Near-infrared Spectroscopy Research Articles

Evaluation method for proteoglycans using near-infrared spectroscopy.

Cartilage is a connective tissue composed of mainly water, collagen (COL) and proteoglycans (PGs) including chondroitin sulfate (CS). Near-infrared (NIR) spectroscopy is adequate for examination of soft and hard tissues with large amount of water non-destructively and non-invasively. We measured tablets containing CS and COL using NIR spectroscopy to develop an evaluation method for PGs in cartilage non-destructively and non-invasively. Calibration curves were constructed using the NIR spectra of the tablets that show the quantitative linear relationship between the concentration and height of the second derivative at 4260cm-1 for COL and at 5800cm-1 for COL and CS. An equation to calculate the CS-to-COL ratio was derived from the calibrated slopes at 5800 and 4260cm-1, and the utility of the equation was demonstrated by the evaluation of tablets. Moreover, we conducted an evaluation of the CS-to-COL ratio in the aqueous nucleus pulposus and annulus fibrosus, and the results were consistent with the glycosaminoglycans (GAGs)-to-COL ratios obtained through Raman spectroscopy of the same specimens. Thus, this method is adequate for evaluating PGs with large amount of water non-destructively, non-invasively and with less damage.

Loblolly pine downed timber: Box-Behnken design and first derivative pretreatment for predictive modeling with near-infrared spectroscopy and machine learning (NIRS-ML)

Loblolly pine downed timber: Box-Behnken design and first derivative pretreatment for predictive modeling with near-infrared spectroscopy and machine learning (NIRS-ML)

Feasibility study on fingerprinting organic and conventional mango fruits, chips, and juice using portable near-infrared spectroscopy.

This research examined the distinction between organic and conventional mango fruits, chips, and juice using portable near-infrared (NIR) spectroscopy. A comprehensive analysis was conducted on a sample of 100 mangoes (comprising 50 organic and 50 conventional) utilising a portable NIR spectrometer that spans a wavelength range from 900 to 1700 nm. The mangoes were assessed in their entirety and their juice and chip forms. The spectral data underwent pre-processing through methodologies such as multiplicative scatter correction (MSC), standard normal variate (SNV), and derivatives to enhance the precision of the models. Principal component analysis (PCA) and various multivariate classification algorithms, including linear discriminant analysis (LDA), random forest (RF), k-nearest neighbors (kNN), and partial least squares discriminant analysis (PLSDA), were utilised to categorise the samples effectively. The findings indicated that the random forest method and specific pre-processing techniques achieved the highest classification accuracy for distinguishing organic and conventional mango products. For mango fruit and chips, it achieved 88.76% and 77.98% accuracy, respectively, when pre-processed using the second derivative, while for juice, it achieved 87.53% accuracy without pre-processing. This investigation demonstrates the efficacy of portable NIR spectroscopy as a dependable and non-invasive method for verifying organic mango products, thereby enhancing the integrity of food labelling and fostering consumer confidence.

Changes in Cerebral Hemodynamic Among Patients With Schizophrenia or Bipolar Disorder Receiving Electroconvulsive Therapy: A Task-Related Functional Near-Infrared Spectroscopy Study.

There remains a scarcity of studies to evaluate the treatment effect of electroconvulsive therapy (ECT). Functional near-infrared spectroscopy (fNIRS) offers a cost-effective method to measure cerebral hemodynamics. This study used fNIRS to evaluate the effect of ECT in patients suffering from schizophrenia or bipolar disorder (manic phase). Thirty patients with mania and 31 with schizophrenia were recruited. Each participant received 6 sessions of ECT. This study utilized the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and fNIRS-verbal fluency test paradigm at baseline and after each session of ECT. The prefrontal cortex hemodynamic response during the performance of verbal fluency test was recorded via a commercial wireless high-density continuous-wave fNIRS system device. The effect of categorical and continuous variables was determined using Pearson's chi-square test and Student's t test or 1-way analysis of variance with Bonferroni-corrected post hoc pairwise comparison, respectively. Comparing the Positive and Negative Syndrome Scale and Young Mania Rating Scale scores between baseline, sessions 3 and 6, the scores were significantly decreased (P < 0.001), with both patient groups achieving more than 50% reduction in scores from baseline to session 6. The fNIRS also showed significant increases in oxy-hemoglobin levels (session 6 vs baseline) in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex for both patient groups (P < 0.05). There were significant correlations in the reduction of symptom severity and increase in HbO2 levels in people with bipolar disorder (manic phase) and schizophrenia (P < 0.05). Monitoring the activation in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex is an objective ECT monitoring indicator for patients suffering from bipolar disorder (manic phase) or schizophrenia.

Efficacy of Cerebral Oxygen Saturation Monitoring for Perioperative Neurocognitive Disorder in Adult Noncardiac Surgical Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Perioperative neurocognitive disorders are common perioperative complications associated with various poor outcomes. Regional cerebral oxygen saturation (rSO2) monitoring is a noninvasive technique based on near-infrared spectroscopy detection. Due to the considerable controversy among currently published studies on the application of intraoperative rSO2 monitoring in adult patients undergoing elective noncardiac surgery, this study aims to conduct a systematic review and meta-analysis to provide more comprehensive and robust evidence to support clinical decision-making. This study conducted a systematic literature search of databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science, from their inception to May 1, 2024. The eligible randomized controlled trials included adult patients undergoing elective noncardiac surgery under general anesthesia who received optimized anesthesia management guided by rSO2 monitoring and those in the control group who received routine anesthesia management under standard monitoring or blinded rSO2 monitoring. The primary outcomes were the incidence of perioperative neurocognitive disorders, including postoperative delirium (POD) and postoperative cognitive dysfunction (POCD), and Mini-Mental State Examination (MMSE) scores. Secondary outcomes included the incidence of intraoperative cerebral desaturation and length of hospital stay (LOS). The pooled results showed that compared to the control group, optimized anesthesia management guided by intraoperative rSO2 monitoring significantly reduced the incidence of POCD within 7days postoperatively and may reduce the incidence of POCD at 3months and longer periods postoperatively. However, it may not reduce the incidence of POD within 7days or longer periods postoperatively, improve MMSE scores, reduce the incidence of intraoperative cerebral desaturation, or shorten LOS. Given the substantial heterogeneity in the pooled results for MMSE scores within 7days postoperatively and LOS, and the limited number of studies reporting the incidence of POD, POCD, and MMSE scores after 7days postoperatively, the related results should be interpreted with caution. Despite the presence of heterogeneity and the inclusion of a limited number of studies for some outcomes, it is still recommended that clinical anesthesiologists routinely perform intraoperative rSO2 monitoring and optimize intraoperative anesthesia management based on the monitoring results to maximize rSO2 and improve cerebral perfusion, thereby improving patients' neurocognitive outcomes. Further large-scale, high-quality studies are needed to confirm the conclusions of this study.

A rapid and non-invasive classification of hydrothermally modified wood material using integrated approach of NIR spectroscopy and SIMCA

A rapid and non-invasive classification of hydrothermally modified wood material using integrated approach of NIR spectroscopy and SIMCA

The effect of distraction and feedback on prefrontal cortex activity and balance in middle-aged adults: A functional near-infrared spectroscopy pilot study.

Maintaining balance while simultaneously performing other tasks is common during everyday activities. However, this dual-tasking (DT) divides attention and increases cognitive demand, which can be detrimental to stability in older adults. It is unknown if the focus of attention influences how a dual-task affects balance and whether this is detectable in middle-aged adults. This study investigates the effect of dual-task and attentional focus on prefrontal cortex (PFC) activity in young (YA) and middle-aged (MA) adults using functional-near infrared spectroscopy. Blood oxygen level of the PFC was measured during a quiet standing cognitive-motor dual-task where MA (n = 15, mean age 57.2 ± 4.8 years, 5 female) and YA (n = 20, mean age 24.9 ± 4.7 years, 9 female) stood on a forceplate while either fixating their gaze on a target ('fixed') or viewing their real-time postural oscillations in the anteroposterior direction ('sway') with and without serial 7 subtractions. It was expected that the MA group would show higher PFC activity, larger COP excursions, and poorer performance during DT than the YA group. PFC activity was larger during DT and during the fixed condition but did not differ between groups. COP excursion was also greater when attention was 'fixed' and was consistently larger in MA. MA drove a positive correlation between PFC activity and COP excursion during DT indicative of a higher attentional demand during distraction. Taken together, this study suggests that PFC processing and posture control are different in middle aged adults compared to young adults.

Construct ZnSeTe/ZnTe Nanostructures with the Tunable Emission from 450 to 760 nm.

Developing heavy-metal-free materials with wide tunable emission is important to light-emitters. The alloying method is utilized in ZnSe magic size clusters (MSCs) with Te to form ZnSeTe and manipulate the band gap structure in ZnSe. The growth of ZnTe on alloyed ZnSeTe quantum dots (QDs) forms ZnSeTe/ZnTe core/shell nanostructures, showing the tunable photoluminescence emission peak from 450 to 760 nm with the different thicknesses of ZnTe shell. This is the record tunable range of 310 nm in the full visible and near-infrared spectra based on zinc chalcogenide nanostructures. Further coating thin ZnSe and ZnS shell on ZnSeTe/ZnTe core/shell nanostructures significantly improves the stability and quantum yield of nanoparticles. This work offers a new, cadmium-free material choice for optoelectronic devices aligning with environmental and performance requirements for modern applications.

Monitoring Polypropylene Chain-Scission for Dissolution-Based Recycling by In Situ Near Infrared and Raman Spectroscopy.

Within the context of polypropylene recycling by dissolution, the potential degradation of polypropylene in solution has been investigated using in situ NIR and Raman spectroscopy. Pure polypropylene, completely free of additives, and commercial polypropylene, low in additives, are degraded on purpose under different conditions. Genetic algorithm combined with partial least squares (GA-PLS) models have been built based on near-infrared (NIR)spectra, and partial least squares (PLS) models based on Raman spectra, to predict the mass average molar mass and the chain-scission rate, respectively, during the degradation process. The variables used in the GA-PLS model from NIR spectra suggest that the main variability is related to physical changes via the baseline. In Raman, a baseline drift due to coloration during the degradation has been used to correlate the spectra with the degradation phenomenon. Both techniques show good predictive performances and can potentially be implemented for real-time supervision of degradation during recycling processes.

Prefrontal cortex responses to game rewards and losses in individuals with Internet Gaming Disorder: Insights from fNIRS during mobile gameplay.

This study aimed to explore the brain activity characteristics of individuals with Internet Gaming Disorder (IGD) during mobile gameplay, focusing on neural responses to positive and negative game events. The findings may enhance our understanding of the neural mechanisms underlying IGD. Functional near-infrared spectroscopy (fNIRS) was employed to measure hemodynamic responses (HbO/HbR) in the prefrontal cortex of both IGD participants and recreational gaming users (RGU), during solo and multiplayer mobile gameplay. In solo mode, IGD participants exhibited stronger activation in the dorsolateral prefrontal cortex (dLPFC), frontopolar area (FPA), orbitofrontal cortex (OFC) in response to positive events compared to RGU. Negative events led to reduced activation in the FPA among IGD participants. In multiplayer mode, IGD participants displayed lower activation in the dLPFC and ventrolateral prefrontal cortex (vLPFC), although overall brain response trends to positive and negative events were similar between IGD and RGU. This study suggests that individuals with IGD exhibit heightened sensitivity to rewards and diminished sensitivity to losses, along with potential impairments in the executive control network. These results contribute to a better understanding of the neural mechanisms of IGD and offer insights for developing targeted interventions aimed at addressing abnormal reward and loss processing.

Inter-brain plasticity as a mechanism of change in psychotherapy: A proof of concept focusing on test anxiety

Objective. There is a growing consensus that interpersonal processes are key to understanding psychotherapy. How might that be reflected in the brain? Recent research proposes that inter-brain synchrony is a crucial neural component of interpersonal interaction. The current proof-of-concept study examines, for the first time, therapist-patient inter-brain synchrony measurement during multiple sessions. To guide the design of future studies, we performed a precursory test in a small sample of the association between inter-brain synchrony and therapeutic change, hypothesizing that it would gradually increase over therapy, reflecting inter-brain plasticity. Method. We scanned 18 therapy sessions of participants (N = 8) who underwent a 6-session test anxiety treatment. We measured therapist and patient brain activity using functional near-infrared spectroscopy (fNIRS) and assessed perceived session quality, wellbeing, symptoms, and therapeutic alliance every session. Results. In this proof-of-concept sample inter-brain synchrony gradually increased over treatment, and was associated with reduced symptoms, improved wellbeing and perceived session quality, but not with a stronger therapeutic alliance. fNIRS imaging had no discernable adverse effects. Conclusion. Our findings demonstrate that fNIRS imaging during psychotherapy is a feasible and viable research method and that inter-brain plasticity should be a candidate for future research on biological mechanisms underlying therapeutic change.

Food properties modulate activities in posterior parietal and visual cortex during chewing.

Cross-modal interactions between sensory modalities may be necessary for recognition of chewing food by the invisible oral cavity to avoid damaging the tongue and/or oral mucosa. The present study used functional near-infrared spectroscopy to investigate whether the food properties hardness and size influence activities in the posterior parietal cortex and visual cortex during chewing performance in healthy individuals. It was found that an increase in food hardness enhanced both posterior parietal cortex and visual cortex activities, while an increase in food size enhanced activities in the same regions. These findings suggested a quantitative relationship of oral food properties with activities in the brain regions responsible for object recognition and visuospatial processing. It is thus concluded that heightened neural activities in the posterior parietal cortex and visual area reflect an increased demand for cross-modal representation of food properties related to chewing.

Near-infrared spectroscopy–guided personalized repetitive transcranial magnetic stimulation for bipolar depression: a case report

Near-infrared spectroscopy–guided personalized repetitive transcranial magnetic stimulation for bipolar depression: a case report

Positive resonance: Successful interpersonal emotion regulation facilitated relationship closeness by enhanced inter-brain synchronization.

Interpersonal emotion regulation (IER) refers to the dynamic process where a regulator employs specific strategies to alleviate a target's distress. It remains unclear whether successful IER could facilitate interpersonal relationship closeness (IRC). The present study aimed to explore whether successful IER, based on two typical strategies-cognitive reappraisal (CR) and expressive suppression (ES)-for down-regulating the target's negative emotions, could enhance IRC among friend dyads, and to identify the underlying neural correlates of this process using functional near-infrared spectroscopy system. Seventy-four female dyads (friends) were randomly assigned to one of two strategy groups (CR vs. ES), with one participant as the target and the other as the regulator. Our finds revealed that both strategies have down-regulated the target's negative emotions, however, CR strategy was associated with more successful IER outcomes (more improvement of the targets' negative emotions; higher IRC) than ES strategy. IER recruited the enhanced interpersonal brain synchronization (IBS) of the prefrontal and temporal areas among friend dyads. CR strategy recruited higher IBS of the above-mentioned brain networks than ES strategy in down-regulating the target's sadness, and the reversed IBS pattern was found in down-regulating the target's anger, inferring that CR was more successive in IER of sadness, and ES was more effective in IER of anger. The increased IBS of these brain regions played a mediational role between the effectiveness of down-regulating targets' negative emotions and the increment of IRC. Our findings revealed a neural coupling mechanism through which successful IER fostered supportive social bonds.

Identification of the rank and kind of ten coals including bituminous and anthracite based on near-infrared spectroscopy and interpretable GASF-ResNet18 method

ABSTRACT Different ranks and kinds of coal have different properties (volatile, ash, etc.), which affect the process parameters in clean utilization of coal. Based on near-infrared (NIR) spectroscopy data, the 1D spectral data of 670 coal samples were encoded into 2D images with Gramian Angular Summation Field (GASF) method as input data, and a convolutional neural network (CNN) known as ResNet18 was applied to identify the rank and kind of coal. On a dataset containing seven kinds of bituminous coal and three kinds of anthracite coal, the proposed GASF-ResNet18 method achieves an accuracy of 96.3% for coal rank identification, and 94.8% for coal kind identification, even in the presence of moisture interference. Compared with traditional machine learning methods (partial least squares discriminant analysis, back propagation network, logistic regression, and support vector machine), GASF-ResNet18 method has a higher accuracy. It was attributed to ResNet18 catching the key information provided by the following GASF image regions: the combination of the absorption rate in 1250–1700 nm in column and 1550–1700 nm in row, and the combination of 900–1150 nm in column and 1150–1450 nm in row. The results showed GASF-ResNet18 method based on NIR data can be used to rapidly identify the rank and kind of coal.

Near-infrared brain functional characteristics of mild cognitive impairment with sleep disorders.

Mild cognitive impairment (MCI) has a high risk of progression to Alzheimer's disease. The disease is often accompanied by sleep disorders, and whether sleep disorders have an effect on brain function in patients with MCI is unclear. To explore the near-infrared brain function characteristics of MCI with sleep disorders. A total of 120 patients with MCI (MCI group) and 50 healthy subjects (control group) were selected. All subjects underwent the functional near-infrared spectroscopy test. Collect baseline data, Mini-Mental State Examination, Montreal Cognitive Assessment scale, fatigue severity scale (FSS) score, sleep parameter, and oxyhemoglobin (Oxy-Hb) concentration and peak time of functional near-infrared spectroscopy test during the task period. The relationship between Oxy-Hb concentration and related indexes was analyzed by Pearson or Spearmen correlation. Compared with the control group, the FSS score of the MCI group was higher (t = 11.310), and the scores of Pittsburgh sleep quality index, sleep time, sleep efficiency, nocturnal sleep disturbance, and daytime dysfunction were higher (Z = -10.518, -10.368, -9.035, -10.661, -10.088). Subjective sleep quality and total sleep time scores were lower (Z = -11.592, -9.924). The sleep efficiency of the MCI group was lower, and the awakening frequency, rem sleep latency period, total sleep time, and oxygen desaturation index were higher (t = 5.969, 5.829, 2.887, 3.003, 5.937). The Oxy-Hb concentration at T0, T1, and T2 in the MCI group was lower (t = 14.940, 11.280, 5.721), and the peak time was higher (t = 18.800, 13.350, 9.827). In MCI patients, the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index, sleep time, total sleep time, and sleep efficiency (r = -0.611, -0.388, -0.563, -0.356). It was positively correlated with sleep efficiency and total sleep time (r = 0.754, 0.650), and negatively correlated with oxygen desaturation index (r = -0.561) and FSS score (r = -0.526). All comparisons were P < 0.05. Patients with MCI and sleep disorders have lower near-infrared brain function than normal people, which is related to sleep quality. Clinically, a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.

Near-Infrared Spectroscopic Mapping of the Human Epicardium.

Epicardial catheter ablation is necessary to address ventricular tachycardia targets located far from the endocardium, but epicardial adipose tissue and coronary blood vessels can complicate ablation. We demonstrate that catheter-based near-infrared spectroscopy (NIRS) can identify these obstacles to guide ablation. Eighteen human ventricles were mapped exvivo using NIRS catheters with optical source-detector separations (SDSs) of 0.6 and 0.9 mm. A logistic regression model trained from manually labeled spectra achieved mean area under the receiver operating characteristic curve (AUROC) of 0.907 (0.6 mm SDS) and 0.911 (0.9 mm SDS) in binary adipose detection. Novel optical indices for adipose detection were also proposed, achieving AUROCs of 0.881 (0.6 mm SDS) and 0.873 (0.9 mm SDS), while a blood-specific optical index achieved AUROC of 0.859 for vessel detection (0.9 mm SDS). These results suggest that catheter-based NIRS can detect adipose tissue and coronary vessels to improve efficacy and safety of epicardial ablation.

Individualized autoregulation-guided arterial blood pressure management in neurocritical care.

Cerebral autoregulation (CA) is the physiological process by which cerebral blood flow is maintained during fluctuations in arterial blood pressure (ABP). There are various validated methods to measure CA, either invasively, with intracranial pressure or brain tissue oxygenation monitors, or noninvasively, with transcranial Doppler ultrasound or near-infrared spectroscopy. Utilizing these monitors, researchers have been able to discern CA patterns in several pathological states, such as but not limited to acute ischemic stroke, spontaneous intracranial hemorrhage, aneurysmal subarachnoid hemorrhage, sepsis, and post-cardiac arrest, and they have found CA to be altered in these patients. CA disturbances predispose patients suffering from these ailments to worse outcomes. Much focus has been placed on CA monitoring in these populations, with an emphasis on arterial blood pressure optimization. Many guidelines recommend universal static ABP targets; however, in patients with altered CA, these targets may make them susceptible to hypoperfusion and further neurological injury. Based on this observation, there has been much investigation on individualized ABP goals and their effect on clinical outcomes. The scope of this review includes (1) a summary of the physiology of CA in healthy adults; (2) a review of the evidence on CA monitoring in healthy individuals; (3) a summary of CA changes and its effect on outcomes in various diseased states including acute ischemic stroke, spontaneous intracranial hemorrhage, aneurysmal subarachnoid hemorrhage, sepsis and meningitis, post-cardiac arrest, hypoxic-ischemic encephalopathy, surgery, and moyamoya disease; and (4) a review of the current evidence on individualized ABP changes in various patient populations.

Online monitoring of water quality in industrial wastewater treatment process based on near-infrared spectroscopy.

Water quality monitoring is one of the critical aspects of industrial wastewater treatment, which is important for checking the treatment effect, optimizing the treatment technology and ensuring that the water quality meets the standard. Chemical oxygen demand (COD) is a key indicator for monitoring water quality, which reflects the degree of organic matter pollution in water bodies. However, the current methods for determining COD values have drawbacks such as slow speed and complicated operation, which hardly meet the demand of online monitoring. This article firstly proposed a novel quantitative analysis method based on NIR spectroscopy and multi-preprocessing stacking, successfully enabling real-time online monitoring of COD values during industrial wastewater treatment. First, the existing swarm intelligence algorithm was enhanced to optimize the hyperparameters of various base models. Next, multiple spectral preprocessing techniques were innovatively combined with a stacking strategy to construct multi-preprocessing stacking models, enabling comprehensive extraction of effective spectral information. Finally, various combinations of base models were evaluated, leading to the selection of the multi-preprocessing stacking model with optimal performance. The results indicate that the model achieves excellent predictive performance and strong generalization ability. For equalization tank samples, the R2 and RMSE values were 0.8640 and 326.6845 mg/L, respectively. For secondary settling tank samples, the R2 and RMSE values were 0.8798 and 15.1917 mg/L, respectively. Compared to traditional single and stacking models, the RMSE was reduced by at least 12.75 % and 5.11 %, respectively. In addition, the method has a relatively low modeling cost and offers interpretability. This study presents an efficient and straightforward solution for the online monitoring of COD values in industrial wastewater treatment, laying a solid technical foundation for the efficient management of industrial wastewater and the protection of water resources and the ecological environment.

Role of Bailout Gene-Silencing Therapy in Plaque Lipid Reduction: Intravascular Imaging Study.

Introduction Insufficient statin/ezetimibe effectiveness for low-density lipoprotein cholesterol (LDL-C) reduction is not uncommon. A novel gene-silencing medication inclisiran has been introduced. Near-infrared spectroscopy (NIRS) allows to assess the dynamics of plaque lipid content in the context of optimal lipid-lowering pharmacotherapy. The aim of this study was to evaluate the impact of optimal hypolipidaemic pharmacotherapy, including add-on inclisiran, on the plasma lipid profile and plaque lipid content. Methods This study enrolled patients with stable coronary artery disease, admitted for elective percutaneous coronary intervention (PCI). NIRS of the segment of interest was performed during index PCI and 15 months later. Patients having LDL-C >1.8 mmol/l after 4-6 weeks of maximum tolerated statin/ezetimibe therapy received add-on inclisiran. Lipid profile changes within 15 months were also evaluated. Results Among 42 included patients, 24 drug resistant hypercholesterolemia participants were assigned to inclisiran therapy. After 15 months, a significant LDL-C decrease of 26.42% was established (p=0.006), with 12 participants reaching the LDL-C goal of <1.8 mmol/l. Average 15-month LDL-C reduction was 36.03%. NIRS data demonstrated a significant reduction in maximum lipid-core burden index within 4 mm (maxLCBI4 mm) in the inclisiran group (-117.64, p=0.004) and statin/ezetimibe group (-141.88, p=0.004), with no significant difference between the groups (p=0.213). Conclusion Results demonstrate an association between better LDL-C control and coronary plaque lipid burden reduction. Addition of inclisiran leads to remarkable LDL-C reduction in patients who have run out of statin and ezetimibe treatment options.