Definitive Method Research Articles

Study on the Influence of Sample Size on the Mechanical and Integrity Characteristics of Coal Measure Sandstone under High Strain Rate

In order to explore the size effect of the mechanical and damage characteristics of coal measure sand stones under dynamic load, uniaxial impact compression tests were carried out on coal-bearing sand stones with a diameter of 50 mm and a length–diameter ratio of L/R = 0.5, 0.8, 1, 1.2, 1.5, 1.8, and 2 by using the Hopkinson pressure bar test system. The size effect law of the mechanical properties and energy dissipation of coal-bearing sandstone under a high strain rate were investigated. Then, the mercury injection test was carried out on the fragments at different positions, and the electron microscope scanning test was carried out on the fragments near the end of the transmission rod. Based on the area damage definition method and normalization treatment, the integrity model of coal measure sandstone, considering the influence of the length–diameter ratio, was established. The results showed that the peak strength and dynamic elastic modulus of coal measure sandstone increased first and then decreased with the increase in length–diameter ratio under impact compression load, and they reached the maximum when the length–diameter ratio was 1.2. The dynamic peak strain increased gradually with the increase in length–diameter ratio. The energy of coal-bearing sandstone showed strong size effect, that is, the total absorbed energy, elastic energy, and dissipated energy increased with the increase in length–diameter ratio, and the size effect of total absorbed energy was the most obvious. Under the same impact pressure, the porosity of coal-bearing sand stones with seven kinds of length–diameter ratios near the incident end was roughly the same. But when the length–diameter ratio was greater than 0.5, the porosity decreased gradually with the increase in the distance from the incident end. And the larger the length–diameter ratio, the more obvious the decreasing trend. When the length–diameter ratio was smaller, the size of the holes and cracks and the cluster density were larger. The integrity model of coal measure sandstone, considering the influence of the length–diameter ratio, showed that the larger the length–diameter ratio, the better the relative integrity of coal-bearing sandstone.

A holistic solution to virtual coupling based urban rail train control system

Virtual coupling (VC) is an emerging concept that is gaining popularity in railway control systems. It has the potential to significantly enhance railway capacity and flexibility, and has attracted considerable research attention. This study explores several key aspects of VC research in the context of urban rail transit systems, including system structure, train platoon control method, scenario definition, and train scheduling. The paper presents three main contributions: Firstly, it proposes a potential system structure for VC and discusses infrastructure occupancy procedures within typical operational scenarios. Secondly, a VC platoon controller based on the adaptive back-stepping method is designed to realize the function of the operation layer. Thirdly, combining operational scenario definition and control methods, we propose a VC train scheduling method based on mixed integer linear programming (MILP). A case study demonstrated that the proposed solution could effectively achieve the primary functions of VC.

Breast cysticercosis mimicking malignancy: A case report from Nepal

Cysticercosis, caused by the larval stage of Taenia solium, is an uncommon parasitic infection typically associated with the central nervous system. Despite its relatively common occurrence in Nepal due to agricultural practices and pig farming, breast involvement in cysticercosis remains an exceptional clinical phenomenon, which we elucidate through a distinctive case report, highlighting the complexities it introduces in diagnosis. A 62-year-old woman presented with a painful lump in her left breast, which raised concerns of malignancy on clinical examination. Mammography and ultrasound further supported this suspicion, revealing an irregular, high-density mass without calcification, and an echogenic rind. To confirm the diagnosis, an ultrasound-guided biopsy was performed, leading to the conclusive identification of cysticercosis through histopathological analysis. This case underscores the importance of considering cysticercosis as a potential diagnosis for solitary soft-tissue lesions, even in regions with a high prevalence of breast cancer. While imaging findings can provide valuable hints, histopathological examination remains the definitive confirmation method. A multidisciplinary approach is crucial, involving clinical, radiological, and histopathological assessments to accurately diagnose and manage such cases. Raising awareness of atypical presentations of cysticercosis is essential for prompt and effective treatment, ultimately leading to improved patient outcomes.

AD and ADRD Differences in Luminex and Lumipulse ATN Categories

AbstractBackgroundCerebrospinal fluid (CSF) biomarkers for amyloid (A), tau (T), and neurodegeneration (N) can be utilized to define pre‐mortem pathological status (ATN research framework). However, potential differences across methods present challenges when comparing studies. Our objective was to determine the ATN status in an AD/ADRD cohort using two different methods for measuring CSF AD‐related biomarkers; Fujirebio Lumipulse G1200 and the Luminex 200. The hypothesis was that the proportion of individuals in a given ATN category would differ between these two methods.MethodParticipants were recruited from the Cleveland Alzheimer’s Disease Research Center (CADRC), and Cleveland Clinic Lou Ruvo Center for Brain Health (CBH) and included cognitively normal (CN), mild cognitive impairment (MCI), AD, dementia with Lewy Bodies (DLB), and PD patient groups. Aβ42/40 (A), p‐Tau181 (T) and t‐Tau (N) were quantitated using both Lumipulse and Luminex systems. Receiver Operating Characteristic (ROC) curve was utilized to identify optimal cutpoints for the three biomarkers (A, T, and N) based on the CN and AD cohorts. Youden index was calculated to identify the strength of these biomarkers.ResultCorrelation analyses between the two platforms, indicated that there was a significant correlation for Aβ42/40 (A), p‐Tau181 (T) and t‐Tau (N) among most patient groups, especially for Aβ42/40. The cut‐points were 0.0562 (A), 65 pg/mL (T) and 345 pg/mL (N) for Lumipulse, and 0.1600 (A), 106.77 pg/mL (T) and 399.41 pg/mL (N) for Luminex. Out of the overall cohort of 283 individuals, over half had identical ATN status for both Lumipulse and Luminex.ConclusionThere was a strong correlation for CSF AD‐related biomarkers between the two platforms. However, there was a lack of complete ATN category overlap between platforms suggesting that across study comparisons using ATN categories derived from different platforms (e.g. Luminex and Lumipulse) should be approached with caution. In light of different techniques that are available, it is important to understand the difference between them to inform standardization and data harmonization efforts. A definite and effective method to quantitate AD related biomarkers holds the promise of better differential diagnosis in individuals with AD and ADRD.

On the Definition and Research Methods of Intellectual History: Taking the Origin of Liberation Theology for example

As a kind of historical research consisting of “ideas”and“history”, the study of the intellectual history mainly deals with two kinds of problems: one is to see what a thinker said in the dimension of ideas, and the other is to judge why he said so from the dimension of history. Therefore, the research approach of intellectual history can be divided into“external research method” and “internal research method”. The external research method pays special attention to the interactive relationship between thought and historical context, and places people in the historical context to be observed and analyzed, while the internal research method pays special attention to analyzing the circumference of the system of thought in the theoretical development. This paper analyzes the origin of liberation theology as an example with external research method and internal research method, such as qualitative analysis software, inference and deduction, transcendental dialectic, and also applies the writing patterns of“continuity” and “discontinuity”. The paper proposes that that the origins of liberation theology can be considered in terms of a number of factors, including Christian ecclesiastical base, German theological thought, Roman Catholic Reformation, and the personal situations of liberation theologians，etc.

Rare ovarian tumor in post hysterectomized status: case report

Ovarian tumors are known for their silent nature, non-availability of definitive screening methods and varied clinico pathological variations. Conservation of normal looking ovaries macroscopically during hysterectomy is recommended to benefit the future health of the woman. Still the development of new issues related to ovaries need to be counseled to the patient and stringent vigilance by the clinician is mandatory. Steroid cell tumor is rare ovarian tumor and histopathology is the gold standard for diagnosis. Any patient with high testosterone levels should be investigated meticulously to define the origin adrenal/ovarian with an awareness about this rare entity with malignant potential. Lifetime follow up of the ovaries in women are crucial at all ages. Here we report a case of rare ovarian tumor in post hysterectomized patient.

Balancing Contracts: The Crucial Role of Pre-contractual Disclosure in Technical Assistance Agreements

This study rigorously delineates the imperative of pre-contractual disclosure in technical assistance contracts, spotlighting the legal necessity for suppliers to provide indispensable technical information vital for efficient recipient resource utilization. Emphasizing informed consent and mutual satisfaction, this pre-contractual mandate, rooted in the principle of good faith, addresses negotiation power imbalances. It clarifies that meeting this obligation differs from mere due diligence, demanding a specific outcome prior to contract formation. It asserts that debtors must be apprised of negotiated data unbeknownst to the creditor, justifiably. The ramifications are dual: rectifying power differentials and ensuring parity in knowledge among contracting parties. The study aims to enrich legislative frameworks for party protection, utilizing qualitative methods for definition and analysis. Results shed light on the nuanced aspects of pre-contractual disclosure, impacting contractual rebalancing and knowledge equality. This research advocates global attention to legislative actions promoting transparency and fairness in technical assistance agreements.
 Highlights :
 
 Clarifies the Legal Imperative: The study meticulously defines the legal obligation for suppliers to disclose crucial technical information in technical assistance contracts, ensuring informed consent.
 Addresses Power Imbalances: Emphasizes the role of the principle of good faith in rectifying negotiation power imbalances, contributing to more equitable contractual relationships.
 Global Advocacy for Legislative Measures: Calls for international attention to legislative actions fostering transparency and fairness in technical assistance agreements.
 
 Keywords : Pre-contractual Disclosure, Technical Assistance Contracts, Informed Consent, Good Faith, Legislative Regulation

Quantitative Modeling of Stemness in Single-Cell RNA Sequencing Data: A Nonlinear One-Class Support Vector Machine Method.

Intratumoral heterogeneity and the presence of cancer stem cells are challenging issues in cancer therapy. An appropriate quantification of the stemness of individual cells for assessing the potential for self-renewal and differentiation from the cell of origin can define a measurement for quantifying different cell states, which is important in understanding the dynamics of cancer evolution, and might further provide possible targeted therapies aimed at tumor stem cells. Nevertheless, it is usually difficult to quantify the stemness of a cell based on molecular information associated with the cell. In this study, we proposed a stemness definition method with one-class Hadamard kernel support vector machine (OCHSVM) based on single-cell RNA sequencing (scRNA-seq) data. Applications of the proposed OCHSVM stemness are assessed by various data sets, including preimplantation embryo cells, induced pluripotent stem cells, or tumor cells. We further compared the OCHSVM model with state-of-the-art methods CytoTRACE, one-class logistic regression, or one-class SVM methods with different kernels. The computational results demonstrate that the OCHSVM method is more suitable for stemness identification using scRNA-seq data.

Exploring the mechanism of Gentiana rigescens Franch. in the treatment of pulmonary fibrosis based on network pharmacology

Pulmonary fibrosis (PF) is a severe chronic interstitial lung disease with high mortality, and there is currently a lack of definite and effective treatment methods. Studies have found that gentiopicroside, a secoiridoid glycoside compound derived from plants of the Gentiana genus, can significantly improve pulmonary inflammation and fibrosis lesions in mice with pulmonary fibrosis. However, the mechanism of its anti-fibrotic effect is unclear. Therefore, in this study, we employed network pharmacology's virtual computer technology to investigate the potential mechanism underlying the anti-pulmonary fibrosis effect of Gentianae Radix et Rhizome (Longdan in Chinese, GRR). Our findings offer valuable theoretical insights and serve as a guiding reference for future experimental investigations. A total of 10 active compounds and 920 drug-target proteins were identified from the TCMSP database. The compound-target-pathway-disease network showed that GRR could potentially treat PF by regulating the MDM2, ERBB2 and VEGFA, signaling pathways through its key targets, including AKT1, TNF, and MAPK1. The protein‒protein interaction network revealed that these targets had strong interactions with each other, indicating a potential synergistic effect of GRR in treating PF. The GO and KEGG enrichment analyses further supported the potential anti-pulmonary fibrosis mechanisms of GRR, including regulating the inflammatory response, ECM-receptor interaction, and TGF-beta signaling pathways. Our study provides a systematic analysis of the potential anti-pulmonary fibrosis mechanisms of GRR based on network pharmacology. These findings could contribute to the development of novel treatments for PF and provide a basis for further experimental studies.

Assessment method for determining rock brittleness based on statistical damage constitutive relations

The brittleness index of rocks is able to provide crucial guidance to the operation of the drilling and hydraulic fracturing. The definition and evaluation method of the rock brittleness has not yet been unified and standardized due to their diversity. We therefore develop an evaluation method of the rock brittleness based on statistical damage relation. A set of uniaxial compression tests on different rock samples are conducted, and corresponding experimental data is collected and analyzed. Then we establish piecewise damage constitutive models based on different combinations of statistical distribution functions, including power function distribution, Weibull distribution, lognormal distribution and logistic distribution. A new evaluation method of rock brittleness based on energy method and the piecewise statistical damage constitutive model is proposed, and the evaluation results show that the increase of damage variable of peak strain will undermine rock brittleness, and the mineral composition contents have influence on the brittleness of rocks. Comparison work between this proposed method and previous brittleness criteria shows that the brittleness index B43 exhibits enhanced stability and consistency in rock brittleness. This study presents a novel method to studying rock brittleness, enhancing current evaluation methods and deepening our understanding of the rock index. Regarding practical application, some field operations involved with the process of drilling or fracturing lead the continuous damage evolution of rocks under loading conditions. The brittleness index from the proposed evaluation method is comparatively reliable and practical for on-site drilling and fracturing.

Efficacy and safety of platelet-rich plasma combined with Tai Chi for knee osteoarthritis: study protocol for a placebo-controlled randomized trial

BackgroundNo definitive treatment methods of curative for knee osteoarthritis (KOA). The combined therapies that into account both the biochemical and biomechanical may provide potential opportunities for treat KOA, and previous studies have demonstrated that the platelet-rich plasma of intra-articular injection (IAI-PRP) and exercise treatments afford more benefits than do their corresponding monotherapies. The absence of a specific exercise plan and detailed explanation renders the aforementioned study results questionable. Furthermore, Tai Chi (TC) with moderate-intensity, whole body movements and good adherence may prove to be more effective for treating KOA. However, few studies examined the effectiveness and safety of combined IAI-PRP and TC for KOA.MethodsThis study protocol will be a placebo-controlled, assessor-blinded randomized trial involving 12-week intervention and 1-year follow-up. The stratified randomization will be used to randomly assign the 212 participants to four groups: group A (placebo IAI); group B (PRP IAI); group C (TC and placebo IAI); group D (TC and PRP IAI). Injection will be performed once a week, three consecutive times as a course, after a week of rest to continue the next course, a total of 3 courses (12 week). Additionally, the TC interventions will be carried out 3 days per week for a total of 12 weeks. The primary outcome measures will include the efficacy (Western Ontario and McMaster Universities Osteoarthritis Index), acceptability and safety of these interventions. The secondary outcome measures will include physical function (Timed Up and Go test), walking function (Gait Analysis), inflammatory factor levels (e.g., Interleukin-1 β, interleukin-6, vascular endothelial growth factor), quality of life (36-Item Short Form Health Survey), volume of patellofemoral cartilage and effusion-synovitis (MRI). Two-way of variance with repeated measures will be applied to examine the main effects of the group and the time factor and group-time interaction effects for all outcome measures.DiscussionThis trial will be first one to propose an integrated scheme combing IAI-PRP and TC for treatment of KOA, based on the consideration of the biochemical and biomechanical pathogenesis of KOA. These results of the study will provide evidence with high quality for integrated IAI-PRP and TC to treatment KOA.Trial Registration Chinese Clinical Trial Registry ChiCTR2300067559. Registered on 11 January 2023.

A STUDY OF POST-OP HEMIARTHROPLASTY DISLOCATIONS AT A DISTRICT GENERAL HOSPITAL

AbstractBackground1. 63,284 patients presented with neck of femur fractures in England in 2020 (NHFD report 2021)2. To maximise theatre efficiency during the first wave of COVID-19, NHSE guidance recommended the use of HA for most patients requiring arthroplasty.3. The literature reports an incidence of Hemiarthroplasty dislocations of 1–15%.Aims1. To study the number and possible causes of dislocations in patients with Primary hemiarthroplasty for fracture neck of femur2. To compare our data with national and international data in terms of dislocation and revision rates for Hemiarthroplasty.MethodsRetrospective study Duration- 1st April 2021–31st March 20223. Inclusion criteria- Patients with neck of femur fracture treated with Hemiarthroplasty. Exclusion criteria- Patients treated with other surgical options for neck of femur fracturesResults1. No. of neck of femur patients- 4442. No. of patients treated with Hemiarthroplasty- 2143. No. of dislocations- 44. 75% were female, 75% had AMTS>7, 50% were operated within 36 hours of trauma, 75% dislocated within a month of surgery, 75% of the dislocations were revised. 5. One dislocation was due to >72 hour delay to surgery, second dislocation was due to smaller offset and shortening, third was due to acetabular dysplasia, fourth was due to larger head used. Discussion-1. Our 1.86% dislocation rate matches that in the literature of 1–6%2. 75% dislocated within a month of surgery matches that in the literature that maximum dislocations occur within one month. 3. Closed reduction as definitive method of management of dislocation 25% matches that in the literature of 22–25%4. 75% dislocations revised similar to literature of 75–80% revision rate.ConclusionPre-operative templating can reduce surgical error involving limb length discrepancy and shortening to prevent dislocationsDeclaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Clinical Presentation and Histological Types of Ovarian Tumor in Patients Admitted in Tertiary Care Center

Background: Ovarian cancer is the eighth most frequent cancer among women worldwide, accounting for 4% of all cancers in the female population. When compared to other reproductive system cancers, ovarian cancer has a high death and morbidity rate. Objectives: The aim of the study was to assess the clinical presentation and histological types of ovarian tumor in patients admitted in tertiary care center. Methods: A descriptive cross-sectional study was conducted to determine the clinical presentation and histopathological types of ovarian tumour diagnosed at Medical college for women, Uttara and Nightingale medical college, Ashulia. The study was approved by the Institutional Review Board (IRB) and 600 patients diagnosed with ovarian tumors were consecutively included in the study from July 2009 to August 2016. The cases were diagnosed and subclassified in accordance with the WHO Classification of Female Genital Tumours, Fourth Edition. Statistical Package for Social Sciences (SPSS) application, version 25, was used for data analysis. Results: Out of Total Gynaecological admission of 4800 patients during the study period, 600 patients were admitted with diagnosis of ovarian Tumor, So occurance was 12.5%. the mean age of the patients was 35 ± 2.09. About 8.6% of the patients had less than 20 years old. 56.6% were within the age group of 21-40, 29.8% were within the age group of 41-60 and only 5% had more than 60 years. The mean Menarche in years was 14.6 ± 1.02 and Menopause in years was 48.7 ± 2.46. Regarding clinical presentation 37.40% had abdominal pain, 55.50% had abdominal mass, 3% had abdominal distension,2% had ascites, 0.50% had menstrual irregularities and 2.50% were asymptomatic. Regarding surgical procedure, 35% undergone Total abdominal hysterectomy and bilateral salpingo-oophorectomy, 18.33% Bilateral salpingo-oophorectomy, 15% Right salpingo-oophorectomy and Left salpingo-oophorectomy recommendation, 13.33% Right cystectomy, 3.33% Left cystectomy. Regarding consistency of tumour 57.33% were cystic, 37% were solid, 5.33% were complex and 0.33% were Diffuse pattern (metastatic tumor). Benign tumors were 77%, borderline 16.67% and malignant 6.33% cases. Out of 462 benign tumors, Serous cystadenoma (230/49.78%), Mucinous cystadenoma (60/12.98%), benign Brenner tumor (10/2.16%), Mature cystic teratoma (110/23.80%), stroma ovarii (10/2.16%), Fibroma (10/2.16%), Fibro-thecoma (12/ 2.59%), leiomyoma (20/4.34%). Out of 38 malignant tumour, Serous cystadenocarcinoma (11/28.94%), mucinous cystadenocarcinoma (6/15.78%), clear cell carcinoma (1/2.63%), Malignant Brenner tumor (1/2.63%), endometroid adenocarcinoma (4/10.52%), squamous cell carcinoma arising in mature teratoma (1/2.63%), Dysgerminoma (7/18.4%), Immature teratoma (1/2.63%), malignant mixed germ cell tumor (1/2.63%), Adult granulosa cell tumor (4/10.52%), Krukenburg tumor (1/2.63%). Survival status was satisfactory; 99.67% patients was alive. Conclusion: The study found that ovarian neoplasms had ambiguous signs and symptoms, were mostly seen in reproductive age groups, and were mostly benign. The proportion of malignant ovarian neoplasms was significantly lower than that of benign ovarian neoplasms. Although incidence of malignant tumor is less common but gynocologists should be more careful in diagnosis of malignancy as ovaries are pelvic organs and definite screening methods are not available and malignancy can occur in any age.

High-sensitivity neonatal urine drug testing has similar positivity rates to meconium fordetecting in utero exposure to methamphetamine andcocaine.

Current guidelines recommend universal screening for substance use disorders in obstetric patients, and neonatal drug testing is also frequently performed. Meconium is often the preferred specimen type to detect neonatal drug exposure due to a longer window of detection compared to urine, but most laboratories send out meconium testing to specialized reference laboratories, which can delay results for several days or more. Here, we evaluate a rapid and definitive liquid chromatography-tandem mass spectrometry method for neonatal urine drug testing and compare results obtained using this method to paired meconium drug testing in 1,424 neonates for amphetamines, cocaine, cannabinoids, opiates, oxycodone and phencyclidine. Urine testing showed equivalent sensitivity to current meconium methods for detecting in utero exposure to amphetamines and cocaine.

NIMG-36. IMAGE LOCALIZATION OF CLINICAL SAMPLES IN BRAIN CANCER: A PROSPECTIVE PROTOCOL

Abstract It has been widely acknowledged that limited access to the human brain, along with the importance of its structures, presents significant challenges in obtaining brain tumor tissue. This poses difficulties for clinical decision-making, as healthcare professionals often have to rely solely on imaging to address complex problems. There is currently no definitive method to make these decisions other than relying on informed yet subjective human judgment. That said, imaging abnormalities are a result of a presence of particular tumor-related biology. Because of this, and the heterogeneity frequently observed in brain tumors, we have developed an image-localized biopsy protocol that has been employed for research purposes at Mayo Clinic Arizona for over five years. This multidisciplinary approach involves the collaborative efforts from neurosurgeons, neuro-oncologists, scrub-techs, nurses, radiologists, as well as multiple research labs, all working within a well-established pipeline. The implementation of this protocol has allowed us to obtain image-localized biopsies during surgical procedures, enabling the correlation of local imaging findings with corresponding tissue features through the utilization of machine learning models. The primary objective of this endeavor is to enhance our understanding of the underlying biological mechanisms of brain tumors based on patients' imaging data. This protocol has been successful for our research purposes, and with minor adjustments, it can be readily adopted by any hospital in order to collect more data about these incredibly heterogeneous diseases. While the use of neuronavigation during surgery has become commonplace in many medical institutions, localization of tissue samples is not. Utilizing pre-existing infrastructure in the operating room is a small burden with big potential positive outcomes. Sample locations can be useful to clinicians during tumor board discussions, to better assess disease heterogeneity. These minor refinements in the surgical workflow have the capacity to provide clinicians with additional clinically-relevant data without disrupting patient care.

Are Allergy-Induced Implant Failures Actually Hypersensitivity Reactions to Titanium? A Literature Review.

This literature review was performed to assess whether implant failures are associated with titanium allergy. An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed by two reviewers. Articles describing cases of implant failure in which the cause of implant failure was only identified as allergy were included. Twelve studies were included. Eight studies identified Ti allergy by clinical examinations, of which four used patch tests, three used the lymphocyte transformation test (LTT)/memory lymphocyte immunostimulation assay (MELISA), and one used both tests. Nine studies reported cases of titanium hypersensitivity in combination with other systemic allergy-related disorders, with eight cases also showing positive results for Ni, Hg, Cr, and Co hypersensitivity. Ten papers reported the improvement of symptoms after the removal of the Ti implants and their replacement with zirconia implants, and two of these papers showed good results. Cases of probable titanium allergy included those with true titanium allergies and those with a potentially different cause. However, the differentiation of these cases is difficult. Since no definitive method has been established for diagnosing titanium allergy, a comprehensive diagnosis based on the clinical course and clinical examination using a patch test/LTT/MELISA is necessary. Implant treatment should be performed with caution in patients with any preoperative allergies.

Cardiac sympathetic hyperinnervation after myocardial infarction: a systematic review and qualitative analysis

Abstract Background Cardiac sympathetic hyperinnervation after myocardial infarction (MI) is associated with arrhythmogenesis and sudden cardiac death. The characteristics of cardiac sympathetic hyperinnervation remain largely underexposed. Objective To provide a systematic review on cardiac sympathetic hyperinnervation after MI taking into account: 1. Definition, experimental model and quantification method of hyperinnervation, and 2. Location, amount and timing of hyperinnervation, in order to obtain an overview of current knowledge and to expose gaps in literature. Methods References on cardiac sympathetic hyperinnervation were screened for inclusion. The included studies received a full-text review, and subsequently a quality appraisal was performed. Relevant data on cardiac sympathetic hyperinnervation were collected and qualitatively analysed. Results Our literature search identified 60 eligible studies performed between 2000 and 2022. Cardiac hyperinnervation is generally defined as an increased sympathetic nerve density or increased number of sympathetic nerves compared to another control group (100%). Studies were performed in a multitude of experimental models, but most commonly in male rats with permanent LAD ligation (male: 63%, rat: 68%, permanent ligation: 93%, LAD: 97%). Hyperinnervation seems to occur mainly in the borderzone. Quantification after MI relied on calculating the nerve density in regions of interest in µm2/mm2 (41%) or in percentage of nerve fibers (46%) and the reported amount showed a great variation ranging from 439 to 126718 µm2/mm2. Remarkably, cardiac sympathetic hyperinnervation seems to be present at all timepoints starting from 3 days onwards to >3 months without an evident peak, although studies on structural evaluation over time and in the chronic phase were scarce. Conclusion Cardiac sympathetic hyperinnervation occurs already at 3 days after MI mainly in the borderzone and remains present at all timepoints. It is most commonly studied in male rats with permanent LAD ligation. The amount of hyperinnervation differs greatly between studies, possibly due to the differential quantification methods. Further studies are required that evaluate cardiac sympathetic hyperinnervation over time and in the chronic phase, in transmural sections, in the female sex, and in MI with reperfusion.

Predictive role of intracoronary electrocardiography for procedural success in patients with ST-elevation myocardial infarction developing coronary no-reflow

Abstract Background The no-reflow phenomenon (NRP) is associated with increased mortality and development of heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Although there is no definitive method for NRP treatment in current guidelines, methods to predict the success of procedures with NRP are also limited. There is a need for a practical, real-time method for predicting the outcome of procedures in NRP patients. Intracoronary electrocardiography (ic-ECG) which is simple, cost-effective, and a bedside indicator of myocardial ischemia, is proposed as a potential solution in this study. Purpose The aim of this study was to examine the potential of ic-ECG in predicting the success of primary percutaneous intervention (pPCI) in patients with STEMI and the development of coronary no-reflow. Methods This was a prospective investigation that included 71 patients diagnosed with acute anterior STEMI and underwent pPCI between November 2021 and May 2022. The patients were separated into two groups based on the Thrombolysis in Myocardial Infarction (TIMI) flow grade criteria, with those having a grade of less than 3 defined as NRP. The NRP group was further analyzed to determine the relationship between the percentage of ST-segment resolution (STR) in the ic-ECG records taken during pPCI and short-term major adverse cardiovascular events rates and left ventricular ejection fraction (LVEF) recovery status. Results A total of 71 patients, with a mean age of 56.8 years and 76.1% of them being male, were included in the study. Of these patients, 26 were found to have developed NRP, while TIMI-3 flow was observed in 45 patients. In the NRP group, various parameters were found to be associated with LVEF recovery, such as peak troponin value (6267.8±2488.4 ng/ml vs 3244.6±3183 ng/ml, p=0.013) basal low-density lipoprotein cholesterol (LDL-C) (138.8±29.9 mg/dl vs 104.5±40 mg/dl, p=0.021), total cholesterol value (222.7±69.2 mg/dl vs 167.5±44.5 mg/dl, p=0.024), and ic-ECG STR level (21±22.3% vs 65.5±17%, p<0.001). The results of the multivariate analysis and subsequent ROC analysis showed that an ic-ECG STR ratio greater than 42% (sensitivity 100%, specificity 84.6%) was an independent predictive factor for LVEF improvement (Table 1). Conclusions The results showed that the STR rate measured by ic-ECG was significantly associated with LVEF recovery and was an independent predictive factor for LVEF recovery with a sensitivity of 100% and specificity of 84.6%. The study highlights the usefulness of ic-ECG in predicting pPCI success in NRP patients and supports its integration into clinical practice.

Su ANCA susijusio vaskulito sukelta polineuropatija: klinikinio atvejo pristatymas

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAVs) are a group of autoimmune diseases that can affect many vital organs and tissues, as well as the nervous system. When peripheral nerves are affected, one of the clinical features of AAVs can be vasculitic neuropathies (VNs). This usually causes asymmetric weakness and numbness in the distal parts of extremities, frequently followed by pain. Nerve conduction study (NCS) reveals axonal loss in multiple individual nerves, whereas a length-dependent process may also be observed. As AAV is a rare diagnostic entity and can manifest with a vast variety of symptoms, it is seldom involved in the initial diagnostic work-up of polyneuropathy. Moreover, the only definitive diagnostic method for VN is peripheral nerve biopsy. Therefore, AAV represents one of the greatest difficulties in the differential diagnosis of neuropathies. In this article, we present a clinical case of a 73-year-old patient admitted to the hospital due to blurry vision, headache, and limb weakness. The findings of the neurological examination were consistent with polyneuropathy. A thorough examination was performed to determine the exact diagnosis. However, due to the lack of typical symptoms, VN was diagnosed only after acute renal failure evolved. This case demonstrates the many symptoms that AAV can present with and the importance of a thorough differential diagnosis for multiple mononeuropathies.

Galaxy mergers in Subaru HSC-SSP: A deep representation learning approach for identification, and the role of environment on merger incidence

Context.Galaxy mergers and interactions are an important process within the context of galaxy evolution, however, there is still no definitive method which identifies pure and complete merger samples is still not definitive. A method for creating such a merger sample is required so that studies can be conducted to deepen our understanding of the merger process and its impact on galaxy evolution.Aims.In this work, we take a deep-learning-based approach for galaxy merger identification in Subaru HSC-SSP, using deep representation learning and fine-tuning, with the aim of creating a pure and complete merger sample within the HSC-SSP survey. We can use this merger sample to conduct studies on how mergers affect galaxy evolution.Methods.We used Zoobot, a deep learning representation learning model pretrained on citizen science votes on Galaxy Zoo DeCALS images. We fine-tuned Zoobot for the purpose of merger classification of images of SDSS and GAMA galaxies in HSC-SSP public data release 3. Fine-tuning was done using ∼1200 synthetic HSC-SSP images of galaxies from the TNG simulation. We then found merger probabilities on observed HSC images using the fine-tuned model. Using our merger probabilities, we examined the relationship between merger activity and environment.Results.We find that our fine-tuned model returns an accuracy on the synthetic validation data of ∼76%. This number is comparable to those of previous studies in which convolutional neural networks were trained with simulation images, but with our work requiring a far smaller number of training samples. For our synthetic data, our model is able to achieve completeness and precision values of ∼80%. In addition, our model is able to correctly classify both mergers and non-mergers of diverse morphologies and structures, including those at various stages and mass ratios, while distinguishing between projections and merger pairs. For the relation between galaxy mergers and environment, we find two distinct trends. Using stellar mass overdensity estimates for TNG simulations and observations using SDSS and GAMA, we find that galaxies with higher merger scores favor lower density environments on scales of 0.5 to 8h−1Mpc. However, below these scales in the simulations, we find that galaxies with higher merger scores favor higher density environments.Conclusions.We fine-tuned a citizen-science trained deep representation learning model for purpose of merger galaxy classification in HSC-SSP, and make our merger probability catalog available to the public. Using our morphology-based catalog, we find that mergers are more prevalent in lower density environments on scales of 0.5–8h−1Mpc.