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The discrete element computer simulation method is an effective tool that enables the study of the interaction mechanism between the pulping components and the paddy soil during the paddy field pulping process. The findings are valuable in optimizing the parameters of the paddy beating device to improve its working quality and efficiency. However, the lack of accurate soil models for paddy soil has limited the application and development of the discrete element method in paddy pulping research. This study selected the Hertz-Mindlin with Johnson-Kendall-Roberts discrete element model for the pre-pulping paddy loam soil and used the slump error as the test index to select nine parameters, including soil Poisson’s ratio and surface energy, as test factors to calibrate the model parameters. The Plackett-Burman test identified soil shear modulus, surface energy, and soil-iron plate static friction coefficient as significant factors affecting the test index. The steepest ascent test results determined the test range of the above parameters. The Box-Behnken test obtained the regression model between the significant factors and the test index, and the regression model was optimized using the slump error as the target. The optimal combination of parameters was surface energy of 3.257 J/m 2 , soil shear modulus of 0.709 MPa, and static friction coefficient between soil and iron plate of 0.701. The slump simulation test using this combination of parameters yielded an average slump error of 2.04%. The collective results indicate the accuracy of the calibrated discrete element simulation parameters for paddy loam soil. These parameters can be used for discrete element simulation analysis of the paddy pulping process after paddy field soaking.

Introduction In clinical practice, the dose of bivalirudin may not be fully applicable to the Chinese population. Therefore, this study aimed to explore the efficacy and safety of a reduced dose (80% of the recommended dose) of bivalirudin without post-procedure infusion for 3–4 h in patients with acute coronary syndrome (ACS) undergoing elective percutaneous coronary intervention (PCI). Methods This was a single-center, retrospective study. Patients who met the inclusion criteria and no exclusion criteria were divided into reduced-dose and recommended-dose groups for analysis. Confounders were corrected using propensity score matching. The incidence of net adverse clinical events (NACE), major adverse cardiovascular events (MACE), and Bleeding Academic Research Consortium (BARC) type 2–5 bleeding events were observed 30 days postoperatively. Results In total, 1,590 patients (795 per group) were obtained after propensity score matching. The results after propensity score matching were as follows: The activated clotting time (ACT) after 5 min in the reduced-dose group was 349.37 ± 47.59 s, which was statistically lower than that in the recommended-dose group, 353.12 ± 44.98 s ( P  = 0.024). There was no significant difference in the proportion of ACT values of ≥ 250 s after 5 min between the two groups ( P  > 0.05). There were no significant differences in NACE, MACE, and BARC type 2–5 bleeding events between the two groups (5.0% vs. 4.5%, P  = 0.638; 0.0% vs. 0.1%, P  = 1.000; 0.3% vs. 0.5%, P  = 0.687). There were no statistically significant differences in cumulative NACE and cumulative bleeding events between the two groups at 30 days ( P  = 0.635 and P  = 0.716, respectively). Conclusion In patients with UA and NSTEMI undergoing elective PCI, 80% of the recommended dose of bivalirudin without post-procedure infusion can be used for anticoagulation without increasing the risk of thrombosis and bleeding.

Background Dual antiplatelet therapy (DAPT) with aspirin and a P2Y 12 inhibitor is recommended for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) to antithrombosis, meanwhile, increasing the risks of gastrointestinal bleeding. Rivaroxaban, a novel oral anticoagulant, combined with a P2Y 12 receptor inhibitor reduces adverse events in patients with CHD and atrial fibrillation who underwent PCI. The effect of rivaroxaban plus P2Y 12 inhibitor on reducing bleeding events in patients with CHD and gastrointestinal disease (GID) undergoing PCI remains unclear. Method The study is a prospective, single-center, randomized controlled trial. A total of 1020 patients with CHD and GID undergoing PCI will be enrolled. Patients are randomized (1:1) to receive either rivaroxaban 10 mg plus clopidogrel 75 mg daily or aspirin 100 mg plus clopidogrel 75 mg daily; both treatments will last 6 months. The primary endpoint is Bleeding Academic Research Consortium (BARC) type 2–5 bleeding requiring medical intervention. The secondary endpoint is a composite of major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemia-driven target vessel revascularization, and stroke. Discussion The objective of this study is to evaluate the efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with CHD and GID undergoing PCI. We aim to explore an optimized antithrombotic strategy, which achieves the same anti-ischemic effect as standard DAPT without increasing the risk of GIB, for patients with CHD and GID undergoing PCI. Trial registration This protocol is registered at the Chinese Clinical Trial Registry under the number ChiCTR2100044319. And this publication is based on version 1.4 of the trial protocol dated Sep 6, 2021. Highlights 1. To find a more appropriate antithrombotic strategy for patients with CHD and GID undergoing PCI. 2. To identify whether rivaroxaban can reduce the bleeding risk of the gastrointestinal tract compared with aspirin.

Discrete element modelling (DEM) parameters are of great importance for the accurate prediction of soil properties and disturbance. This study aimed to provide an efficient method for accurately determining the DEM parameters of a paddy soil with a high moisture content (45.66%). The DEM parameters of the paddy soil modelled using the Hertz–Mindlin with JKR contact model were determined by using the Plackett–Burman (PB), steepest ascent, and central composite tests. The accuracies of the developed DEM models were evaluated using actual slumping tests. Based on the PB test, the surface energy of soil, coefficients of soil–soil rolling friction, and coefficients of soil–steel static friction exerted larger influences on the overall relative error (δZH). The optimization results showed that to achieve a minimum δZH (5.96%), the surface energy of soil, the coefficients of soil–soil rolling friction, and the coefficients of soil–steel static friction should be 0.808 J m−2, 0.11, and 0.6, respectively. The optimized DEM model had an overall relative error of 7.27% with a coefficient of variation of 1.32%, indicating that the DEM parameters of the calibrated paddy soil had good accuracy.

Background Abdominal aortic aneurysm (AAA) is a fatal disease due to the tendency to rupture. The drug treatment for small AAA without surgical indications has been controversial. Previous studies showed that high-sensitivity C-reactive protein (hs-CRP) had become a potential biomarker of the disease, and the anti-inflammatory effect of rivaroxaban for AAA had been well established. Thus, we hypothesized that rivaroxaban could control the progression of AAA in patients with hs-CRP elevation. Methods The study is a prospective, open-label, randomized, controlled clinical trial. Sixty subjects are recruited from the General Hospital of Northern Theatre Command of China. Subjects are randomly assigned (1:1) to the intervention arm (rivaroxaban) or control arm (aspirin). The primary efficacy outcome is the level of serum hs-CRP at 6 months. The secondary outcomes include imaging examination (the maximal diameter of AAA, the maximal thickness of mural thrombus, and the length of aneurysm), major adverse cardiovascular and cerebrovascular events (MACCE, including AAA transformation, non-fatal myocardial infarction, acute congestive heart failure, stent thrombosis, ischemia-driven target vessel revascularization, vascular amputation, stroke, cardiovascular death, and all-cause death), and other laboratory tests (troponin T, interleukin 6, D-dimer, and coagulation function). Discussion The BANBOO trial tested the effect of rivaroxaban on the progression of AAA in patients with elevated Hs-CRP for the first time. Trial registration ChiCTR2100051990, ClinicalTrials.gov, registered on 12 October 2021.

In this paper, we proposed a complete study method to achieve accurate aortic dissection diagnosis at the patient level. Based on the CT angiography (CTA) images, a classification model named DAT-DenseNet, which combined the deep attention Transformer module with the DenseNet architecture is proposed. In the first phase, two DAT-DenseNet are combined in parallel. It is used to accurately achieve two classification task at the CTA images. In the second stage, we propose a feature fusion module. It concatenates and fuses the image features output from the two classification models on a patient by patient basis. In the comparison experiments of classification model performance, DAT-DenseNet obtained 92.41% accuracy at the image level, which was 2.20% higher than the commonly used model. In the comparison experiments of model fusion method, our method obtained 90.83% accuracy at the patient level. The experiments showed that DAT-DenseNet model exhibits high performance at the image level. Our feature fusion module achieves the mapping from two classification image features to patient outcomes. It achieves accurate patient classification. The experiments’ results in the Discussion section elaborate the details of the experiment and confirmed that the results were reliable.

This study aims to develop and validate a nomogram based on the Systemic Inflammatory Response Index (SIRI) to predict short-term aortic-related adverse events (ARAEs) in patients with acute uncomplicated Type B intramural hematoma (IMH). We retrospectively analyzed 332 patients diagnosed with acute uncomplicated Type B IMH between April 2018 and April 2024. Patients were categorized into the stable group (N=225) and the exacerbation group (N=107) based on the occurrence of ARAEs within 30-day observation period. SIRI was calculated using neutrophil, monocyte, and lymphocyte counts. ARAEs were defined as death related to aortic disease, and the progression of IMH to aortic dissection or penetrating aortic ulcer. The nomogram was developed incorporating SIRI and other significant clinical variables. The model's performance was evaluated using the area under the curve (AUC), calibration curves, decision curve analysis (DCA), and net reclassification index (NRI). Among the 332 patients, 217 were male (65.4%), with a mean age of 64.3±9.4 years. Multivariate logistic regression and LASSO regression analyses identified SIRI, anemia, diabetes, maximum diameter of aortic diameter (MDAD), and ulcer like projection (ULP) as independent predictors of ARAEs. Two nomogram models were developed: the Clinical model, including anemia, diabetes, MDAD, and ULP; and the Clinical-SIRI model, incorporating SIRI to the Clinical model. The Clinical-SIRI model demonstrated higher predictive accuracy, with an AUC of 0.788 (95% CI: 0.740-0.831), compared to the Clinical model's AUC of 0.742 (95% CI: 0.691-0.788, P = 0.012). SIRI improved predictive accuracy, as shown by a continuous NRI of 0.521 (95% CI: 0.301-0.743). Calibration curves and DCA further supported the clinical utility of the Clinical-SIRI model. The SIRI-based nomogram is a valuable prognostic tool for predicting short-term ARAEs in patients with acute uncomplicated Type B IMH.

Plant diseases caused by pathogenic fungi seriously affect the yield and quality of crops, cause huge economic losses, and pose a considerable threat to global food security. Phenylpyrrole analogues were designed and synthesized based on alkaloid lycogalic acid. All target compounds were characterized by 1H NMR, 13C NMR, and HRMS. Their antifungal activities against seven kinds of phytopathogenic fungi were evaluated. The results revealed that most compounds had broad-spectrum fungicidal activities at 50 μg/mL; 14 compounds displayed more than 60% fungicidal activities against Rhizoctonia cerealis and Sclerotinia sclerotiorum, and in particular, the fungicidal activities of compounds 8g and 8h against Rhizoctonia cerealis were more than 90%, which could be further developed as lead agents for water-soluble fungicides. The molecular docking results indicate that compounds 8g and 8h can interact with 14α-demethylase (RcCYP51) through hydrogen bonding with strong affinity.

Considering the duration of grade 4 neutropenia as 1 day with a standard deviation of 1.5 days in cycle 1 of chemotherapy in telpegfilgrastim (2 mg fixed dose and 33 μg/kg) and control groups, using Power Analysis & Sample Size (PASS) version 15 with a predefined non-inferiority margin of 1 day at a power (1−β) of 0.9 and a one-sided test level of 0.025, the study required minimum sample size of 49 patients in each group. Using the analysis of variance (ANOVA), differences in the duration of grade 4 neutropenia between the treatment groups were evaluated, the least-squares mean and 95% confidence interval (CI) were calculated using the analysis of covariance model (ANCOVA). The least-squares mean difference between the telpegfilgrastim (2 mg and 33 μg/kg) groups and the control (rhG-CSF) group was 0.10 day (95% CI: −0.19, 0.38; P = 0.51) and 0.22 day (95% CI: −0.09, 0.52; P = 0.17), respectively, 95% CI were within the prespecified margin of ±1 day, confirming the non-inferiority of both telpegfilgrastim groups compared to the control (rhG-CSF) group [Supplementary Table 2, http://links.lww.com/CM9/C275]. ANC showed a double-peak pattern [Supplementary Figure 2, http://links.lww.com/CM9/C275], and the stratification analysis based on age or previous chemotherapy is shown in the Supplementary Tables 3 and 4, http://links.lww.com/CM9/C275.

Atherosclerosis and cardiovascular diseases are significantly affected by low-grade chronic inflammation. As a new inflammatory marker, the systemic inflammation response index (SIRI) has been demonstrated to be associated with several cardiovascular disease prognoses. This study aimed to investigate the prognostic impact of SIRI in individuals having ischemic heart failure (IHF) following percutaneous coronary intervention (PCI). This observational, retrospective cohort study was conducted at a single site. Finally, the research involved 1,963 individuals with IHF who underwent PCI, with a 36-month follow-up duration. Based on the SIRI quartiles, all patients were classified into four groups. Major adverse cardiovascular events (MACEs) were the primary outcomes. Every element of the main endpoint appeared in the secondary endpoints: all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan-Meier survival analysis was conducted to assess the incidence of endpoints across the four groups. Multivariate Cox proportional hazards analysis confirmed the independent impact of SIRI on both the primary and secondary endpoints. The restricted cubic spline (RCS) was used to assess the nonlinear association between the SIRI and endpoints. Subgroup analysis was performed to confirm the implications of SIRI on MACE in the different subgroups. The main outcome was much more common in patients with a higher SIRI. The Kaplan-Meier curve was another tool that was used to confirm the favorable connection between SIRI and MACE. SIRI was individually connected to a higher chance of the main outcome according to multivariate analyses, whether or not SIRI was a constant [SIRI, per one-unit increase, hazard ratio (HR) 1.04, 95% confidence interval (95% CI) 1.01-1.07, p = 0.003] or categorical variable [quartile of SIRI, the HR (95% CI) values for quartile 4 were 1.88 (1.47-2.42), p <0.001, with quartile 1 as a reference]. RCS demonstrated that the hazard of the primary and secondary endpoints generally increased as SIRI increased. A non-linear association of SIRI with the risk of MACE and any revascularization (Non-linear P <0.001) was observed. Subgroup analysis confirmed the increased risk of MACE with elevated SIRI in New York Heart Association (NYHA) class III-IV (P for interaction = 0.005). In patients with IHF undergoing PCI, increased SIRI was a risk factor for MACE independent of other factors. SIRI may represent a novel, promising, and low-grade inflammatory marker for the prognosis of patients with IHF undergoing PCI.