Fractional Change Research Articles

Effect of ertugliflozin on left ventricular function in type 2 diabetes and pre-heart failure: the Ertu-GLS randomized clinical trial

BackgroundThe therapeutic effects of ertugliflozin, a sodium-glucose cotransporter 2 inhibitor, on cardiovascular outcome are not fully understood. This study aimed to evaluate the efficacy and safety of ertugliflozin on cardiac function in people with type 2 diabetes and pre-heart failure.MethodsWe conducted a 24-week randomized, double-blind, placebo-controlled trial involving individuals with type 2 diabetes inadequately controlled with antidiabetic medications. Participants with left ventricular hypertrophy, E/e’ >15, or impaired left ventricular global longitudinal strain (LVGLS) were randomized 1:1 to receive either ertugliflozin (5 mg once daily) or a placebo. The primary outcome was the change in LVGLS. Secondary outcomes included changes in left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF). Prespecified exploratory outcomes, including angiotensin-converting enzyme 2 (ACE2) and angiotensin (1–7) levels, were also assessed.ResultsA total of 102 individuals (mean age, 63.9 ± 9.2 years; 38% women) were included. The ertugliflozin group showed a significant improvement in LVGLS (− 15.5 ± 3.1% to − 16.6 ± 2.8%, P = 0.004) compared to the placebo group (− 16.7 ± 2.7% to − 16.4 ± 2.6%, P = 0.509), with a significant between-group difference (P = 0.013). Improvements in LVMI and LVEF were also observed. Additionally, significant reductions in HbA1c, systolic blood pressure, whole-body and visceral fat, uric acid, proteinuria, N-terminal pro–B-type natriuretic peptide, and lipoprotein(a) were noted. ACE2 and angiotensin (1–7) levels significantly increased in the ertugliflozin group compared to the placebo group and correlated with changes in LVGLS [r = 0.456, P < 0.001 for ACE2; r = 0.541, P < 0.001 for angiotensin (1–7)]. Adverse events were similar between the two groups.ConclusionsThis study demonstrated that ertugliflozin has beneficial effects on left ventricular function in individuals with type 2 diabetes and pre-heart failure, and it provided insights into potential underlying mechanisms.Clinical trial registration ClinicalTrials.gov Identifier: NCT03717194.

Carbon Budgeting of a Long-term Rice-rice Cropping Sequence in the Typic ustipsamments of Kerala, India

A judicious management practice to improve the soil's organic carbon level and soil fertility is essential for agricultural and environmental sustainability. The present study was undertaken to assess the long-term effect of various management practices on soil carbon dynamics and agricultural sustainability by computation of indices like carbon pool index (CPI), carbon lability index (CLI), carbon management index (CMI), critical carbon input and carbon budgeting. CMI has been used as a more sensitive indicator to evaluate capacity of a management practice to promote soil quality. Sensitivity index was used to determine the degree of changes in each carbon fraction due to management practices. The study was carried out in a permanent manurial trial plot started in 1964 under a long term rice-rice cropping sequence in Kerala. Based on the results obtained, integrated application of NPK fertilizers along with FYM showed significantly higher carbon indices, increased soil carbon fractions, and carbon sequestration compared to other management practices. The study revealed that applying organics coupled with inorganic fertilizers will manage the SOC level and result in enhanced soil fertility, productivity, and agricultural sustainability.

Safety and outcomes with use of FlowTriever for mechanical thrombectomy i n acute pulmonary embolism

Objectives: Mortality in the pulmonary embolism (PE) risk categories has historically been reported between 30% and 40% in high-risk and &lt;15% in intermediate-risk group. In those who survive, there is a high rate of morbidity with dyspnea and exercise intolerance. Advanced therapies with a favorable safety profile have the potential to improve outcomes. We present the largest single-center data set studied to-date for safety, mortality, and outcomes post-mechanical thrombectomy including functional assessment 3 months post-discharge. Material and Methods: We analyzed retrospective database of patients with PE undergoing catheter directed mechanical thrombectomy (CDMT). We report clinical characteristics and outcomes stratified by PE risk categories. Comparison in the groups has been made using analysis of variance method. Results: A total of 365 patients were evaluated in the CDMT group. Among these 81 (22%) presented with high-risk and 261 (71%) with intermediate-risk PE. The average age at diagnosis was 61 ± 17 years with male-to-female distribution ratio of 1.2. Most common risk factors being reduced mobility (18%), malignancy (15%), recent surgery (13%), and hormonal therapy (12%). Mortality within 30 days of PE diagnosis was 8.6% (7/81) in high-risk, 1.7% (4/230) in intermediate-high-risk groups. There were no deaths in intermediate-low and low-risk group post-CDMT. Before thrombectomy, 349 (95%) patients had right heart strain, 307 (84%) had elevated troponin, and 197 (54%) had elevated B-type natriuretic peptide. Post-procedure echocardiogram at 3 month revealed improvement in the right ventricular (RV) fractional area change (27.53 ± 10.38% to 39.73 ± 8.3%, P &lt; 0.01), tricuspid annular plane systolic excursion (10.9 ± 8.3 mm to 21.81 ± 4.75 mm), and RV systolic pressure (43.96 ± 14.48 mmHg to 28.47 ± 7.88 mmHg, P &lt; 0.01). At 3 months post-thrombectomy, the majority (74%) of the patients fell into non-to-negligible functional limitation. Conclusion: We present a descriptive analysis of outcomes including improved mortality, and functional assessment of patients undergoing CDMT.

Left Ventricular Ejection Fraction Change Following Percutaneous Coronary Intervention: Correlates and Association With Prognosis.

The association between left ventricular ejection fraction (LVEF) change (ΔLVEF) following percutaneous coronary intervention (PCI) and the long-term mortality rate in patients with coronary artery disease is incompletely investigated. We aimed to assess the impact of PCI on LVEF and the association of ΔLVEF after PCI with the long-term mortality rate. This observational study included 8181 patients with paired angiographic LVEF measurements performed at baseline and 6 to 8 months following the index PCI. ΔLVEF was defined as LVEF measured on the 6- to 8-month angiography minus LVEF measured on the baseline angiography. LVEF change was classified according to the following categories: reduced (ΔLVEF <0), mildly improved (ΔLVEF >0% to <10%) and largely improved (ΔLVEF ≥10%). The primary outcome was the 5-year mortality rate. In patients with baseline LVEF <40%, 40% to <50% and ≥50%, ΔLVEF (median [25th-75th percentiles]) was 6.0% [0.0% to 14.0%], 4.0% [-1.0% to 11.0%] and 0.0% [-4.0% to 3.0%], respectively (P<0.001). In patients with reduced, mildly improved, and largely improved ΔLVEF, the 5-year mortality rate (n=712) was 29.1%, 23.1%, and 16.5%, respectively, in patients with baseline LVEF <40%; 17.0%, 12.2% and 9.8%, respectively, in patients with baseline LVEF 40% to <50%; and 7.8%, 7.1%, and 5.6%, respectively, in patients with baseline LVEF ≥50% (adjusted hazard ratio [HR], 0.91 [95% CI, 0.86-0.96]; P<0.001) for all-cause death and adjusted (HR, 0.86 [95% CI, 0.81-0.92]; P<0.001) for cardiac death, calculated for 5% higher ΔLVEF. In patients with coronary artery disease undergoing PCI, improvement of LVEF following PCI was associated with a reduced long-term mortality rate in patients with reduced LVEF but not in patients with preserved LVEF before intervention.

MiPrime: A model for the microbially mediated impacts of organic amendments on measurable soil organic carbon fractions and associated priming effects

Priming effects can influence the efficiency with which organic amendments sequester carbon in the soil. Yet, few soil models currently include priming effects. Those models that do are often based on operationally defined soil pools and implicitly allow only for positive priming effects. This limits the verification of model processes with experimental data and hinders the optimization of our carbon sequestration strategies. To address these shortcomings, we developed MiPrime, which offers a framework for the mechanistic modelling of organic amendment impacts on microbially mediated transformation of carbon fractions that are quantifiable through parsimonious soil extraction methods. MiPrime allows for assessment of organic amendment impacts on soil carbon dynamics, including priming effects, by simulating changes in mineralized, microbial biomass, dissolvable, hot water extractable and insoluble carbon fractions in soil exogenous (i.e. organic amendment-derived) and endogenous (i.e. soil) pools. After calibration of model parameters using Markov Chain Monte Carlo methods to incubation data of three types of isotopically labelled roadside grasses (a fresh grass product, a compost thereof, and a Bokashi-fermented product thereof), MiPrime was able to simulate changes in carbon fractions of the soil with a good degree of accuracy for five compositionally complex organic amendments, namely the three types of roadside grasses, as well as non-isotopically labelled wood chips and water weeds and reeds. Validation of the model results with experimental data demonstrates that changes in total carbon were very well predicted but that there is room for improvement in predicting mineralization rates and changes in dissolvable, hot water extractable and insoluble carbon fractions in the soil endogenous pool. MiPrime thus offers an initial step towards the mechanistic modelling of organic amendment impacts on measurable soil carbon fractions and can operate as a new tool for designing effective carbon sequestration strategies and understanding organic amendment impacts.

Vertical Profile Analysis of Cloud Feedbacks

AbstractCloud feedback is the largest source of uncertainty in climate sensitivity. This feedback is generally discussed in terms of radiative flux at the top of the atmosphere, but the vertical distribution of the contribution of cloud changes to the top‐of‐atmosphere cloud feedback should be discussed to understand the feedback in greater detail. We have developed a simple analysis method called “vertical profile analysis of cloud feedback,” which simply uses radiative flux data from each level of the model. The analysis is applied for typical cloud regimes and the results are discussed together with cloud fraction change profiles. The advantages and disadvantages of the vertical profile analysis, compared with the commonly used International Satellite Cloud Climatology Project (ISCCP) histogram kernel method, are discussed. Our analysis has the advantage of resolving the detailed vertical profiles of the contribution to the top‐of‐atmosphere cloud feedback from the changes in cloud regimes associated with warming, such as reduced cloud cover and upward shifts of the cloud layer in subtropical low‐cloud regions as well as the increased height of the melting layer in tropical deep convection. The main disadvantage is that the vertical profile analysis cannot represent the feedback components sorted by cloud optical thickness as in the ISCCP histogram kernel method.

Interaction of a Dense Layer of Solid Particles with a Shock Wave Propagating in a Tube

A numerical simulation of an unsteady gas flow containing inert solid particles in a shock tube is carried out using the interpenetrating continuum model. The gas and dispersed phases are characterized by governing equations that express the concepts of mass, momentum, and energy conservation as well as an equation that shows the change of the volume fraction of the dispersed phase. Using a Godunov-type approach, the hyperbolic governing equations are solved numerically with an increased order of accuracy. The working section of the shock tube containing air and solid particles of various sizes is considered. The shock wave structure is discussed and computational results provide the spatial and temporal dependencies of the particle concentration and other flow quantities. The numerical simulation results are compared with available experimental and computational data.

Particle crushing mechanism of recycled aggregate with different component categories: applied to pervious concrete base

This paper focuses on the particle crushing mechanism of construction solid waste recycled aggregate (CWRA), particularly recycled concrete (RC) and recycled bricks (RB), using natural gravel (NG) as a control group. Compression tests, combined with the Weibull distribution, fractal dimension theory, and relative crushing rate, were conducted to investigate the crushing behavior of these materials under different loads. Results indicate that, under the same load, the crushing degree ranks from highest to lowest as RB, RC, and NG. The Weibull distribution effectively describes the crushing state, with “fragmentation” being the primary mode for most materials, while RC also exhibits “grinding.” As the load increases, the relative crushing rate rises for all materials but slows beyond a certain load threshold, indicating greater difficulty in further crushing. The study identifies a load threshold of 400 kN, beyond which changes in void fraction and relative crushing rates become less significant, particularly in stronger aggregates. Highlights Identified that mortar attached to the RC surface is the primary cause of the increased particle crushing below 0.6 mm. Introduced Weibull distribution parameters a and b to accurately characterize the crushing state of RA particles. Revealed the errors between fractal dimension-based evaluations and the actual crushing state of RC particles. Proposed a two-stage crushing mode for RC. Determined the critical threshold value for the variation of crushing degree with load level.

Sodium-Glucose Cotransporter-2 Inhibitors After Acute Myocardial Infarction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Cardiovascular disease is on the rise globally, with ischemic heart disease being the leading cause of mortality and morbidity. While sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve cardiovascular outcomes in patients with heart failure, evidence is limited in guiding initiation in post-acute myocardial infarction (post-AMI) patients. Hence, this study aimed to appraise the current literature on the effect of SGLT2i on the clinical outcomes of post-AMI patients. A comprehensive search of PubMed, EMBASE, SCOPUS, and ClinicalTrials.gov was conducted up to 1 May 2024. Only randomized controlled trials studying the use of SGLT2i in post-AMI patients were included. We included adult patients aged 18 years old and older diagnosed with AMI and initiated on SGLT2i in the acute post-AMI setting. SGLT2i studies solely in heart failure settingswere excluded. Eight clinical trials were included in the systematic review, comprising 11,436 patients. Compared with placebo, SGLT2i initiation in post-AMI patients significantly reduced total number of heart failure hospitalizations (risk ratio [RR] 0.74, 95% confidence interval [CI] 0.62-0.90) and was associated with a lower N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (- 26.67 pg/ml, 95% CI - 41.74 to - 11.59). There was no difference in all-cause mortality (RR 1.02, 95% CI 0.81-1.28), cardiovascular mortality (RR 1.03, 95% CI 0.83-1.28), change in left ventricular ejection fraction, and glycated hemoglobin (HbA1c), as compared with placebo. SGLT2i use in patients with AMI was associated with a reduction in heart failure hospitalizations and a decrease in NT-proBNP. There were no significant differences in mortality outcomes. PROSPERO identifier number CRD42024540843.

Ventricular Dysfunction in Patients With Congenital Diaphragmatic Hernia Who Die After Repair

BackgroundQuantitative echocardiographic (echo) measures of ventricular function predict mortality in pediatric pulmonary hypertension (PH), but studies in congenital diaphragmatic hernia (CDH)-related PH are limited. Few studies report quantitative echo data beyond the first week of life in CDH non-survivors. MethodsA single-center retrospective, cross-sectional, cohort study included CDH patients born between January 2013 and April 2022 who survived to surgical repair but died during the neonatal hospitalization. Quantitative measures of right (RV) and left ventricular (LV) size and function including tricuspid annular plane systolic excursion Z-score (TAPSEZ), RV fractional area change (FAC), RV/LV ratio, LV eccentricity index, LV M-mode dimensions, and RV/LV systolic strain were performed offline on the last echocardiogram before death. Data were compared between patients who died ≤30 days after repair (“early”) vs. >30 days after repair (“late”) using the Wilcoxon rank sum test. ResultsTwenty-five (11 early, 14 late) deceased patients had echo images available for analysis. LV size by end-diastolic dimension Z-score was smaller in patients who died early vs. late after repair [-3.03 (−3.93, −2.51) vs. −0.24 (−2.11, 0.53), p = 0.021]. There were trends toward worse RV function (TAPSEZ, RVFAC, RV global and free wall strain) and LV function (apical 4 chamber strain) in patients who died early vs. late after repair. ConclusionThese preliminary findings support future study of the impact of ventricular hypoplasia and dysfunction on mortality and opportunities for risk stratification based on quantitative echo findings in CDH. Level of EvidenceCohort study, 4.

Evaluation of Fetal Heart Using Fetal Heart Quantification (fetalHQ) Technique in an Indian Cohort.

To evaluate the intra- and interobserver reproducibility of parameters used to determine cardiac morphometry and deformation using FetalHQ in Indian population. Two operators blinded to each other performed FetalHQ analysis independently on 35 normal fetuses of gestational age between 18 + 0 and 37 + 0 weeks and days. Intra- and interobserver correlation coefficient and limits of agreement were ascertained for parameters obtained from HQ analysis. Excellent reproducibility (ICC > 0.9) was observed for global morphometric parameters. Ejection fraction, stroke volume, stroke volume/kg demonstrated excellent reliability (ICC > 0.9), cardiac output, fractional area change showed a lower correlation (ICC < 0.8), and right and left ventricular global strain showed no correlation. Twenty-four segment sphericity index of left ventricle (LV) and right ventricle (RV) showed low to moderate correlation (LV-ICC 0.48-0.79; RV-ICC 0.43-0.82). Fractional shortening (FS) showed poor intraobserver reliability in RV. FetalHQ provides reliable estimates of the global cardiac morphometry but not for global cardiac strain. Regional transverse contractility represented by FS has poor correlation in right ventricle, especially in the apical region, possibly due to moderator band. Nevertheless, it is a promising tool which requires technical advancements and validation to improve its accuracy and reliability.

Changes in Physical Fractions within Soil Aggregates Under Nitrogen Reduction and Film Mulching Measures in Dryland Wheat Field

We studied the changes in various physical fractions within aggregates in the arid plateau of southern Shanxi Province, which has great significance for synergistically improving soil fertility and crop productivity in this region. Bulk soil samples were collected from 0-20 cm layers during a 7-year long-term experiment in Hongtong County, Shanxi Province. Wheat grain yields, SOC concentrations, proportions, and OC contents within soil aggregates were analyzed. OC contents included： unprotected coarse particulate organic carbon within macroaggregate （M-cPOC） and fine particulate organic carbon within macroaggregate （M-fPOC）, physically protected intra-aggregate particulate organic carbon within macroaggregate （M-iPOC）, chemically/biochemically protected mineral organic carbon within macroaggregate （M-MOC）, unprotected fine particulate organic carbon within microaggregate （m-fPOC）, physically protected intra-aggregate particulate organic carbon within microaggregate （m-iPOC）, and chemically/biochemically protected mineral organic carbon within microaggregate （m-MOC）. The treatments were ① farmer fertilization （FP）, ② nitrogen reduction monitoring and control fertilization （MF）, ③ nitrogen reduction monitoring and control fertilization plus ridge film and furrow sowing （RF）, and ④ nitrogen reduction monitoring and control fertilization plus flat film hole sowing （RF）. The results showed that compared with that in the FP treatment, MF reduced SOC concentration while maintaining wheat grain yield, RF and FH synergistically improved soil fertility and crop yield, especially for the FH with SOC concentration, and wheat grain yield increased by 8.44% and 48.86%, respectively. MF significantly reduced the content of M-cPOC, RF significantly increased the content of M-iPOC, and FH significantly increased the contents of M-fPOC, M-iPOC, M-MOC, and m-iPOC by 64.00%, 98.39%, 6.16%, and 17.48%, respectively. In addition, combined with redundancy analysis, we found that the M-iPOC fraction played a major role in increasing SOC concentration and wheat grain yield, with a contribution rate of 61.5%. Therefore, the contribution of macroaggregates to soil fertility and crop productivity was higher than that of microaggregates in the arid plateau area of southern Shanxi, and flat film hole sowing could increase the content of M-iPOC, thereby synergistically increasing SOC sequestration and wheat grain yield, which could promote this cultivation technology in the region and even in the country's arid agricultural areas.

COVID-19 is associated with cardiac structural and functional remodelling in healthy middle-aged and older individuals.

Coronavirus disease 2019 (COVID-19) was declared a global pandemic in 2019. It remains uncertain to what extent COVID-19 effects the heart in heathy individuals. To evaluate the effect of the COVID-19 on cardiac structure and function in middle-aged and older individuals. A single-centre prospective observational study enroled a total of 124 participants (84 with history of COVID-19 [COVID-19 group] and 40 without a history of COVID-19 [non-COVID group]). All participants underwent echocardiography with speckle tracking to assess cardiac structure and function at rest and during peak exercise. There were no differences in left and right ventricular diastolic function (p ≥ 0.05) between the COVID-19 and non-COVID-19 groups. Participants in COVID-19 group demonstrated higher left ventricular mass (130 ± 39.8 vs. 113 ± 27.2 g, p = 0.008) and relative wall thickness (0.38 ± 0.07 vs. 0.36 ± 0.13, p = 0.049). Left ventricular global longitudinal strain was reduced in the COVID-19 group at rest and at peak-exercise (rest: 18.3 ± 2.01 vs. 19.3 ± 1.53%, p = 0.004; peak exercise: 19.1 ± 2.20 vs. 21.0 ± 1.58%, p ≤ 0.001). However, no difference was seen in resting left ventricular ejection fraction (58 ± 2.89 vs. 59 ± 2.51%, p = 0.565) between groups. Right ventricular fractional area change was reduced in the COVID-19 group (p = 0.012). Cardiac structural and functional remodelling was observed in middle-aged and older otherwise healthy individuals with a history of COVID-19.

The pace of change of summertime temperature extremes

Summer temperature extremes can have large impacts on humans and the biosphere, and an increase in heat extremes is one of the most visible symptoms of climate change. Multiple mechanisms have been proposed that would predict faster warming of heat extremes than typical summer days, but it is unclear whether this is occurring. Here, we show that, in both observations and historical climate model simulations, the hottest summer days have warmed at the same pace as the median globally, in each hemisphere, and in the tropics from 1959 to 2023. In contrast, the coldest summer days have warmed more slowly than the median in the global average, a signal that is not simulated in any of 262 simulations across 28 CMIP6 models. The observed stretching of the cold tail indicates that observed summertime temperatures have become more variable despite the lack of hot day amplification. The interannual variability and trend in the warming of both hot and cold extremes compared to the median can be explained from a surface energy balance perspective based on changes in net surface radiation and evaporative fraction. Tropical hot day amplification is projected to emerge in the future (2024-2099, SSP3-7.0 scenario), while Northern Hemisphere heat extremes are expected to continue to follow the median.

6819 Adult-Onset Craniopharyngioma Patients Are at High Risk for Hepatic and Metabolic Dysfunction in the First Year After Surgery

Abstract Disclosure: O. Cooper: None. V.S. Bonert: None. M. Noureddin: Advisory Board Member; Self; GlaxoSmithKline, Novo Nordisk, Merck, Takeda, Altimmune, BI, Northsea Therapeutics, Terns, 89BIO, Madrigal, Cytodyn, Corcept. Research Investigator; Self; Bristol-Myers Squibb, Akero, BI, GlaxoSmithKline, Allergan, Galectin, Genfit, Conatus, Enanta, Madrigal, Novartis Pharmaceuticals, Novo Nordisk, Shire, Takeda, Terns, Viking, Zudus, Gilead, Corcept. Stock Owner; Self; Rivus Pharma, CIMA, Cytodyn, ChronWell. M. Ader: None. M.O. Goodarzi: Advisory Board Member; Self; Nestle Health Science, Organon Laboratories. A.N. Mamelak: None. Background: Observational studies of adult-onset craniopharyngioma (AoCP) suggest that hepatic and metabolic dysfunction begin perioperatively, but rigorous evidence is lacking. We assessed prevalence of these sequelae in AoCP to better understand their long-term impact. Methods: The retrospective study included all patients with AoCP who underwent surgery at our center from 1993 to 2017. In the prospective study, newly diagnosed patients were assessed preoperatively and at 3 and 12 months postoperatively with MRI-PDFF/elastography, frequently sampled intravenous glucose tolerance test (FSIGT), and cardiometabolic biomarkers. The primary endpoint was hepatic fat fraction change from baseline. Secondary endpoints were changes in fibrosis, glucose/insulin metabolism, hypertension (HTN), and lipids. Data are summarized as median (IQR) or mean ± SD. Results: 35 patients were followed retrospectively for a mean of 116 months. After surgery, 73% had new-onset obesity. Mean BMI increased by 5.0 ± 5.8 kg/m2 and 40% progressed from overweight to obese. 43% had new-onset type 2 diabetes mellitus (T2DM) and 39% hyperlipidemia. In 16 patients with liver imaging, 11 had metabolic dysfunction-associated steatotic liver disease (MASLD), 5 metabolic dysfunction-associated steatohepatitis (MASH), and 4 cirrhosis. In the prospective study, data from 6 patients were analyzed, 4 for ≥12 months. Median age was 48.5 (40.5, 59); 50% were female. At baseline, 17% had HTN, 50% hyperlipidemia, 67% prediabetes, 50% obesity class 1, and 17% class 2. 40% had mild steatosis and none had fibrosis. Median A1C was 5.9% (5.3, 6.1). By 3 months postop, 83% had elevated liver enzymes and median hepatic fat fraction increased 213%, with steatosis in 67%. BMI increased by 4% (-1.8, 12.5); 1 patient remained normal weight, 1 progressed to overweight, 3 remained class 1 obesity and 1 class 2. By 12 months, 50% had elevated liver enzymes and all had steatosis, with fibrosis grade 3 in 1 patient. Median hepatic fat fraction increased 670% from baseline and 62% from month 3. 50% had T2DM and 50% prediabetes. Median A1C was 6.4% (5.9, 7.3). On FSIGT, disposition index decreased by 69% (-91, 50) and insulin sensitivity decreased by 51% (-70, 46). Median BMI was 30.8 kg/m2 (25.3, 37.1); 1 patient remained normal weight, 1 was overweight, 1 class 1 obesity, and 1 class 2. 50% had HTN and 50% had hyperlipidemia. Conclusion: By 10 years after surgery, most patients with AoCP have MASLD, with some progressing to MASH, fibrosis, and cirrhosis. T2DM, hyperlipidemia, and obesity are prevalent. In our small prospective cohort, by 1 year after surgery, all patients had developed MASLD, and BMI, blood pressure, and insulin and lipid profiles worsened. These results underscore the need for early interventions to halt progression of metabolic sequelae in patients with AoCP undergoing surgical resection and impede long-term comorbidity development. Presentation: 6/3/2024

Изменение состава пектиновых веществ при замораживании и хранении растительной продукции

To keep up with the growing demand, producers of frozen plant products have to develop new freezing technologies that would preserve the sensory and biological properties of fruits and vegetables. Pectins are important structural and moisturebinding components of plant cells that improve their stability at high and low temperatures. The research objective was to study the effect of blanching and various freezing methods on the composition of pectin substances during long-term storage of fruits and vegetables. The research featured scorzonera, salsify, kohlrabi, apples, and plums. The freezing modes included two temperature modes (–24 and –35°C) and three freezing methods, i.e., blanching, air-freezing represented by natural air-freezing, artificial convection, and fluidization, and immersion in a mix of water, ethyl alcohol, sucrose, and sodium chloride. The frozen samples were stored in sealed bags at –18°C for 7–12 months. The water-soluble pectin, intermediate fraction, and protopectin obtained by extraction were determined using the colorimetric carbazole method. The qu alitative analysis relied on infrared spectroscopy. Blanching reduced the pectin content by 2–10% in vegetables and by 18–21% in apples. Fluidization and immersion freezing had the least damaging effect on pectins. Air-freezing with natural convection caused the greatest damage to protopectin. During storage, the maximal loss of pectins (66%) occurred in the salsify sample subjected to natural air convection at –24°C. The least damage (9%) was detected in the kohlrabi sample frozen at –24°C in ice environment. A higher moisture content in the native state correlated with minimal losses of pectins by the end of refrigerated storage. The research also included identification of absorption bands for pectic substances in fro zen scorzonera and salsify. In this study, pectin content depended on moisture content in tissues, blanching process, and freezing method. All frozen samples demonstrated losses of protopectin and an increase in the intermediate fraction. An intense freezing process had a positive effect on the pectin content during long-term storage. However, after six months of storage, the samples demonstrated significant fractional changes and pectin losses.

Runtime reliability fractional distribution change analytics against cloud-based systems DDoS attacks

With the help of the Software as a Service (SaaS) delivery model, the rapid advancement of cloud computing has become the most prevalent distributed computing paradigm. A large number of application vendors and developers choose to integrate cloud-hosted Application Program Interfaces (APIs) into their systems as system components to construct new and value-added cloud-based systems. When executed in an open cloud environment, each system component is constantly at risk of Distributed Denial of Service (DDoS) attacks. Such cloud-based systems are challenged by reliability fluctuations when a system component is attacked. A change in the reliability of the remote system components, e.g., performance decline or runtime anomalies, can threaten the stability of the entire cloud-based system. To enable timely reliability assurance against cloud-based systems DDoS attacks, it is necessary to analyze runtime reliability of its system components. In this paper, we formally present a new model for evaluating the reliability of the system components based on concept drift. Based on the model, we propose a novel method named runtime reliability anomaly detection (RAD), leveraging the Singular Value Decomposition (SVD) technique. RAD analyzes the reliability of a system component during its operation by detecting peaks in Fractional Distribution Change (FDC) within its reliability time series data. Specifically, it calculates the Jensen Shannon divergence between historical and up-to-date reliability data streams, based on feature vectors that are dimensionality-reduced using SVD. The results of extensive experiments conducted on two public cloud APIs performance datasets demonstrate the effectiveness and efficiency of RAD.

Structural determinants of tendon multiscale mechanics and their sensitivity to mechanical stimulation during development in an embryonic chick model

There is an abrupt increase in the multiscale mechanical properties and load-bearing capabilities of tendon during development. While prior work has identified numerous changes that occur within the collagenous structure during this developmental period, the primary structural elements that give rise to this abrupt increase in mechanical functionality, and their mechanobiological sensitivity, remain unclear. To address this knowledge gap, we used a shear lag model along with ultrastructural imaging, biochemical/thermodynamic assays, and multiscale mechanical testing to investigate the dynamic structure-function relationships during late-stage embryonic chick development and to establish their sensitivity to mechanical stimulation. Mechanical testing and modeling suggested that the rapid increase in multiscale mechanics can be explained by increases in fibril length, intrafibrillar crosslinking, and fibril area fraction. To partially test this, we inhibited collagen crosslinking during development and observed a drastic reduction in multiscale mechanical behavior that was explained by a reduction in both fibril modulus and length. Using muscle paralysis to investigate mechanosensitivity, we observed a significantly impaired multiscale mechanical response despite minimal changes in fibril diameter and fibril area fraction. Additionally, the shear lag model found a trend toward lower fibril lengths with paralysis and experimental data found decreased crosslinking and fibril modulus values following flaccid paralysis. Together, these data suggest that both intrafibrillar crosslink formation and fibril elongation are critical to the formation of load-bearing capabilities in tenogenesis and are sensitive to mechanical loading. These findings provide critical insights into the biological and structural mechanisms that give rise to tensile load-bearing soft tissue. Statement of SignificanceDespite prior work investigating the structural and mechanical changes that occur during tendon development, there has not been a comprehensive analysis of how these simultaneous changes in structure and function are connected. In this study, we performed a comprehensive battery of mechanical and structural assessments of embryonic chick tendons and input these data into a shear lag model to estimate the individual importance of each structural change to the tendon mechanical properties. Additionally, we inhibited muscle activity in the embryos to evaluate the impact of mechanical stimulation on these evolving structure-function relationships during tendon development. These data provide insight into the primary structural elements that produce the tensile load-bearing capabilities of tendon, which will inform efforts to produce tissue engineered tendon replacements.

Design and Rationale of MYOFLAME-19 RCT: MYOcardial protection to reduce inFLAMmatory heart disease due to COVID-19 Infection using CMR Endpoints

Cardiac symptoms due to postacute inflammatory cardiac involvement affect a broad segment of previously well people with only mild acute COVID-19 illness and without overt structural heart disease. Cardiac magnetic resonance (CMR) imaging can identify the underlying subclinical disease process, which is associated with chronic cardiac symptoms. Specific therapy directed at reducing postacute cardiac inflammatory involvement prior to development of myocardial injury and impairment is missing. Prospective multicentre randomised placebo-controlled study of myocardial protection therapy (combined immunosuppressive/antiremodelling) of low-dose prednisolone and losartan. Consecutive symptomatic individuals with a prior COVID-19 infection, no preexisting significant comorbidities or structural heart disease, undergo standardised assessments with questionnaires, CMR imaging and cardiopulmonary exercise testing (CPET). Eligible participants fulfilling the criteria of subclinical Post-COVID inflammatory involvement on baseline CMR examination are randomised to treatment with either verum or placebo for a total of 16 weeks (W16). Participants and investigators remain blinded to the group allocation throughout the study duration. The primary efficacy endpoint is the absolute change of left ventricular ejection fraction (LVEF) to baseline at W16, measured by CMR, between the verum treatment and placebo group by absolute difference, using unpaired t-test confirmatively at the 5% significance level. Secondary endpoints include assessment of changes of symptoms, CMR parameters, and CPET after W16, and frequency of major adverse cardiac events after 1 year. Safety data will be analysed for frequency, severity and types of adverse events (AEs) for all treatment groups. The proportion of AEs related to the contrast agent gadobutrol will also be analysed. A calculated sample size is a total of 280 participants (accounting for 8% drop-out), randomised in 1:1 fashion to 140 in the verum and 140 placebo group. Myoflame-19 study will examine the efficacy of a myocardial protection therapy in symptomatic participants with post-COVID inflammatory cardiac involvement determined by CMR. The aim of the intervention is to reduce the symptoms and inflammatory myocardial injury, to improve exercise tolerance and preclude the development of cardiac impairment. NCT05619653.

Effect of Zr addition on MnS inclusion characteristics and mechanical properties in medium carbon ferrite-pearlite steel

In this paper, the influence of decreasing Zr content (0.0110wt%, 0.0044wt%) on the microstructure, MnS inclusion characteristics, and mechanical properties of medium carbon ferrite-pearlite steel was studied. The results show that the volume fraction of intragranular ferrite (IGF) in steel increases with a reduction in Zr content. The ductility of the steel is reduced by 1.83%, the impact toughness is increased by 2.5 times, and the yield strength is almost unchanged. Compound MnS inclusions are the main inclusions that induce IGF formation. The proportion of heterogeneous nucleation of MnS inclusions using oxides as nucleation sites is increased, which is the main reason for the increase in the volume fraction of IGF. Furthermore, MnS inclusions change from type Ⅲ to type Ⅰ and Ⅱ, and their distribution is gradually uniform. Thermodynamic analysis reveals that the underlying cause for the morphological transformation of MnS inclusions is the rapid surge in the supersaturation of S element in molten steel. The presence of liquid-phase low-melting inclusions (MnS-Al2O3) promotes the formation of type Ⅰ MnS inclusions. The volume fraction and the dimension perpendicular to the fracture surface of the MnS inclusions are increased by at least 33% and 111%, while their aspect ratio is reduced by a maximum of up to 19%. The change in the volume fraction of MnS inclusions is the primary factor contributing to the decrease of tensile plasticity. The toughness of steel is mainly affected by the aspect ratio and the dimension perpendicular to the fracture surface of MnS inclusions.