromatic compound)too can form learning and memory when associated with an appetitive gustatory reinforcer.The association of PAH with sucrose(PAH/SUC)led to learning and formation of the long-term memory(LTM).Additionally,the Orco^(1),Ir84a^(MI00501),and Ir8a^(1)mutant flies were used to confirm the exclusive participation of the IR84a/IR8a complex in PAH/SUC olfactory associative conditioning.These results highlight the involvement of IRs via an IR-activated pathway in facilitating robust olfactory behavior.
基金support of the staff members of the Clinical Research Department of the National Institute of Cardiovascular Diseases(NICVD)Karachi,Pakistan.
文摘BACKGROUND Even though percutaneous coronary intervention(PCI)improved the survival of patients with acute myocardial infarction,still multivessel coronary artery disease remains an important factor burdening prognosis and it is being associated with a worse prognosis compared to single-vessel disease(SVD).AIM To compare the clinical profile and outcomes after the primary PCI in young patients with SVD vs multivessel disease(MVD).METHODS The retrospective cohort of patients were divided into two groups:SVD and MVD group.The study population consisted of both male and female young(≤45 years)patients presented with ST-elevation myocardial infarction(STEMI)at the National Institute of Cardiovascular Disease,Karachi,Pakistan and undergone primary PCI from 1 st July 2017 to 31 st March 2018.Pre and postprocedure management of the patients was as per the guidelines and institutional protocols.RESULTS A total of 571 patients with STEMI,≤45 years were stratified into two groups by the number of vessels involved,342(59.9%)with SVD and 229(40.1%)with MVD.The average age of these patients was 39.04±4.86 years.A lower prevalence of hypertension and diabetes was observed in SVD as compare to MVD group(25.1%vs 38%,P<0.01;11.7%vs 27.5%,P<0.001)respectively.While,smoking was more prevalent among the SVD group as compare to MVD group(36.3%vs 28.4%,P=0.05).The high-C Lesion was observed in a significantly higher number of younger patients with MVD as compared to SVD group(48.8%vs 39.2%,P=0.021).Post-procedure thrombolysis in myocardial infarction flow grade was found to be not associated with the number of diseased vessels with a P value of 0.426 and thrombolysis in myocardial infarction flow grade III was observed in 98%vs 96.5%of the patients is SVD vs MVD group.CONCLUSION The MVD comprised of around 40%of the young patients presented with STEMI.Also,this study shows that diabetes and hypertension have a certain role in the pathogenesis of multivessel diseases,therefore,preventive measures for diabetes and hypertension can
文摘The application of natural fibers as reinforcement in composite material has increased due to environmental concerns,low cost,degradability and health concerns.The purpose of this study is to identify the best type of bamboo fibers to be used as reinforcement for kenaf(K)/bamboo hybrid composite.There were three types of bamboo fibers evaluated in this study which include bamboo mat(B),bamboo fabric(BF)and bamboo powder(BP).Chemical composition of B,BF,BP and K fibers were analyzed in this study.The effect of different types of bamboo fibers on tensile,impact,and morphological properties were investigated.The B/epoxy composites displayed the highest tensile strength(53.03 MPa)while K/epoxy composite had the highest tensile modulus(4.71 GPa).Scanning electron micrographs of B/epoxy composites displayed better fiber/matrix interfacial bonding in comparison to other studied composites.Results showed that impact strength of BF-based composite was highest(45.70 J/m).In conclusion,the tensile strength of B/epoxy composite is superior to the other bamboo reinforced composites and will be further evaluated in the next study.
文摘Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly trusted members of society, can help mitigate climate change effects in their countries. Objectives: The present study assessed perceptions of physicians from four South Asian countries (Bangladesh, Bhutan, India, and Pakistan). We hypothesized that physicians from these countries will be aware and knowledgeable about health effects of climate change. Methods: We conducted a cross-sectional online survey of physicians between March and July 2022. Data of 201 physicians was analyzed using the Kruskal-Wallis test and Dunn’s post hoc method. Results: Physicians from four South Asian countries were attuned to the health risks associated with climate change. A majority of physicians (86.6%) believed that climate change would make health conditions in their countries more severe or frequent (Bangladesh 83.3%;Bhutan 70%;India 91% and Pakistan 90.8%). The most common health effect related to climate change was illnesses related to reduced outdoor air quality (54.3%). Common barriers to discuss climate change with patients from all four countries were physicians’ lack of knowledge (strongly agree, 13.8%;agree 47.7%) in how to approach the issue with patients, lack of time (strongly agree, 12%;agree, 48%) and their perception that patients were not interested in knowing about climate change (strongly agree, 8.6%;agree, 42.6%). More than half (56.2%) of the physicians reported no training (Bangladesh, 51.7%;Bhutan, 80%;India, 44.6%;Pakistan, 63.1%) and approximately 30% reported less than 20 hours of training (Bangladesh, 28.3%;Bhutan, 15.0%;India, 39.3%;Pakistan, 27.7%) in climate-change-related health effects. Conclusion: While additional large-scale research is needed to understand the trends observed in our pilot study, our findings identify the need to introduce interventions to improve physicians’
基金This work is supported by UPM under GP-IPS Grant 9486400.
文摘This research focused on the dynamic mechanical and thermal properties of woven mat jute/kenaf/jute(J/K/J)and kenaf/jute/kenaf(K/J/K)hybrid composites.Dynamic mechanical analysis(DMA)and Thermo-gravimetric Analysis(TGA)were used to study the effect of layering sequence on the thermal properties of kenaf/jute hybrid composites.The DMA results;it was found that the differences in the stacking sequence between the kenaf/jute composites do not affect their storage modulus,loss modulus and damping factor.From the TGA and DMA results,it has been shown that stacking sequence has given positive effect to the kenaf/jute hybrid composite compared to pure epoxy composite.This is because kenaf and jute fibre has increased the Tg values of the composites,thus affect the thermal degradation.Results showed that the storage modulus for kenaf/jute hybrid composites increased compared with pure epoxy composites with increasing temperature and the values of remained almost the same at glass transition temperature(Tg),the hybrid composite perhaps due to the improved fibre/matrix interface bonding.The preliminary analysis could provide a new direction for the creation of a novel hybrid composite which offers unique properties which cannot be accomplished in a single material system.
基金financially supported by the National Natural Science Foundation of China(NSFC,Nos.51572011 and 51802012)。
文摘MXenes have emerged as versatile 2D materials that are already gaining paramount attention in the areas of energy,catalyst,electromagnetic shielding,and sensors.The unique surface chemistry,graphene-like mo rphology,high hydrophilicity,metal-like conductivity with redox capability identifies MXenes,as an ideal material for surface-related applications.This short review summarizes the most recent reports that discuss the potential application of MXenes and their hybrids as a transducer material for advanced sensors.Based on the nature of transducing signals,the discussion is categorized into three sections,which include electrochemical(bio)sensors,gas sensors,and finally,electro-chemiluminescence&fluorescent sensors.The review provides a concise summary of all the analytical merits obtained subsequent to the use of MXenes,followed by endeavors that have been made to accentuate the future perspective of MXenes in sensor devices.
基金supported by grants from National Science Centre(NCN)Poland(SONATA,DEC-2020/39/D/NZ3/01887)the EU Joint Programme-Neurodegenerative Disease Research(JPND)(TREMENDOS,UMO-2022/04/Y/NZ5/00122)+1 种基金supported by grants from the Swiss National Science Foundation(SNSF 310030_197940)the European Research Council(ERC StGrant REMIND 804949).
文摘Microglia,the resident immune cells of the brain,are increasingly implicated in the regulation of brain health and disease.Microglia perform multiple functions in the central nervous system,including surveillance,phagocytosis and release of a variety of soluble factors.Importantly,a majority of their functions are closely related to changes in their metabolism.This natural inter-dependency between core microglial properties and metabolism offers a unique opportunity to modulate microglial activities via nutritional or metabolic interventions.In this review,we examine the existing scientific literature to synthesize the hypothesis that microglial phagocytosis of amyloid beta(Aβ)aggregates in Alzheimer’s disease(AD)can be selectively enhanced via metabolic interventions.We first review the basics of microglial metabolism and the effects of common metabolites,such as glucose,lipids,ketone bodies,glutamine,pyruvate and lactate,on microglial inflammatory and phagocytic properties.Next,we examine the evidence for dysregulation of microglial metabolism in AD.This is followed by a review of in vivo studies on metabolic manipulation of microglial functions to ascertain their therapeutic potential in AD.Finally,we discuss the effects of metabolic factors on microglial phagocytosis of healthy synapses,a pathological process that also contributes to the progression of AD.We conclude by enlisting the current challenges that need to be addressed before strategies to harness microglial phagocytosis to clear pathological protein deposits in AD and other neurodegenerative disorders can be widely adopted.
文摘In this study,the best manufacturing process will be selected to build an automotive crash box using green oil palm natural fibre-reinforced polyurethane composite materials.This paper introduces an approach consist of technical aspects(T),the economic point of view(E)and availability(A),and it’s also called as TEA requirement.This approach was developed with the goal of assisting the design engineer in the selection of the best manufacturing process during the design phase at the criteria selection stage.In this study,the TEA requirement will integrate with the analytical hierarchy process(AHP)to assist decision makers or manufacturing engineers in determining the most appropriate manufacturing process to be employed in the manufacture of a composite automotive crash box(ACB)at the early stage of the product development process.It is obvious that a major challenge in the manufacturing selection process is lack of information regarding manufacturing of ACB using natural fibre composite(NFC).There have been no previous studies that examined ranking manufacturability processes in terms of their suitability.Therefore,the TEA-AHP hybrid method was introduced to provide unprejudiced criteria-ranking selection prior to evaluation of pairwise comparisons.At the end of this study,the pulforming process was selected as the best manufacturing process for fabrication of the ACB structural component.
文摘This paper focuses on the study of the effect of modification of Oil Palm Empty Fruit Bunch(OPEFB)and sugarcane bagasse(SCB)biomass as potential reinforcement for composites panel and thermal insulation.Both fibres were treated with three types of chemicals:2%silane,4%H2O2 and 4%H2O2-2%silane for 3 h.The influence of modified fibres content in composites was examined by structural changes using image analyser,Fourier transform infrared(FTIR),Scanning Electron Microscopy(SEM),tensile,interracial shear strength(IFSS)and thermal characteristic.The diameter of both fibres was reduced after treatment and showed decreasing of lignin and hemi-cellulose in fibre.Tensile strength has been increased by 2%silane treatment for both fibres and 4%H2O2 treatment displays higher result for IFSS.Thermal properties of treated SCB fibre with silane display higher residual content and better thermal stability.SEM charac-terization showed that 2%silane treatment removed silica bodies of OPEFB fibre while 4%H2O2 treatment uniformly filled porosity of SCB fibre.Finally,results revealed that treated OPEFB fibre is enough to improve compatibility and mechanical properties,while treated SCB fibre was effective in thermal stability for fabrication of composite materials.
基金supported by the Ph.D. Programs Foundation of the Ministry of Education of China (No. 20110006110011)the National Natural Science Foundation of China (No. 51272024)
文摘A pulse current technique was conducted in a boron-doped diamond （BDD） anode system for electrochemical waste- water treatment. Due to the strong generation and weak absorption of hydroxyl radicals on the diamond surface, the BDD elec- trode possesses a powerful capability of electrochemical oxidation of organic compounds, especially in the pulse current mode. The influences of pulse current parameters such as current density, pulse duty cycle, and frequency were investigated in terms of chemical oxygen demand （COD） removal, average current efficiency, and specific energy consumption. The results demon- strated that the relatively high COD removal and low specific energy consumption were obtained simultaneously only if the current density or pulse duty cycle was adjusted to a reasonable value. Increasing the frequency slightly enhanced the COD re- moval and average current efficiency. A pulse-BDD anode system showed a stronger energy saving ability than a constant-BDD anode system when the electrochemical oxidation of phenol of the two systems was compared. The results prove that the pulse current technique is more cost-effective and more suitable for a BDD anode system for real wastewater treatment. A kinetic analysis was presented to explain the above results.
基金gratitude to Institute of Tropical Forestry and Forest Products(INTROP),Universiti Putra Malaysia for supporting the funding of research through Grant No:6369108funded by Researchers Supporting Project number(RSP-2021/117),King Saud University,Riyadh,Saudi Arabia.
文摘Polylactic acid(PLA)possesses good mechanical and biodegradability properties which make it a suitable material for polymer composites whereas brittleness and high costs limit its utilization in various applications.The reinforcement of natural fibres with biopolymers has been formed to be an efficient technique to develop composites having the ability to be fully biodegradable.This study concerns with the incorporation of various percentages of untreated and alkali-treated Coir Fibres(CF)and pineapple leaf fibres(PALF)in PLA biocomposites and characterizations of flexural,morphological and dynamic mechanical properties.Flexural properties showed that the treated C1P1 hybrid composites(C1P1A)displayed highest flexural strength(35.81 MPa)and modulus(5.28 GPa)among all hybrid biocomposites.Scanning Electron Microscopy(SEM)revealed a behaviour of fibre-matrix adhesion in untreated treated biocomposites.SEM observation revealed good dispersion of the fillers in PLA.Dynamic mechanical analysis revealed that C1P1A showed highest glass transition temperature(Tg)and storage modulus(E')while untreated C3P7 displayed the least Tg and E'.Overall findings showed that alkali-treated hybrid biocomposites(CF/PALF/PLA)especially C1P1A have improved flexural properties,dynamic and morphological properties over untreated biocomposites.Success of these findings will provide attracting consideration of these hybrid biocomposites for various lightweight uses in a broad selection of industrial applications such as biomedical sectors,automobile,construction,electronics equipment,and hardware tools.
基金This work was supported by the MSIT(Ministry of Science and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2023-2018-0-01431)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation).
文摘An Information-Centric Network(ICN)provides a promising paradigm for the upcoming internet architecture,which will struggle with steady growth in data and changes in accessmodels.Various ICN architectures have been designed,including Named Data Networking(NDN),which is designed around content delivery instead of hosts.As data is the central part of the network.Therefore,NDN was developed to get rid of the dependency on IP addresses and provide content effectively.Mobility is one of the major research dimensions for this upcoming internet architecture.Some research has been carried out to solve the mobility issues,but it still has problems like handover delay and packet loss ratio during real-time video streaming in the case of consumer and producer mobility.To solve this issue,an efficient hierarchical Cluster Base Proactive Caching for Device Mobility Management(CB-PC-DMM)in NDN Vehicular Networks(NDN-VN)is proposed,through which the consumer receives the contents proactively after handover during the mobility of the consumer.When a consumer moves to the next destination,a handover interest is sent to the connected router,then the router multicasts the consumer’s desired data packet to the next hop of neighboring routers.Thus,once the handover process is completed,consumers can easily get the content to the newly connected router.A CB-PCDMM in NDN-VN is proposed that improves the packet delivery ratio and reduces the handover delay aswell as cluster overhead.Moreover,the intra and inter-domain handover handling procedures in CB-PC-DMM for NDN-VN have been described.For the validation of our proposed scheme,MATLAB simulations are conducted.The simulation results show that our proposed scheme reduces the handover delay and increases the consumer’s interest satisfaction ratio.The proposed scheme is compared with the existing stateof-the-art schemes,and the total percentage of handover delays is decreased by up to 0.1632%,0.3267%,2.3437%,2.3255%,and 3.7313%at the mobility speeds of 5 m/s,10 m/s,15 m/s,20 m/s,and
文摘INTRODUCTION Worldwide, cancer is an important cause of mortality in children aged over 1 year. Numerically, the major cancers include acute lymphoblastic leukemia, CNS tumors and lymphomas. Cancer incidence is increasing in children globally as well as in Pakistan but the etiology is poorly understood. There are an estimated 160 000 new cases and 90 000 deaths per year worldwide in children aged under 15 years.The exact incidence in Pakistan is not known as there is no national tumor registry
文摘Objective: To analyze the use of all subsidized prescription drugs including their use of drug combination generally accepted as carrying a risk of severe interactions. Methodology: In a cross sectional study, we analyzed all prescriptions (n = 1014) involving two or more drugs dispensed to the population (age range 4-85 years) from all pharmacies, clinics and hospitals. Data were stratified by age and sex, and frequency of common interacting drugs. Potential drug interactions were classified according to clinical relevance as significance of severity (types A: major, B: moderate, and C: minor) and documented evidence (types 1, 2, 3, and 4). Result and Discussion: The growing use of pharmacological agents means that drug interactions are of increasing interest for public health. Monitoring of potential drug interactions may improve the quality of drug prescribing and dispensing, and it might form a basis for education focused on appropriate prescribing. To make the manifestation of adverse interaction subside, management strategies must be exercised if two interacting drugs have to be taken with each other, involving: adjusting the dose of the object drug;spacing dosing times to avoid the interaction. The pharmacist, along with the prescriber has a duty to ensure that patients are aware of the risk of side effects and a suitable course of action they should take. Conclusion: It is unrealistic to expect clinicians to memorize the thousands of drug-drug interactions and their clinical significance, especially considering the rate of introduction of novel drugs and the escalating appreciation of the importance of pharmacogenomics. Reliable regularly updated decision support systems and information technology are necessary to help avert dangerous drug combinations.
文摘The aim of the present study was to develop sugar palm fiber(SPF)reinforced thermoplastic polyurethane(TPU)composites and to investigate the effects of fiber surface modification by 2%silane treatment and fiber loading(0,10,20,30,40 and 50 wt%)on the mechanical and thermal properties of the obtained composites.Surface treatment was employed to improve the fiber-matrix interface,which was expected to boost the mechanical strength of the composites,in terms of tensile,flexural and impact properties.Thermal properties were also investigated by thermal gravimetric analysis(TGA)and dynamic mechanical analysis(DMA)to assess the thermal stability of the developed composites.Furthermore,scanning electron microscopy(SEM)was used to study the tensile fracture samples of composites with a view towards evaluating the effects of fiber surface treatments on the fiber/matrix interfacial bonding.The findings of this study reveal that the silane treatment has determined good bonding and linkage of the cellulose fiber to the TPU matrix,hence contributing to enhanced mechanical and thermal properties of the composites.The composite formulation with 40 wt%sugar palm fiber loading showed optimum values such as 17.22 MPa for tensile,13.96 MPa for flexural,and 15.47 kJ/m^2 for impact strength.Moreover,the formulations with higher fiber content exhibited satisfactory values of storage modulus and thermal degradation,while their good interfacial adhesion was evidenced by SEM images.
文摘BACKGROUND Cardiogenic shock(CS)is a life-threatening complication of acute myocardial infarction with high morbidity and mortality rates.Primary percutaneous coro-nary intervention(PCI)has been shown to improve outcomes in patients with CS.AIM To investigate the immediate mortality rates in patients with CS undergoing primary PCI and identify mortality predictors.METHODS We conducted a retrospective analysis of 305 patients with CS who underwent primary PCI at the National Institute of Cardiovascular Diseases,Karachi,Pak-istan,between January 2018 and December 2022.The primary outcome was immediate mortality,defined as mortality within index hospitalization.Uni-variate and multivariate logistic regression analyses were performed to identify predictors of immediate mortality.RESULTS In a sample of 305 patients with 72.8%male patients and a mean age of 58.1±11.8 years,the immediate mortality rate was found to be 54.8%(167).Multivariable analysis identified Killip class IV at presentation[odds ratio(OR):2.0;95%co-nfidence interval(CI):1.2-3.4;P=0.008],Multivessel disease(OR:3.5;95%CI:1.8-6.9;P<0.001),and high thrombus burden(OR:2.6;95%CI:1.4-4.9;P=0.003)as independent predictors of immediate mortality.CONCLUSION Immediate mortality rate in patients with CS undergoing primary PCI remains high despite advances in treatment strategies.Killip class IV at presentation,multivessel disease,and high thrombus burden(grade≥4)were identified as independent predictors of immediate mortality.These findings underscore the need for aggressive management and close monitoring of patients with CS undergoing primary PCI,particularly in those with these high-risk characteristics.
