Sudden cardiac death (SCD) still accounts for the majority of deaths from the four major cardiovascular events (myocardial infarction (MI), heart failure (HF), atrial fibrillation (AF), and stroke) ...despite substantial progress on prevention.
Four separate cohorts (one for each of the four major cardiovascular conditions) were captured through person-linked hospital morbidity and mortality data collections between 2000 and 2009 and followed-up for 11.5 years. The incidence rate for each cohort was total SCD cases divided by sum of follow-up time for each individual alive. Kaplan–Meier survival curve was used to calculate unadjusted risk of SCD. Predictors of SCD were identified by fitting multivariable adjusted Cox regression models in each of the cohorts.
There were 1,174 cases of SCD from 53,614 total CVD events across the cohorts (35.6% for MI, 15.6% for HF, 22.4% for AF, 26.4% for stroke). The incidence rate and unadjusted risk of SCD were both highest after incident hospitalisation for HF, followed by MI, stroke and AF. The elevated risk of SCD was independently associated with MI, HF, arrhythmias, peripheral artery disease, diabetes, chronic kidney disease, and prior coronary heart disease (hazard ratios ranging from 1.1 to 2.8). Early revascularisation is protective in 28-day survivors after an incident MI event.
An appreciable incidence of SCD following an incident event of MI, HF, AF and stroke deserves greater prevention efforts. Major medical conditions such as MI, HF, peripheral artery disease, and arrhythmias are risk markers of SCD and coronary revascularisation is protective.
•Deflection of the hourglass lattice panel is 60% less than that of the solid plate.•The hourglass lattice has higher face tearing resistance than the pyramidal one.•Front-face deflections of ...hourglass panels are 22%−38% less than pyramidal ones.
In this paper the enhanced lattice topology (defined as hourglass), with the improved resistance to tearing of face sheets, is used to improve the underwater blast impact performance of lattice truss structures. The stainless-steel lattices are fabricated by an interlocking and vacuum brazing method, all with a core relative density of about 4%. Their mechanical behaviors are investigated under quasi-static out-of-plane compression and underwater blast impact, in the latter case using an underwater shock simulator. Results show that the quasi-static compressive strength of the hourglass lattice is similar to that of the pyramidal lattice for the relative density chosen in this paper. The failure modes of the hourglass lattice panels subjected to underwater blast impact consist of core truss buckling, node imprinting and stretching of the front face sheets. The obtained results confirm that the hourglass lattice sandwich panel shows an approximately 60% reduction in the maximum panel deflection with respect to a monolithic plate of equal mass per unit area. Furthermore, the underwater blast impact performance of the hourglass lattice panels outperforms that of the pyramidal lattice panels of equal weight per unit area in the sense of resistance to stretching and tearing of the face sheets. Therefore, sandwich structure with the hourglass lattice design is a potential candidate for protective structures.
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To design heap biooxidation process, it is necessary to understand its internal rules. The heap biooxidation of gold ore from Anhui province was researched in this study. The results showed that the ...main microorganisms in the heap were
A. ferrooxidans
,
F. acidiphilum
and
L. ferrodiazotrophum
. Under their combined action, gold leaching extent rose from 35.62% to 78.08% in 80 d. Boltzmann model matches the actual oxidation effect better and the model equations were obtained. The model predicted that the oxidation extents of arsenic and sulfur are 58.577% and 42.122% after one year, and the gold leaching extent was 80.40%. The arsenic and sulfur oxidation extents, and gold leaching extent were all linearly correlated. It is more reliable to predict gold leaching extent by sulfur oxidation extent. These results provided good guidance for practical application in the actual production.
Five-year ovarian cancer survival rates are below 50%; there is considerable interest in whether common medications like statins may improve survival.
We identified women diagnosed with ovarian ...cancer in Australia from 2003 to 2013 through the Australian Cancer Database and linked these records to national medication and death databases. We used Cox proportional hazards regression to estimate hazard ratios (HR) and confidence intervals (CI) for associations between statins and survival.
Pre-diagnosis statin use was not associated with survival overall but was associated with better survival among women with endometrioid cancers. Statin use after diagnosis was associated with better ovarian cancer-specific survival (OVS, HR = 0.87, 95%CI 0.81-0.94), but this association was largely restricted to women who started using statins after their cancer diagnosis (OVS HR = 0.68, 0.57-0.81 vs. HR = 0.94, 0.87-1.01 for continuing users). The association was strongest for endometrioid cancers (OVS HR = 0.48, 0.29-0.77).
Use of statins may confer a survival benefit for women with ovarian cancer but it is impossible to rule out bias in observational studies. Particularly problematic are reverse causation where disease status affects statin use, confounding by indication and the absence of data for women with normal cholesterol levels. A randomised trial is required to provide definitive evidence.
Exploring lightweight sandwich structures with excellent load-bearing and vibration damping performances is one of the important topics in structural and functional applications. The aim of the ...present work is to design, fabricate novel metallic sandwich structures with Hourglass truss cores and investigate their modal characteristics and vibration isolation performances by comparing with the traditional pyramidal sandwich structure experimentally and numerically. It is shown that the natural frequencies of the Hourglass sandwich structures are much higher than that of the pyramidal sandwich structures under free-free boundary condition and equal relative density of the truss cores. The torsional modes and transverse bending modes of the Hourglass sandwich structures separately play a dominant role in lower and higher modes of vibration, which are opposite to the pyramidal sandwich structures. From the results of the acceleration frequency responses and vibration level difference (VLD), it is indicated that the Hourglass sandwich structures exhibit better vibration isolation performance than the pyramidal sandwich structures. Furthermore, experimentally validated finite element analysis (FEA) models are developed to study the influences of truss inclination angles and boundary conditions on the modal characteristics of the present sandwich structures. Some conclusions are summarized, which may be useful for understanding the vibration behavior of such kinds of lattice sandwich structures.
•Metallic Hourglass and pyramidal sandwich panels are fabricated.•Modal tests are conducted to investigate the vibration behaviors of metallic Hourglass and pyramidal sandwich panels.•The influences of truss inclination angle and boundary condition on the modal properties of sandwich panels are discussed.•The natural frequencies of Hourglass sandwich panels are much higher than that of pyramidal sandwich panels.•The Hourglass sandwich panels generally have better vibration isolation performance than the pyramidal sandwich panels.
This paper focuses on strengthening carbon fiber hierarchical composite square honeycomb structures (HCSH) by selecting high-modulus hierarchical phase and optimizing its thickness. HCSH have been ...manufactured from carbon fiber composite foam sandwich structures by a simple snap-fit and bonding method. The measured compressive and shear strengths are shown to be well predicted by micromechanics failure models of HCSH. Compared to the monolithic composite square honeycomb structures (CSH), the measured specific out-of-plane compressive strength of HCSH improves to approximately 330% and the specific shear strength improves to about 180%. Furthermore, the relationships between hierarchical phase modulus and its optimum thickness are developed to design the optimum HCSH. Carbon fiber HCSH are found to exhibit better mechanical properties than other cellular structures, and thus provide new opportunities for light-weight multifunctional sandwich structures.
Topological-reinforcement and material-strengthening were used and employed to improve the mechanical properties of lattice truss sandwich structures. This new type of three-dimensional aluminum ...alloy lattice truss (named enhanced lattice truss) sandwich structure, with a relative density ranging from 1.7% to 4.7%, was designed and fabricated by interlocking and vacuum-brazing method. The out-of-plane compression and shear properties of the enhanced lattice truss sandwich structures (both as-brazed and age-hardened cores) were experimentally and analytically investigated. Good correlations between analytical predictions and experiment results were achieved. Experimental results showed that the mechanical properties of the enhanced lattice truss cores were sensitive to the unit-cell size and parent-alloy properties (i.e. inelastic buckling and tangential modulus). The compressive and shear characteristics of enhanced lattice truss sandwich structures were discussed and found superior to competing lattice truss structures in low density area (0.046–0.124 g/cm3) of material property charts. The combination of topological-reinforcement and material-strengthening provided a way to achieve lightweight sandwich structures with high specific strengths and low densities.
CKLF-like MARVEL transmembrane domain-containing 6 (CMTM6), a regulator of programmed cell death ligand 1 (PD-L1), has attracted extensive attention due to its role in tumors. However, research on ...the expression of CMTM6 in colorectal cancer (CRC) and its relationship with PD-L1 expression and immune cell infiltration is limited. We used The Cancer Genome Atlas database to mine and analyze data from patients with CRC using bioinformatics methods. We investigated the expression of CMTM6 in CRC and its relationship with PD-L1 expression and immune cell infiltration. Immunohistochemistry and PCR were performed to detect CMTM6 and PD-L1 expression in CRC tissues. Differential gene expression analysis was performed using the edgeR package in R and immune cell infiltration analysis was performed using the ssGSEA algorithm. Additionally, GO and KEGG enrichment analyses were conducted to identify the biological processes and pathways associated with low CMTM6 expression. Our study found that CMTM6 expression was significantly upregulated in CRC tissues compared to that in adjacent normal tissues. Patients with high CMTM6 expression exhibited significantly increased levels of PD-L1 expression and higher levels of tumor-infiltrating immune cells compared to patients with low CMTM6 expression. GO and KEGG analyses suggested that CMTM6 may be involved in multiple immune regulatory pathways in CRC.
A recent paper suggested all women with endometrial cancer should take statins but it is unclear whether there is sufficient evidence to justify this recommendation.
We identified all women diagnosed ...with uterine cancer in Australia between July 2003 and December 2013 (2012 in New South Wales) through the Australian Cancer Database (N = 16,501) and linked these to the national prescription database and National Death Index to identify statin use and survival outcomes to December 2015. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between statin use and survival.
Among the 15,703 women with endometrial cancer, pre-diagnosis statin use was not associated with survival. Endometrial cancer-specific mortality was lower among women who used statins after diagnosis (time-varying models: HR = 0.92; 95%CI 0.82–1.03) but the association was only seen among women with type 1 cancers (0.87; 0.76–1.00), for hydrophilic statins (0.84; 0.68–1.03) and for new use of statins after diagnosis (0.75; 0.59–0.95). There was a weak dose-response with increasing number of statin prescriptions. Sensitivity analyses using inverse probability of treatment weights were similar.
Women with endometrial cancer who take statins after diagnosis may have better survival than those who do not use statins. However, it is impossible to completely rule out bias, particularly reverse causation where disease status may affect statin use. We believe it is too early to recommend all women with endometrial cancer take statins, but there is sufficient evidence to justify a randomized trial.
•This national data-linkage study confirms a potential survival benefit for use of statins by women with endometrial cancer.•However, it is impossible to eliminate all bias, particularly reverse causation where disease status may affect statin use.•It is too early to recommend all women with endometrial cancer take statins, but a randomized trial is justified.
The effect of the face thickness to core height ratio on different multi-layer pyramidal core sandwich columns under in-plane compression is investigated theoretically and numerically. Numerical ...simulation is in good agreement with theory. Results indicate that one specified face thickness to core height ratio corresponds to one optimum layer number of multi-layer pyramidal core sandwich columns in consideration of engineering application. This result can guide the sandwich structure design.
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