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Acute gastrointestinal (GI) bleeding is not an uncommon complication of oral anticoagulation (OAC) therapy that requires medication cessation. However, drug cessation may cause fatal stroke or systemic embolization in patients at high thromboembolic risk. Here we sought to find an appropriate anticoagulation cessation strategy in cases of GI bleeding during OAC therapy. This single-center retrospective cohort analysis was performed between 2010 and 2018. Patients were enrolled if the following three consecutive conditions were met: 1) electrocardiography electrocardiography-proven atrial fibrillation; 2) OAC therapy; and 3) GI bleeding. We divided the drug cessation strategy into the continuation and discontinuation groups. During 1-year follow-up, the rates of major thromboembolic and rebleeding events were calculated. One hundred and forty-six patients (continuation [n = 54] vs. discontinuation [n = 92] group) were enrolled. Patients in the discontinuation group were more likely to be older (69.8 ± 9.0 yrs vs. 74.9 ± 8.9 yrs, p = 0.001), while patients in the continuation group were more likely to have undergone cardiac valve surgery (51.9% vs. 20.7%, p<0.001). The presence of a mechanical mitral valve was a determinant of continuation strategy (38.9% vs. 7.5%, p<0.001). However, the mean CHA₂DS₂-VASc (3.4±1.3 vs. 4.1±1.6, p = 0.010) and Glasgow-Blatchford (8.0±2.4 vs. 8.9±2.5, p = 0.037) scores were higher in the discontinuation group. Two major embolic strokes occurred in each group (3.7% vs. 2.2%, p = 0.585). Four of 54 (7.4%) and five of 92 (5.4%) patients had rebleeding events during follow-up (p = 0.632). One embolic event in the continuation group and one rebleeding event in the discontinuation group were fatal. The Glasgow-Blatchford score was a predictor of 1-year rebleeding events (odds ratio [OR], 1.36; 95% confidence interval [CI], 0.68-2.20; p = 0.028). The high CHA₂DS₂-VASc score showed a strong trend (OR, 1.71; 95% CI, 0.92-3.20; p = 0.089) in 1-year thromboembolic events. No single risk factor or drug cessation strategy was attributed to adverse clinical events after GI bleeding. The risk of future thrombotic or rebleeding events should be individualized and controlled for based on a pre-existing stratification system.

This study focuses on improving the efficiency of interior permanent magnet synchronous motors (IPMSMs) for electric vehicle (EV) compressors. Seven rotor topologies (B, dB, V, dV, D, U, and UV) were first compared, among which the U-type rotor demonstrated the highest efficiency and the lowest total loss. Subsequently, the influence of the turn number and rotor outer diameter (ROD) on the shift of the high-efficiency region was analyzed, and six key design variables were identified through Pearson correlation-based sensitivity analysis. Using these variables, a multi-objective optimization was performed in Ansys OptiSLang, which improved the integrated part load value (IPLV)-weighted efficiency from 91.05% to 92.29% and shifted the high-efficiency region closer to the main operating point. Experimental validation of the reference model confirmed the reliability of the FEM analysis, and the proposed optimal design is expected to enhance low-speed efficiency and reduce battery energy consumption in EV compressor applications.

Herein, a new ternary strategy to fabricate efficient and photostable inverted organic photovoltaics (OPVs) is introduced by combining a bulk heterojunction (BHJ) blend and a fullerene self‐assembled monolayer (C60‐SAM). Time‐of‐flight secondary‐ion mass spectrometry ‐ analysis reveals that the ternary blend is vertically phase separated with the C60‐SAM at the bottom and the BHJ on top. The average power conversion efficiency ‐ of OPVs based on the ternary system is improved from 14.9% to 15.6% by C60‐SAM addition, mostly due to increased current density (Jsc) and fill factor ‐. It is found that the C60‐SAM encourages the BHJ to make more face‐on molecular orientation because grazing incidence wide‐angle X‐ray scattering ‐ data show an increased face‐on/edge‐on orientation ratio in the ternary blend. Light‐intensity dependent Jsc data and charge carrier lifetime analysis indicate suppressed bimolecular recombination and a longer charge carrier lifetime in the ternary system, resulting in the enhancement of OPV performance. Moreover, it is demonstrated that device photostability in the ternary blend is enhanced due to the vertically self‐assembled C60‐SAM that successfully passivates the ZnO surface and protects BHJ layer from the UV‐induced photocatalytic reactions of the ZnO. These results suggest a new perspective to improve both performance and photostability of OPVs using a facial ternary method. A new ternary system is introduced that can form a vertically self‐assembled passivation layer on the interface between photoactive layer and ZnO layer in n‐i‐p device architecture. This system not only improves photostability against UV light but also increases in Jsc and fill factor ‐ by encouraging to make a favorable molecular orientation of photoactive materials from edge‐on to face‐on orientation.

Despite advances in gastric cancer diagnosis and treatment, its prognosis remains poor owing to aggressive tumor progression and metastasis. As understanding the relevant molecular mechanisms is essential to effectively improve patient outcomes, we elucidated the role of Kindlin-1 in gastric cancer progression and metastasis. Kindlin-1 expression was analyzed in 359 gastric cancer tissue samples provided by Kangnam Sacred Heart Hospital and publicly available GSE datasets. Kindlin-1 showed significantly higher expression in gastric cancer tissues than that in normal tissues, and high Kindlin-1 expression was associated with poor prognosis. Further, the mRNA and protein expression of Kindlin-1 were high in gastric cancer cell lines, where they were associated with increased proliferation, migration, and invasion. Our findings demonstrated that Kindlin-1 regulated epithelial–mesenchymal transition-related genes through interaction with activated Wnt/β-catenin signaling. Notably, Kindlin-1 enhanced β-catenin expression and promoted its nuclear translocation from the cytoplasm, increasing TCF4 transcriptional activity and inducing gastric cancer progression and metastasis. Overall, these findings demonstrate that Kindlin-1 is upregulated in gastric cancer and activates Wnt/β-catenin signaling to promote cell proliferation and motility.

An inflammatory reaction caused by the activation of microglia in the brain can lead to neurodegeneration and cause diseases, such as Alzheimer's and Parkinson's disease. The regulation of inflammation can aid in preventing the development of neurodegenerative disease. Malonic acid has a variety of biological activity. The effects of malonic acid on microglia are not currently well known. Therefore, in this study, we investigate the effects of inflammation of malonic acid in BV2 microglia cells. As a result, we demonstrated that malonic acid on LPS-treated microglia decreased pro-inflammatory responses and mechanisms of the p38 MAPK/NF-κB pathway. Inflammatory mediators significantly decreased the LPS-induced production of nitric oxide and reactive oxygen species. Pro-inflammatory cytokines of IL-6 suppressed gene expression. In addition, the protein expression of NF-κB decreased at the nucleus, as did the protein expression of activated phosphorylated IκB-α, which is an NF-κB regulator-related protein. The expression of phosphorylated p38, a mediator of inflammatory cytokines, was regulated. Therefore, our results indicate that malonic acid has anti-inflammatory effects and may be a potential therapeutic candidate for neuroinflammatory diseases.

Elevated serum transaminase or alkaline phosphatase (ALP) has been proposed as a novel prognosticator for ST-segment elevation myocardial infarction (STEMI). We evaluated the combined prognostic impact of elevated serum transaminases and ALP on admission in STEMI patients who underwent primary percutaneous coronary intervention (PCI). A total of 1176 patients with STEMI undergoing primary PCI were retrospectively enrolled from the INTERSTELLAR registry. Hypoxic liver injury (HLI) was defined as serum transaminase > twice the upper limit of normal. The cut-off value of high ALP was set at the median level (73 IU/L). Patients were divided into four groups according to their serum transaminase and ALP levels. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. Median follow-up duration was 25 months (interquartile range, 10-39 months). The rate of MACCE was highest in patients with HLI (+) and high ALP (25.9%), compared to those in the other groups (8.2% in HLI [-] and low ALP, 11.8% in HLI [-] and high ALP, and 15.0% in HLI [+] and low ALP). Each of HLI or high ALP was an independent predictor for MACCE (HR 1.807, 95% CI 1.191-2.741; HR 1.721, 95% CI 1.179-2.512, respectively). Combined HLI and high ALP was associated with the worst prognosis (HR 3.145, 95% CI 1.794-5.514). Combined HLI and high ALP on admission is associated with poor clinical outcomes in patients with STEMI who have undergone primary PCI.

Serum alkaline phosphatase (ALP) has been shown to be a prognostic factor in several subgroups of patients due to its promotion of vascular calcification. However, the prognostic impact of serum ALP level in ST-segment elevation myocardial infarction (STEMI) patients with a relatively low calcification burden has not been determined. We aimed to investigate the association of ALP level measured at time of presentation on clinical outcomes in patients with STEMI requiring primary percutaneous coronary intervention (PCI). A total of 1178 patients with STEMI undergoing primary PCI between 2007 and 2014 were retrospectively enrolled from the INTERSTELLAR registry and classified into tertiles by ALP level (<64, 65-82, or >83 IU/L). The primary study outcome was a major adverse cardiac or cerebrovascular event (MACCE), defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia-driven revascularization. Median follow-up duration was 25 months (interquartile range, 10-39 months). The incidence of MACCE significantly increased as ALP level increased, that is, for the <64, 65-82, and >83 IU/L tertiles incidences were 8.7%, 11.7%, and 15.7%, respectively; p for trend = 0.003). After adjustment for potential confounders, the adjusted hazard ratios for MACCE in the middle and highest tertiles were 1.69 (95% CI 1.01-2.81) and 2.46 (95% CI 1.48-4.09), respectively, as compared with the lowest ALP tertile. Elevated ALP level at presentation, but within the higher limit of normal, was found to be independently associated with higher risk of MACCE after primary PCI in patients with STEMI.

Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by chronic, complement-mediated hemolysis, frequently leading to debilitating clinical symptoms and life-threatening complications such as thromboembolism (TE). A retrospective analysis was performed on 301 patients from the South Korean National PNH Registry to describe disease burden and identify TE-associated risk factors. TE was identified in 18 % of patients and was associated with increased risk for mortality [odds ratio (OR), 6.85; P  < 0.001]. A multivariate analysis showed that PNH patients with elevated hemolysis [lactate dehydrogenase (LDH) levels ≥1.5 times the upper limit of normal (ULN)] at diagnosis were at significantly higher risk for TE than patients with LDH <1.5 × ULN (OR 7.0; P  = 0.013). The combination of LDH ≥1.5 × ULN with the clinical symptoms of abdominal pain, chest pain, dyspnea, or hemoglobinuria was associated with a greater increased risk for TE than elevated hemolysis or clinical symptoms alone. Continuous monitoring of these risk factors is critical for identifying PNH patients at risk for morbidities and mortality and allowing early intervention. (clinicaltrials.gov identifier: NCT01224483).

Citation metrics and h indices differ using different bibliometric databases. We compiled the number of publications, number of citations, h index and year since the first publication from 340 soil researchers from all over the world. On average, Google Scholar has the highest h index, number of publications and citations per researcher, and the Web of Science the lowest. The number of papers in Google Scholar is on average 2.3 times higher and the number of citations is 1.9 times higher compared to the data in the Web of Science. Scopus metrics are slightly higher than that of the Web of Science. The h index in Google Scholar is on average 1.4 times larger than Web of Science, and the h index in Scopus is on average 1.1 times larger than Web of Science. Over time, the metrics increase in all three databases but fastest in Google Scholar. The h index of an individual soil scientist is about 0.7 times the number of years since his/her first publication. There is a large difference between the number of citations, number of publications and the h index using the three databases. From this analysis it can be concluded that the choice of the database affects widely-used citation and evaluation metrics but that bibliometric transfer functions exist to relate the metrics from these three databases. We also investigated the relationship between journal's impact factor and Google Scholar's h5-index. The h5-index is a better measure of a journal's citation than the 2 or 5 year window impact factor.

This study presents an analysis of the electromagnetic noise and vibration in a surface-mounted permanent magnet synchronous machine (SPMSM), focusing on their excitation sources. To investigate this, the excitation sources were identified through an analytical approach, and their effects on electromagnetic noise and vibration were evaluated using a finite element method (FEM)-based analysis approach. Additionally, an equivalent curved-beam model based on three-dimensional shell theory was applied to determine the deflection forces on the stator yoke, accounting for the tooth-modulation effect. The stator’s natural frequencies were derived through the characteristic equation in free vibration analysis. Modal analysis was performed to validate the analytically derived natural frequencies and to investigate stator deformation under the tooth-modulation effect across various vibration modes. Furthermore, noise, vibration, and harshness (NVH) analysis via FEM reveals that major harmonic components align closely with the natural frequencies, identifying them as primary sources of elevated vibrations. A comparative study between 8-pole–9-slot and 8-pole–12-slot SPMSMs highlights the impact of force variations on the stator teeth in relation to vibration and noise characteristics, with FEM verification. The proposed method provides a valuable tool for early-stage motor design, enabling the rapid identification of resonance operating points that may induce severe vibrations. This facilitates proactive mitigation strategies to enhance motor performance and reliability.