Search Results (616)

Background and objective: Evidence of percutaneous left atrial appendage closure (LAAC) and oral anticoagulants (OACs) in non-valvular atrial fibrillation (NVAF) patients with intermediate-to-borderline high stroke risk is scarce. We aimed to compare the efficacy and safety of these treatments in the latter clinical population. Methods: This retrospective cohort study included NVAF patients with CHA₂DS₂-VA scores of 1–2 and used 1:1 propensity score matching (184 patients per group) to compare efficacy and safety outcomes. The primary efficacy outcome was a composite of stroke, transient ischemic attacks, systemic embolism, and cardiovascular death during follow-up. Adverse safety events were categorized into peri-procedure (LAAC group) and non-procedural (both groups) events. Results: Over a mean follow-up of 48.93 ± 28.50 months, a total of 26 patients (7.07%) reached the primary composite efficacy endpoint. The LAAC group showed a significantly higher incidence of the efficacy endpoint compared to the OAC group (HR = 3.09; 95% CI 1.22–7.85; log-rank p = 0.01). Procedure-related events occurred in five LAAC patients (one contributing to primary endpoint), while non-procedural bleeding rates were similar (0.54% vs. 1.09%; p = 0.56). Subgroup analyses suggested concomitant ablation of NVAF in LAAC group did not significantly improve efficacy composite endpoints (HR = 0.47). Conclusions: In NVAF patients with intermediate-to-high stroke risk, OACs were more effective than LAAC in preventing thromboembolic events, with comparable rates of clinically relevant bleeding. Full article

Accurately predicting the full-scale performance of submarines is challenging due to their complex propulsor systems and limited sea-trial information. This study investigated a full-scale extrapolation method from model tests for a submarine pumpjet propulsor, as a reliable method has not been established. Three extrapolation methods from ITTC reports were reviewed and applied to the pumpjet propulsor of the SUBOFF submarine, then compared with full-scale CFD results. Among the reviewed methods (Methods 1 to 3), Method 3, which separates the duct and stator as appendages of the hull and includes the entire pumpjet in the POW test but uses only the rotor’s force, was the most reasonable, but showed significant differences from the calculated results, especially in the $P_D$. This study proposed a modified Method 3, improving it by adopting the continuity theory to predict the oncoming velocity of a rotor and by applying a correction factor for the drag of the duct and stator. The modified PJP extrapolation method 3 showed excellent agreement with the full-scale CFD analysis results across all propulsion coefficients, with a minimal error of 0.45% for $P_D$. Despite the structural differences in PJPs, such as stators and longer ducts, velocity changes are dominated by the duct’s internal area. Therefore, the proposed extrapolation method is equally applicable to general ducted propellers. Full article

Background: Positron emission tomography (PET) is a valuable tool in the diagnosis of cardiovascular infections. However, increased radiotracer uptake can also be observed in non-infectious inflammatory processes, leading to potential false positives. This study analyzed the uptake related to left atrial appendage closure devices (LAACD—AtriClip^®) to determine its association with infectious or inflammatory processes. Methods: We retrospectively analyzed 28 PET/CT scans from 20 patients with implanted LAACDs: 24 using ¹⁸F-fluorodeoxyglucose (FDG) and 4 using ¹⁸F-Choline (CHO). Clinical, laboratory, and imaging data were reviewed, and PET uptake was measured semi-quantitatively. All patients had at least 12 months of follow-up after PET imaging to assess for evidence of device-related infection. Results: Homogeneous PET uptake in the LAACD was observed in 93% (26/28) of the PET studies, regardless of the radiotracer used, clinical indication, or time since implantation. Clinical follow-up and laboratory findings revealed no signs of infection related to the LAACD in any case. SUV ratios did not differ significantly between the three PET indication groups (infection, neoplasia, or other; p = 0.46), nor between scans performed in patients with and without other confirmed infections unrelated to the LAACD (p = 0.37). Conclusions: FDG and CHO uptake in LAACDs appears to be a consistent and reproducible finding, most likely reflecting a sterile inflammatory response postoperative inflammatory uptake rather than true infection. Clear recognition of this uptake pattern is important to prevent misinterpretation and reduce the risk of false-positive PET/CT results in patients evaluated for suspected cardiovascular infections. Full article

Wind power generation ships (WPG ships), which combine rigid sails for propulsion and underwater turbines for onboard power generation, have attracted increasing attention as a promising concept for utilizing renewable energy at sea. This study presents an integrated assessment of a WPG ship by combining towing-tank experiments, CFD simulations using ANSYS Fluent, and theoretical analysis to evaluate the coupled performance of sails, hull, and underwater turbines. First, sail thrust and bare-hull resistance were quantified to identify the effective operating-speed range under Beaufort 6–8 wind conditions, and the optimal number of rigid sails was determined. Based on a thrust–resistance balance at a representative rated operating point, two turbine configurations (two and four turbines) were preliminarily sized. The results show that ten rigid sails can provide near-maximum thrust without excessive aerodynamic interference, and the installation of turbines significantly reduces the feasible operating range compared to the bare-hull case. For the two-turbine configuration, a common effective ship-speed range of 6.58–8.0 m/s is obtained, whereas the four-turbine configuration is restricted to 6.58–7.44 m/s due to wake losses, additional appendage drag, and near-free-surface effects. The four-turbine configuration exhibits approximately 30% lower total power output than the two-turbine configuration. These findings demonstrate that an integrated, system-level evaluation is essential for WPG ship design and indicate that the two-turbine configuration offers a more favorable balance between power generation capability and operational flexibility. Full article

Plant functional traits are key to understanding species performance, community assembly and ecosystem processes. Fruit and seed traits play an important role in early life-cycle processes by influencing seed dispersal, germination, and establishment, ultimately shaping plant regeneration and ecosystem dynamics. While global initiatives such as TRY and Seed Information Database (SID) have assembled extensive trait data, coverage of reproductive traits remains limited, and high-quality images of diaspores are particularly scarce, particularly in subtropical Asia. To address this need, we created an open-source, comprehensive database of fruit and seed traits, accompanied by diaspore images against a high-contrast background. This dataset documents 684 species in 128 families recorded in Hong Kong and provides standardised measurements of morphological attributes (e.g., length, mass, number of seeds per fruit) and dispersal characteristics (e.g., presence of appendages). Our measurements were validated against previously published records of common species in Hong Kong, showing strong consistency with R² = 0.80 (p < 0.001) for fruit dry mass and R² = 0.91 (p < 0.001) for seed dry mass, respectively. This database provides a valuable resource for trait-based ecology, forest dynamics and conservation biology. Additionally, it supports applications in ecological restoration, habitat management, and predicting plant responses to environmental change. This initiative enhances our understanding of trait-based ecology by complementing global initiatives such as TRY and SID and improving the representation of reproductive traits from subtropical Asia, a region that is underrepresented in existing global databases. Full article

The left atrial appendage (LAA) is a highly dynamic anatomical structure that plays a key role in left atrial reservoir function, pressure and volume modulation, and endocrine hormone secretion during sinus rhythm. However, its physiological contribution is profoundly altered in atrial fibrillation (AF). Electrical and structural remodeling, impaired contractility, and blood stasis within the LAA collectively transform this functional component into the principal cardiac source of thrombus formation and embolic events in patients with AF. This review focuses on the conceptual continuum from physiological LAA function in sinus rhythm to its pathological transformation in AF and the evolving rationale for progressively more complete (“radical”) anatomical exclusion A variety of strategies, including systemic anticoagulation therapy, percutaneous device-based exclusion, and surgical closure, are currently employed, each with specific indications, limitations, and procedure-related risks. Beyond summarizing available techniques, this review critically synthesizes mechanistic, anatomical, and clinical data to address unresolved controversies regarding patient selection, residual leaks, device-related thrombosis, and post-procedural antithrombotic management. Finally, emerging directions toward minimizing residual foreign material, reducing thrombogenicity, and achieving durable exclusion are discussed, supporting a more personalized and radical approach to stroke prevention in AF. Full article

The adaptation strategies of species to local environments are reflected in phenotypic variations, which could be expressed as trait patterns across the community level. Here, we compiled a dataset of small mammal traits to evaluate the classic ecological rules and to assess predictions related to drought resistance. In June 2017, July 2023, and May–June 2024, a field survey was conducted in Baima Snow Mountain, southwest China, using standardized methods to capture small mammals. Traits potentially corresponding to variations in temperature, productivity, and water availability were measured in the field or calculated in the laboratory. We applied ordinary least squares (OLS) linear regressions to determine the community-level trait variations along the gradients of environmental factors influenced by rain-shadow effects of the mountain system. Results showed that (1) body size decreased with increasing temperature, aligning well with conventional prediction; (2) the proportion of appendage size attributable to allometry decreased with temperature but increased slightly with productivity, thereby violating Allen’s rule while being partly consistent with the resource rule; (3) the renal features did not support the expected negative association concerning water availability but its converse, which may be explained by microhabitat conditions and broad-scale zoogeographic influences within the local community. We conclude that community-level phenotypic variations in small mammals result from complex influences, including climate, productivity, habitat characteristics, and adaptive strategies operating at both micro and macro scales. Full article

The epithelial egg tooth is used by birds to open the eggshell for hatching. This ectodermal structure consists of a multilayered periderm and a hard cornified portion, the caruncle or actual egg tooth. Here, we determined the protein composition of the egg tooth of the chicken and compared the proteins to markers of other epithelia identified in previous studies. The egg tooth and the upper beak of chicken embryos of Hamburger and Hamilton (HH) stage 44 were subjected to mass spectrometry-based proteomics. We found that scaffoldin, a marker of the embryonic periderm and the feather sheath, was enriched in the egg tooth relative to the beak. Likewise, Epidermal Differentiation protein containing DPCC Motifs (EDDM) and Epidermal Differentiation protein starting with a MTF motif and rich in Histidine (EDMTFH), which had previously been characterized as markers of the subperiderm on embryonic scutate scales and the barbs of feathers, were also enriched in the egg tooth. The expression of EDDM and EDMTFH was confirmed RT-PCR analysis. Our data suggest that the epithelial egg tooth is related to the subperiderm and feathers, a hypothesis with potentially important implications for the evolution of the avian integument. Full article

Recent developments in machine learning have enabled prediction models that estimate not only hydrodynamic force coefficients but also full CFD fields. Unlike conventional surrogate models that focus primarily on integrated quantities, such approaches can provide real-time predictions of pressure and wall shear stress distributions, making them highly promising for applications in ship hydrodynamic design where detailed surface flow characteristics are essential. In this study, we address the low prediction accuracy observed near protruding appendages in U-Net-based field prediction models by introducing a positional encoding (PE)-enhanced data processing scheme and evaluating its performance across a dataset of 500 SUBOFF variants. While PE enhances prediction accuracy, especially for the sail, its effectiveness is constrained by the boundary discontinuity introduced at the 12 o’clock seam. To resolve this structural limitation and ensure consistent accuracy across components, the projection seam is relocated to the 6 o’clock position, where high-gradient flow features are less concentrated. This modification produces clear quantitative gains: the drag-integrated MAPE decreases from 3.61% to 1.85%, and the mean field-level errors of $∆{\mathrm{C}}_{\mathrm{p}}$ and $∆{\mathrm{C}}_{\mathrm{f}}$ are reduced by approximately 5.6% across the dataset. These results demonstrate that combining PE with seam relocation substantially enhances the model’s ability to reconstruct fine-scale flow features, improving the overall robustness and physical reliability of U-Net-based surface field prediction for submarine hull forms. Full article

We report the case of a 53-year-old male patient who presented to the cardiology department with presyncope and atypical chest pain. The transthoracic echocardiography revealed a homogeneous hypoechoic mass measuring 2.5 × 5.7 cm at the level of the anterolateral wall of the right ventricle. In order to further characterize the identified right-ventricle-adjacent mass, we performed a cardiac computed tomography, which confirmed the presence of a homogeneous hypodense mass with a single wall, without septation. Cardiac magnetic resonance imaging demonstrated a serous fluid mass capping the right atrium, right atrial appendage, and coronary sinus, without evidence of myocardial invasion. The multimodality imaging performed clarified the diagnosis of an uncomplicated pericardial cyst. The patient was managed conservatively with every 6 months echocardiographic evaluation. At a 2-year follow-up, he presented no recurrent symptoms, and the pericardial cyst maintained the same characteristics. The cornerstone of this case report was relying on multimodality imaging in order to characterize the adjacent cardiac mass and to arrive at the diagnosis of an uncomplicated pericardial cyst, which established the prognosis and management of the patient. Full article

Apis cerana is an important native honey bee species in China, and its body size is closely related to its production performance and environmental adaptability. Prpk (TP53-regulating kinase) has been confirmed to regulate cell growth and proliferation, thereby influencing body size development. However, its function in honey bees remains unclear. In this study, the protein structure and function of PRPK were analyzed, and the expression characteristics were examined at different developmental stages and tissues in Hainan Chinese honey bee and Aba Chinese honey bee. The molecular weight of this protein was 30.3 kDa, and the predicted isoelectric point was 9.13, and it had a conserved PKc_like superfamily domain. The sequence of PRPK was highly conserved from insects to mammals and fungi. The results of RT-qPCR showed that Prpk expression significantly increased during honey bee pupation, and its expression level was significantly higher in the larvae and early-stage pupae of the larger-bodied Aba Chinese honey bee. Additionally, Prpk exhibited the highest expression in the thoraces, suggesting its potential involvement in appendage development. This study indicated that Prpk may play a potential regulatory role in body size development in honey bees, providing a theoretical basis and candidate gene for elucidating the molecular mechanisms of body size formation and genetic improvement in honey bees. Full article

Background: Left atrial appendage (LAA) closure is an alternative to oral anticoagulants (OAC) for stroke prevention in atrial fibrillation (AF), but comparative evidence remains inconsistent. This study systematically evaluates the efficacy and safety of LAA closure versus OAC in AF patients. Methods: We systematically searched PubMed, EmBase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) and propensity score-matched (PSM) studies published up to 30 September 2025. Treatment effects were estimated using relative risks (RR) with 95% confidence intervals (CI), and a random-effects model was applied for all analyses. Results: Fifteen studies (17,116 AF patients) were included, comprising 4 RCTs, 3 prospective PSM studies, and 8 retrospective PSM studies. Compared with OAC, LAA closure significantly reduced the composite endpoint (RR: 0.79; 95% CI: 0.66–0.95; p = 0.010), all-cause mortality (RR: 0.58; 95% CI: 0.49–0.69; p < 0.001), and cardiovascular mortality (RR: 0.55; 95% CI: 0.44–0.67; p < 0.001). Risks of any stroke (RR: 1.06; 95% CI: 0.86–1.31; p = 0.555), ischemic stroke (RR: 1.00; 95% CI: 0.85–1.17; p = 0.972), hemorrhagic stroke (RR: 0.96; 95% CI: 0.54–1.70; p = 0.879), and major bleeding (RR: 0.84; 95% CI: 0.67–1.04; p = 0.112) were not significantly different between groups. Conclusions: In AF patients, LAA closure significantly reduces mortality and a composite clinical endpoint compared to OAC, with similar risks of stroke and major bleeding. It is a favorable alternative for patients unsuitable for long-term anticoagulation. Full article

(1) Background: Whether anticoagulation can be resumed in atrial fibrillation (AF) combined with intracranial hemorrhage (ICH), and which anticoagulation modality is used with better efficacy and safety, is unknown. (2) Method: Randomized controlled trials (RCTs) and observational studies on relevant topics were included by searching five databases: PubMed, EMBASE, EBSCO, Cochrane Central Register of Controlled Trial and ClinicalTrials. Bayesian network meta-analysis was performed to analyze the effect of oral anticoagulant (OAC), new oral anticoagulant (NOAC), warfarin, antiplatelet, left atrial appendage occlusion (LAAO) and no therapy in patients with AF after intracranial hemorrhage. (3) Results: We included 16 studies involving 25,483 patients. Compared with no antithrombotic therapy, the risk of thromboembolism and all-cause mortality were both reduced with OAC (OR: 0.38, 95% CI: 0.21–0.67; OR: 0.45, 95% CI: 0.25–0.8) and LAAO (OR: 0.11, 95% CI: 0.01–0.76; OR: 0.11, 95% CI: 0.01–0.88), and there was no increased risk of recurrent intracranial hemorrhage. Regarding thromboembolism, OAC (OR: 0.28, 95% CI: 0.11–0.69) was superior to antiplatelet therapy, and antiplatelet therapy (OR: 12.59, 95% CI: 1.57–133.50) was associated with a higher risk of thromboembolism than LAAO. There were no significant differences in recurrent intracranial hemorrhage between the interventions. LAAO appeared to be the best option for reducing thromboembolism (SUCRA: 0.96), recurrent intracranial hemorrhage (SUCRA: 0.75) and all-cause mortality (SUCRA: 0.94). (4) Conclusions: Based on this network meta-analysis, we hypothesize that LAAO has the highest likelihood of reducing the risk of thromboembolism and recurrent intracranial hemorrhage, as well as all-cause mortality in patients with AF after intracranial hemorrhage, followed by OAC. Full article

Background/Objectives: Surgical ablation for atrial fibrillation (AF) during cardiac surgery decreases perioperative morbidity and mortality and improves long-term patient outcomes. Because of these benefits, it has been designated a Class I surgical society recommendation. As surgical ablation techniques have evolved, so too have ablation tools such as radiofrequency and cryothermal devices. In this study, we evaluated real-world evidence (RWE) of concomitant surgical ablation featuring an epicardial left atrial encircling lesion created by a novel bipolar radiofrequency clamp. Methods: Thirteen centers in the observational Tracking Results of Ablation to Combat AF (TRAC-AF) Registry (NCT05111015) contributed data used in this analysis. Included patients had AF and received the epicardial encircling lesion during cardiac surgery. Additional ablation and follow-up were per institutional standard of care. Freedom from AF/atrial tachycardia (AT)/atrial flutter (AFL) and survival were evaluated using the Kaplan–Meier method. Safety was evaluated within 30 days of the procedure. Results: Among 327 patients, 70% were male with a median age of 69 years. Sixty-nine percent had paroxysmal AF. Median left atrial diameter was 4.1 cm, and CHA₂DS₂-VASc score was 3. Isolated coronary artery bypass graft and aortic valve surgery were performed in 51% and 11% of patients, respectively. One- and two-year survival rates were 95.3% (95% CI, 91.7–97.3%) and 88.1% (95% CI, 81.5–92.5%). Through 12- and 24-months freedom from AF/AT/AFL was 87.4% (95% CI, 81.3–91.6%) and 79.9% (95% CI 72.0–85.8%). Mortality within 30 days of the index procedure was 1.5%. No serious adverse events were related to the epicardial cardiac ablation procedure or device. Conclusions: RWE from the TRAC-AF Registry demonstrates surgical ablation including an epicardial left atrial encircling lesion made by a novel bipolar RF clamp was safe and resulted in favorable long-term rhythm outcomes. Full article

The rate of appressoria formation following conidial germination in Beauveria bassiana is closely associated with its pathogenicity. This study investigated the effects of insect cuticular compounds on the formation and metabolism in B. bassiana through the addition of insect cuticle analogues. Results indicate that both the fatty acid compound carnitine C3:0 and the organic acid compound Thiamine Pyrophosphate (TPP) exert dose-dependent bell-shaped effects on B. bassiana spore germination and appressorium formation at different concentrations. Both low and high concentrations inhibit spore germination and appendage formation. At a concentration of 0.10 mg/mL, spore germination and appendage formation rates peaked at all time points, being significantly higher than the control (p ≤ 0.05). Compounds in the benzene and its derivatives class, such as enilconazole and disulfide bis(2-hydroxy-3-methylpropan-2-yl) (DSBA), significantly reduced spore germination and appressorium formation in B. bassiana (p ≤ 0.05), with stronger inhibition becoming more pronounced at higher concentrations. In contrast, amino acids and their metabolites (e.g., glycylmethionine) and glycerophospholipid compounds like 1,2-Dioleoyl-sn-Glycero-3-Phosphocholine (DOPC) had no significant effects on spore germination or appressorium formation at any tested concentration (p > 0.05). LC-MS analysis revealed that the insect cuticular fatty acyl compound carnitine C3:0 broadly modulated the secondary metabolism of B. bassiana. Following appressorium formation, 146 metabolites with significant changes in abundance were identified. Before appressorium formation, carnitine C3:0 promoted the activation of B. bassiana signaling pathways, such as Rap1, and stimulated antibiotic biosynthesis (penicillin and cephalosporin), thereby suppressing competing microorganisms and facilitating initial attachment. After appressorium formation, carnitine C3:0 activated pathways related to metabolite synthesis (e.g., arginine and nucleotides biosynthesis) and population regulation (ferroptosis), thereby enhancing appressorium function and structural stability. Thus, carnitine C3:0 enhances B. bassiana’s ability to establish infection sites before appressorium formation through antibiotic clearance and signal activation, and maintain infection structures after formation via metabolic reinforcement and population regulation. This study lays a theoretical foundation for further investigations into B. bassiana infection mechanisms, pathogenicity, and the role of its conidiophores. Full article