Chung-Ang University

Potassium-competitive acid blockers (P-CABs) are newly introduced gastrointestinal protectants, but their interaction with clopidogrel remains uncharacterized. Proton pump inhibitors (PPIs) are often coprescribed with clopidogrel, despite potential pharmacodynamic interactions. This study evaluated the effectiveness and safety of P-CAB and PPI coadministered with clopidogrel in patients with ischemic stroke. This population-based, longitudinal, retrospective cohort study used the Korean National Health Insurance Service database, covering 51.4 million individuals (≈97% of the Korean population) from 2016 to 2022. Patients with incident ischemic stroke were identified using predefined criteria. Propensity score matching compared the 6-month incidence of major adverse cardiovascular events (including myocardial infarction, stroke recurrence, and all-cause mortality) and gastrointestinal bleeding among 3 cohorts: clopidogrel alone, clopidogrel+P-CAB, and clopidogrel+PPI. Between 2017 and 2021, 40 752 of 65 180 patients with incident stroke (62.5%) received clopidogrel. A total of 6680 patients (16.4%) formed the clopidogrel-alone cohort, 578 (1.4%) the clopidogrel+P-CAB cohort, and 8806 (21.6%) the clopidogrel+PPI cohort. During the follow-up period, stroke recurred in 268 patients (4.0%) receiving clopidogrel alone, 26 patients (4.5%) receiving clopidogrel+P-CAB, and 431 patients (4.9%) receiving clopidogrel+PPI. After propensity score matching, the clopidogrel+P-CAB cohort showed a higher risk of major adverse cardiovascular events (hazard ratio [HR], 2.40 [95% CI, 1.18-4.85]) and stroke recurrence (HR, 2.64 [95% CI, 1.27-5.47]) than the clopidogrel-alone cohort. The clopidogrel+PPI cohort also had an increased risk of major adverse cardiovascular events (HR, 1.38 [95% CI, 1.17-1.63]) and stroke recurrence (HR, 1.41 [95% CI, 1.20-1.67]) relative to clopidogrel alone. Among PPIs, esomeprazole was associated with a higher risk of major adverse cardiovascular events (HR, 1.46 [95% CI, 1.10-1.92]) and stroke recurrence (HR, 1.50 [95% CI, 1.13-2.00]). Gastrointestinal bleeding did not differ significantly among the clopidogrel-alone, clopidogrel+P-CAB, and clopidogrel+PPI cohorts. Concomitant use of P-CABs or PPIs with clopidogrel was associated with an increased risk of ischemic events in patients with stroke. P-CABs or PPIs should, therefore, be prescribed cautiously for patients with stroke treated with clopidogrel.

Although coal remains essential for global energy production, the inevitable self-heating within coal piles poses significant economic and safety risks. Existing thermal anomaly detection methods based on low-resolution (LR) infrared (IR) imaging often fail to identify subtle thermal signatures, especially across large storage areas. To address these limitations, we systematically implemented guided depth super-resolution (GDSR), specifically tailored for coal pile monitoring. Due to the scarcity of realistic field data, we developed a novel testbed using gravel piles embedded with controlled heaters to simulate real-world conditions. Multi-modal images were captured using synchronized RGB and IR sensors. We established a framework evaluated on both synthetic testbed datasets and real-world coal-field data to ensure practical applicability. In this study, we propose a novel Edge-Guided Thermal Super-Resolution (EGTSR) network, benchmarked against representative methods such as the efficient Discrete Cosine Transform Network (DCTNet) and the accuracy-oriented Structure-Guided Network (SGNet). Crucially, EGTSR integrates a segmentation-guided alignment module to explicitly correct spatial discrepancies, which enables the network to maximize the utilization of gradient-based structural guidance from RGB images. Experimental results demonstrate that the proposed EGTSR outperforms existing methods, achieving up to a 31% reduction in root mean squared error compared to the baseline. This AI-based framework significantly improves thermal imaging resolution and detection accuracy, offering safer and more efficient coal storage management.