Series Combination Research Articles

Hysteresis Behavior Modeling of Hard Rock Based on the Mechanism and Relevant Characteristics

The modeling of cyclic behavior in rock remains a challenge due to complex deformation characteristics. This paper studied the mechanical behaviors of granite samples under uniaxial cyclic loading and unloading through cyclic compression tests and acoustic emission (AE) monitoring. Then, a comprehensive body that consisted of an elastic element, plastic element, and friction element was proposed to describe the stress–strain relationship with respect to cyclic behavior, in which the friction element was connected in parallel with the serial combination of the elastic element and plastic element. Finally, the parameters of the proposed model were calibrated based on the mechanism analysis and backpropagation (BP) neural network. Results show that the behavior during unloading is primarily elastic and is accompanied by the obstruction of friction. During reloading, the behavior changes from elastic to elastic–plastic before and after the Kaiser point. The tangential modulus of the elastic element is dynamic in a linear positive correlation with elastic strain and a linear negative correlation with plastic strain; specifically, the elastic strain controls the variation process of the elastic modulus while the plastic strain determines the lower limit. The constitutive law of the plastic element is expressed by a logistic function, which means that the plastic strain increases in a trend of acceleration–deceleration. The friction element plays a major role in processing the massing effect, and the plastic element is prompted before the historical maximum stress, which reflects the ratcheting effect and Felicity effect. The reliability of the proposed constitutive model is confirmed by the comparison of the simulated stress–strain curves with the experimental curves.

Comparison of morphing techniques to develop subject-specific finite element models of vertebrae

This study compared two morphing techniques (and their serial combination) to create subject-specific finite element models of 15 astronaut vertebrae. Surface deviations of the morphed models were compared against subject geometries extracted from medical images. The optimal morphing process yielded models with minimal difference in root-mean-square (RMS) deviation (C3, 0.52 ± 0.14 mm; T3, 0.34 ± 0.04 mm; L1, 0.59 ± 0.16 mm) of the subject’s vertebral geometry. <1% of model elements failed quality checks and compression simulations ran to completion. This research lays the foundation for the development of subject-specific finite element models to quantify musculoskeletal changes and injury risk from spaceflight.

Clinical Performance of a Multivariate Index Assay in Detecting Early-Stage Ovarian Cancer in Filipino Women.

This study evaluated the clinical performance and overall utility of a multivariate index assay in detecting early-stage ovarian cancer in a Filipino population. This is a prospective cohort study among Filipino women undergoing assessment for an ovarian mass in a tertiary center. Patients diagnosed with early-stage ovarian cancer and who underwent a physical examination before level III specialist ultrasonographic and Doppler evaluation, multivariate index assay (MIA2G), and surgery for an adnexal mass were included in this study. Ovarian tumors were classified as high-risk for malignancy based on the IOTA-LR2 score. The ovarian imaging and biomarker results were correlated with the reference standard: surgico-pathologic findings. The MIA2G exhibited the best overall performance among individual classifiers with a sensitivity of 91.7% and NPV of 84.7%, with a concomitant higher sensitivity in early-stage disease, whether as an individual classifier (93.5%) or in serial combination with ultrasound (85.5%). The performance of biomarkers (specificity, positive predictive values, and AUROC) such as MIA2G and CA-125 significantly improved when combined with an ultrasound risk scoring approach (p < 0.01). MIA2G showed a higher sensitivity for detecting lesions among EOC and late-stage ovarian cancers than otherwise. The application of biomarkers for evaluating ovarian masses in our local setting is secondary to ultrasound but adopting multivariate index assays rather than CA-125 would increase the detection of early-stage ovarian cancers regardless of menopausal status. This is most relevant in areas where level III sonographers or gynecologic oncologists are limited and preoperative referrals to these specialists can improve the survival of our patients.

INVESTIGATING THE ELECTROLYTE MEDIUM FOR ELECTRIC GENERATION USING PROBIOTIC YOGURTS

Rationale: The importance of energy generation cannot be emphasized enough in every aspect. Even though the traditional electrical generation has been mainly focused on high voltage sources such as hydroelectric and nuclear power, the low-power sources of electrical acquisition are also essential, particularly in the era of digital technology. Batteries have been advanced as an integral component of electric devices for decades. The advent of digital technology leads us to the necessity of low-power energy sources. Electrolyte batteries consist of a pair of metal electrodes in an aqueous solution that facilitates electron transfer through the medium when a circuit is formed. New ideas for these low-power electrical generations have been tried around, even using potatoes, apples, and mud.&#x0D; Methods: This study investigated yogurt as the electrolyte medium using a metal pair of stainless steel and coiled magnesium electrode. A four-channel data acquisition system recorded the electric generation waveforms from the electrochemical battery cells changing the variables as examined, such as temperature, concentration, pH, stirring power, serial connection, and whole concentration. &#x0D; Results: The study confirmed that the pair of coiled Mg and stainless-steel electrodes produced the highest electrical potential, 25% higher among the metal pairs tested, while Chobani brand yogurt was the best electrolyte, 10% higher for electricity generation. The variables of temperature, concentration, pH, and stirring power were all highly linearly related to electricity generation. Serial combination with the 4 battery cell study demonstrated the feasibility of high voltage generation up to 7.8V.&#x0D; Conclusions: The highest electrical potential was acquired when used the whole yogurt of Chobani with stainless steel and coiled-type electrodes. The study demonstrated the superiority of probiotic yogurt electrolytes, which might need to elaborate for further detailed mechanisms.

Adaptation of Optokinetic Reflex by Training with Different Frequency and Amplitude.

Although the occurrence of optokinetic reflex (OKR) adaptation after OKR training is well established, the dynamic properties of OKR adaptation has not been fully studied. This study aimed to examine the difference in the amount of OKR adaptation according to OKR training protocols which have different frequency or amplitude of drum oscillation. Using C57BL/6N male mice, we induced OKR adaptation by 3 different categories of learning paradigm as follows: (1) Optokinetic drum oscillation for 60 min with same amplitude and different frequency. (2) Optokinetic drum oscillation for 60 min with same frequency and different amplitude. (3) Training with serial combination of different frequency or amplitude. The results show that the amount of OKR adaptation was greater after OKR training with lower frequency or amplitude than that with higher frequency or amplitude. This finding may suggest that the retinal slip signal with lower-velocity OKR stimulation serves as more precise instructive signal for learning, leading to induction of more efficient training effect. Another interesting finding was that the OKR gain increase tended to be greater after training composed of sequential combination of decreasing frequency or amplitude than that composed of sequential combination of increasing frequency or amplitude. Furthermore, the OKR training with high frequency or amplitude eliminated a part of learning effects which have already formed by previous training. We postulate that the stimulation during training with high frequency or amplitude may implement a disturbing instruction for OKR learning when it is conducted in mice with increased OKR gain after previous OKR training.

PredAoDP: Accurate identification of antioxidant proteins by fusing different descriptors based on evolutionary information with support vector machine

Antioxidant proteins play a vital role in diseases prevention caused by free radical intermediates. Accurate identification of antioxidant proteins may provide significant clues to improve their fundamental understanding in the field of bioinformatics and pharmacology. Prediction of antioxidant protein is meaningful and a challenging task. In this study, we develop a novel predictor called PredAoDP based on two different descriptors, which incorporates salient evolutionary profile features with support vector machine (SVM), to predict antioxidant proteins. The evolutionary information in the PSI-BLAST profile is encoded and transformed into a series of fixed-length feature vectors by extracting 20-D, amino acid composition and 400-D bigram features from position-specific scoring matrix (PSSM). As a result, a feature vector of 420-dimensional (420-D) feature vector via serial combination was constructed from two training datasets of antioxidant protein Z1 and Z2. The descriptors are then fed to the SVM for classification along with jack-knife cross-validation test method for evaluating the prediction performance. Our proposed intelligent predictor achieved ACC, 93.18% and MCC, 0.712 for Z1 similarly for Z2 datasets ACC, 97.89% and MCC, 0.949 by jack-knife cross-validation test. To evaluate the generalization abilities of the developed method, we performed an independent test and achieved superior performance compared the other published approaches. The experimental results revealed the effectiveness of the proposed approach and can be utilized as a reliable tool for predicting large-scale antioxidant proteins in particular and other proteins in general. The source code and benchmark datasets are available at https://github.com/saeed344/PreAoDp.

Commentary on “PANoptosis-like cell death in ischemia/reperfusion injury of retinal neurons”

Commentary on “PANoptosis-like cell death in ischemia/reperfusion injury of retinal neurons”

Assessment of Noninvasive Markers of Steatosis and Liver Fibrosis in Human Immunodeficiency Virus-Monoinfected Patients on Stable Antiretroviral Regimens.

BackgroundNonalcoholic fatty liver disease (NAFLD) is a major nonacquired immune deficiency syndrome-defining condition for persons with human immunodeficiency virus (PWH). We aimed to validate noninvasive tests for the diagnosis of NAFLD in PWH.MethodsThis is a cross-sectional study of PWH on stable antiretroviral therapy with persistently elevated transaminases and no known liver disease. The area under the receiver operating characteristic curve (AUROC) was calculated to compare the diagnostic accuracy of liver biopsy with abdominal ultrasound, transient elastography (TE) (including controlled attenuation parameter [CAP]), and noninvasive markers of steatosis (triglyceride and glucose index [TyG], hepatic steatosis index [HSI], fatty liver index [FLI]) and fibrosis ([FIB]-4, aminotransferase-to-platelet ratio index [APRI], NAFLD fibrosis score). We developed a diagnostic algorithm with serial combinations of markers.ResultsOf 146 patients with increased transaminase levels, 69 underwent liver biopsy (90% steatosis, 61% steatohepatitis, and 4% F ≥3). The AUROC for steatosis was as follows: ultrasound, 0.90 (0.75–1); CAP, 0.94 (0.88–1); FLI, 0.81 (0.58–1); HSI, 0.74 (0.62–0.87); and TyG, 0.75 (0.49–1). For liver fibrosis ≥F3, the AUROC for TE, APRI, FIB-4, and NAFLD fibrosis score was 0.92 (0.82–1), 0.96 (0.90–1), 0.97 (0.93–1), and 0.85 (0.68–1). Optimal diagnostic performance for liver steatosis was for 2 noninvasive combined models of tests with TyG and FLI/HSI as the first tests and ultrasound or CAP as the second tests: AUROC = 0.99 (0.97–1, P < .001) and 0.92 (0.77–1, P < .001).ConclusionsUltrasound and CAP performed best in diagnosing liver steatosis, and FLI, TyG, and HSI performed well. We propose an easy-to-implement algorithm with TyG or FLI as the first test and ultrasound or CAP as the second test to accurately diagnose or exclude NAFLD.

A serial mediation model of the relationship between suppression emotion-regulation tendency and outcomes of MOOC learning by Chinese university students: The role of cognitive appraisals, boredom, and behavioral avoidance

Suppression emotion-regulation tendency was integrated with control-value theory variables (control appraisal, value appraisal, boredom) and behavioral avoidance and MOOC learning outcomes to comprehensively explore the mechanisms by which suppression affected MOOC learning. A total of 191 Chinese university students participated in this study. They completed a pre-test prior to learning a MOOC, and a questionnaire and a post-test at the end of 15-week MOOC. Results of mediation analysis showed that suppression was indirectly rather than directly related to the outcomes of MOOC learning through different patterns of mediation. The pathways found to be significant were through control appraisal, through boredom, and through any two or all of control, boredom, and behavioral avoidance in serial combinations. Value appraisal was found to negatively moderate the relationship between perceived control and boredom. Based on these results, we adduce practical implications for how to reduce learners’ tendency to use suppression in MOOCs, increase their perceived control and value of MOOC learning, and attenuate the boredom they may experience. This study is intended to contribute to expanding our understanding of MOOC learning as an integrated construct under the interplay of emotional, cognitive and behavioral aspects of learners.

Interpersonal mindfulness and forgiveness: Examining the mediating roles of anger rumination and state anger.

Measuring mindfulness without accounting for specific contexts may lead to controversial results. This study attempted to examine whether the newly proposed construct of interpersonal mindfulness, mindfulness as it happens within the interpersonal context, was connected to forgiveness and the mechanisms behind this connection. Data were collected from 312 participants using measures of interpersonal mindfulness, trait mindfulness, anger rumination, state anger, self-reported forgiveness, and forgiving behavior. Results showed that interpersonal mindfulness was significantly associated with both self-reported forgiveness and forgiving behavior even while accounting for trait mindfulness. Mediation analysis revealed that anger rumination and state anger could mediate this link separately and sequentially, but only when trait mindfulness was uncontrolled. When controlling for trait mindfulness, the mediating role of state anger remained significant, but neither anger rumination nor the serial combination did. An alternative model was also supported, showing that after controlling for interpersonal mindfulness, trait mindfulness was indirectly associated with forgiveness through anger rumination and the serial mediating effect of anger rumination and state anger, but not state anger. These findings suggest that interpersonal mindfulness is more suitable for predicting interpersonal forgiveness than trait mindfulness. State anger may operate as a proximal mechanism in explaining how mindfulness relates to interpersonal forgiveness, whereas anger rumination may operate at a more distal level.

Effective acetylene length dependence of the elastic properties of different kinds of graphynes

• A serial combination of springs is capable to describe the elasticity of graphynes; • Values of elastic moduli of 10 graphynes of each one of 7 families are shown; • Linear compressibility of graphynes depend linearly on acetylene length; • Two families of graphyne present negative linear compressibility; Graphyne is a planar network of connected carbon chains, each formed by n acetylene linkages. Uncountable ways to make these connections lead to uncountable structural graphyne families (GFs). As the synthesis of graphynes with n > 1 has been reported in literature, it is of interest to find out how their physical properties depend on n for each possible GF. Although literature already present specific models to describe the dependence on n of the elastic properties of specific GFs, there is not yet enough amount of data for the physical properties of different graphynes with different values of n . Based on fully atomistic molecular dynamics simulations, the Young's modulus, shear modulus, linear compressibility and Poisson's ratio of 10 graphyne members of 7 different GFs are calculated. A simple elastic model consisting of a serial combination of n springs is proposed to describe the dependence on n of the elastic properties of these 7 GFs. We show that except for the Poisson's ratio, this simple unique elastic model is able to numerically describe, with good precision, the Young's modulus, shear modulus and linear compressibility of all different graphynes, including anisotropy and negative values of linear compressibility of some GFs.

In asthma positive phase III slopes can result from structural heterogeneity of the bronchial tree.

We have previously identified bronchial generations 5-7 as the locus of maximum contribution to the convective portion of the phase III slope in computed tomography (CT)-based lung models of patients with asthma. In the present study, we examined how phase III slope is generated locally, by specifically interrogating at individual branch points, the necessary condition for a phase III slope to occur: some degree of convective flow sequencing between any two daughter branches that have a heterogeneity in gas washout concentration between them. Flow sequencing at individual branch points showed a wide range of values, including branch points where flow sequencing was such that phase III slopes were negative locally. Yet, the net effect in the 24 bronchial trees that we studied was that flow sequencing between pairs of less and better ventilated units most frequently drove positive phase III slopes in generations 5-7. By investigating the link of local flow sequencing between any two daughter branches to the corresponding heterogeneity of mechanical lung properties, heterogeneity of compliance was seen to be a major determinant of flow sequencing. In these bronchial structures, compliance heterogeneity was essentially brought about by volume asymmetry resulting from terminating pathways within the three-dimensional (3-D) confines of the lung contours. We conclude that the serial and parallel combination of lung mechanical properties at individual branch points in an asymmetrical branching network generates flow sequencing in mid-range conductive airways, leading to a positive at-mouth phase III slope.NEW & NOTEWORTHY Conceptually, the simplest way to obtain a sloping phase III during a washout exhalation is when there is convective flow sequencing between two lung units, such that the better ventilated unit contributes relatively more to exhaled flow at the beginning of phase III in the exhalation. Here, we show how compliance heterogeneity across the serial and parallel arrangement of branch points in bronchial trees of patients with asthma leads to flow sequencing, and thus phase III slopes of positive sign at the patient's mouth.

A Matter of Timing: Rudy Tanzi on Alzheimer's Disease

A Matter of Timing: Rudy Tanzi on Alzheimer's Disease

Novel highly efficient absolute optical resolution method by serial combination of two asymmetric reactions from acetylene monomers having racemic substituents.

For general optical resolution, an optical resolution agent is necessary, and the best agent should be selected for each racemic compound. In this study, we will report that a novel optical resolution method by circularly polarized light (CPL) without any optical resolution agents has been developed by serially connecting two enantioselective reactions. These reactions we developed are the enantiomer-selective helix-sense-selective polymerization (ES-HSSP) and helix-sense-selective highly selective photocyclic aromatization (SCAT) by CPL (HS-SCAT). Since this significantly unique EPHS method (EPHS = ES-HSSP + HS-SCAT) does not need any optical resolution agents, any cocatalysts, and solvents for the selective decomposition reaction (HS-SCAT), this process is quite simple and convenient. Since this process does not include any decomposition of the target racemates themselves, both enantiomers could be obtained. The optical yields for isolated compounds that were enantiomerically separated by the EPHS method were very high, for example, 78%ee, 93%ee, and 85%ee for menthol, phenethyl alcohol, and 2-butanol, respectively. In addition, their chemical yields were around 85% to 94%. Therefore, the EPHS method was found to show an excellent performance and can be applied to actual optical resolution for a wide range of racemic compounds. This is the first absolute optical resolution by CPL showing high optical and chemical yields and expected to become a practical optical resolution method.

Generalized Model and Configuration Design of Multiple-Axis Flexure Hinges

This paper presents two generalized models that can quickly formulate the closed-form equations of compliance and precision for multiple-axis flexure hinges including symmetric and hybrid types under small-deflection occasions, and introduces new types of multiple-axis flexure hinges. Notch contours of multiple-axis flexure hinges are divided into multiple-axis base and mirror segments with multiple segments. Solving closed-form compliances and precisions of multiple-axis flexure hinges is transformed into several definite integrals associated with the notch shape functions of designated base segments and matrix operations. The closed-form compliances for the conic-section, elliptical-arc and truncated-cone base segments are derived. Utilizing the pre-designed base segments, mirroring operations and serial combination design, more than two hundred multiple-axis flexure hinges are designed and their closed-form compliances can be formulated with the presented models, and tedious integral operations are avoided. The presented models are verified by means of the finite element results and existing equations. The design domain is introduced and the performances of the designed hinges are investigated. The presented models and designed hinge configurations are helpful in improving the integrated performances of spatial compliant mechanisms.

Passive surveillance of human African trypanosomiasis in Côte d'Ivoire: Understanding prevalence, clinical symptoms and signs, and diagnostic test characteristics.

BackgroundLittle is known about the diagnostic performance of rapid diagnostic tests (RDTs) for passive screening of human African trypanosomiasis (HAT) in Côte d’Ivoire. We determined HAT prevalence among clinical suspects, identified clinical symptoms and signs associated with HAT RDT positivity, and assessed the diagnostic tests’ specificity, positive predictive value and agreement.MethodsClinical suspects were screened with SD Bioline HAT, HAT Sero-K-Set and rHAT Sero-Strip. Seropositives were parasitologically examined, and their dried blood spots tested in trypanolysis, ELISA/Tbg, m18S-qPCR and LAMP. The HAT prevalence in the study population was calculated based on RDT positivity followed by parasitological confirmation. The association between clinical symptoms and signs and RDT positivity was determined using multivariable logistic regression. The tests’ Positive Predictive Value (PPV), specificity and agreement were determined.ResultsOver 29 months, 3433 clinical suspects were tested. The RDT positivity rate was 2.83%, HAT prevalence 0.06%. Individuals with sleep disturbances (p<0.001), motor disorders (p = 0.002), convulsions (p = 0.02), severe weight loss (p = 0.02) or psychiatric problems (p = 0.04) had an increased odds (odds ratios 1.7–4.6) of being HAT RDT seropositive. Specificities ranged between 97.8%-99.6% for individual RDTs, and 93.3–98.9% for subsequent tests on dried blood spots. The PPV of the individual RDTs was below 14.3% (CI 2–43), increased to 33.3% (CI 4–78) for serial RDT combinations, and reached 67% for LAMP and ELISA/Tbg on RDT positives. Agreement between diagnostic tests was poor to moderate (Kappa ≤ 0.60), except for LAMP and ELISA/Tbg (Kappa = 0.66).ConclusionIdentification of five key clinical symptoms and signs may simplify referral for HAT RDT screening. The results confirm the appropriateness of the diagnostic algorithm presently applied, with screening by SD Bioline HAT or HAT Sero-K-Set, supplemented with trypanolysis. ELISA/Tbg could replace trypanolysis and is simpler to perform.Trial registrationClinicalTrials.gov NCT03356665.

Sex Differences in Voyeuristic and Exhibitionistic Interests: Exploring the Mediating Roles of Sociosexuality and Sexual Compulsivity from an Evolutionary Perspective

Sociosexuality and sexual compulsivity predict sex differences in voyeuristic interest in the population. In this study, we used a sample of 1113 participants from the UK (46% men) to consider whether sociosexuality and sexual compulsivity interacted to explain these sex differences and whether this relationship extended to the related domain of exhibitionism. In doing so, we tested novel predictions derived from an evolutionary perspective which views voyeuristic and exhibitionistic interest as manifestations of a short-term mating strategy. Participants reported their levels of repulsion toward voyeurism and exhibitionism and their interest in performing such acts under different levels of risk. There were clear sex differences in voyeuristic and exhibitionistic repulsion that were partially mediated by the serial combination of sociosexuality and sexual compulsivity. Examining the sexes separately revealed qualitatively different relationships between sociosexuality and sexual compulsivity when predicting exhibitionistic, but not voyeuristic, repulsion. Combined, sociosexuality and sexual compulsivity also mediated the sex difference in willingness to commit acts of voyeurism, but not exhibitionism, which was equally low for both sexes. The results highlight the role sociosexuality plays in voyeuristic and exhibitionistic interest, which coupled with an evolutionary perspective, may have implications for how we view courtship disorders.

Incremental improvement of diagnostic performance of coronary CT angiography for the assessment of coronary stenosis in the presence of calcium using a dual-layer spectral detector CT: validation by invasive coronary angiography.

To investigate value of spectral reconstructions for the quantification of coronary stenosis in the presence of calcified or partially calcified plaques using a dual-layer spectral detector CT (SDCT). Seventy-two consecutive patients were retrospectively enrolled. Conventional 120 kVp images, eight virtual monoenergetic images (VMI) (70 to 140 keV), the effective atomic number (Z effective) and iodine no water images were reconstructed. Invasive coronary angiography was used as the reference standard. Parallel and serial testing were used to assess the incremental diagnostic value of Z effective and iodine no water images to the best VMI series. 122 coronary lesions of 72 patients (49 men and 23 women; 63.7 ± 10.2 years) were enrolled in analysis. Reconstruction at 100 keV yielded optimal diagnostic performance, the sensitivity, specificity, PPV, NPV and diagnostic accuracy to identify stenosis ≥ 50% or ≥ 70% were 84%, 70%, 80%, 76%, 79% and 78%, 98%, 93%, 91%, 92%, respectively. A serial combination (100 keV VMI followed by Z effective images) resulted in an improved specificity (from 70 to 80%) with a moderate loss of sensitivity (81% from 84%) in identifying ≥ 50% stenosis (P = 0.021). For patients with high Agatston score, this combination could further reduce false positive cases and improve diagnostic accuracy. 100 keV VMI provide optimal diagnostic performance for the detection of coronary stenosis in the presence of calcified or partially calcified plaques using a dual-layer SDCT, with further improvements obtained with the combined use of Z effective images.

New scheme for PAPR reduction in FBMC-OQAM systems based on combining TR and deep clipping techniques

Filter bank multi-carrier with offset quadrature amplitude modulation (FBMC-OQAM) system is a very efficient multicarrier modulation technique for 5G, but it suffers as all multicarriers designs from large peak-to-average power ratio (PAPR). Tone reservation (TR) is a method designed to solve this problem by reserving several subcarriers called tones in the frequency domain to generate a cancellation signal in the time domain to eliminate high peaks. In this paper, we suggest a serial combination of tone reservation (TR) method with an enhanced version of clipping called deep clipping (DC) method (TR&amp;DC) to enhance the peaks (PAPR) mitigation in FBMC-OQAM signal model without significantly impacting the quality of transmission. Numerical results and analysis show that the new TR&amp;DC approach allows better overall performance and offers remarkable gain in term of PAPR mitigation than the TR method, with similar BER performance to TR over additive white gaussian noise channel and Rapp HPA model.

Angio-Based Fractional Flow Reserve, Functional Pattern of Coronary Artery Disease, and Prediction of Percutaneous Coronary Intervention Result: a Proof-of-Concept Study

PurposeWire-based coronary physiology pullback performed before percutaneous coronary intervention (PCI) discriminates coronary artery disease (CAD) distribution and extent, and is able to predict functional PCI result. No research investigated if quantitative flow ratio (QFR)–based physiology assessment is able to provide similar information.MethodsIn 111 patients (120 vessels) treated with PCI, QFR was measured both before and after PCI. Pre-PCI QFR trace was used to discriminate functional patterns of CAD (focal, serial lesions, diffuse disease, combination). Functional CAD patterns were identified analyzing changes in the QFR virtual pullback trace (qualitative method) or after computation of the QFR virtual pullback index (QVPindex) (quantitative method). QVPindex calculation was based on the maximal QFR drop over 20 mm and the length of epicardial coronary segment with QFR most relevant drop. Then, the ability of the different functional patterns of CAD to predict post-PCI QFR value was tested.ResultsBy qualitative method, 51 (43%), 20 (17%), 15 (12%), and 34 (28%) vessels were classified as focal, serial focal lesions, diffuse disease, and combination, respectively. QVPindex values >0.71 and ≤0.51 predicted focal and diffuse patterns, respectively. Suboptimal PCI result (post-PCI QFR value ≤0.89) was present in 22 (18%) vessels. Its occurrence differed across functional patterns of CAD (focal 8% vs. serial lesions 15% vs. diffuse disease 33% vs. combination 29%, p=0.03). Similarly, QVPindex was correlated with post-PCI QFR value (r=0.62, 95% CI 0.50–0.72).ConclusionOur results suggest that functional patterns of CAD based on pre-PCI QFR trace can predict the functional outcome after PCI.Clinical Trial RegistrationClinicalTrials.gov, number NCT02811796. Date of registration: June 23, 2016.