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OBJECTIVES: Earlier electrocardiogram (ECG) acquisition for ST-elevation myocardial infarction (STEMI) is associated with earlier percutaneous coronary intervention (PCI) and better patient outcomes. However, the exact relationship between timely ECG and timely PCI is unclear. METHODS: We quantified the influence of door-to-ECG (D2E) time on ECG-to-PCI balloon (E2B) intervention in this three-year retrospective cohort study, including patients from 10 geographically diverse emergency departments (EDs) co-located with a PCI center. The study included 576 STEMI patients excluding those with a screening ECG before ED arrival or non-diagnostic initial ED ECG. We used a linear mixed-effects model to evaluate D2Es influence on E2B with piecewise linear terms for D2E times associated with time intervals designated as ED intake (0-10 min), triage (11-30 min), and main ED (>30 min). We adjusted for demographic and visit characteristics, past medical history, and included ED location as a random effect. RESULTS: The median E2B interval was longer (76 vs 68 min, p 10 min than in those with timely D2E. The proportion of patients identified at the intake, triage, and main ED intervals was 65.8%, 24.9%, and 9.7%, respectively. The D2E and E2B association was statistically significant in the triage phase, where a 1-minute change in D2E was associated with a 1.24-minute change in E2B (95% confidence interval [CI]: 0.44-2.05, p = 0.003). CONCLUSION: Reducing D2E is associated with a shorter E2B. Targeting D2E reduction in patients currently diagnosed during triage (11-30 min) may be the greatest opportunity to improve D2B and could enable 24.9% more ED STEMI patients to achieve timely D2E.

Background: Delayed intervention for ST-segment elevation myocardial infarction (STEMI) is associated with higher mortality. The association of door-to-ECG (D2E) with clinical outcomes has not been directly explored in a contemporary US-based population. Methods: This was a three-year, 10-center, retrospective cohort study of ED-diagnosed patients with STEMI comparing mortality between those who received timely (10 min) diagnostic ECG. Among survivors, we explored left ventricular ejection fraction (LVEF) dysfunction during the STEMI encounter and recovery upon post-discharge follow-up. Results: Mortality was lower among those who received a timely ECG where one-week mortality was 5% (21/420) vs. 10.2% (26/256) among those with untimely ECGs (p = 0.016), and in-hospital mortality was 6.0% (25/420) vs. 10.9% (28/256) (p = 0.028). Data to compare change in LVEF metrics were available in only 24% of patients during the STEMI encounter and 46.5% on discharge follow-up. Conclusions: D2E within 10 min may be associated with a 50% reduction in mortality among ED STEMI patients. LVEF dysfunction is the primary resultant morbidity among STEMI survivors but was infrequently assessed despite low LVEF being an indication for survival-improving therapy. It will be difficult to assess the impact of STEMI care interventions without more consistent LVEF assessment.

This study investigated the inhibitory effect of antimicrobial peptide from Paenibacillus ehimensis on the biofilms of Candida albicans by the microdilution and time-kill curve assays. Microscopic observation was conducted to assess the impact of the peptide on the formation of C. albicans germ tube and hyphae. Additionally, the 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay was employed to investigate the influence on the formation of C. albicans biofilms, pre-formed biofilms, and the clearance rate of mature biofilms. Fluorescent probes were utilized to observe the alteration in the structure of biofilms and the status of intracellular fungal entities. The number of viable cells in biofilms was measured by the spread plate method, and real-time polymerase chain reaction (PCR) was employed to determine the expression levels of genes associated with biofilm formation. The results showed that the minimum inhibitory concentration of the antimicrobial peptide against C. albicans was 8.28 AU/mL. This peptide reduced the rate of germ tube formation in C. albicans, and prevented the formation of hyphae, making it exist in the form of yeasts. Furthermore, the antimicrobial peptide influenced both the formation and eradication of biofilms and disrupted the structural integrity of biofilms after a short duration, leading to damage and even death of C. albicans, and reducing cell counts in biofilms. The antimicrobial peptide reduced the expression levels of multiple genes related to biofilm formation (such as ALS1, ALS3, HWP1, EFG1, ECE1 and UME6), therefore inhibiting biofilm formation. The above findings demonstrated that antimicrobial peptide effectively inhibited the biofilm formation, mature biofilm clearance and the expression of biofilm-forming genes in C. albicans. This study lays a theoretical foundation for the development of novel antimicrobial agents against C. albicans and provides a basis for the prevention and control of foodborne pathogen contamination to ensure food quality and safety.

This study addressed the challenges of vortex formation and dead air zones in traditional long-pressure short suction ventilation and dust removal systems. By leveraging the Coanda effect, the system's structure was optimized through the nesting of the exhaust and pressure ducts. This design enhanced airflow in the negative pressure duct, promoting adherence to the tunnel walls, reducing dust dispersion, and significantly lowering energy consumption. Simulations utilizing flow field analysis and discrete phase model (DPM) revealed an optimal pressure-extraction ratio of 2∶3. Under this ratio, results indicated that the optimized system reduced dust concentrations at the driver's position and downwind side by 5.56% and 55.41%, respectively, compared to traditional systems. With the structure and pressure-extraction ratio established, further improvements in dust removal efficiency were achievable through parameter regulation. Key parameters included the distance between the duct and the dust-producing surface, the distance from the duct's central axis to the ground, and the distance between the pressure and extraction ducts. Convolutional neural network (CNN) was employed for intelligent parameter control, enabling the identification of optimal parameters for varying initial dust concentrations. Experiments conducted on 45 parameter regulation schemes using a scaled-down experimental platform demonstrated that the CNN model outperformed BP neural networks in accuracy and stability for dust concentration predictions. When initial dust concentrations at the driver's position and downwind side ranged from 300 to 900 mg/m3, the optimized system achieved an average dust concentration reduction of 51.49% to 83.88%, thereby validating the effectiveness of parameter control.

BackgroundSchizophrenia patients often face high level of stigma and low level of self-esteem， significantly hindering their recovery. Mindfulness-based intervention has proven be effective in reducing stigma and improving self-esteem. However， traditional mindfulness intervention typically involve high costs and require long-term professional involvement.ObjectiveTo explore the effects of blended mindfulness interventions on stigma and self-esteem in patients with stable schizophrenia， so as to provide references for reducing stigma， enhancing self-esteem and promoting recovery.MethodsPatients receiving outpatient treatment at the Third Hospital of Daqing from June 2022 to January 2023， who met the diagnostic criteria for schizophrenia in the International Classification of Diseases， tenth edition （ICD-10） and were in a stable phase， were recruited for the study （n=84）. According to the random number table method， participants were randomly assigned to study group and control group， with 42 cases in each group. Both groups received treatment with the second-generation antipsychotic medications， while the study group additionally received blended mindfulness intervention for 8 weeks， with sessions lasting 45~60 minutes， three times a week. Both groups were evaluated with Five Facet Mindfulness Questionnaire （FFMQ）， Internalized Stigma of Mental Illness Inventory （ISMI） and Rosenberg Self-Esteem Scale （RSES） at baseline and after 8-week intervention. Covariance analysis was used to compare the FFMQ， ISMI and SES scores between two groups after 8-week intervention.ResultsAfter 8-week intervention， there were statistically significant differences between two groups in total FFMQ scores， as well as in the observation， acting with awareness， non-judgment and non-reactivity subscale scores （F=50.680， 12.952， 13.567， 22.799， 14.043， P