bluuebunny/crossref_metadata_2025 huggingface dataset:
The resistive wall impedance and the effects of the non-evaporable getter thickness in an ultra-low emittance ring
Authors: Talebi Motlagh S. , Rahighi J. , Zamani F. , Saeidi F.
Published: January 2023

In modern particle accelerators with ultra-low emittance,
the vacuum chambers are designed based on Non-Evaporable Getter
(NEG)-coated vacuum chambers. The thickness of the NEG coating plays
a critical role in the dynamic beam effects. So, in this paper, the
longitudinal and transverse impedance of a copper chamber coated
with a NEG are investigated, and the effects of the NEG thickness
over a wide range of frequencies have been studied. A good selection
of NEG layer thickness could minimize the coating effects on the
longitudinal and transverse beam impedance. The numerical results in
this work show that the beam dynamic effects could be minimal with
selecting a NEG coating thickness of about 1 μm.
Friction stir lap joining techniques effects on microstructure and tensile properties of high-strength automotive steel top hat sections
Authors: Abhilash V , Lakshminarayanan A K
Published: January 2023

Dual Phase (DP) steel, a type of Advanced High Strength Steel (AHSS) with a thickness of 1.7 mm, is used to fabricate single-hat components that are then joined to the base plate using two friction stir welding processes: friction stir lap welding (FSLW) and friction stir spot lap welding (FSSLW). It is difficult to join this assembly using fusion welding techniques. The welding variables for the FSLW process, tool rotation speed (TRS), tool traverse speed (TTS), and plunge depth (PD), were optimized using the design of an experiments-based response surface method by experimentally measured tensile shear failure load (TFL) of top hat assembly. For the FSSLW process, the welding variable TTS was replaced by dwell time (DT). Peak temperature, microstructure at different zones, microhardness mapping, and energy absorption capacity of both processes were evaluated under optimal welding conditions. For both processes, the stir zone and the heat-affected zone had the highest and lowest microhardness, which can be correlated with the level of martensite tempering, martensite lath spacing, polygonal ferrite volume, and precipitated carbides. Under optimum welding conditions, the TSL and energy absorption of FSLW joints were 14 kN and 170 J, respectively, which is 20% and 47 higher than the TSL and energy absorption of FSSLW joints.
Thermal cycle stability of glass-to-metal seals with glass preforms produced via powder-metallurgy and casting-machining methods
Authors: Gong Keqian , Cai Yangyang , Liu Zheng , Zhang Yong
Published: January 2023

In order to evaluate the influence of preform preparation processes on thermal cycle stability of glass-to-metal seals, this work embraced two different methods to produce the preform for seals. For the conventional powder metallurgy (PM) method, the molten glass was quenched to form frits, then the frits were ball milled to prepare glass powders. These glass powders were pressed into green bodies and heated to prepare preforms. While for the casting-machining (CM) method, the molten glass was cast into a graphite mold and annealed before accurate machining to preforms. In contrast to the PM method, the CM method provided an ultralow-porosity preform structure and a low porosity glass seal region. Field emission scanning electron microscope (FE-SEM) was conducted to investigate the bubbles and cracks in glass region. Furthermore, thermal cycling tests confirmed that these two tremendously different glass regions strongly affected the thermal cycle stability of the seals. To support the understanding of cracking in seals, the damage features of the samples were observed by FE-SEM and the extended finite element method (XFEM) was used to simulate the crack initiation and propagation. The experimental results demonstrated that cracking in the seals made from CM preforms occurred in the glass region near the sealing interface. However, cracks initiated from the bubbles in the seals made from PM preforms, which was verified by the XFEM simulation results. In addition, the CM seals demonstrated little degradation of the leakage rate until 105 thermal cycles, while cracking was found in the PM seals after 70 thermal cycles, indicating a decreased thermal cycle stability and resulting in hermetic failure.
An iterative decoupled algorithm with unconditional stability for Biot model
Authors: Gu Huipeng , Cai Mingchao , Li Jingzhi
Published: January 2023

This paper is concerned with numerical algorithms for Biot model. By introducing an intermediate variable, the classical 2-field Biot model is written into a 3-field formulation. Based on such a 3-field formulation, we propose a coupled algorithm, some time-extrapolation based decoupled algorithms, and an iterative decoupled algorithm. Our focus is the analysis of the iterative decoupled algorithm. It is shown that the convergence of the iterative decoupled algorithm requires no extra assumptions on physical parameters or stabilization parameters. Numerical experiments are provided to demonstrate the accuracy and efficiency of the proposed method.
Stochastic algorithms for self-consistent calculations of electronic structures
Authors: Ko Taehee , Li Xiantao
Published: January 2023

The convergence property of a stochastic algorithm for the self-consistent field (SCF) calculations of electron structures is studied. The algorithm is formulated by rewriting the electronic charges as a trace/diagonal of a matrix function, which is subsequently expressed as a statistical average. The function is further approximated by using a Krylov subspace approximation. As a result, each SCF iteration only samples one random vector without having to compute all the orbitals. We consider the common practice of SCF iterations with damping and mixing. We prove that the iterates from a general linear mixing scheme converge in a probabilistic sense when the stochastic error has a second finite moment.
Ramsey theory constructions from hypergraph matchings
Authors: Joos Felix , Mubayi Dhruv
Published: January 2023

We give asymptotically optimal constructions in generalized Ramsey theory using results about conflict-free hypergraph matchings. For example, we present an edge-coloring of

K

n
,
n

K_{n,n}

with

2
n

/

3
+
o
(
n
)

2n/3 + o(n)

colors such that each

4
4

-cycle receives at least three colors on its edges. This answers a question of Axenovich, Füredi and the second author [J. Combin. Theory Ser B 79 (2000), pp. 66–86]. We also exhibit an edge-coloring of

K
n

K_n

with

5
n

/

6
+
o
(
n
)

5n/6+o(n)

colors that assigns each copy of

K
4

K_4

at least five colors. This gives an alternative very short solution to an old question of Erdős and Gyárfás [Combinatorica 17 (1997), pp. 459–467] that was recently answered by Bennett, Cushman, Dudek, and Prałat [J. Combin. Theory Ser. B 169 (2024), pp. 253–297] by analyzing a colored modification of the triangle removal process.
Social Environmental Predictors of Lapse in Dietary Behavior: An Ecological Momentary Assessment Study Amongst Dutch Adults Trying to Lose Weight
Authors: Roordink Eline M , Steenhuis Ingrid H M , Kroeze Willemieke , Hoekstra Trynke , Jacobs Nele , van Stralen Maartje M
Published: January 2023

Background

When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed.

Purpose

Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight.

Methods

Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse.

Results

Injunctive norm (OR = 1.07, 95% CI = 1.03–1.11), descriptive norm (OR = 1.04, 95% CI = 1.02–1.07), and social pressure (OR = 1.09, 95% CI = 1.05–1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day.

Conclusions

Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure.
A life in dark times
Authors: Villa Dana
Published: January 2023

This chapter traces Arendt’s trajectory from her birth in Königsberg, East Prussia in 1906 to her death in New York in 1975. It describes her study of philosophy with Heidegger and Jaspers in the 1920s; her initiation into politics with the rise of the Nazi movement in the early 1930s; her escape from Germany and her sojourn in Paris; and her eventual arrival in America in 1941. The chapter then provides context and background for some of her major works, including Origins of Totalitarianism, The Human Condition, Eichmann in Jerusalem, and The Life of the Mind.
Political freedom, the public realm, and the vita activa
Authors: Villa Dana
Published: January 2023

The chapter discusses Arendt’s best-known contribution to political theory, The Human Condition (1958). It describes what she means by “the human condition” and why she eschews any appeal to “human nature.” The chapter explains why Arendt thought that the three activities—labor, work, and action—that traditionally comprised the vita activa (or active life) had undergone profound and disturbing changes in the modern age. These changes charted not just an inversion of their traditional ranking (with political action deemed the highest of human activities, and labor the lowest), but also their denaturing as the economic “life process” of society came to be increasingly channeled into the public realm.
A wider spectrum of avoidance and tolerance mechanisms explained ozone sensitivity of two white poplar ploidy levels
Authors: Wang Miaomiao , Li Guolei , Feng Zhaozhong , Liu Yong , Yuan Xiangyang , Uscola Mercedes
Published: January 2023

Background and Aims

Polyploidization can improve plant mass yield for bioenergy support, yet few studies have investigated ozone (O3) sensitivity linked to internal regulatory mechanisms at different ploidy levels.

Methods

Diploid and triploid Populus tomentosa plants were exposed to ambient and ambient plus 60 ppb [O3]. We explored their differences in sensitivity (leaf morphological, physiological and biochemical traits, and plant mass) as well as mechanisms of avoidance (stomatal conductance, xanthophyll cycle, thermal dissipation) and tolerance (ROS scavenging system) in response to O3 at two developmental phases.

Key Results

Triploid plants had the highest plant growth under ambient O3, even under O3 fumigation. However, triploid plants were the most sensitive to O3 and under elevated O3 showed the largest decreases in photosynthetic capacity and performance, as well as increased shoot:root ratio, and the highest lipid peroxidation. Thus, plant mass production could be impacted in triploid plants under long-term O3 contamination. Both diploid and triploid plants reduced stomatal aperture in response to O3, thereby reducing O3 entrance, yet only in diploid plants was reduced stomatal aperture associated with minimal (non-significant) damage to photosynthetic pigments and lower lipid peroxidation.

Conclusions

Tolerance mechanisms of plants of both ploidy levels mainly focused on the enzymatic reduction of hydrogen peroxide through catalase and peroxidase, yet these homeostatic regulatory mechanisms were higher in diploid plants. Our study recommends triploid white poplar as a bioenergy species only under short-term O3 contamination. Under continuously elevated O3 over the long term, diploid white poplar may perform better.
Improving the enzymatic activity ofl-amino acid α-ligase for imidazole dipeptide production by site-directed mutagenesis
Authors: Kino Kuniki , Komabayashi Takuma , Hashida Ayaka , Kuramoto Ayumu
Published: January 2023

Imidazole dipeptides, histidine-containing dipeptides, including carnosine (β-alanyl-l-histidine), anserine (β-alanyl-3-methyl-l-histidine), and balenine (β-alanyl-1-methyl-l-histidine) in animal muscles have physiological functions, such as significant antioxidant and antifatigue effects. They are obtained by extraction from natural raw materials, including chicken and fish meat. However, using natural raw materials entails stable supply and mass production limitations. l-amino acid α-ligase (Lal) catalyzes the formation of various dipeptides from unprotected l-amino acids by conjugating with adenosine 5'-triphosphate (ATP) hydrolysis reaction. In this study, site-directed mutagenesis of Lal was applied to establish an efficient method for producing imidazole dipeptides by the enzymatic process. We significantly improved the conversion rate from substrate amino acids compared with wild-type Lal.
Characterization of hydantoin-5-propionic acid amidohydrolase involved in ergothioneine utilization inBurkholderiasp. HME13
Authors: Muramatsu Hisashi , Koujitani Akihito , Yamada Masaaki , Maguchi Hiroki , Kashiwagi Takehiro , Kato Shin-ichiro
Published: January 2023

In our previous study, ertABC genes encoding ergothionase, thiourocanate hydratase, and 3-(5-oxo-2-thioxoimidazolidin-4-yl) propionic acid desulfhydrase were identified, all of which may be involved in ergothioneine utilization of Burkholderia sp. HME13. In this study, we identify the ertD gene encoding metal-dependent hydantoin-5-propionic acid amidohydrolase in this strain. Mn2+-containing ErtD showed maximum activity at 45 °C and pH 8.5 and was stable at temperatures up to 45 °C. The Km and Vmax values of Mn2+-containing ErtD for hydantoin-5-propionic acid were 2.8 m m and 16 U/mg, respectively. Real-time polymerase chain reaction (PCR) revealed that ertD expression levels in Burkholderia sp. HME13 cells cultivated in ergothioneine medium were 3.3-fold higher than those in cells cultivated in Luria–Bertani (LB) medium. ErtD activity in the crude extract from Burkholderia sp. HME13 cells cultured in ergothioneine medium was 0.018 U/mg, whereas that in LB medium was not detected. Accordingly, we suggest that ErtD is involved in ergothioneine utilization in this strain.
DeepGpgs: a novel deep learning framework for predicting arginine methylation sites combined with Gaussian prior and gated self-attention mechanism
Authors: Zhou Haiwei , Tan Wenxi , Shi Shaoping
Published: January 2023

Protein arginine methylation is an important posttranslational modification (PTM) associated with protein functional diversity and pathological conditions including cancer. Identification of methylation binding sites facilitates a better understanding of the molecular function of proteins. Recent developments in the field of deep neural networks have led to a proliferation of deep learning-based methylation identification studies because of their fast and accurate prediction. In this paper, we propose DeepGpgs, an advanced deep learning model incorporating Gaussian prior and gated attention mechanism. We introduce a residual network channel to extract the evolutionary information of proteins. Then we combine the adaptive embedding with bidirectional long short-term memory networks to form a context-shared encoder layer. A gated multi-head attention mechanism is followed to obtain the global information about the sequence. A Gaussian prior is injected into the sequence to assist in predicting PTMs. We also propose a weighted joint loss function to alleviate the false negative problem. We empirically show that DeepGpgs improves Matthews correlation coefficient by 6.3% on the arginine methylation independent test set compared with the existing state-of-the-art methylation site prediction methods. Furthermore, DeepGpgs has good robustness in phosphorylation site prediction of SARS-CoV-2, which indicates that DeepGpgs has good transferability and the potential to be extended to other modification sites prediction. The open-source code and data of the DeepGpgs can be obtained from https://github.com/saizhou1/DeepGpgs.
Engineering Vengeful Effervescence: Lynching Rituals and Religious–Political Power in Pakistan
Authors: Asif Muhammad , Weenink Don , Mascini Peter
Published: January 2023

Based on case studies of seven (attempted) lynchings in Pakistan, we argue that they can be considered lynching rituals, which are instrumental in a context of political strife. ‘Shrpsnd anasr’ (agitators) play an important role as ritual engineers; they assemble crowds by spreading rumours and vocalizing accusations, use rhythmic chanting and slogan repetition to generate a shared vengeful mood and focus the crowd’s attention on the (fabricated) encroachment of a moral imperative (notably blasphemy). We conclude that the vengeful effervescence generated in lynching rituals strengthens the clientelistic interdependency networks of religious–political leaders. The contribution of our study lies in demonstrating the importance of bodily practices in lynching rituals and their instrumental political value for both masses and political leaders.
288 Once-daily crisaborole as a long-term maintenance treatment in patients with mild-to-moderate atopic dermatitis: A 52-week clinical trial
Authors: Gower Richard , Xu JinHua , Alam Maryam S , Su John C , Myers Daniela E , Sanders Paul , Vlahos Bonnie , Zang Chuanbo , Lan Jar , Werth John 
Published: January 2023

Treatments for atopic dermatitis (AD) often fail to achieve lasting disease control despite patient adherence, with safety concerns limiting the long-term use of many therapies. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate AD. Crisaborole has the potential as a long-term maintenance therapy. To assess the long-term efficacy and safety of crisaborole once daily as a maintenance treatment to reduce the incidence of flares in patients who had achieved response with treatment with crisaborole twice daily. CrisADe CONTROL (NCT04040192) was a randomized, double-blind, vehicle-controlled, 52-week, phase 3 study of patients aged ≥ 3 months with mild-to-moderate AD involving ≥ 5% treatable body surface area. In an open-label run-in period, patients received crisaborole twice daily for up to 8 weeks. Patients who achieved success per Investigator’s Static Global Assessment (ISGA; ISGA score of 0 [clear] or 1 [almost clear] with a ≥ 2-grade improvement from baseline) and ≥ 50% reduction from baseline on the Eczema Area and Severity Index during the run-in were randomly assigned to receive blinded crisaborole or vehicle once daily during the 52-week maintenance period. Patients who experienced a flare (ISGA score ≥2) during the maintenance period switched to crisaborole twice daily for up to 12 weeks (assessed every 4 weeks); if the flare resolved (ISGA score ≤ 1), patients resumed their blinded once-daily treatment. Endpoints included flare-free maintenance until the onset of the first flare (primary), the number of days without flare and the number of flares. The incidence of treatment-emergent adverse events was also evaluated. Of 270 randomly assigned patients, 135 were assigned to crisaborole and 135 to a vehicle once daily. The median time of flare-free maintenance was longer for patients treated with crisaborole vs. vehicle (111 vs. 30 days, respectively; P = 0.0034). The mean number of flare-free days was higher for patients treated with crisaborole vs. vehicle (234.0 vs. 199.4, respectively; P = 0.0346). The mean number of flares was lower for patients treated with crisaborole vs. vehicle (0.95 vs. 1.36, respectively; P = 0.0042). Crisaborole was well tolerated, with no unexpected safety findings or new safety signals when used as a maintenance treatment for 52 weeks. Once-daily treatment with crisaborole was effective and well tolerated for long-term maintenance treatment and flare reduction in adult and paediatric patients with mild-to-moderate AD.
315 A patient survey to identify atopic dermatitis prescription treatment access barriers
Authors: Loiselle Allison R , Thibau Isabelle J C , Guadalupe Michele , Butler Lisa , Begolka Wendy Smith
Published: January 2023

Atopic dermatitis (AD) is the most prevalent form of eczema and is a chronic disease with a relapsing-remitting nature. Multiple treatment options exist, yet little is known about patients’ ability to obtain recommended prescription treatments. The aim of this web-based survey was to ascertain the frequency, causes and patient impact of insurance delays and denials for AD prescription treatments. Adult AD patients (18 + years) or caregivers of pediatric AD patients were recruited to complete a survey about experiences with prescription treatment access in the last 12 months. Responses from 1234 AD patients (42.0 ± 16.7 years) and 248 caregivers (8.5 ± 4.7 years) were included in the analysis; 55.4% (n = 680) reported moderate or severe AD. Overall, there were 789 insurance delays or denials for AD prescriptions, with 37.0% (457/1234) of respondents experiencing at least one in the past 12 months. Overall, the majority of delays/denials were for topical steroids (38.3%; 302/789), which is likely due to the high number of patients using one or more topical steroid prescriptions (82.5%; 1018/1234). However, the highest individual drug class burden was on biologics, for which 38.7% of all prescriptions (122/315) faced a delay or denial. Coverage denials were caused primarily by step therapy (25.5%), and delays by prior authorization (61.1%), and only 62.0% of respondents said they would know what to do if they faced an issue getting a prescription covered by their insurer. Patient-reported impacts of prescription denials and delays included: AD flares (85.0%; n = 255), needing alternate medications (72.3%; n = 217), emergency care (49.0%; n = 147) and giving up on treatment altogether (59.0%; n = 177). Patients with AD and their families frequently experience issues obtaining recommended therapies which can result in detrimental health and quality of life impacts. As many as one-third of patients may not know how to respond if their prescriptions are met with insurance delays or denials, further exacerbating those impacts. These data may help identify strategies to improve timely and beneficial therapeutic access.
318 Facilitating mentorship for caregivers of children with atopic dermatitis: the supporting eczema caregivers initiative
Authors: Tu Michelle , Amaro Lauren , Kidder Bennett , Kelley Keri , Capozza Korey , Schwartz Alan
Published: January 2023

Caregivers of children with atopic dermatitis (AD) report high levels of stress, feelings of failure and isolation, and a need for social support. These socioemotional effects accumulate over time, often resulting in dramatic changes in career, finances and social activities for caregivers and families when childhood AD is poorly controlled. Psychosocial support and supportive relationships are critical to handling stressful life events. The present study assesses a psychosocial support programme for parents of children with AD. This mentorship program’s primary objective was to promote improvements in stress, resilient coping and loneliness among AD caregivers. Participants were randomized to an email-only group (n = 40) or a one-to-one mentorship pairing (n = 17). We collected measures of stress, coping resilience, loneliness, AD severity and program satisfaction at baseline, 6 weeks and 12 weeks. Eczema severity significantly decreased overall from baseline to 6 weeks (P < 0.001) and remained decreased at 12 weeks (P < 0.001 vs. baseline). There was no significant difference between groups or change in stress, resilience or loneliness over time. Qualitative data demonstrated high program satisfaction. While there was no change in loneliness, resilience or stress, we found a reduction in self-reported eczema symptoms. Continued reduction in these symptoms could affect the overall quality of life, which in turn could yield improved measures of loneliness, resilience and stress.
323 Onset of atopic comorbidities relative to atopic dermatitis diagnosis in a real-world setting using an Israeli claims database
Authors: Leshem Yael , Becker Allan , Busse William W , Beck Lisa A , Weil Clara , Daoud Moataz , Lubwama Robert
Published: January 2023

Patients with atopic dermatitis (AD) are more likely than the general population to have other type 2 associated conditions, for example, asthma, allergic rhinitis (AR) and food allergy (FA).1,2 Classically, the atopic march is thought to begin with AD and progresses to FA, asthma and AR,1,2 but this may be an oversimplification. This study aimed to describe the epidemiology of type 2 associated conditions included in the atopic march among patients newly diagnosed with AD in a large healthcare provider database in Israel. This retrospective cohort study was performed using the Maccabi Healthcare Services database in Israel, which includes over 2.5 million members. Based on the International Classification of Diseases, 9th revision (ICD-9) diagnosis codes, patients with diagnosed AD during 2000–2019 were identified. The earliest AD diagnosis was defined as the index date and patients had to have been enrolled for ≥12 months pre-index to exclude prevalent AD. Diagnosis data were obtained during 1998–2020 to describe the cumulative prevalence of asthma, AR and FA pre- and post-AD diagnosis (−1, 0, 1, 5, 10 and 20 years) using Kaplan–Meier analysis among patients aged <3, 3–5, 6–11, 12–17 and ≥18 years at AD diagnosis. The study included 243,687 patients (51.6% female) with AD. The median (interquartile range) age at AD diagnosis was 4.3 (1.1–22.8) years, with 43.9% and 72.7% of patients diagnosed before age 3 and 18 years, respectively. At AD diagnosis, 28.1% had a prior/concurrent diagnosis of asthma/AR/FA (asthma: 17.1%, AR: 12.8%, FA: 3.4%). Among patients diagnosed with AD at age <3 years, 16.2% had been diagnosed with asthma/AR/FA by/at the time of their AD diagnosis (asthma: 10.6%, AR: 2.2%, FA: 4.9%). In this youngest age group, the cumulative prevalences of asthma/AR/FA were 28.8%, 42.7%, 49.6% and 59.6% within 1, 5, 10 and 20 years post-AD diagnosis. Among patients diagnosed with AD in adulthood, 37.7% had been diagnosed with asthma/AR/FA by/at the time they were diagnosed with AD (asthma: 16.5%, AR: 29.7%, FA: 0.8%). It this oldest age group, the cumulative prevalences of asthma/AR/FA were 40.3%, 46.1%, 50.9% and 57.6% within 1, 5, 10 and 20 years post-AD diagnosis. The results of this real-world analysis are consistent with previous evidence that AD is primarily a childhood-onset disease. The sharpest increase in type 2 associated conditions was seen in the 5 years post-AD diagnosis among patients diagnosed with AD at age <3 years. Most adults newly diagnosed with AD who developed another type 2 associated condition had already done so prior to AD diagnosis, although it is possible that earlier AD diagnoses were not captured. Regardless of age at AD diagnosis, nearly 60% of patients with AD were estimated to have ≥1 of asthma/AR/FA within 20 years of their AD diagnosis.
Feasibility and effectiveness of segmentectomy versus wedge resection for clinical stage I non-small-cell lung cancer
Authors: Akamine Takaki , Yotsukura Masaya , Yoshida Yukihiro , Nakagawa Kazuo , Yatabe Yasushi , Watanabe Shun-ichi
Published: January 2023

OBJECTIVES

With recent improvements in surgical techniques for segmentectomy, we hypothesized that segmentectomy is feasible and more effective than wedge resection for non-small-cell lung cancer (NSCLC). We compared perioperative and oncological outcomes for segmentectomy and wedge resection.

METHODS

We performed a retrospective analysis of 720 patients who underwent sublobar resection (segmentectomy, 479; wedge resection, 241) for clinical stage 0 or I NSCLC from January 2017 to June 2020. An adequate surgical margin was defined as a surgical margin distance of ≥2 cm or ≥ the total tumour size. Recurrence-free survival (RFS) was estimated using the Kaplan–Meier method for clinical stage IA.

RESULTS

There was no significant difference in the rate of major (grade ≥III) complications between segmentectomy (1.7%) and wedge resection (1.2%) (P = 0.76). The probability of obtaining adequate surgical margins was significantly higher with segmentectomy (71.4%) versus wedge resection (59.5%) (P = 0.002), and the difference was especially prominent for clinical stage IA2 (75.3% vs 56.9%; P = 0.012). Among patients with clinical stage IA, segmentectomy significantly improved the RFS compared with wedge resection (hazard ratio 2.7; 95% confidence interval 1.60–4.61; log-rank P < 0.001). Subgroup analysis based on the tumour status revealed that segmentectomy had a better RFS in clinical stage IA2 (P < 0.001) and in pure-solid tumours (P = 0.022) than wedge resection.

CONCLUSIONS

We demonstrate that segmentectomy is a feasible procedure with comparable safety outcomes and better surgical margins and cancer control than wedge resection, particularly for clinical stage IA2 NSCLC.
Efficacy of cryoablation versus antiarrhythmic therapy for treatment of atrial fibrillation: a systematic review and meta-analysis
Authors: Villanueva P , Sibulo M , David B , Cheng F
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

Atrial fibrillation (AF) is a common arrhythmia that causes various complications if left untreated. Current primary care guidelines recommend administration of antiarrhythmic drugs (AAD) as the preferred treatment regimen for first diagnosed AF and considers ablation if there is failure of therapy. However, recent studies show the benefit of cryoablation on the initial treatment of AF.

Purpose

The primary objective of this study is to determine the efficacy and the safety of cryoablation therapy over AAD as treatment regimen for atrial fibrillation.

Methods

A comprehensive and relevant search of randomized controlled trials (RCT) was conducted examining the use of cryoablation as initial treatment of AF compared to AAD. Outcome measures for recurrence of atrial arrhythmias and serious adverse effects (SAEs) were extracted and analyzed using Review Manager 5.4. Fixed effects model was used initially for both outcomes; however, if there was substantial heterogeneity (I² > 50%), random effects model was then used.

Results

Four studies were included in the meta-analysis with a total of 969 subjects analyzed. Initially, a fixed effect model was used to compute for the Risk Ratio (RR) which yielded RR of 0.55 [95% CI: 0.49-0.63], I²=93, p < 0.0001. Since there was substantial heterogeneity among the four RCTs, a random effects model was then used. The heterogeneity may be attributed to the difference in study designs as some of the studies involved a cross-over design. Using the random effects model, the computed RR was 0.50 [95% CI: 0.33-0.85], I²=93, p = 0.01. Hence, cryoballoon therapy is found to be more beneficial in preventing recurrence of atrial arrhythmias. This result can be interpreted as statistically significant given that the p value is < 0.05.

On the other hand, the fixed effects model revealed there was no significant difference between cryoballoon therapy and AAD in terms of SAE (RR 0.80 [95%CI: 0.58-1.10], I²=0, p=0.17). SAEs included in the studies included the following but not limited to death, stroke, acute coronary syndrome, syncope, pulmonary embolism, etc.

Conclusion

Cryoablation therapy is more beneficial in preventing atrial arrhythmias compared to AADs. The rate of serious adverse event is similar between cryoablation therapy and AAD.
Estimation of brain natriuretic peptide values from N-terminal pro brain natriuretic peptide levels and other factors
Authors: Kajikawa Y , Ueda A , Ikeda M , Hirota M
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Backgrounds

Both brain natriuretic peptide (BNP) and N-terminal proBNP (NT-pro BNP) are established biomarkers that are necessary in the diagnosis and management of heart failure (HF). Recently with the introduction of angiotensin receptor-neprilysin inhibitor in the treatment of HF, the course of HF is now assessed using NT-ProBNP levels1). However, it is difficult to infer BNP concentration from NT-proBNP levels for a physician who is familiar with BNP. Generally, simultaneous measurement of BNP and NT-proBNP is not permitted in medical insurance.

Purpose

To estimate BNP concentration from NT-proBNP levels and other factors as an equivalent prognostic strength compared to the actual BNP concentration.

Methods

From August 2021 to October 2021, we measured BNP and NT-proBNP levels of patients who were known or suspected to have HF (n=200). We created a formula for estimating BNP concentration from the data of NT-proBNP, age, body mass index (BMI), white cell counts, hemoglobin (Hb), estimated glemerular filtration rate) (eGFR) and C-reactive protein (CRP) using multivariate analysis.

Results

Patients’ background were as follows: age 66.4±23.6 years, male /female : 112/88 , BMI: 23.1±5.2 kg/m2, Hb level: 12.3±2.2 g/dL, albmine level: 3.7±0.7 g/dL, eGFR level: 63.3±27.0 mL/min/1.73m², CRP level; 1.80±4.67 mg/dL, BNP level: 103.3±207.9 pg/mL, NT-proBNP level: 1,505.1±3,479.6 pg/mL (mean ± SD). There was a strong correlation between BNP concentration and NT-proBNP level when using actual measured values (r= 0.84) and when using log-transformed values (r=0.92) in these patients.Using multiple regression analysis, we created an equation that estimated

LogBNP=-0.864+0.734×LogNT-proBNP+0.005×age-0.003×eGFR-0.009×BMI+0.016×CRP (R²=0.89).

Conclusion

This equation will be useful, especially for a physician who is not familiar with NT-proBNP. Testing BNP concentrations were reliably estimated from an equation featuring NT-proBNP, eGFR, age, BMI and CRP2),3),4).
The surprises in optical coherence tomography (OCT) findings in patients presenting with in-stent restenosis: the road less travelled
Authors: Roy S , Singh V , Ahmed J , Dwivedi S K , Sethi R , Chandra S , Pradhan A K , Vishwakarma P , Sharma A K , Bhandari M , Shukla A , Singh A , Chaudhary G
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Background

Morphological features of neointimal tissue play a pivotal role in the pathophysiology of In-Stent Restenosis (ISR) after percutaneous coronary intervention, hence understanding these features and patterns is crucial.

Purpose

The present study was designed to qualitatively and quantitatively assess neointimal characteristics of lesions using OCT in patients presenting with ISR.

Methods

This was a single-center, prospective, observational study performed between 1st August 2020 and 30th December 2021 at a tertiary-care center in India. Patients diagnosed with stable angina and acute coronary syndrome with post-procedural angiographically documented restenosis (>50%) were included. Qualitative and quantitative assessment of neointimal hyperplasia patterns was performed using OCT.

Results

A total of 34 patients with ISR were studied. Neointimal hyperplasia was classified as (i) homogenous group (n=18) and (ii) non-homogenous group (n=16). As many as 14 (77.8%) diabetics belonged to the homogenous group. Predominant plaque characteristics such as neoatherosclerosis, cholesterol crystals, and calcium were documented in 14 (77.8%), 12 (66.7%), and 11 (61.1%) patients in the homogenous group and in 10 (62.5%), 10 (62.5%), and 9 (56.2%) patients in the non-homogenous group, respectively. Unexpanded stent struts were identified in 11 (61.1%) and 11 (68.8%) patients in the homogenous and non-homogenous groups, respectively. Mean strut thickness was 93.73 ± 31.03 µm and 83.54 ± 18.0 µm, ISR was 72.50 ± 15.93% and 65.37 ± 21.69%, the neointimal thickness was 588.06 ± 167.82 mm and 666.25 ± 218.05 mm, and neointimal hyperplasia was 54.54 ± 11.23% and 59.26 ± 8.86% in the homogenous and non-homogenous groups, respectively.

Conclusion

Neoatherosclerosis and stent underexpansion was predominantly observed in our study, which was in contrast to most of the existing literature [1,2,3], and only diabetes was found to be significantly associated with homogenous neointimal hyperplasia, irrespective of the generation of the stent.
Statin use after valvular heart surgery is associated with a decreased risk of prosthetic valve endocarditis
Authors: Tse Y K , Ren Q W , Wu M Z , Huang J Y , Leung C K L , Li H L , Yiu K H
Published: January 2023

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Sanming Project of Medicine in Shenzhen, China;

HKU-SZH Fund for Shenzhen Key Medical Discipline

Background

Prosthetic valve endocarditis (PVE) is a rare but serious complication following valvular heart surgery for which preventive strategies remain unknown. Recent epidemiological evidence suggests that statins may reduce the risk of infections and infection-related complications.

Purpose

We aim to assess the association between statin use and the risk of prosthetic valve endocarditis in patients undergoing valvular heart surgery.

Methods

In all patients undergoing valvular heart surgery in Hong Kong between 2010 and 2021, statin use was ascertained by ≥14-day consecutive filled prescriptions after surgery. Stepwise Poisson regression was applied to identify predictors of PVE. Baseline characteristics between statin nonusers (N = 1400) with statin users (N = 976) were balanced using the inverse probability of treatment weighting. Cox proportional-hazard models with competing risk regression were further performed to estimate the risk of PVE and cardiovascular mortality associated with statin use.

Results

Our study included 2376 patients; the mean age was 57.8±14.2 years, and 54.4% were males. Over a median follow-up of 5.5 years (interquartile range 2.8-8.6), PVE occurred in 93 patients (6.75 [95% CI 5.51-8.26] PVE events per 1000 person-years). PVE was associated with New York Heart Association Class (Relative Risk [RR] 1.22, 95% Confidence Interval [CI] 1.01-1.45; P = 0.035), prior infective endocarditis (RR 8.64, 95% CI 5.58-13.19; P < 0.001), and aortic valve replacement (RR 1.67, 95% CI 1.11-2.53; P = 0.014).

Compared with non-use, statin use was associated with a 47% lower risk of PVE incidence (multivariable-adjusted subdistribution hazard ratio [SHR] 0.53, 95% CI 0.33-0.83; P = 0.006) (Figure 1). This inverse association with the risk of PVE was duration dependent, with an adjusted SHR of 0.60 (95% CI 0.47-0.73; P < 0.001) per year of statin use. Results were consistent across subgroups of sex (male vs female), the number of valvular procedures (single vs multiple), and prosthesis type (mechanical vs biological), but not in groups aged ≤60 years or with prior infective endocarditis (Figure 2). Statin use was associated with a 45% decreased risk of cardiovascular death (SHR 0.55, 95% CI 0.36-0.84; P = 0.006).

Conclusions

In patients undergoing valvular surgery, post-operative statin use is associated with a lower risk of PVE. These results provide new avenues for preventing PVE and hence valve failure.
In-hospital outcomes of rotational atherectomy in relation to operator volumes: data from an asian national databank
Authors: Uy F M , Keh Y S , Lu R Y , Lau Y H , Goh Y S , Low A F , Lim Z Y , Jafary F H , Yeo K K
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

Studies investigating the relationship between percutaneous coronary intervention operator volumes and patient adverse events largely, but not consistently, suggest an inverse association. A recent study of rotational atherectomy (Rota-PCI) suggests lower adverse events as operator volumes increased.

Purpose

In this study, we aimed to use a Southeast asian national registry to investigate the relationship of Rota-PCI operator volumes to patient selection, procedural success, and in-hospital outcomes.

Methods

Data from a national databank was analysed for all Rota-PCI procedures performed at public hospitals from 2013 to 2019. No procedures were excluded. Operator volumes were divided into 3 tertiles and logistic regressions were performed to investigate the association to patient selection, procedural success, and in-hospital clinical outcomes.

Results

A total of 1,278 Rota-PCI procedures, with 37 operators performing a median volume of 23 procedures per year was included. The tertiles had median volumes of 5, 17 and 30 annually respectively. Operators at the highest tertile performed Rota-PCI in more patients with renal disease (43% vs 49% vs 53%, Tertiles 1, 2, 3 respectively; p=0.006), ACS presentations (34% vs 37% vs 41%, p=0.036), severe left ventricular dysfunction (28% vs 42% vs 44%, p<0.001), and left main disease (17% vs 24% vs 31%, p<0.001). This group also attempted more lesions (2 vs 2 vs 3, p<0.001), and utilized more circulatory support (4.2% vs 7% vs 12%, p<0.001). Intracoronary imaging was used most by the lowest tertile (29% vs 24% vs 12%, p<0.001). Operators at the highest tertile had a higher incidence of complete heart block (2.1% vs 0.8% vs 3.9%, p=0.05) but had no difference in coronary complications. There was an increase in length of stay (2 vs 3 vs 3 days, p<0.001) but otherwise no difference in in-hospital outcomes of MI, major bleed, stroke and mortality in multivariate analysis.

Conclusion

In summary, in-hospital outcomes were similar between all three tertiles of operator volumes. These findings may reflect our local practice where operators appropriately triage Rota-PCI cases, with the most complex cases being assigned to high volume operators.
Myocardial bridge over coronary arteries and myocardial coat over coronary sinus: a cadaveric study
Authors: Borthakur D , Kumar R , Dada R
Published: January 2023

Funding Acknowledgements

Type of funding sources: None.

Background

Myocardial Bridge (MB) over the coronary artery and myocardial coat (MC) over the cardiac veins are sometimes detected in angiography and cadaveric dissection. Left anterior descending (LAD) branch of left coronary artery is most frequent site of MB. Rarely MB is also seen over right coronary artery (RCA) branch. MB has proven association with ischemic heart disease and other critical cardiac consequences like myocardial infarction (MI)(1)(2). MC on the other hand has not gained enough attention in erstwhile studies. Large MB can be readily identified in angiograms, but minute MB can be picked up by newer imaging studies like multi-detector computed tomography (MDCT) and optical coherence tomography (OCT) scan(3). Cadaveric dissection however holds its unique place in direct visualization and studying the macro and micro-anatomical characteristics.

Purpose

To study the prevalence and anatomical attributes of MB and MC in cadaveric hearts.

Methods

Ten adult cadaveric hearts (6 male and 4 female) were dissected as part of routine undergraduate teaching during academic year 2021-22. MB over the coronary artery and MC over cardiac vein was identified. Data pertaining to the MB and MC dimensions were measured with digital vernier calliper. Histology of the MC was carried out to confirm its presence and observe the cyto-architecture pattern. Relevant gross macroscopic and microscopic images were photographed and photomicrographed.

Results

20% of the dissected cadavers revealed MB involving LAD in first heart while LAD and RCA both in second heart with length 7.5 mm, 11.5 mm and 1.8 mm respectively. MC was noted over coronary sinus and proximal few millimeters of great and middle cardiac veins. Histological examination revealed cardiac striated muscle in MC with typical cyto-architecture. The mean myocardial muscle index (MMI) of MBs was 1.39.

Conclusions

Present study highlights 20% prevalence of MBs in cadavers involving both right and left coronary artery. 10% of the subjects had histologically confirmed MC over cardiac veins. MC over coronary sinus and other cardiac veins needs more elaborate explorative studies to quantify the anatomic properties and to examine the possible association with cardiovascular disease. Nevertheless, anatomic attributes should be kept in mind to better appreciate MI in evolution and MI at evaluation in a case with MB.
Methane and nitrous oxide fluxes from clonal eucalyptus forests in different spacing arrangements
Authors: Rodrigues Gleice Gomes , Zanatta Josileia Acordi , Rachwal Marcos Fernando Glück , Higa Rosana Clara Victoria , Lavoranti Osmir , Silva Luciana Duque
Published: January 2023

Although Eucalyptus is the most commonly cultivated genus in Brazil, more information is needed on how these forests can act as a sink for greenhouse gases. This study assessed the potential greenhouse gas (GHG) mitigation of eucalyptus forests by quantifying both the seasonal rates of exchange of methane (CH4) and nitrous oxide (N2O) gases at the soil–atmosphere interface and their relationships with soil variables (moisture, temperature and physicochemical attributes). Soil organic carbon sequestration rate was used together with soil GHG emission to estimate net global warming potential. This study was conducted at an experimental forestry station in the south-central region of the state of São Paulo, Brazil. No differences were found between treatments in the seasonal fluxes of N2O and CH4, which may have resulted from similar soil properties, particularly bulk density and nitrate (NO3−) contents. CH4 flux dynamics were mainly controlled by the concentrations of ammonium (NH4+) in the soil. In all treatments, the soil acted as a continuous sink for CH4, absorbing it at an average rate of −65 μg C m−2 h−1, which was higher than the results of other studies conducted in native areas of the Cerrado biome and planted forests. However, although CH4 removal helped offset greenhouse gas emissions, net emissions were seen in most treatments due to N2O emissions in greater magnitude and soil carbon losses.
The effect of Drosophila attP40 background on the glomerular organization of Or47b olfactory receptor neurons
Authors: Duan Qichen , Estrella Rachel , Carson Allison , Chen Yang , Volkan Pelin C
Published: January 2023

Bacteriophage integrase-directed insertion of transgenic constructs into specific genomic loci has been widely used by Drosophila community. The attP40 landing site located on the second chromosome gained popularity because of its high inducible transgene expression levels. Here, unexpectedly, we found that homozygous attP40 chromosome disrupts normal glomerular organization of Or47b olfactory receptor neuron (ORN) class in Drosophila. This effect is not likely to be caused by the loss of function of Msp300, where the attP40 docking site is inserted. Moreover, the attP40 background seems to genetically interact with the second chromosome Or47b-GAL4 driver, which results in a similar glomerular defect. Whether the ORN phenotype is caused by the neighbouring genes around Msp300 locus in the presence of attP40-based insertions or a second unknown mutation in the attP40 background remains elusive. Our findings tell a cautionary tale about using this popular transgenic landing site, highlighting the importance of rigorous controls to rule out the attP40 landing site-associated background effects.