Addition of FFRct in the diagnostic pathway of patients with stable chest pain to reduce unnecessary invasive coronary angiography (FUSION): Rationale and design for the multicentre,randomised, controlled FUSION trial

BackgroundCoronary computed tomography angiography (CCTA) is widely used in the diagnostic work-up of patients with stable chest pain. CCTA has an excellent negative predictive value, but a moderate positive predictive value for detecting coronary stenosis. Computed tomography-derived fractional flow reserve (FFRct) is a non-invasive, well-validated technique that provides functional assessment of coronary stenosis, improving the positive predictive value of CCTA. However, to determine the value of FFRct in routine clinical practice, a pragmatic randomised, controlled trial (RCT) is required. We will conduct an RCT to investigate the impact of adding FFRct analysis in the diagnostic pathway of patients with a coronary stenosis on CCTA on the rate of unnecessary invasive coronary angiography, cost-effectiveness, quality of life and clinical outcome.MethodsThe FUSION trial is a prospective, multicentre RCT that will randomise 528 patients with stable chest pain and anatomical stenosis of ≥ 50% but < 90% in at least one coronary artery of ≥ 2 mm on CCTA, to FFRct-guided care or usual care in a 1:1 ratio. Follow-up will be 1 year. The primary endpoint is the rate of unnecessary invasive coronary angiography within 90 days.ConclusionThe FUSION trial will evaluate the use of FFRct in stable chest pain patients from the Dutch perspective. The trial is funded by the Dutch National Health Care Institute as part of the research programme ‘Potentially Promising Care’ and the results will be used to assess if FFRct reimbursement should be included in the standard health care package.Supplementary InformationThe online version of this article (10.1007/s12471-022-01711-w) contains supplementary material, which is available to authorized users.     

An improved indicator of simulated grassland production based on MODIS NDVI and GPP data: A case study in the Sichuan province,China

Grassland monitoring is important for both global change research and regional sustainable development. Gross primary production (GPP) is one of the key factors for understanding grass growing conditions. Methods for estimating GPP are plentiful, and the light use efficiency (LUE) model based on remote sensing data is widely used. The MODIS GPP product, which is employed by the National Aeronautics and Space Administration (NASA), is calculated using the LUE model and the surface reflection data from the Moderate Resolution Imaging Spectroradiometer onboard the Terra/Aqua satellite. The MODIS GPP product harbors its own uncertainties arising from the sources and parameters, such as FPAR and light use efficiency (ɛ). In this study, we propose an improved indicator for monitoring grassland based on MODIS GPP and NDVI data. Fractional vegetation coverage and the percentage of grass area (1 km²) were used to reduce the mixed pixel effect. A function of NDVI was used to simulate the light use efficiency and FPAR. The modified GPP data were calculated and validated with in situ measured data from the Sichuan province, China, 2011. The results indicated that the modified GPP data were a more accurate indicator for monitoring grassland than previous indicators, and the precision of grass production simulated by SsGPP_ndvi reached 85.6%. Spatial statistic results were consistent with the practical condition in most cases. Since MODIS data are available twice a day, the improved indicator can meet the actual requirement of grassland monitoring at regional scale.     

输尿管软镜与经皮肾镜碎石术对≤2 cm肾结石患者血清IL-6、IL-10、Cor水平的影响及安全性研究

目的:比较输尿管软镜碎石术(FURL)与经皮肾镜碎石术(PCNL)治疗≤2 cm肾结石的疗效及对患者血清白介素(IL)-6、IL-10、皮质醇(Cor)水平的影响以及手术治疗的安全性。方法:选择2015年2月~2017年2月我院泌尿外科收治的132例直径≤2 cm的肾结石患者作为研究对象,其中行FURL治疗者72例,行PCNL治疗者60例,比较两组围手术期相关临床指标、治疗前后肾功能以及血清IL-6、IL-10、Cor水平的变化。结果:FURL组术后住院时间较PCNL组显著缩短,术后输血率较PCNL组显著降低(P0.01);两组手术时间、结石总清除率比较差异无统计学意义(P0.05)。PCNL组术后24 h Hb值较术前显著降低(P0.01),FURL组无明显变化(P0.05);两组术后24 h WBC值较术前显著升高(P0.01),但两组组间比较无明显差异(P0.05)。两组术后1h血清IL-6、IL-10、Cor水平均较术前显著升高,术后1、3、5d逐渐降低,FURL组术后1 h、1、3、5 d血清IL-6、IL-10、Cor水平均较PCNL组各时点显著降低(P0.01)。两组术后6 h、1、2 d尿Kim-1及血清CysC水平均较术前显著升高(P0.01),FURL组尿Kim-1水平于术后3 d恢复至正常水平,PCNL组为术后5d恢复正常,PCNL组血CysC水平于术后3 d恢复至正常水平,FURL组为术后5 d恢复正常;FURL组术后2、3 d尿Kim-1水平显著低于PCNL组同时点(P0.01),术后1、2、3 d血Cys C水平显著高于PCNL组同时点(P0.01)。结论:FURL与PCNL治疗直径≤2cm的肾结石均能取得满意的取石效果,但FURL手术创伤更小、出血更少,术后应激反应更轻,更有利于术后机体恢复。     

牙齿残留物反映的闽西新石器时代人类食谱

本项目对福建闽西地区奇和洞与南山两处新石器时代遗址出土古人类牙齿进行了表面残留物提取与鉴定,通过对其中淀粉粒残留物的种类与数量对比,讨论了全新世初期至中期闽西地区古人类对植物资源的利用方式。这些古人类牙齿表面包含四大类形态不同的淀粉粒:1)多面体形;2)圆形或椭圆形;3)圆锥形;4)水滴形。这些淀粉粒分别代表了禾本科植物种子、植物地下根茎部分和疑似的坚果类,这些都是古人类容易获得的野生食物资源,在新石器时代古人类的饮食中占据着重要的地位。     

Quantitative fluorescence analysis of the adsorption of lysozyme to phospholipid vesicles

Experiments directed to measure the interaction of lysozyme with liposomes consisting of phosphatidylcholine (PC) and phosphatidylserine (PS) have been conducted by monitoring both protein and lipid fluorescence and fluorescence anisotropy of the protein. The binding of lysozyme to the unilamellar vesicles was quantified using a novel method of analysis in which the fractional contribution at moderate binding conditions is determined from either total fluorescence decay or anisotropy decay curves of tryptophan at limiting binding conditions. In the energy transfer experiments PC and PS lipids labelled with two pyrene acyl chains served as energy acceptors of the excited tryptophan residues in lysozyme. The binding was strongly dependent on the molar fraction of negatively charged PS in neutral PC membranes and on the ionic strength. Changes in the tryptophan fluorescence decay characteristics were found to be connected with long correlation times, indicating conformational rearrangements induced by binding of the protein to these lipid membranes. The dynamics of membrane bound protein appeared to be dependent on the physical state of the membrane. Independent of protein fluorescence studies, formation of a protein-membrane complex can also be observed from the lipid properties of the system. The interaction of lysozyme with di-pyrenyl-labelled phosphatidylserine in anionic PS/PC membranes resulted in a substantial decrease of the intramolecular excimer formation, while the excimer formation of dipyrenyl-labelled phosphatidylcholine in neutral PC membranes barely changed in the presence of lysozyme.Abbreviations dipyr₄ sn-1,2-(pyrenylbutyl) - dipyr₁₀ sn-1,2-(pyrenyldecanoyl). - DMPC dimyristoyl-phosphatidylcholine - DOPC dioleoyl-phosphatidylcholine - DPPC dipalmitoyl-phosphatidylcholine - DPPC dipalmitoylphosphatidylcholine - PC phosphatidylcholine - PS phosphatidylserine Correspondence to: A. J. W. G. Visser     

Fractional factorial design optimization of the separation of pilocarpine and its degradation products by capillary electrophoresis

The separation of pilocarpine and its degradation products by micellar electrokinetic capillary chromatography (MECC) has been optimized by using fractional factorial design of the experiments. Critical parameters were identified in a screening design, and an optimization design was used to optimize the separation. The optimal separation method was based on a borate buffer with sodium dodecyl sulfate (SDS). It is concluded that by using fractional factorial design it is possible to improve the separation of pilocarpine, it trans epimer, isopilocarpine and their hydrolysis products, pilocarpic acid and isopilocarpic acid.     

水激光与超声洁治对中度慢性牙周炎的疗效对比

目的:探讨水激光与超声洁治对中度慢性牙周炎的疗效。方法:选取81例中度慢性牙周炎患者,年龄27-62岁,随机分为两组:激光组(41例)采用水激光治疗,超声组(40例)采用超声洁治法治疗。通过患者治疗后1个月,3个月的菌斑指数(plaque index,PLI),牙龈指数(gingival index,GI),牙周袋深度(probing depth,PD),牙周附着水平(clinical attachment level,CAL),治疗过程中的VAS评分等观察指标,对水激光与超声洁治进行疗效对比。结果:与基线各项牙周指数相比,激光组和超声组治疗后1个月,3个月的各项牙周指数均明显降低(P0.05)。与超声组相比,激光组治疗后1个月的GI值明显低于超声组,治疗后1个月和3个月的PD值和CAL值均低于超声组(P0.05)。治疗前,两组VAS评分相比,差异没有统计学意义(P0.05),治疗后,激光组的VAS评分明显低于超声组(P0.05)。结论:水激光治疗中度慢性牙周炎,治疗过程痛觉感受轻微,能轻易清除引起炎症的牙石及菌斑,促进牙周组织愈合。     

Hollow fiber-based liquid phase microextraction with factorial design optimization and gas chromatography–tandem mass spectrometry for determination of cannabinoids in human hair

A new method, based on hollow fiber liquid-phase microextraction (HF-LPME) and gas chromatography–tandem mass spectrometry (GC–MSMS), was developed for determination of Δ⁹-tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) in samples of human hair. Since hair is a solid matrix, the samples were subjected to alkaline digestion using NaOH. The aqueous solutions obtained were extracted using a 6 cm polypropylene fiber (600 μm i.d., 200 μm wall thickness, 0.2 μm pore size) for each extraction. A 2⁵⁻¹ fractional factorial design for screening, and a central composite design for optimization of significant variables, was applied during development of the extraction method. The variables evaluated were the type of extraction solvent, pH, stirring speed, extraction time, and acceptor phase volume. The optimized conditions for the proposed extraction procedure were 10 mg of hair sample; 20 μL of butyl acetate; aqueous (pH 14) donor phase containing 6.8% NaCl; 600 rpm stirring speed; 20 min extraction time. A linear response was obtained in the ranges 1–500 pg mg⁻¹ (CBD and CBN) and 20–500 pg mg⁻¹ (THC), with regression coefficients >0.99. Precision, determined as the relative standard deviation, was 3.3–8.9% (intra-day) and 4.4–13.7% (inter-day). Absolute recoveries varied in the ranges 4.4–4.8% (CBD), 7.6–8.9% (THC) and 7.7–8.2% (CBN). Limits of detection (LOD, S/N = 3) and quantification (LOQ, S/N = 10) were 0.5–15 pg mg⁻¹ and 1–20 pg mg⁻¹, respectively. The method was successfully used to determine CBD, THC and CBN in hair samples from patients in a drug dependency rehabilitation center. Concentrations varied in the ranges 1–18 pg mg⁻¹ (CBD), 20–232 pg mg⁻¹ (THC) and 9–107 pg mg⁻¹ (CBN), confirming the suitability of the method for monitoring studies.     

Response surface designs for experiments in bioprocessing

Many processes in the biological industries are studied using response surface methodology. The use of biological materials, however, means that run-to-run variation is typically much greater than that in many experiments in mechanical or chemical engineering and so the designs used require greater replication. The data analysis which is performed may involve some variable selection, as well as fitting polynomial response surface models. This implies that designs should allow the parameters of the model to be estimated nearly orthogonally. A class of three-level response surface designs is introduced which allows all except the quadratic parameters to be estimated orthogonally, as well as having a number of other useful properties. These subset designs are obtained by using two-level factorial designs in subsets of the factors, with the other factors being held at their middle level. This allows their properties to be easily explored. Replacing some of the two-level designs with fractional replicates broadens the class of useful designs, especially with five or more factors, and sometimes incomplete subsets can be used. It is very simple to include a few two- and four-level factors in these designs by excluding subsets with these factors at the middle level. Subset designs can be easily modified to include factors with five or more levels by allowing a different pair of levels to be used in different subsets.